Circulatory problems and heart disease: an interview with Caldwell B. Esselstyn, Jr., M.D

Nutrition Health Review, Spring, 2006

During the brachial artery tourniquet test, an ultrasound probe is placed over the brachial artery, just below the elbow. There, the technician takes a reading of the diameter of the brachial artery. A blood pressure cuff is encircled above the upper arm and inflated above the systolic blood pressure for five minutes, during which time there is no circulation to the forearm. Then the cuff is released, and the technician again measures the diameter of the brachial artery below the elbow. When there is no circulation to the forearm, there is a great stimulus to the healthy, normal endothelial cells to pour out nitric oxide. This is why when you re-measure that diameter of the brachial artery, it is now wider, because it has dilated. That is a perfectly healthy response.

Dr. Vogel took a group of students to a fast-food restaurant; half of them ate corn flakes, and their tourniquet test result remained normal. However, two hours later, the students who consumed the hash brown potatoes and sausages had failing results. Those young students were unable to experience normal dilatation or widening of the artery, because the fat and grease from their meal had so injured their endothelial cells that they were unable to respond in a normal way. Because these were young students, a few hours later the endothelial cells recovered.

This test produces similar results when we eat saturated fats from meat, dairy, olive oil, and so on. Although we might not feel the injury to the endothelial cells, if we eat this way--meal after meal, three times a day, day after day, week after week, month after month, year after year, decade after decade--it is not surprising that with those repetitive injuries to the most delicate cells in our arteries, teenagers and young adults already begin to develop this disease. It universally affects all people by the time they are in their middle and late 60's.

Scientifically, this is a powerful condemnation of the present food pyramid in the United States,. which recommends all of these foods that, when eaten, guarantee that such a significant portion of our population will develop and perish from this disease; this need never occur. When we recognize the power that food has and how immediately it can cause injury, we can also see how this whole thing can be turned around and worked the other way. We saw that from the Norway experience. That was the basis of the research in which I became involved.

Q: What is a heart attack?

A: The public's misconception is perhaps the same one that the medical profession had until 15 or 18 years ago. The popular belief used to be that the coronary arteries of the heart would just slowly and gradually accumulate debris and become smaller and smaller. Then, when the artery finally closed off, the person would have a heart attack because all of the blood and nutrients that were being supplied through a portion of the heart muscle was suddenly gone. Theft a portion of the heart muscle, now deprived of its blood supply, dies.