ASK DR. PAM

by Dr. Pamela A. Popper

Dear Dr. Pam: I have been reading your newsletters about not eating a lot of nuts and I am confused. I keep seeing articles saying that nuts are good for cardiovascular health.

Dr. Caldwell Esselstyn was asked this very question during a recent Diet and Lifestyle Intervention class, and he responded by saying that there has never been a documented case of reversal of coronary artery disease that resulted from eating nuts; these results only have been documented for people eating a low-fat plant-based diet.

There are studies showing that eating nuts changes biomarkers, such as raising HDL levels, but there is no evidence that this results in better long-term health. In fact, Dr. Esselstyn cited a study in which researchers looked at 108 randomized controlled trials with 299,310 participants to determine if intervention to raise HDL cholesterol levels resulted in lowering the incidence of adverse cardiovascular events or death. The researchers concluded that "Available data suggest that simply increasing the amount of circulating high density lipoprotein cholesterol does not reduce the risk of coronary heart disease events, coronary heart disease deaths, or total deaths."

Heart disease remains the number one killer of Americans, and most Americans eventually are treated for it. The objective of practicing dietary excellence is to reduce the risk of, stop the progression of, or reverse degenerative conditions like heart disease. Therefore, only those interventions proven to produce those results, such as a low-fat plant-based diet, should be considered.

Briel M, Ferreira-Gonzalez I, You J, et al. "Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis" BMJ 16 February 2009;338:b92

Dear Dr. Pam: Is your advice to eliminate oils and reduce fat so much just for people who have cardiovascular disease or who are at risk, or should everyone do this?

I'll again cite Dr. Esselstyn's response to this question from our practitioner training class. The answer is that everyone should eliminate oils and eat a low-fat diet. A 50-year old person who has been eating an American-style diet with lots of animal protein, fat, and processed foods already has cardiovascular disease; that person just may not have experienced an event yet. We know this because we know the effect of animal protein and fat on the endothelial tissue lining the blood vessels. It's only a matter of time before this individual will experience some adverse health issue related to their poor dietary habits. Of course, younger people who have not yet developed cardiovascular disease (or any other condition) should aspire to stay healthy, which requires the same oil-free, low-fat eating pattern.

Article printed with permission from Dr. Pamela A. Popper and taken from Newsletters Vol 8 Issue 30 July 26, 2010. Dr. Popper is the founder and Executive Director of The Wellness Forum, a chain of health and wellness centers located throughout the United States and the Far East.