In the United States coronary heart disease will kill one out of every three

Americans. It is the number one health problem and is the leading cause of
death for men and women. Some of the risk factors for heart disease are:
smoking cigarettes, obesity, diabetes, stress, high blood pressure & cholesterol,
and a sedentary lifestyle. These are only some examples we will touch base on
in my paper. One of the problems we face as Americans is we have grown up
eating steaks, hamburger, pepperoni, deli meat, candy, cakes, cookies, French
fries, soda and white bread. Drive-thru fast food with supersize servings right at
our fingertips. All of which contain processed oils and animal products. These
foods have been linked to contribute to a higher risk of Coronary Heart Disease
because they contain higher saturated fats and cholesterol.
But how do we change? When this way of life is all we have known? My
sister was vegan for a couple of years and my Grandpa razzed her over her
decision. He is a rancher in Nevada and we grew up helping on the farm when
we stayed there. We would help brand, herd, and feed the hundreds of
Hereford cattle. So you can see how my Grandpa would not like nor support my
sisters decision. One, because it is his livelihood and two, because that is all he
has ever known. We are the typical American family a meat and potatoes kind
of menu is what we have grown up on.
When I tried to explain to them that an animal fat based diet is the reason
for all their health problems they do not believe what I was saying. My Grandpa
has gallbladder disease and has had a heart attack. My Grandma has
cardiomyopathy, a heart muscle disease, which diet and long-term high blood
pressure are some of the causes of this disease. His Father had a heart attack at
70 and died at 75. And his brother had a heart attack in his 50s. All were cattle
farmers and the lifestyle of living an animal product diet the majority of your life
does take a toll on your health.
The majority of our diets contain the lipids - triacylglycerols, which contain
a glycerol and three fatty acids. The fatty acids can be three of the same acid
or a combination of saturated such as palmitic and stearic acid combined with
an unsaturated fat such as oleic or linoleic acid. Saturated fats generally
contain a long chain of carbon atoms saturated on all their bonds with
hydrogen atoms and are solid at room temperature. Whereas, unsaturated fats
have long carbon chains with double bonds that will kink so the molecules
cannot stack and therefore tend to stay liquid at room temperature.
We like to consume these TAGs (triacylglycerols) because it takes our
bodies longer to break down and digest, making us feel fuller longer. As a result
of the Western (American) diet. people are becoming increasingly predisposed
for diabetes, obesity, and heart disease. Coronary heart disease is a narrowing
of the arteries to the heart that decreases blood flow. Plaque is what

accumulates on the inner walls of the arteries (atherosclerosis) and is made up

of calcium, fat, cholesterol, cellular waste, and fibrin. Saturated fats, trans fats,
and cholesterol all contribute to the buildup of plaque. Reduced blood supply
to your heart may cause you to have shortness of breath, chest pain or a heart
attack. About 600,000 people die in the US each year and it costs $108.9 billion
in health care services, medications, and lost productivity.
Doctors like Dr. Caldwell Esselstyn, Dr. T. Colin Campbell, and Dr. Junshi
Chen have researched and documented over twenty years of studies to show
us why limiting our intake of animal products, oils, and adopting a plant-based
diet will not only stop progression of heart disease but could even reverse its
effects. Yet it is a big hurdle to try to convince Americans that heart disease can
have other solutions of remedy besides drugs and surgery.
One problem we face is many doctors get paid by pharmaceutical
companies and medical device manufacturers to push their products.
Therefore, they would not be advocates to promote a healthier life by diet and
exercise. They would prescribe you medications and surgery resulting in more
money in their pockets.
Medications such as Lotensin and Accupril are angiotension converting
enzyme (ACE) inhibitors that block the hormone angiotensin II which can
constrict blood vessels and help widen the vessel to reduce the workload on
your heart and help lower blood pressure. When Lotensin chemically breaks
down in the liver the ester group benazepril is converted to a non-sulfhydryl its
active form resulting in the ACE inhibitor. Beta-blockers, Calcium channel
blockers, and angiotensin II receptor blockers also help inhibit the heart
workload, vasodilation of the blood vessels, and help lower blood pressure.
Aspirin is prescribed because it is a blood thinner agent and inhibits cyclooxygenase (COX), which is needed for the formation of prostaglandins.
Prostaglandins contain 20 carbon atoms and a 5-carbon ring, it is a lipid from
the eicosanoid class of hormones. The aspirin inhibits thromboxane, a
prostaglandin derivative, which promotes platelet aggregation (blood clotting).
Patients with heart disease need to have platelet aggregation prevented.
Another problem is the cost of heart surgery can range into the hundreds
of thousands and with heart disease becoming more prevalent the costs will
probably continue to rise. An article in Forbes magazine said cardiologist
guaranteed base salary is $512,000, according to the Merritt Hawkins data.
Cardiology procedures generate big revenues for hospitals and the insurance
companies support mechanical and procedural coverage for vascular
diseases. The disease is controlled with medicine, stents and bypasses but these
are only temporary fixes. If the diet and lifestyle of an individual does not
change then that individual will need more medicine and surgeries, generating

more money for the doctors, hospitals, etc. How would the big companies be
able to document, code, and quantify a healthier lifestyle approach and still
make money?
Dr. Caldwell Esselstyn, a surgeon at the Cleveland Clinic in Ohio, realized
he was doing nothing for his patients who had heart disease except surgery
after surgery. He saw while researching other cultures around the world that
have a low heart disease rate is due to eating a more plant-based diet. He
decided he wanted to help prevent his patients from having only temporary
benefits from surgery. He wanted long-term success and decided to put them
on diets like the Tarahumara Indians of Mexico, and other poorer countries
where coronary artery disease is low.
Dr. Esselstyn conducted a twenty-year study of the effects of a plantbased, oil-free diet. The subjects he picked were literally patients that were on
their last months/years of life because of this disease. He said, they could not
eat anything with a mother, or a face, no dairy products, no oil of any kind, and
generally no nuts or avocados. You could have a variety of delicious nutrientdense foods. You could eat all the fruits, vegetables, legumes, whole grains,
bread and pasta (as long as they contain no added fats). His results after 20
years of research; supported his hypothesis. Of the original participates, the 5
that were told by their cardiologists they had less than a year to live saw within
months on the program, their levels, symptoms, and blood flow improved
dramatically. Twelve years later, 17 compliant patients had no further cardiac
events and achieved cholesterol levels of less than 150 mg/dL. And adherent
patients survived beyond the twenty years later with symptoms that came to a
stop and even reversed against atherosclerosis.
T. Colin Campbell, PhD, a Cornell University professor, saw that we spend
the most on health care in the world, yet obesity, diabetes, cancer, and heart
disease rates keep rising. He noticed millions of Americans have high cholesterol
and are taking prescription drugs for heart disease. He spent his career
researching animal products and the biochemical effects they had on the
body. He went to the Philippines to study childrens lifestyle and diet. He found a
link between children who ate the highest protein diets and cancer. They were
the children of the wealthiest families who could afford animal products. He
discovered a connection between protein casein found in mammalian milk and
liver cancer in the children. He experimented on rats and found when casein
levels increased so did tumor growth but when casein levels decreased the
tumor growth decreased as well. Later he teamed up with Dr. Junshi Chen to
direct and co-write the most comprehensive study of diet, lifestyle & disease
ever attempted in biomedical research, with 367 variables and sixty-five
countries across China the results are, The China Study. They found that people
who ate more animal protein developed more diseases such as cancers and

heart disease, then people who ate plant protein.

Other scientific articles also support the benefits of a plant-based diet.
Intensive Lifestyle Changes for Reversal of Coronary Heart Disease researched
patients with CHD and changed their lifestyle intensively for 5 years to show the
effects it had on the disease, without lipid-lowering drugs. The experimental
group was put on a 10% fat vegetarian diet, moderate aerobic exercise, stress
management training, ceased smoking, and group psychosocial support. After
5 years, regression of coronary atherosclerosis occurred 1 year into the research.
And the control group that was not put on the intensive program continued to
progress with their disease and had more than twice as many cardiac events
occur. Optimal Diets for Prevention of Coronary Heart Disease, is another article,
that shows dietary strategies are effective in preventing CHD. If you have nonhydrogenated unsaturated fats instead of saturated and trans-fats. Increase
your consumption of omega-3 fatty acids from fish, or fish oil supplements and
consume a diet high in fruits, vegetables, nuts, and whole grains, along with low
refined grain products. They found substantial evidence these foods can offer
significant protection against CHD. Along with regular physical activity, no
smoking, and a healthy body weight you may prevent the majority of
cardiovascular disease in Western populations.
Eating healthy tremendously benefits your health because fruit and
vegetables have nutrients like dietary fiber, antioxidant vitamins, folate,
potassium and a low GI index. Which means a measurement of carbohydrates
and their impact on our blood sugar. Consumption of foods such as pastries,
cookies, and French fries invoke in your body a response of high glycemic and
insulinemic responses. The bodys job is to maintain homeostasis and when you
eat a meal your blood glucose levels rise. Which stimulate the pancreas to
secrete insulin, a hormone. Which helps the glucose move through blood and
into the cells where it is stored for energy later. The blood glucose levels drop,
which causes the pancreas to stop secreting insulin. This is an example of a
negative feedback loop.
When you repeatedly spike blood glucose levels by overconsumption of
high sugar sodas, processed foods, etc., your body may become insulin
resistant. Because constantly consuming large amounts of sugar will build up in
the blood due to down-regulated receptors. A down-regulated receptor is a
reduction in sensitivity or quantity of working receptors. So all that sugar cannot
enter into the cells because the receptors are not working properly causing
hyperglycemia. Continual abuse of these foods along with a sedentary lifestyle
will result in obesity and eventually cause type-2 diabetes.

A high Lipoprotein in
blood in associated with CHD,
CVD, Atherosclerosis. We have
lipoproteins that transport the
lipids in our bodies. The five
major types are Chylomicrons,
which only transport our dietary
lipids from the intestine after
digestion by bile acids and into
our blood and liver. They are
the lowest-density lipoproteins,
because they have the highest
ration of lipids to proteins.
Very-low-density lipoproteins (VLDLs) are synthesized by the liver and carry
triacylglycerols from the liver to tissues for storage and energy. Intermediatedensity lipoproteins (IDLs) carry the remnants of VLDLs from the tissues back to
the liver to be used again in synthesis.
Low-Density lipoproteins (LDLs) bad cholesterol help transport
cholesterol from the liver to tissues, which, is then used in the cell membranes or
for synthesis of steroids. But excessive amounts can cause buildup and blockage
to your arteries.
High-density lipoproteins (HDLs) good cholesterol removes fats,
cholesterol, phospholipids, and triglycerides from your tissues back to the liver,
where it is converted into bile acids used for digestion or excreted when in
excess. The LDLs and HDLs are the important lipoproteins associated with heart
disease. High blood pressure (140/90 mmHg) can affect LDL lipoproteins. When
your total cholesterol level is 240 mg/dL or above, your LDL is 160-189 mg/dL and
higher, and your HDL is less than 40 mg/dL you are a major risk factor for heart
disease. If your total cholesterol level is less than 200 mg/dL, your LDL is less than
100 mg/dL, and your HDL is 60 mg/dL or higher you are considered protective
against heart disease. Once again it is reiterated how important diet, weight,
and physical activity is to help reduce your risk of diseases.
Exercise is one of the most beneficial to help lower your risk and CHD. Your
heart is a muscle and like any muscle it will weaken and atrophy when not used.
Therefore you need to work it out regularly to make it stronger, resulting in better
blood flow in the vessels and arteries because the heart doesnt have to pump
as hard when it gets stronger. When you begin to work out your skeletal muscle
needs a lot of ATP the energy for your muscles to contract. Obtaining ATP from
your food is slow therefore it has several other sources.
The first source creatine phosphate transfers its phosphate group to ADP
by the enzyme CPK (creatine phosphokinase) forming ATP + creatine. This only

lasts a few seconds because the stores of creatine phosphate become

depleted. Clinically CPK can be tested for in blood tests because it spills out of
damaged muscle cells, so can diagnose things such as myocardial infarction,
muscular dystrophy, and acute renal failure.
The next five to ten minutes the muscle skeletal fiber will break down
glycogen to glucose, where aerobic cellular respiration begins. The citric acid
cycle and oxidative phosphorylation will produce ATP. But because of maximum
muscle exertion oxygen cannot keep up and sustain in the muscle cell therefore
cellular respiration cannot keep going. Glucose from the blood will breakdown
the next thirty minutes through glycolysis and oxidative phosphorylation. And
when all that is depleted the body will get its energy from anaerobic respiration.
Where pyruvate from glycolysis supplies ATP but lactate is produced and a
buildup of lactate will cause muscle fatigue.
Examples of anaerobic exercise are sprinting and weight lifting, any
exercise you can only sustain for short periods of time. These types of exercises
make you faster, stronger, increases bone strength and it burns twice the
calories for a gram of fat versus a gram of carbohydrate. Therefore burning
more calories throughout the day the more muscle you have. Where aerobic
exercises you can sustain for long periods of time, like cardio, jogging, biking.
These help you increase the amount and efficiency of oxygen throughout your
body burning more calories during the session. It is said you need a balanced
exercise routine between both these types of exercises along with core
exercises and stretching to get the most for what your body needs. According
to the American Heart Association as many as 250,000 deaths yearly can be
attributed to lack of regular exercise here in the US. Exercising just 30 minutes a
day five days a week will improve your heart health and help lower your risk of
heart disease.
I have two examples where glycogen levels were completely depleted
and my friend and I hit the wall. The expression used when extreme exhaustion
sets in and your body has nothing left to give. Apparently you burn
approximately 100 calories for every mile you run. And your body only stockpiles
about 2,000 calories worth in your body of glycogen in your muscles and liver. So
when I was running the St. George Marathon in 2011, it was my first 26.2 mile
marathon ever. I had trained vigorously from the schedules you print off the
Internet and did not waiver from the schedule. My longest run was twenty-three
miles and I accomplished this in about four hours and thirty-five minutes. I felt
ready, prepared mentally, physically, and of course the adrenaline was
pumping at the start of the race. I was running with my friend who hardly ever
trains for a marathon.
Last year he did the 100-mile run out in the Salt Flats in Wendover. He too is
an example of depleting all your resources in your body. Because by mile eighty
about seventeen hours into his run, he started seeing things. We took turns

pacing him once it got dark because we knew he had not trained adequately
for a 100-mile race. The most he had run was 35-miles. By four a.m. he thought
the bushes were monsters and it did not help the runners that it had started
raining about six p.m. that night, and continued until they finished the next
morning. To be able to witness him accomplish such a tremendous goal and see
others that crossed the finish line too. Made me cry and stand in awe at what
determination, passion, and a little bit of craziness the human body and mind
can endure.
Back to our marathon where he had not trained again, we started at six
a.m. and the terrain is a lot of uphill and downhill climbs. It was some of the most
beautiful scenery I have ran, but my body was used to training at five a.m. in
Northern Utah weather. Which is around fifty degrees and a bit chilly, in St.
George the temperature at six a.m. was already sixty degrees. By eight in the
morning it was up to eighty. As the temperature continued to raise you saw
people lying on the sides of the road, others giving them their water reserves. I
am not sure if the organizers of the race planned the water stations poorly for
the hot temperature or if the runners planned poorly not having enough of a
water supply with them? I was lucky that I am adamant about having my water
when I run. I purchased a fifty-dollar fanny-pack belt that held two water
containers just for this race. To see all the individuals that could not go on and
accomplish their goal that they had trained so long for was disheartening. I was
determined; and my friend kept pushing me to stay at my goal pace of, 4 hrs. 15
min., we were still on track to make.
However, at mile 19 I started to look around and see all the miserable
faces that I know reflected my own. I told my friend I was done and no longer
had the desire or the strength to continue, my glycogen was depleted. It was
too hot, I was miserable, and I had hit the wall! I am so grateful that he did not
give up on me even when I had. He let me walk for about half a mile until I
decided, Ok, we have to get to the finish line anyway. And we made it to the
finish at 4 hrs. 18 mins., only three minutes off my goal! I could not have been
more amazed at the chemistry of my body enduring. To set out and accomplish
this goal I had set for myself and pretty close to my goal time. Unfortunately for
my body, the next three days were some of the most painful I have ever
experienced. From having to take ice baths (not a fun experience) to make the
stinging in my legs subside and my husband having to help me walk around the
house and to the restroom because my legs were too weak to hold myself up
alone. I could not even straighten my back and stand erect. Obviously, way too
much lactate acid! Every pain was still worth it all. We have no excuse why we
cannot learn to eat a healthier variety of foods. You can find many recipes
online, in books, and TV. Learn ways on how to cook vegetables properly so
they are tasty. Stay active, learn techniques to help with stress, and maintain a
healthy body weight. Education is always the key to help you live a long healthy
life. And to take care of our only bodies we have in this lifetime.

Resources
Esselstyn, Jr., MD, Caldwell B. (2007). Prevent and Reverse Heart Disease. New
York: Avery
Campbell, T., & Campbell, T. (2005). The China study: The most comprehensive
study of nutrition ever conducted and the startling implications for diet, weight
loss and long-term health. Dallas, Tex.: BenBella Books.
Dean Ornish, MD; Larry W. Scherwitz, PhD; James H. Billings, PhD, MPH; K. Lance
Gould, MD; Terri A. Merritt, MS; Stephen Sparler, MA; William T. Armstrong, MD;
Thomas A. Ports, MD; Richard L. Kirkeeide, PhD; Charissa Hogeboom, PhD;
Richard J. Brand, PhD (1998, December 16) Intensive Lifestyle Changes for
Reversal of Coronary Heart Disease. The Journal of the American Medical
Association. 280(23): 2001-2007
Frank B. Hu, MD, PhD; Walter C. Willett, MD, DrPH (2002, November 27) Optimal
Diets for Prevention of Coronary Heart Disease. The Journal of the American
Medical Association. 288(20): 2569-2578
Forks Over Knives. Lee Fulkerson. Caldwell B. Esselstyn, Jr., MD, T. Colin Campbell,
PhD. Virgil Films, 2011.
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