C: "What I usually do as
a first step is for two and a half hours I'll give
them the background of the study. Then I'll
break away from the study and we'll go into the physiology
of the disease and it's creation. The most
important illustration I share with them is showing
how a "plaque" actually ruptures --- what
is going on in there metabolically, because once
they understand how a plaque can rupture, what forces
it to and what creates it, then they understand what
they have to do to make the metabolic changes so
that cascade of events does not occur. You
may think that little changes are important, but
let me tell you how very important little change
is... you can think of it in this way: suppose
that you've got water at 33 degrees F. What
happens when that only goes down one degree? You've
got a force that is so strong it'll break up your
THE BOOK & THE OLYMPICS
M: "I was noticed that the tone of your book is firm,
but very gentle at the same time. You effectively deal with any number
of possible arguments to your conclusions and advice, while at the same time,
and this is reflected also in the recipe and cooking advice section, there
is this consistent tone of encouragement... you're not beating people over
the head. You may be a "compassionate authoritarian" of
M: "It's hard to imagine
how much went into getting this book out. A
lot of documentation, great set of media resources...
recommended "safe food" section. Clearly
a lot of hard work and passion went into this effort. Early
in your life you won a Gold Medal at the Olympics. Did
that experience compare in some way to this work?"
C: "In a way it does. There's
a little piece I wrote on the website in past few
weeks about "from the Olympics to this study." I
think what the Olympics did, for me, in terms of
this particular 20 year study... is learning that
when the forces are pretty much against you and you're
not given much of a chance, and yet you have a feeling
that this is something that really ought to work,
you dig in your heels and make absolutely certain
that you're not going to be dissuaded. I think
the most important thing, at least in my lifetime,
that you can discover about science more than perhaps
sheer brilliance, is the willingness to be persistent
when everything logically would indicate you may
be correct. I would think that sort of tenacity
is a bit of a remnant from my athletic background."
M: "Do you find that people want to have to change ---
you can lecture or try to convince them if there isn't that inherent desire. As
an example, I've some dear friends doing an "Atkins-style" diet
and I want to scream. You have to wait for them to come around?"
C: "You could say that,
although I think one of the things that brings people
around very rapidly, that is thinking people, is
education. I'm not a great believer at all
in trying denigrate the work of others at all. Let's
just say that when you have a program that advocates
a program that is high in fat, high in meat and dairy,
and denigrates the value of carbohydrates, I'm totally
unaware that the author that you mentioned ever did
any research that would indicate this is a nutritional
profile that can arrest and reverse heart disease. As
a matter of fact, I've had experience with any number
of patients who have tried that program and it left
them filled with disease, and we were able to arrest
and reverse it when they converted."
M: "Who are the people who've most inspired you in your
C: "Oh, I think my Dad...
even though he was ravaged with disease, I can remember
a few years before he died that he was really appalled,
this was probably early in the 1970s, he was so appalled
at the way the amount of expenditures of health dollars
was going through the roof. And he said, "I
don't know how it's going to happen, but we really
have to figure out how to make people live healthier
lives." And that was really quite prophetic
as he had no concept or idea about how that would
be handled. He certainly saw though, that was
where the opportunity was to make this happen.
Certainly I've been influenced by people like Pritikin...
like John McDougall... by T. Campbell... Neal Barnard...
all kindred spirits at the same time. We always
end up standing on the shoulders of a lot of people
who have gone before us to try to make this happen. We
all have to have humility there, even if we often
sometimes can't identify who those people are or
where those thoughts came from, and that somehow
an idea or concept just clicks in your brain. All
those multiple influences that made you have these
thoughts, concepts, ideas, or drive to do this are
in there somewhere. It's hard to say
anything except the fact that you have to be very
thankful to those that have gone before and led the
way. They put us on a springboard that lets
us go even farther, and we hope that there will be
others that will stand on our shoulders and do the
DINNER GUESTS FROM HISTORY
M: "You are an incredibly gracious man... let's see...
if you could have some dinner guests from history, who would you invite?"
C: "Oh, I would like to
have dinner with Abe Lincoln and George Washington."
M: "Now THAT would be an
C: "I think it would be
terrific... then I have Sir William Osler, who I
think was one of the greatest physicians at the turn
of the century. It be great to have someone
like that on board. It would really be quite
M: "Okay, someone has read your book, followed your program,
and decided to give you a million dollars in appreciation. What would
you do with the money?"
C: "There is some very exciting
research on the endothelial cells that still has
to be done. But I think here's what I would
probably do right off the bat --- of course it might
be a shortcut to getting the public to come around.
I would use that million dollars to do a Brachial
Artery Tourniquet Test (BART) on almost all the foods
that people regularly eat. If you can do this,
if you can demonstrate the fact that all these oils,
animal-based foods, and processed flour, are absolutely
devastating our endothelium immediately with each
bite and with each meal, and here are all these plants
foods that are absolutely enhancing that capacity,
then I think you can take the next logical argument,
and that go to our nation's schools to deal with
the notorious lunch problem --- that our schools
are providing a lunch that is absolutely ghastly
for the vascular system. That'll put a lot
of pressure on the USDA. We have to also then
go to the culinary institutes of the world. They
are the ones that design and create all these education
materials, training all these magnificent chefs. These
chefs take their skills to the greatest hotels, spas,
retreats, and business cafeterias throughout the
world, and we're going to say "now wait a minute...
when you print out this menu, you're going to have
to tell people whether this is the kind of food that
is immediately damaging or injuring their blood vessels,
or the kind that's going to enhance them. We
can put a "skull'n'crossbones" next to
the ones that are going to injure them, and we'll
put a smiling sunshine next to the ones that will
M: "You obviously work very
hard. Do you experience burnout? How
do you relax?"
C: "It was very exciting
putting this book together as you've no idea when
you're doing all this how it will be received. The
fact that we didn't know where this would end up
when we started doing the research, we didn't know
where it'd end up starting the book, and now when
things work out, makes you just want to work even
harder. As far as relaxing goes, my wife likes
to go biking and I try to swim a mile every day. That
really keeps me going pretty well. And of course
we have the farm in Upstate New York in the summer,
where there are trails we can hike and be outdoors."
ANN ESSELSTYN & COOKING
M: "Hi Ann! Glad you could join us. Y'know,
when I first looked at the second half of the new book, I wondered if your
husband was some sort of gourmet chef in addition to being a world-class
surgeon. Then I realized it was you! You were responsible for
the 150 recipes section... it's amazing. Your helpful hints and
tips, as well as the recipes themselves, show the same encouraging and friendly
tone of Essy's in the first half. You even have a recipe from the co-owners
of the incredible vegan Millennium Restaurant. Some very creative work. Let
me ask you the basics: what are the rules you cook under?"
A: "Well, plant-based, of
course. No oil. I don't use salt, I use
low-sodium Bragg Liquid Amino or Tamari... occasionally
miso... no nuts or avocados... if I use tofu, I use
a lite tofu. As you noticed, I use tofu mainly
in some of the dessert recipes. There are some
times when tofu makes a good a good dip or sauce."
M: "I think that's marvelous,
regarding tofu. Many people don't realize the
high-fat content of most tofu and tend to lean on
it a bit too much, say for entrees. I found
it unique that your "main dish" recipes
were essentially "tofu-less." You
obviously worked with Essy's patients in helping
them learn to eat differently. Did people have
a hard time adjusting to the new approach?"
A: "It's weird. I
find that by the time people get here, in most cases,
they have made up their minds, their health is so
bad, that they have to do something and they're willing
to do it. If you're aren't fighting it all
along, if you're not saying "I CAN'T live without
olive oil," but if your attitude is "well,
that's interesting, I'll try it" you don't even
know don't have any olive oil --- you don't miss
it. Our food is so good we have to not eat
too much of it!"
M: "Well, the recipes are just so interesting. What
happens to the cravings for fat?"
C: "Within about 8 to 12
weeks you've down-regulated the fat receptors and
it's no longer an issue."
A: "I don't have any cravings
for fat, the thing that is tempting is more towards
sweets. Not fat."
M: "You do a very useful
identification of the common problems and solutions
to same, that people might experience in switching
over to your recommended program. Can you summarize
some of them?"
A: "I think eating out is
a big challenge. In fact, an even bigger challenge
may be eating at a friend's house, and especially
if you go to a friend's house who knows how you eat,
and has made a huge effort to make something very
special for you, and it turns out to be not at all
what you can eat."
M: "How do you recommend
people deal with that situation?"
A: "Well... if it's your
life, then you don't eat it. We have gone out
to dinners where you have salad with oily dressing,
I mean there isn't one thing I can sort of focus
on, and they have nothing. And Essy always
tells his patients: "you don't have eat." It's
your friend, and that's a hard one. You can
also offer to bring something to the event... that's
often the easiest thing to do. Then you eat
what you've brought."
LEGAL LEMON PIE
M: "I loved how you approached a challenge in converting
recipes in some cases. You write about seeing a "lemon pie" in
the movie "Million Dollar Baby" and were "determined to find" a "legal
lemon pie." You pulled actually did it!"
A: "Ah!! I worked and worked
on that, and then one day..."
A: "...I got this lemon
juice and added tofu, and swirled it around... then
I decided, "I've got to do this in a cake." I
took the birthday cake, and split in half, and made
layers of the lemon tofu topping and thickened pineapple
juice filling. It's just fabulous! Of
course it's messy. I love that lemon taste
and the cake looks very elegant."
M: "That positive attitude
shows throughout. I can honestly say your work
is one of the most unique collections I've seen anywhere. I
kept looking for the fat and salt... not there. You
really pulled it off."
A: "I think following these
recipes without salt may be hard for some people
at first, but I find when it might taste a little
flat, one of the first things I'll add is a little
lemon or vinegar.
M: "This seems like a family affair... I noticed that
some of your children contributed recipes?"
A: "All the children gave
they're all vegan?"
A: "Yes... our son-in-law,
Brian, cooked for "Outward Bound" for
a long time and gave us a lot of recipes. He's
the Chef in the family. Now, our son, Rip,
there's a lot of his recipes there, too... he's a
fireman in Austin, Texas. Rip has always eaten
plant-based. Do you want to hear the whole
A: "His fellow firefighters
do a lot of competitions in their off time, and there
was this "cholesterol-checking" competition. JR's
cholesterol was way over 300, and he's pretty young...
in his 30s or 40s... and his father died at 50-something. There
was heart disease in his family, so they decided
to eat plant-based at the firehouse. Somehow
this got out to the Austin Herald, and there was
an article about "Tofu
Outmuscling Red Meat in the Firehouse," NPR
[National Public Radio] picked that up, and a year ago Thanksgiving they
had a national piece on the firehouse and Rip, and
then the New
York Times must have picked that up,
and they had a half-page Sunday National Page on
Rip and the firehouse. And THAT led to all
sorts of agents and writers e-mailing Rip, and he
decided to right a book. He'd already been
thinking about it, and they
have a website.
And now, Rip is doing something absolutely fascinating...
he was going to get 30 people to go on a six-week
program and take measurements of cholesterol, blood
pressure, and weigh them, and all that before and
after. Well, it turns out he's now he's got
66 people in that group. He's put together
this amazing six-weeks of menus, of meal plans...
M: "That's fantastic! I
have to ask you this... did you and your children
all go vegan at the same time together?"
A: "Well... that's what
we were eating at home, and anyone that was here,
that's how they ate!"
FAMILY FEARS & CURE
M: "Let me just say towards the end here, that Howard
was absolutely right: you are an amazing couple and Essy's research
is incredibly important. A tremendous job on a ground-breaking book
that really nails heart disease, pulls no punches, and provides some wonderful
recipes as a guide for eating heart safe."
C: "There's a point that
I'd like to add that I don't think I mentioned earlier. Where
this is really so very powerful from an emotional
standpoint, is the following: you've got a
patient, and their family, but a patient who has
had a heart attack. That family is going to
live, with every day and week that goes by, with
that deep fear of when the next shoe is going to
drop. When is Grandpa going to have his next
heart attack? Or if you're a relative and live
with him or her, when is it going to happen again? And
that really takes away a lot of the humor and spontaneity
of life, if so many people have it in the back of
their mind that concern of when that next event is
going to happen. What is so powerful for people
who've had heart disease where this has occurred,
when they KNOW that as long as they can eat a plant-based
diet where they keep that LDL cholesterol at 80 and
under, I have not seen a heart attack. You
have made yourself, and will remain, heart attack
proof by maintaining adherence to this nutritional
lifestyle change. This is such a great relief...
and we know that it works because we now have data
beyond 20 years as proof."