Is a Low-Fat Vegetarian Diet Healthy for Your Heart?

by Dr. Stephen Sinatra
Filed Under: Heart Health, Food and Nutrition
Last Reviewed 02/20/2014

Is a Low-Fat Vegetarian Diet Healthy for Your Heart?

Recently, a reader wrote to ask, “If fat and cholesterol do not cause heart disease, why was Dr. Esselstyn able to cure heart disease with a low-fat, healthy vegetarian diet?” That’s an excellent question.

Dr. Caldwell Esselstyn is a great American, and I thoroughly enjoyed reading his New York Times Best-Seller, Prevent and Reverse Heart Disease (2007). However, I disagree with Dr. Esselstyn’s premise that total cholesterol is the biological marker for developing heart disease.

As many of you know from reading my newest book, The Great Cholesterol Myth, I’ve debunked the long-held theory that hypercholesterolemia (high cholesterol) is a disease. I also pointed out the dangers of statin drugs and their many side effects, despite the fact that statins have remained the treatment of choice for millions of Americans. Interestingly, Dr. Esselstyn and I have jockeyed for the No. 1 and 2 positions on Amazon in the heart-disease category—attesting to just how critical this issue is for many Americans.

Now, if you follow Dr. Esselstyn’s healthy vegetarian diet, you will get favorable outcomes in cardiovascular disease, just as he demonstrated in his studies. However his pure vegetarian approach and the strict avoidance of fats he advises on his vegetarian diet make food preparation a challenge. Plus, it’s a difficult diet to adhere to for many of the people I advise. 

But, if your motivation and discipline are sky-high and you have lots of time for food prep, this nonprocessed, complex carbohydrate diet—which is extraordinarily high in fiber—will absolutely lower cholesterol drastically.

Is a Healthy Vegetarian Diet Enough?

Yet, is Dr. Esselstyn right that lowering your cholesterol will slash your future risk of developing heart disease or having a cardiovascular event? I believe it’s much more complicated than that.

I feel the most beneficial effect of Dr. Esselstyn’s vegetarian diet is the combination of the drastic reduction of omega-6 oils (which are pro-inflammatory) and the impressive increase of fiber which clears the gut of toxins. However, my personal preference is a more balanced approach.

I eat a Pan-Asian/Mediterranean diet (PAM), since the cultures with the highest longevity rates include the Okinawans of Japan, as well as those of the Mediterranean basin. I also follow the 80/20 rule. That means I eat 80 percent healthy vegetarian diet, and 20 percent meat—including lamb, buffalo, salmon and chicken. I also eat a lot of organic vegetables, fruit, eggs, yogurt and some cheese on a day-to-day basis and use coconut milk on cereals.

Both Dr. Esselstyn’s healthy vegetarian diet plan and my own are rich in carotenoids, flavonoids and polyphenols, which nurture the heart and cardiovascular system. But there is one word of caution with pure vegetarianism: If you’re eating a pure plant-based diet you need to supplement with L-carnitinecoenzyme Q10, alpha lipoic acid and vitamin B12. Otherwise, you risk putting yourself in harm’s way from severe nutrient depletions.

Now it’s your turn: What is the most heart-friendly diet that you are able to stick to?

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