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Any sound rebuttals out there of Dr Esselstyn's diet plan?

cad heart disease

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#1 TheFountain

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Posted 20 February 2020 - 04:15 AM


In watching the following video, the Doctor makes a very strong point regarding endothelial cells and the lining of the arteries. 

 

What I am wondering is, is there any sound rebuttal to his schematic approach toward diet which he convincingly demonstrates can reverse or prevent CAD?

 

I have never seen anyone Paleo touch him in any way when it comes to rebutting his evidence based claims. 

 

Please chime in.

 

https://www.youtube....h?v=HpQJk-h3IwY



#2 TheFountain

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Posted 20 February 2020 - 05:42 PM

Yikes, I guess not. 



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#3 Juangalt

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Posted 20 February 2020 - 08:33 PM

Yikes, I guess not. 

 

Maasai and Inuit (pre-western hybrid diet) seem to avoid CVD. It seems to be the high carb/ high fat diet that most contributes to CVD. High fat low carb and Low fat high carb seem to avoid it. Esselstyn isn't comparing a keto type diet and his diet; he's comparing his diet to something closer to the Standard American Diet. From a practical standpoint, he's probably right because hardly anyone can stick to an ultra low carb diet. But a Maasai or Inuit might say the introduction of carbs is the problem.
 


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#4 Mind

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Posted 20 February 2020 - 10:05 PM

People who eat the traditional Mediterranean diet - a diet very high in the consumption of nuts and olive oil - are some of the longest lived people in the world with the least amount of CVD.

 

The list of studies affirming this fact is vast: https://www.jpost.co...MJ-study-618064

 

He falsely claims that improvements in Finnsh heart disease rates are solely due to dietary changes, when it was really due to less smoking. https://www.knowable...t-health-nation

 

People developed the term "French Paradox" because the traditional French diet was high in fat, particularly lard - yet they had low rates of heart disease. It isn't a paradox. Natural fats are good for health.

 

Dr. Esselstyn says ALL oils are bad. In the video he show a graph of oils which shows most of them have too many omega 6 oils in relation to omega 3 oils. This is well known. Soybean oil, canola oil, etc. are well known to be bad for you. (Notice that he leaves off butter, lard, and coconut oil). Olive oil has a very low ratio which is good.

 

He says avoid caffeine yet large studies show people who drink coffee live longer: https://www.healthli...onger#longevity

 

I could go on and on and on, but the LongeCity crowd has already discussed all of these points for decades.

 

The more significant contributor to many diseases, including heart disease is excess sugar and carb consumption - which he barely mentions.

 

It is well known that vegan and vegetarian diets are very good for health, but they are not the end-all be-all for good health.


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#5 TheFountain

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Posted 20 February 2020 - 11:23 PM

People who eat the traditional Mediterranean diet - a diet very high in the consumption of nuts and olive oil - are some of the longest lived people in the world with the least amount of CVD.

 

The list of studies affirming this fact is vast: https://www.jpost.co...MJ-study-618064

 

He falsely claims that improvements in Finnsh heart disease rates are solely due to dietary changes, when it was really due to less smoking. https://www.knowable...t-health-nation

 

People developed the term "French Paradox" because the traditional French diet was high in fat, particularly lard - yet they had low rates of heart disease. It isn't a paradox. Natural fats are good for health.

 

Dr. Esselstyn says ALL oils are bad. In the video he show a graph of oils which shows most of them have too many omega 6 oils in relation to omega 3 oils. This is well known. Soybean oil, canola oil, etc. are well known to be bad for you. (Notice that he leaves off butter, lard, and coconut oil). Olive oil has a very low ratio which is good.

 

He says avoid caffeine yet large studies show people who drink coffee live longer: https://www.healthli...onger#longevity

 

I could go on and on and on, but the LongeCity crowd has already discussed all of these points for decades.

 

The more significant contributor to many diseases, including heart disease is excess sugar and carb consumption - which he barely mentions.

 

It is well known that vegan and vegetarian diets are very good for health, but they are not the end-all be-all for good health.

 

Thanks Mind,

 

I remember a lot of the conversations we have had regarding a lot of the points you reiterated above. The problem is, we have discussed this so much that when you look into something that is new (to you at least) and the doctor is claiming that the mediterranean diet (for example) showed an increase in heart disease rather than a reduction, where is he getting his data from? 

 

And, what do you make of his angiographic data showing reversal of occlusion using his dietary approach etc? 

 

Sorry to dredge this subject up again but I honestly never looked into Dr. Esselsyn's findings till now even though I have herd his name multiple times over the years. 


Edited by TheFountain, 20 February 2020 - 11:24 PM.


#6 TheFountain

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Posted 20 February 2020 - 11:26 PM

Maasai and Inuit (pre-western hybrid diet) seem to avoid CVD. It seems to be the high carb/ high fat diet that most contributes to CVD. High fat low carb and Low fat high carb seem to avoid it. Esselstyn isn't comparing a keto type diet and his diet; he's comparing his diet to something closer to the Standard American Diet. From a practical standpoint, he's probably right because hardly anyone can stick to an ultra low carb diet. But a Maasai or Inuit might say the introduction of carbs is the problem.
 

 

He categorically states that he believes strongly that the mediterranean diet does not reverse heart disease but causes it. Where is he getting his data points from I wonder?


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#7 Mind

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Posted 21 February 2020 - 06:09 PM

His diet advice is fine. People who have a "bad" diet or a SAD diet, will be much healthier going with Esselstyn's advice.

 

He is just extreme in avoiding all fat. There is hardly any research that suggests all fat is bad and should be avoided at all costs. Particularly in regards to olive oil: https://www.longecit...ts-extend-life/


Edited by Mind, 20 December 2021 - 10:08 PM.

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#8 Daniel Cooper

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Posted 15 September 2020 - 01:58 PM

I've read Esselstyn's book and I've spoken with him on the phone (send him an email and he'll talk to you as well I suspect).  He seems to be getting some results from it, if he's a reliable reporter of his results.

 

However, is he correct as to why he's getting results (plant based diet, no meat, low fat, low carbs, etc.)?

 

In his book he shows before and after pictures of his patients.  Most before pictures are of morbidly obese people. Most of his after pictures honestly look like concentration camp survivors.

 

So it is the particulars of his diet that give him the results, or is it the extreme caloric restriction giving the result?  I think it could easily be the latter.

 

I recall a study years ago (forgive me but I can't locate it at the moment) where they looked at people that had been on a starvation diet.  And they noted some reversal of cardiovascular disease.  It even commented on an apparent reduction in CVD in people that had been starved in a concentration camp setting. Apparently when the body becomes extremely starved for calories it will even start to consume fatty deposits in the arteries. I think this extreme caloric restriction is equally plausible for whatever result Esselstyn is getting as it being the details of exactly what his patients are eating.

 

Again, get his book and look at his patients.  They are clearly on a nearly starvation level diet.  You cut almost all carbs and fat out of a diet and it's damned hard to get adequate calories, especially when all that's left for those on the Esselstyn diet is plant based protein.

 

 


Edited by Daniel Cooper, 15 September 2020 - 02:01 PM.

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#9 aza

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Posted 11 October 2020 - 12:38 PM

Generally speaking, the program seems to get positive effects. But it is impossible to attribute it to veganism.

The study itself didn't have a control group, wasn't randomized, was very small and was riddled with confounding factors.

The group reduced or stopped consuming vegetable oil, trans fats, refined starch, processed meat and sugar.

They lost a good deal of weight, were on medication and possibly exercised.

Really, the study can only really state with confidence that unprocessed food, with drugs and a healthy lifestyle can improve health,

It cant say whether the diet is more/less effective with or without meat.

 

 


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#10 ta5

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Posted 13 March 2021 - 06:42 PM

Here is one critique:

The Incredibly Bad Science Behind Dr. Esselstyn's Plant-based Diet

 


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#11 KBAnthis

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Posted 30 March 2021 - 10:14 PM

You may be interested in my copy paste from another topic I started. I will post below this comment. It ties together why I enjoy cold-pressed oils. It is only my opinion from trial and error of the optimal diet over my life. Cold-pressed oils have greatly improved my life. It is also the absence of cooking oil that improves my life. I have gone about 2 years oil free, consuming raw nuts and seeds for omega 6 and 3. Although I did do some cod liver oil , there was no cooking oils. Except col-pressed coconut oil but I didn't cook in it.

Here is the post. 
Do you currently take Borage Seed Oil or Evening Primrose Oil? I have just recently ordered a bottle of each, both organic, both food grade, and both cold-pressed. The borage seed oil I believe is further refined or filtered and is PA free. I am not sure about the evening primrose oil, if it is further refined, I will e-mail the company to ask. I will update once they e-mail back. I am currently on a diet that is as low in cooked fats as possible. My daily diet consists of raw nuts and seeds (unpasteurized) which I will sprout before blending in a smoothie. Lately I have been doing about a half cup of raw hulled sunflower seeds and 2 tbsp. of flax seeds. I have done other seeds and nuts including: walnuts, almonds, hulled sesame seeds, pumpkin seed, and others. I will also consume Raw Butter, about a tbsp. a day. While I prefer raw butter, store bought pasteurized butter can be substituted just fine. I do not do as well with pasteurized nuts and seeds as they do not nourish me as good and can bog me down after consumption. So many store bought varieties have to be researched through the vendors, and often I resort to online ordering. Though not always as I have found some bulk food stores which carry nuts and seeds unpasteurized. I also do a virgin cod liver oil.  About less than a tbsp. of cold-pressed coconut oil a day. With meats I do mostly organs, and on occasion lean cuts of muscles. I am doing this to promote the highest quality of health and am trying to find the best diet I can make up. I enjoy hot cereals with water and vegetable soups with lentils. With the studies on GLA, with Borage Seed Oil and Evening Primrose oil, I am uncertain if they use cold-pressed oils. This has the potential to change the results and conclusions. From my experience the cold-pressed oils are invaluable, and conventionally produced oils are good as useless. I had some borage seed oil , cold-pressed, filtered and pa free from another country in my fridge that I tried again after stopping it do to weight-loss dieting. It reduced inflammation, seems to be speeding up healing time, and has increased nerve sensations, like sense of touch, other sensual things, making my life more enjoyable. I am curious what others have to say about this , if anything. I will report back after trying the new oils. I do not do much oil, taking 1/2 tsp. sometimes a little more. I am trying to loose some body fat currently. I have been doing some fasting similar to the snake diet, drinking a sodium chloride free snake juice. I am hoping the oils will replenish omega-6 faster and increase well-being after breaking the fasts. I also consume 3 raw egg yolks a day.


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#12 Mike C

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Posted 19 December 2021 - 06:08 PM

I've read Esselstyn's book and I've spoken with him on the phone (send him an email and he'll talk to you as well I suspect).  He seems to be getting some results from it, if he's a reliable reporter of his results.

 

However, is he correct as to why he's getting results (plant based diet, no meat, low fat, low carbs, etc.)?

 

In his book he shows before and after pictures of his patients.  Most before pictures are of morbidly obese people. Most of his after pictures honestly look like concentration camp survivors.

 

So it is the particulars of his diet that give him the results, or is it the extreme caloric restriction giving the result?  I think it could easily be the latter.

 

I recall a study years ago (forgive me but I can't locate it at the moment) where they looked at people that had been on a starvation diet.  And they noted some reversal of cardiovascular disease.  It even commented on an apparent reduction in CVD in people that had been starved in a concentration camp setting. Apparently when the body becomes extremely starved for calories it will even start to consume fatty deposits in the arteries. I think this extreme caloric restriction is equally plausible for whatever result Esselstyn is getting as it being the details of exactly what his patients are eating.

 

Again, get his book and look at his patients.  They are clearly on a nearly starvation level diet.  You cut almost all carbs and fat out of a diet and it's damned hard to get adequate calories, especially when all that's left for those on the Esselstyn diet is plant based protein.

Not true at ALL! YOU CAN GET DAMN FAT EATING POTATOES, YAMS, OATMEAL, WHOLE GRAIN BREAD ETC. CHECK OUT HIS COOKBOOKS. IF IT WHOLE PLANT BASED AND LOW FAT ITS OK WITH ESSELTYNE. IVE TALKED TO HIM SEVERAL TIMES ALSO. HES A VERY DECENT HUMBLE PERSON. HE HAS THE DATA THAT SHOWS REVERSAL. THE ARTERIES ARE LITERALLY LOOKED AT BEFORE AND AFTER. SOMETHINGS GOING ON.

 

AS FOR MEDITERRANEAN DIETS HELL NO. HEART DISEASE IS STILL A MAJOR KILLER AND AT EPEDEMIC LEVELS IN THOSE COUNTRIES INCLUDING FRANCE! ITS JUST BETTER THAN THE SAD DIET SO WHAT!


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#13 Daniel Cooper

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Posted 19 December 2021 - 06:10 PM

Not true at ALL! YOU CAN GET DAMN FAT EATING POTATOES, YAMS, OATMEAL, WHOLE GRAIN BREAD ETC. CHECK OUT HIS COOKBOOKS. IF IT WHOLE PLANT BASED AND LOW FAT ITS OK WITH ESSELTYNE. IVE TALKED TO HIM SEVERAL TIMES ALSO. HES A VERY DECENT HUMBLE PERSON. HE HAS THE DATA THAT SHOWS REVERSAL. THE ARTERIES ARE LITERALLY LOOKED AT BEFORE AND AFTER. SOMETHINGS GOING ON.

 

AS FOR MEDITERRANEAN DIETS HELL NO. HEART DISEASE IS STILL A MAJOR KILLER AND AT EPEDEMIC LEVELS IN THOSE COUNTRIES INCLUDING FRANCE! ITS JUST BETTER THAN THE SAD DIET SO WHAT!

 

Please knock it off with the all caps posts.



#14 Mike C

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Posted 19 December 2021 - 06:13 PM

Please knock it off with the all caps posts.

WHY? GIVE ME A RATIONAL REASON. 



#15 Daniel Cooper

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Posted 19 December 2021 - 06:16 PM

WHY? GIVE ME A RATIONAL REASON. 

 

Because it is considered to be the internet equivalent of shouting and therefore rude.  We make some effort to have a reasonable discourse here.

 

You don't go around in your real life shouting all the time, do you?

 


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#16 Mind

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Posted 20 December 2021 - 10:11 PM

Not true at ALL! YOU CAN GET DAMN FAT EATING POTATOES, YAMS, OATMEAL, WHOLE GRAIN BREAD ETC. CHECK OUT HIS COOKBOOKS. IF IT WHOLE PLANT BASED AND LOW FAT ITS OK WITH ESSELTYNE. IVE TALKED TO HIM SEVERAL TIMES ALSO. HES A VERY DECENT HUMBLE PERSON. HE HAS THE DATA THAT SHOWS REVERSAL. THE ARTERIES ARE LITERALLY LOOKED AT BEFORE AND AFTER. SOMETHINGS GOING ON.

 

AS FOR MEDITERRANEAN DIETS HELL NO. HEART DISEASE IS STILL A MAJOR KILLER AND AT EPEDEMIC LEVELS IN THOSE COUNTRIES INCLUDING FRANCE! ITS JUST BETTER THAN THE SAD DIET SO WHAT!

 

Heart disease increased in the Mediterranean zones in recent years because they have abandoned the traditional healthy diet.


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#17 TheFountain

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Posted 21 December 2021 - 04:14 AM

Heart disease increased in the Mediterranean zones in recent years because they have abandoned the traditional healthy diet.

 

What did they change?



#18 KetoLinguine

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Posted 29 December 2021 - 12:25 AM

A vegan blogger writes:

"As a vegan, you don’t consider heart disease as something that will affect you, especially not in your 40s. So I didn’t believe that as a possibility when I felt tightness in my chest, and my arms felt weak.

"I thought by being vegan for 15+ years and vegetarian for 22+ years I would avoid the heart disease and type 2 diabetes in my family. Apparently not.

He notes:

"Dr. Esselstyn says over and over in Prevent and Reverse Heart Disease that if you have a cholesterol level less than 150, you will not have heart disease.*cough* Mine was 134 when I had my heart attack.
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#19 TheFountain

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Posted 29 December 2021 - 04:09 AM

A vegan blogger writes:

"As a vegan, you don’t consider heart disease as something that will affect you, especially not in your 40s. So I didn’t believe that as a possibility when I felt tightness in my chest, and my arms felt weak.

"I thought by being vegan for 15+ years and vegetarian for 22+ years I would avoid the heart disease and type 2 diabetes in my family. Apparently not.

He notes:

"Dr. Esselstyn says over and over in Prevent and Reverse Heart Disease that if you have a cholesterol level less than 150, you will not have heart disease.*cough* Mine was 134 when I had my heart attack.

 

I see nothing about the constituency of his diet, lifestyle or anything in this. Vegan can mean anything. On the opposite end of the spectrum there's this from the self proclaimed "carnivore kid"

 

https://twitter.com/...122272579833863

 

He states 

 

"How the f*ck did I have three blocked arteries?? I fasted, ate low carb, cut seed oils, did cardio and weights at least 5x a week. End result…. My widow maker was 95% blocked?? thank the Lord I just happened to go to cardiologist after iwatch reported afib"

 

So, use what ever you want to justify what ever you deem necessary to justify, but meta-data on Cholesterol in all but some cases seems to be very reliable.

 

Don't forget to factor in Lp(a) which is not a normal standardized test currently.



#20 KetoLinguine

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Posted 29 December 2021 - 05:17 AM

The carnivore kid had only been Paleo/keto since "2016ish" and carnivore since 2018. Source: https://mobile.twitt...256585505189894

That's about 5-6 years of dieting compared to the 22+ years of the case I posted. 22 years should've been enough time to clean up his arteries, while 6 is less time.

More from the same vegan blog post:

"And while I was not a health food super fit vegan, I also wasn’t a junk food slothy vegan slamming Oreo’s and potato chips. I think like many vegans I was somewhere in between. Sure, we occasionally made Daiya Mac & Cheese from the box ate decadent fatty veggie burgers like the Beyond Burger, and ate vegan doughnuts when we found them (thankfully, that’s a rare occurrence.)

"On the other side of that, we destroyed tons of kale, I defaulted to whole grains, and almost never chose the deep-fried option. Also, I rarely drink and never smoked. And yet, I still had a heart attack at 49 years old.

Source: https://veganrv.com/...at-do-they-eat/

Edited by KetoLinguine, 29 December 2021 - 05:45 AM.

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#21 Mind

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Posted 29 December 2021 - 05:51 PM

What did they change?

 

They adopted the SAD diet. Processed food, higher carbs, etc... They used to consume unholy amounts of olive oil everyday and were the healthiest people on the planet. Now they are advised to keep their olive oil intake very low and they are suffering higher rates of heart disease and obesity.

 

Here is a blog post that encapsulates some of the changes (not all based upon fat intake). https://www.olivetom...e-greeks-obese/


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#22 TheFountain

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Posted 30 December 2021 - 04:16 AM

The carnivore kid had only been Paleo/keto since "2016ish" and carnivore since 2018. Source: 

 

And this is somehow confidence inspiring? How do you know that 5 years of Carnivore didn't do it?

 

Even that "vegan Blogger" is less precise than the Carnivore Kid is regarding his diet. Sounds to me like he might've been on an unhealthy variant of a vegan diet and comforted himself by saying he was somewhere in between. He may have taken in table sugar there's no mention of any of that. 

 

I find people leave out details of diets all too frequently which could be related to confirmation bias of some sort or another, and admitting the truth would muddy the waters of their own bias. He didn't mention where his carbs came from, where his fats came from, the relative ratio, etc. If you look at the Carnivore kids blog he documented his intake of different things a lot better than the "vegan blogger" you are quoting. 

 

Furthermore I have experimented with high fat Keto and demonstrated in my own numbers that it raised things like Lp(a) unnaturally. I had a reading of 90 NMOL/L after an almost two year primal/Keto diet and I was extremely careful with it. 

 

Contrast that to what happened to me on my Mostly vegetable plant based diet. When I saw how stupid my blood panel numbers were as a result of Keto I did some research and realized I needed to experiment.

 

I did just that. I went on a diet where I ate tons of green vegetables cut out pretty much the majority of fats, except went down to about 30-40 grams a day of mostly Monounsaturated fat and the results were astonishing after just 4 months on this diet. My total Cholesterol went from 237 on Keto to 145 on the clean (and I emphasize the word CLEAN here) plant based diet my LDL went from 130 to 60, my HDL went from 60 on Keto to 95 on the vegan diet and perhaps most significantly my Lp(a) dropped from an unnatural 90 nmol/l to an optimal <75 measurement of 60 nmol/l which is no longer "slightly elevated" according to all professionals in the field. 

 

To top it off, my A1C went down from 5.2 on Keto to 4.6 on the clean plant based diet.  Which to me proves Keto causes insulin resistance. 

 

I have Had my numbers measured twice since then and they were relativistically all about the same measurement.  It's been about two years since I got rid of that Misguided Keto experiment and started eating truly healthy foods. 


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#23 Phoebus

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Posted 31 December 2021 - 02:12 AM

 

 

 

I did just that. I went on a diet where I ate tons of green vegetables cut out pretty much the majority of fats, except went down to about 30-40 grams a day of mostly Monounsaturated fat and the results were astonishing after just 4 months on this diet. My total Cholesterol went from 237 on Keto to 145 on the clean (and I emphasize the word CLEAN here) plant based diet my LDL went from 130 to 60, my HDL went from 60 on Keto to 95 on the vegan diet and perhaps most significantly my Lp(a) dropped from an unnatural 90 nmol/l to an optimal <75 measurement of 60 nmol/l which is no longer "slightly elevated" according to all professionals in the field. 

 

To top it off, my A1C went down from 5.2 on Keto to 4.6 on the clean plant based diet.  Which to me proves Keto causes insulin resistance. 

 

 

what is a "Clean plant based diet"? 



#24 TheFountain

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Posted 31 December 2021 - 07:18 AM

what is a "Clean plant based diet"? 

 

A vegan diet that consists of 90% or higher of unprocessed foods. In my case I am at about 97% unprocessed. I do eat veggie burgers, albeit organic ones made with Pea protein and no added sugar but that and "No cow" cars are about the only processed food I consume for added protein. 

 

The rest of it is pretty much vegetables like Kale, Tomatoes, Avocado, a ton of mushrooms (for Spermidine) Arugula, Collard greens, beets and Broccoli, Olives. I used to eat a ton of spinach but now I only eat it once or twice a week due to oxilates and the potential for Kidney stones. 

 

For added B vitamins I sprinkle a fair amount of Nutritional yeast over my salads or cooked vegetable plates. 

 

I WAS eating a lot of Legumes up till recently but I cut them out to see what the affects would be. I was eating mostly lentils, Northern beans, Chick peas and tri-blends. Too much gas led me to try living without those for a while. 

 

This diet is naturally moderate in protein, lower in calories and HIGH in nutrients. 

 

Oh, I do eat Vegan yogurt alternatives with no added sugar with a lot of berries added. Honestly the yogurt part is just a couple spoon fulls to mix the berries up with. I consume blueberries, Blackberries, Rasberries, Cherries and Banana's as my primary fruit choices. 

 

My nut consumption is very little, A couple spoon fulls of Artisan organic Walnut butter 3-4 times a week is about what I do in terms of nuts. 

 

As for as Cocoa is concerned I have minimized my consumption to 1 or 2 squares daily of dark Cocoa, and if I am not doing that I make a really amazing vegan hot cocoa which consists of Low Cadmium cocoa powder and sweetened with natural plant sweetener like Xylitol or Stevia.

 

So this is my "clean" plant based diet which changed my numbers. 


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#25 sensei

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Posted 08 February 2022 - 04:40 AM

Long term ketosis fRom a ketotic diet can and may result in beneficial -- YES BENEFICIAL pseudo-diabetes.

Resistance to insulin/glucose in non brain cells may occur as a glucose sparing function - if glucose becomes available only the brain will be able to use it.

Look it up.

As far as diet, an 80 -10 -10 Fat/protein/carb diet is probably the best for CVD.

Include foods that inhibit MTOR, and lose as much BODYFAT as you can. Excess adipose tissue causes inflammation due to NLRP3 inflammasome activity with causes atherosclerosis and other CVD.
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#26 TheFountain

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Posted 22 August 2022 - 03:36 AM

Long term ketosis fRom a ketotic diet can and may result in beneficial -- YES BENEFICIAL pseudo-diabetes.

Resistance to insulin/glucose in non brain cells may occur as a glucose sparing function - if glucose becomes available only the brain will be able to use it.

Look it up.

As far as diet, an 80 -10 -10 Fat/protein/carb diet is probably the best for CVD.

Include foods that inhibit MTOR, and lose as much BODYFAT as you can. Excess adipose tissue causes inflammation due to NLRP3 inflammasome activity with causes atherosclerosis and other CVD.

Where's the Data on this?







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