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Diets with Customary Levels of Fat from Plant Origin May Reverse Coronary Artery Disease

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Diets with Customary Levels of Fat from Plant Origin May Reverse Coronary Artery Disease Medical Hypotheses 122 (2019) 103–105 Contents lists available at ScienceDirect Medical Hypotheses journal homepage: www.elsevier.com/locate/mehy Diets with customary levels of fat from plant origin may reverse coronary artery disease T ⁎ Albert Sancheza,b, , Alfredo Mejiab, Joanie Sanchezc, Eric Runted, Sherine Brown-Fraserb, Randall L. Bivensa a NEWSTART Lifestyle Center, Weimar Institute, Weimar, CA, United States b Department of Public Health, Nutrition and Wellness, Andrews University, Berrien Springs, MI, United States c Sacramento Cardiovascular Surgeons, Sacramento, CA, United States d Family Practice, Sonora, CA, United States ARTICLE INFO ABSTRACT Keywords: The primary cause of death worldwide is heart disease and the most common type of heart disease is coronary Regression of coronary artery disease artery disease. While coronary artery disease is treated with medications, it responds to lifestyle interventions. A Lifestyle low-fat plant-based diet was designed for reversing coronary artery disease and it is effective in reversing the Vegan diet disease. It has not been tested, however, as far as we know, whether diets with customary levels of fat can also Plant-based diet reverse coronary artery disease. Nevertheless, evidence is accumulating to show that atherosclerosis and cor- Heart disease onary artery disease are reversed with diets containing customary levels of fat. It has been known that fats of plant origin decrease the risk factors of cardiovascular disease. It is also known that vegans who consume diets with customary levels of fat have the lowest risk of cardiovascular disease. But recent and more specific data show that atherosclerosis was decreased when nuts that are rich in fat were added to a Mediterranean diet while atherosclerosis was increased in the controls. Also, two clinical cases show that coronary artery disease was reversed by low-fat plant-based diets that were supplemented with fat-rich foods of plant origin. These data, then, provide evidence that coronary artery disease may be reversed with a diet containing customary levels of fat from plant sources. We hypothesize that coronary artery disease may be reversed by diets with customary levels of fat of plant origin that are low in saturated fat content. This hypothesis needs to be tested by comparing a traditional low-fat plant-based diet with a plant-based diet containing customary levels of fat of plant origin in their effectiveness to reverse coronary artery disease. Introduction CAD has led to the assumption that a low dietary fat level is a means for reversing CAD. However, there is evidence to support the hypothesis Heart disease is the leading cause of death in the United States with that diets with customary levels of fat also reverse CAD. Thus, a low-fat coronary artery disease (CAD) being the most common type of heart diet may not be an essential feature for reversing CAD. The lines of disease and atherosclerosis is the primary pathology of CAD [1]. CAD evidence that we present are the following: (1) Foods of plant origin may be reversed by medications [2–4] or lifestyle [5–10]. The first that are rich in fat protect against cardiovascular disease [12–16]. (2) evidence that diet may reverse CAD was with a clinical case consuming Vegans consuming diets with customary levels (30–35% of energy as a low-fat, largely plant-based diet [11]. Subsequently, a randomized fat) of fat have low risk of cardiovascular disease [17,18]. (3) A Med- clinical trial showed that a low-fat vegetarian diet coupled with ex- iterranean diet with added nuts reversed atherosclerosis [19]. (4) CAD ercise and stress management reversed CAD without the use of lipid- was reversed in clinical cases by plant-based diets supplemented with lowering drugs [6]. The low-fat diets currently used for reversing cor- fat-rich foods of plant origin [20,21]. onary artery disease are plant-based diets which contain 10–12% of energy from fat [5–10]. The effectiveness of these diets in reversing Abbreviations:CAD, coronary artery disease ⁎ Correspondence to: Albert Sanchez, Dr. PH. Coordinator of NEWSTART Research 20601 Paoli Ln., Weimar, CA 95736, United States, Tel.: 209-559-2152; fax: 530- 422-7908. E-mail address: [email protected] (A. Sanchez). https://doi.org/10.1016/j.mehy.2018.10.027 Received 30 August 2018; Accepted 29 October 2018 0306-9877/ © 2018 Published by Elsevier Ltd. A. Sanchez et al. Medical Hypotheses 122 (2019) 103–105 Discussion Dietary component associated with reversing CAD Lines of evidence for the hypothesis A low or lower dietary saturated fat content appears as a possible explanation for the reversing of atherosclerosis [19] and CAD [21]. In the following section we discuss each of the lines of evidence for Low-fat plant-based diets, however, are by nature and by design also reversing the pathology of cardiovascular disease by plant-based diets low in saturated fat. Thus, a low dietary saturated fat content may be a with customary levels of fat. mechanism for reversing CAD by low-fat diets. Therefore, the low sa- turated fat content of the diet (quality of fat) may be a mechanism for Fats of plant origin protect against cardiovascular disease reversing CAD rather than low fat content (quantity of fat). Fat-rich foods of all sources are proscribed by the low-fat ther- The low-fat therapeutic diets referred to above are not only low in apeutic diets, yet fat-rich foods of plant origin, such as nuts, seeds, ol- fat content; they are also plant-based diets which have cardiovascular fi ives, and avocados decrease risk factors associated with cardiovascular disease bene ts [17,18]. While fat has been considered a key dietary fi disease [12–16]. It stands to reason that if we increase the fat level of factor to reverse CAD, other dietary components may be signi cant diets by adding these plant-based fat-rich foods, they will still protect contributors to reverse it. The low risk of mortality of cardiovascular against cardiovascular disease. This, in fact, was the case in the two disease among subjects consuming the Mediterranean diet is attributed clinical cases that we present in which low-fat diets supplemented with to various food groups [26]. The Mediterranean diet, among other fat-rich foods reversed coronary artery disease [20,21]. things, is composed largely of fruits, vegetables, legumes, whole grains, nuts and olive oil. These food groups are the same groups in whole food vegan and plant-based diets. Thus, these food groups singly or in Vegans consuming diets with customary levels of fat have low risk of combination may be involved in reversing CAD by whole food plant- cardiovascular disease based diets irrespective of their fat content. If these food components Vegan diets contain about 30–35% of energy from fat, [22–24] yet are indeed the primary factors in the mechanism for reversing CAD, vegans have the lowest risk of cardiovascular disease as compared to there should be little difference in the effectiveness of reversing CAD by other dietary groups. So, vegan diets containing customary levels of fat the fat restricted and the fat unrestricted plant-based diets. If this is so, not only protect against cardiovascular disease, [17,18] they also re- this could explain why CAD is reversed by plant-based diets having verse CAD [20,21]. either low or customary levels of selected fat. A Mediterranean diet with added nuts reversed atherosclerosis Nuts and coronary artery disease Atherosclerosis was reversed by a Mediterranean diet supplemented with nuts. This Mediterranean diet contained 30% of energy as fat Nuts are a food group that merits particular attention; they are as- before supplementing it with nuts [19]. Although nuts increased the sociated with a significantly decreased risk of cardiovascular disease total fat content of the diet, they decreased the relative ratio of satu- and all-cause mortality [27–29]. It is of interest, therefore, to note that rated fat to unsaturated fat. The diet with added nuts was associated nuts were components of each of the three diets that we present because with decreasing the thickness of the carotid artery and the volume of they reversed CAD with customary levels of fat—the Mediterranean the arterial plaque within a year, while these parameters increased diet with additional nuts, [19] a vegan diet with only nuts [20] or a during the same time in the control Mediterranean diet group without vegan diet with nuts, seeds, olives, and avocados [21]. The role of nuts additional nuts. This study shows that preclinical estimates of athero- in reversing CAD needs further study. sclerosis (thickness of the carotid artery and the volume of the arterial plaque) are reversed by a diet that contained over 30% of energy as fat. Application of the hypothesis on reversing CAD This study provides evidence to support the hypothesis that CAD is reversed with diets having customary levels of fat. The evidence for reversing CAD by diet is focused on research conducted in the United States, but the need for reversing CAD is CAD was reversed in clinical cases by plant-based diets supplemented with worldwide. So, the question arises as to how these findings apply to the fat-rich foods of plant origin rest of the world. The customary level of fat in U.S. diets has been Two recent clinical case reports show that CAD was reversed by around 30–40% of energy as fat since the first report in 1954 comparing diets containing fats of plant origin [20,21]. In one report, CAD was non-vegetarians, vegetarians and vegan diets [24,30]. The customary reversed by a low-fat vegan diet that was supplemented with nuts [20]. content of fat in the vegan diets that we report and which have the The dietary fat content was not given, so we do not know from that lowest risk of mortality from cardiovascular disease are limited to ve- report the level of dietary fat that is compatible with the reversal of gans in the USA and Canada [31].
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