Being a Vegan- President Clinton and Heart Disease

President Clinton is now mimicking President Eisenhower, not in terms of foreign policy, but becoming obsessed with diet as a cure for his heart disease.  President Clinton revealed that he has become a vegan, and is under the tutelage of Dr. Dean Ornish – a proponent of getting rid of all but about ten percent fat in the diet.

The results, as they were with President Eisenhower- are not likely to be different.  Eisenhower ended up eating almost nothing but Melba toast and grapefruit, obsessed with his cholesterol level, and having more heart attacks until the last one killed him.

What is the evidence that a vegan diet is healthier for a person than a diet with animal proteins? None. There is no evidence that a diet that is based around plants or a diet with low animal fat does little.

Some will cite epidemiologic data- a poor source for data less than a level one.  If you cite epidemiologic data you have to explain all the data—and often they ignore the “French Paradox.”  Or ignore that while the Japanese eat little meat and have few heart attacks – their average consumption has increased over 22 percent with no increase in heart attacks (often people cite data from post World War 2 Japan, and not current Japan – and then ignore the data about stroke rate). When all epidemiologic studies are examined – one cannot justify a plant based diet on those.

Some cite the Journal of the American Medical Association (JAMA) study claiming that an animal based diet had more mortality than a plant based diet – but few have read the study.  While Dr. Ornish jumped on this study, saying it justified what he has been telling people- apparently he didn’t read the study either.

This study divided people into two groups- the low-carb group received 37 to 60 percent of their calories from carbohydrates (that isn’t low carbohydrate by any standard). The meat group was not divided out for those who smoked and were overweight (a higher portion of the meat group smoked and were obese). The vegetable group had 30 per cent of their calories from animals, as opposed to 45% for the meat group (so not really a vegetable group).  Once again, an epidemiologic study  and it is flawed.

What we do know from science about low-density-lipoproteins is that they fall into two groups- one group is far more deadly than the other, causing the majority of atherosclerotic plaques.  That is the group with the high tri-glyceride levels is the one that is deadly. Of this there is no doubt in the scientific community.  When the Very Low Density Lipoprotein and apo B – leading to high low density lipoprotein – leads the the increased in artery plaque leading to heart attacks and strokes.  The lower the triglyceride levels then the lipoproteins secreted by the liver become the subspecies of intermediate-density lipoproteins, which are far less cause of atherosclerosis than the others.  Where does the triglycerides come from? Not animal proteins, but primarily carbohydrates.

Bottom line from science – the more triglycerides – result in atherogenic small, dense LDL proteins – and this happens from carbohydrate rich foods.

What about Greece, and Southeast Asia, and Japan (after world war 2) . These populations barely had enough food to survive.  They didn’t use refined carbohydrates – and ate whatever they could. It was not the low-intake of saturated fat that protected them, rather the relative lack of a refined carbohydrate leading to low triglyceride levels. Those studies, championed by the late Ancel Keys, are still cited.  This in spite of overwhelming evidence to the contrary.

Back to President Clinton – a vegan diet will not save his heart. Saturated fat is not what led to the atherosclerotic plaques –  it may have been the abundance of triglycerides from highly processed and abundant carbohydrates. What he has done that will help him is, lose weight, have heart surgery, take medication –but  in terms of diet, President Clinton falls into what Eisenhower did, as well as every anorectic—when the only thing they can control is diet, they will fall victim to fads that sound healthy, are promoted by TV MD’s – but have no science to back them up.

If you want to be a vegan for health, there is no data to support that. In fact, vegans have a life expectancy that is less than pescetarians (fish eaters) and omnivores.President Clinton – a Vegan

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.

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Latest Comments

  1. Robert says:

    Right on the money, Doc! Never believed in veganism, and often felt very alone in that belief. Yet all my reading is in line with what you describe here (ps, I’m RosenetTV on Twitter).

  2. Poor Bill! “@KQEDscience: Fr… | Brent Kearney
    [...] sounds like he’s doing an Eisenhower :(… By @brentkearney on August 23rd, 2011 @ 11:21 • Comments google_ad_client = [...]

  3. John Boye says:

    I studied Ornish’s work after developing heart disease – severe angina was my main symptom – some years back. Following the advice in his books definitely helped me avoid pills and procedures. I’d seen several acquaintances reliant on drugs or undergoing what I consider to be ‘radical’ surgical interventions – angioplasty and bypass – with questionable benefit. I was determined to (in my own modest way) look for what might have caused my condition and, if possible, adopt a more ‘holistic’ approach to my treatment. I must say that within days of following the Ornish’s dietary advice I began to feel better. Incidentally, Ornish does not recommend a vegan diet. He allows skimmed milk, egg-whites and some fish. Interestingly, as I became more immersed in my ‘research’ I came across doctors Esselstyn and McDougall. Now, they certainly do recommend a very low fat vegan way of eating as the best response to and best protection against heart disease and the common cancers – breast and prostrate, to name but two. Ever the optimist, I switched to their recommendations and my symptoms virtually disappeared. Let’s put it this way, if I was getting these results from a pill I’d be hailing it as a miracle drug – and the drug companies would be even richer than they are! I simply don’t understand the animosity that is aroused in some people whenever vegetarianism or, heaven forbid, veganism is mentioned – I put it down to all that meat, fat and junk food they must surely be eating! Good Health!

  4. Vegan Billy says:

    I don’t know what the ‘nutritional issues’ are that a vegan has to deal with – as mentioned by a previous commentator. The only thing you won’t get from a vegan diet (unless you leave dirt on your veggies) is B12. This can easily be supplemented. There is no other nutrient we require that cannot be obtained from a vegan diet based on, say, rice, potatoes, corn, legumes, colourful vegetables and fruits. Yes, I do include protein in that assertion. Check it out! It’s simply incorrect to think you need meat and fish for protein or dairy ‘for calcium’. There’s loads of calcium in spinach, to name just one of the calcium-rich vegetables. Let’s replace some of this prejudice with facts!

  5. thedoc says:

    Confirmation bias– sad that you fell into it. Happy you are feeling better. Just did a bit about Esselstyn – he was also flawed. There is no evidence to support your claim. Sorry

  6. thedoc says:

    Don’t set up the straw man. If you are happy being a vegan- more meat for me. The life span of a vegan is not as long as a vegetarian and far less than someone who eats fish – but don’t let the facts interfere with your prejudice

  7. Ginger June says:

    Been vegan for 35 years and have never been sick a day in my life. We may not live longer but we sure look better. Hard to tell under the beard but you look pretty fat to me!!!

  8. The Doc says:

    Thank you for your kind comments. I became ill after smashing into a ski slope- but that was my shoulder and somehow I don’t think being a Vegan would have helped that.

  9. Baxter Montgomery, MD, FACC says:

    I have practiced in the Texas Medical Center for over 15 years. I have treated thousands of patients with a strictly plant based (vegan) diet. We find a very significant decrease in inflammation as well as an improvement in the lipid profile (decrease total cholesterol, LDL, and triglycerides) of patients who follow the diet. We see angiographic evidence of reversal of CAD. The data that supports the benefit of a plant based diet over an animal protein diet is overwhelming. You should read The China Study. You should also know that no study has shown elective heart surgery or angioplasty has been shown to improve survival or improve quality of life. The scientific and clinical data supports the benefits of a plant based diet over an animal protein diet. If eating meat was beneficial for preventing heart disease, former President Clinton would not have had coronary artery disease to start with.

  10. The Doc says:

    Working on the China Study now- significant issues with it. Angiographic evidence of reversal of CAD is very suspect, as you should know- and the materials published in the literature are not significant. In terms of survival benefit of CABG or angioplasty- it is rather difficult to believe that someone who is surviving ten years post LAD lesion is not an improved survival benefit. When you say scientific and clinical data supports- you are ignoring a large basis of evidence in the literature and cherry picking others. Still- I would like to see the citations (besides China Study which you can respond to later) and the published literature that you have with reversal

  11. Ted Rodosovich says:

    This may sound a little futuristic, buuuuuut, what sort of nutrition are we humans going to have in long space flights? Are we not going to have to depend on some sort of recycling with foods like those that are hyponically grown, etc?

  12. The Doc says:

    We are going to have this as a subject for a future post. Essentially Campbell’s China study did not show what he said it would show. First, there were major issues with how the study was done, second there were major issues with how he drew his conclusions. I’ll have a complete blog post about that in the future – -but here are a few tidbits: (a) The rural provinces that had increased meat intake had the LOWEST rates of deaths from cardiac disease and cancer and (b) He used data for mortality from the end of the cultural revolution, and not current mortality

  13. The Doc says:

    Great question- it will have to be a bio-sustainable form and not something that is brought on board. Right now they bring food for flights, and it is compacted and freeze dried. For long flights they will have to find a way to develop a self-sustaining environment.

  14. Vegetarian says:

    The main reason that I don’t eat meat is because I do not like to contribute to the murder or cruel treatment of animals. There are healthy and unhealthy vegetarians, vegans, pescetarians (people that eat fish and veggies) and omnivores. It is really up to you what you decide to do but we should all respect each other’s decisions and not condescend to one another. I, personally,know people who call themselves vegetarians and vegans who eat more “Junk” than about anyone. Eating a nutritiously sound diet is best regardless of if you eat flesh or not.

  15. The Doc says:

    I appreciate your reasons for not eating meat – and yes, I have done a lot of weight loss surgery on vegetarians and vegans who choose to eat unhealthy foods and do not eat a balanced nutritional profile. I agree, eating a balanced diet is key to health and weight loss.

  16. Lynn says:

    I am Jewish and keep a kosher diet. That means that I don’t eat at non-kosher restaurants nor do I eat pork products or mixtures of milk and dairy. Our religious custom is to eat fish on the sabbath. Not all of our foods are considered healthy, such as potato latkes, hamantashen, and chopped liver. I would say, looking around at my fellow Jews, that although there is plenty of obesity, (not me, I weigh 109lbs), I see very little heart disease. Unfortunately, there are some cases of breast, colon, and prostate cancer and Ashkenazic Jews have their own genetic mutation (not all cancers in Jews, however, are caused by that mutation), however I do not see much heart disease, despite the level of obesity. I wonder if the kosher diet, where all of our meat is cleansed of it’s blood and we don’t eat the rump of the animal, our meat is either from a cow, lamb, or poultry, (some occasional buffalo or deer), and we don’t mix milk and meat, is somehow protective against heart disease but not against cancer. I would say this Doc, I once cooked a duck and found it to be very fatty. I wonder if ducks are not the best foods. Personally, I have to juggle my diet between the medicine for thyroid, the medicine for breast cancer, and my family history of type 2 diabetes. That is the challenge that brings me to websites like this.

  17. The Doc says:

    Genetics plays a larger role in heart disease than diet ever will. And there are those who would state that the Kosher laws were health codes, and perhaps those health codes had implications that we are just understanding. Ducks are fine – especially if the fat is rendered out in the cooking process. Try Peking Duck- probably the best way it is cooked

  18. Jerry Jones says:

    You seem convinced that science is directing your opinions. Have you no biases? Are you not a carnivore? I’m under the impression that nutrition is hardly in the curricula of American medical schools. I appreciate all the work you have done/are doing to maintain this dialog with us. And I’m very grateful. But can you say you are comfortable with the amount of study completed discipline-wide on diet and nutrition? Do you really think you know what you are talking about, at least in regards to health and nutrition? Other sciences move it to the boldest of all levels. They make predictions. Care to predict the future results on studies of diet in relation to: heart disease, cancer, diabetes? Thank you.

  19. The Doc says:

    We all have bias – and what we learn in medical school is a system, but it is not in stone. My career is health and nutrition. I am never comfortable with the amount I study or research with nutrition, and am ready to change when the data comes out.
    In terms of predictions: diet will have little to do with cancer, in terms of cure or prevent, but it can cause. Heart disease – biggest step we made was cigarettes – in terms of nutrition, again a person can commit suicide with a fork but cure it– data isn’t there.
    Everyone wants food to have an answer – it is simple, magical thinking. We can toss terms around like a salad – natural, organic, plant based – but here is my prediction for the future (great blog topic) – there will be a great deal of genetic variation in how people respond to some foods, and how they process them. What is happening now is we see one group and try to make that a general bias — e.g. -gluten. So we will see that some respond better to one set of nutrition than others.
    Will it cure anyone- doubt it.

  20. Scott says:

    Hi Doc,
    I suppose you realize that diet has a strong correlation with disease development, in addition to other lifestyle factors,… but diet is major,… and quantities of the consumed foods and how the body processes them are also major factors.
    Btw, I’m an omnivore, basic four food groups, basic fundamental foods, variably.
    John Boye’s sharings of his experiences, above, are not matters of confirmation bias, going on what I’ve experienced, observed, and known from others with diet – health-lifestyle correlations, since 1984.
    Surgery, drugs, and medication/drugs can be quick fixes, and necessary sometimes to save further harm,…but the reason the disease problem occurred can be controlled by diet, quantities, balance, and lifestyle, all together. I’ve created ‘disease’ and cured ‘disease’ in my own self, simply as a matter of the foods, quantities, and balance,…. and I can create disease,… not as confirmation bias,… I’ve seen enough repeated responses, subtley more or less, with my body with some foods in some quantities, and can make the correlation with what is consumed and my body’s response.
    I’m speaking in generalities here. If you want more specific info I can share. And there is variability among people to one degree or another, due to being different and having different life circumstances.
    Our bodies respond to everything we consume. We have control to a large degree with how our health is and susceptibility to disease. Food is for fuel and maintenance. And it’s up to us to be aware of what works well for us, in appropriate quantities, so that our body can properly process.
    ‘Developed disease'(I suppose there’s a medical term for it, such as with athero/arteriosclerosi, arthritis, cancer, acne, or acute symptoms such as cracks, … and on and on) is basically due to imbalance and immoderation, resulting in varied issues with the body, variable per the disease type.

    Sincerely, with repeatable experience, and variable per the circumstances,
    Scott

    p.s. Bottom line, so top speak,….: be in tune with your body

  21. Scott says:

    Meat and heart disease are not a direct a correlation,…. plant materials, such as plant oils and some starches are at least as highly suspect. Moderation is necessary with anything. Animal products are no more likely to cause disease than are plant products,… different diseases can be developed by different types of foods within both categories, depending on the quantities consumed, and the balance with the rest of ones dietary.

  22. Scott says:

    Vegan Billy,
    Other ‘nutritional issues’ with veganism are inadequate protein and fat absorption, or of the ‘right’ ‘forms’ of protein and fat which the body can make use of, as can be shown by the characteristics of ones skin quality especially in colder seasons(cracks are more likely to occur on the sides of ones fingers), and the ones ability to keep adequately warm(not able to warm up as well). These are demonstrable, repeatable results, variable per person.

  23. mhikl says:

    I’m so glad you upgraded to “probably” regarding curative measures of foods.
    The SAD (Standard American Diet) surely will kill you. Going primal may cure you. I’m not so sure of primal vegan but a good mix of animal fats and proteins, green vegetables and modest fruit could be curative. No, food, good food, can cure. Maybe it is the absence of bad food, but what is one’s bad food is the health mantra of nuts like Dean Ornish.

    It will be interesting to see how Bill fairs under the guidance of the terrible Dean Ornish. The powers of the media, corporations, the government, the medical profession, the list goes on are hard to ignore. Isn’t there something from antiquity about the body healing itself. That does not come from downing Ornish’s blather anymore than from the diet fair of MacDonald’s.

    We must all take responsibility for our own deaths and plan according. Being surprised and pissed at the end means you did not deal with your inevitability. But when you feel like trash from such indulgences as DAD or ODH (Ornish Diet from Hell), who has time to contemplate the mysteries of life and death. (Funny how we plan for that Trip to Anywhere, but never for the Greatest Trip of all time, Death.

    We bless our toes as we sprint for big Mac, but we curse them when we stumble. Sound like some ancient Chinese wisdom.

  24. Krishan says:

    OMG finally sonemoe who sees the big picture.It’s an uphill battle with some of my clients because they want to try everything on the market for their weight loss, all I tell them is keep your money and change the way you live your life and what you eat. Food is meant to be enjoyed!It’s all about balance because how you live your life is a direct reflection on what you will eat.Amen for brining it up!

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