Heart disease is the number one killer worldwide with strokes ranking second. Per Million Hearts data, in the USA:
- Approximately 1.5 million heart attacks and strokes occur every year in the United States
- Heart disease kills roughly the same number of people in the United States each year as cancer, lower respiratory diseases (including pneumonia), and accidents combined.
- Heart disease and stroke cost the nation an estimated $316.6 billion in health care costs and lost productivity in 2011.”
When not fatal, they can also lead to further significant illness, disability, and lower quality of life. Heart attack survivors can suffer fatigue, poor exercise tolerance and depression. Stroke survivors can suffer disability from paralysis, speech problems and emotional problems.
How Do We Get Heart Disease
The current Western diet of meat, dairy, eggs and highly processed foods and the illnesses associated with it (high blood pressure, high cholesterol, diabetes), causes fat deposits into the inner walls of our blood vessels. We call this process atherosclerosis and it can occur to any of our arteries. Atherosclerosis can develop over decades and insidiously cause further and further narrowing of blood vessels which restricts blood flow through them.
When this occurs to the blood vessels of our hearts, there will be times (e.g. certain levels of exertion) where not enough blood can reach our heart muscles to meet the demand. Chest pains can result from this – known as angina. Heart attacks can occur when a piece of the deposited fat (called plaques) breaks off or ruptures, injuring our blood vessel walls. Like when we get a cut on our skin, blood will immediately begin to clot at the site of injury to stop bleeding. Unfortunately for our hearts though, the blood clot forming at the site of plaque formation can completely block our heart vessels, leading to a heart attack. Heart attacks cause damage or even kill parts of heart muscle. They can even lead to sudden cardiac arrest.
The Rise of Younger Heart Attacks
When I was in medical school, I was taught that if heart attacks were occurring at an age of <65 familial/genetic causes needed to be assessed. It was considered less likely to occur in this age group unless there were genetic risk factors. While this may have been true in the past, in clinical practice I have seen multiple cases of heart attacks in patients <65 years of age with multiple people in their 30s or 40s and the youngest being only 17 years of age. I found this deeply concerning but not unfounded. A recent study (1) in 2017 found that when examining county-level trends, there were significant increases in heart disease mortality in the 34-64 yo age groups:
Elevated LDL cholesterol or “bad cholesterol” in our blood is considered a crucial risk factor among many others for fatty plaque build up in our blood vessels. Elevated LDL is in large part a result of trans and saturated fat intake which comes from processed and junk foods, meat and dairy.
So why are so many people still eating significant amounts of animal products as well as highly processed foods despite significant heart disease risk?
Winner, Winner, Chicken Dinner
Part of the answer lies in the business of medicine and pharmacology. It really is about the money.
Statin therapy, which is the use of cholesterol-lowering drugs, is currently worth $22 billion annually. Lipitor, the best selling drug of all time, has sold over $140 billion worth since release. If everyone was lowering their cholesterol via dietary and lifestyle changes, Big Pharma would be losing out. Hence, there is copious amounts advertising to health professionals and the public to encourage the use of statins as opposed to recommending holistic changes.
Compounding this, doctors simply do not make money with the current structure if they spend significant amounts of time with their patients attempting to counsel on dietary changes. It is simply much more financially effective to prescribe a pill lifelong, order blood tests for it and say a quick, generic line on lifestyle changes. Also, with the see more, do more, get paid more system of modern medicine, it’s hard to imagine that family physicians and cardiologists will want to see less heart disease.
Additionally, doctors are simply not appropriately trained in nutrition. Most medical schools do not even have nutritional programs and the ones who do have minimal hours of teaching over 4-6 years. I personally only remember having a handful of lectures about nutrition over 6 years of medical school and none were about which was best based on evidence. Instead they were about what types of diets were currently popular and how to manage them in a clinical setting.
Finally, patients may not be able to or simply do not want to lower their cholesterol naturally via dietary changes. This is not necessarily their fault as there are so many factors at play as to why the Western Diet is as addictive as it is – but more on that in a different article. Patients may actually see that purchasing statin therapy is a quick fix. This allows them to continue their current means of nutrition whilst lowering their cholesterol at the same time.
Statins Are Only A Bandage
Statin therapy drugs can injure both our liver and our muscles. This is why doctors are generally ordering blood tests to assess for liver dysfunction or asking questions regarding muscle pains after commencing the drugs. We can also test for muscle breakdown via blood testing as well if concerned. The issue is that there can actually be muscle damage despite having no symptoms and normal muscle breakdown blood levels(2). The muscle damage might not affect young people so much but it can decrease the muscular strength and increase the risk of falls in our elderly population (3).
Worryingly, statin therapy has been associated with an increased risk of developing diabetes. They have also been associated with doubling the risk of breast cancer in women with long term use (4). There have also been findings of statins causing brain-related side effects of memory loss and confusion.
Why Plant-Based For Intervention & Prevention
Despite substantial evidence that Plant-Based diets can not only prevent heart disease but also reverse it (5), little has changed in the way of how clinicians treat the disease.
The current treatments offered to patients with heart disease are blood pressure lowering medications, statin therapy as mentioned above and blood thinners. These measures are basically attempts at slowing the progression of the disease. Once there is significant heart disease or an active heart attack, the treatments escalate quickly to surgery for coronary artery stent insertions ($5 billion spent yearly for stents) or coronary artery bypass grafts (having our chest opened up to stitch legs veins onto our hearts in order to bypass blocked arteries).
Doctors may suggest improving our diet or quitting smoking but I am yet to see any doctors I have shadowed as a medical student and as a clinician expand further on how to appropriately do either. There simply isn’t enough time and/or understanding of the importance of diet in heart disease – it is too often looked over.
Another issue is that none of these treatment modalities address the underlying cause of heart disease in the Westernised worlds: The Western Diet. Unfortunately the Western Diet remains prominent because of significant corporate and commercial interests in maintaining the demand for processed foods, meat, eggs and dairy. These are multi-billion dollar industries. As a result, they use their power and political influence to keep the current Western Diet as it is so that the public continues to purchase their products.
So why is a Plant-based diet in the shadows? It’s simple, no one gets paid. Well, maybe the plant-based farmers do but the giants of the animal product industries and Big Pharma will lose significant profits if people are healthier and paying for broccoli and spinach instead of animal products, heart medications and heart operations.
While our government and medical profession lags behind, we can make positive changes to improve our health and prevent heart disease. A whole-foods plant-based diet is as effective as statin therapy in reducing LDL cholesterol in our blood vessels without all of the side effects and risk of statins (6).
A plant-based diet also allows our body to potentially reverse heart disease. Below is an angiogram (blood vessel imaging) of a patient who successfully treated their heart disease with a plant-based diet (5).
An Idea To Nourish The World
Heart disease is the number one cause of death in America and yet it is preventable and reversible to a significant degree. With our current lifestyles and treatment regimes, things are not improving despite the billions of public healthcare dollars being spent on heart disease.
A whole-foods, plant-based diet appears to be the best way forward but it remains largely ignored due to corporate and industrial greed. The result is that we are living in a heart-diseased crisis. Despite this, little is being done about it apart from the ongoing bandaging of the problem (for a large fee, of course).
As grim as our situation may seem, we should take refuge in the fact that we now have the knowledge to take charge of our own health and hopefully inspire others to do the same.
We can be the embodiment of using whole-food, plant-based diets in the prevention and treatment of heart disease. While this idea may currently seem very distant compared to current medical practices, we simply need to acknowledge that change will take time and that ideas, no matter how big or small, can ultimately change the world.
- Vaughan AS, Ritchey MD, Hannan J, Kramer MR, Kasper M. Widespread recent increases in county-level heart disease mortality across age groups. Ann Epidemiol. 2017 Dec;27(12):796-800. https://www.ncbi.nlm.nih.gov/pubmed/29122432
- Draeger A, Monastyrskaya K, Mohaupt M, et al. Statin therapy induces ultrastructural damage in skeletal muscle in patients without myalgia. J Pathol. 2006;210(1):94–102. https://www.ncbi.nlm.nih.gov/pubmed/16799920
- Scott D, Blizzard L, Fell J, Jones G. Statin therapy, muscle function and falls risk in community-dwelling older adults. QJM. 2009;102(9):625–33. https://www.ncbi.nlm.nih.gov/pubmed/19633029
- McDougall JA, Malone KE, Daling JR, Cushing-Haugen KL, Porter PL, Li CI. Long-term statin use and risk of ductal and lobular breast cancer among women 55 to 74 years of age. Cancer Epidemiol Biomarkers Prev. 2013;22(9):152. https://www.ncbi.nlm.nih.gov/pubmed/23833125
- Esselstyn CB. Is the present therapy for coronary artery disease the radical mastectomy of the twenty-first century? Am J Cardiol. 2010;106(6):902–https://www.ajconline.org/article/S0002-9149(10)01055-6/fulltext
- Jenkins DJ, Kendall CW, Marchie A, et al. The Garden of Eden—plant based diets, the genetic drive to conserve cholesterol and its implications for heart disease in the 21st century. Comp Biochem Physiol, Part A Mol Integr Physiol. 2003;136(1):141-51 https://www.ncbi.nlm.nih.gov/pubmed/14527636