The following figure shows a representative patient in our study. This is what reversing heart disease looks like. He entered our study in 1986 at age 64. At that time, he had severe coronary artery disease involving all of his major coronary arteries and was advised to undergo coronary bypass surgery due to severe angina. When he entered the study, he was unable to walk more than a few steps without severe chest pain.
After six weeks, he was pain-free and was no longer advised to undergo bypass surgery. By the end of the first year, he was able to climb 130 floors per day on a StairMaster with no angina. His PET scan revealed a 300 percent improvement in blood flow to his heart, and his angiogram revealed reversal of coronary atherosclerosis. He also lost 30 pounds.
The picture in the upper-left-hand corner is the "before" picture of his angiogram, showing a significant narrowing in the coronary artery. One year later, in the upper-right-hand photo, that area is significantly wider.
The PET scans of the same patient are shown in the bottom two pictures. Different shadings correspond to how much blood flow each region of the heart received--the darker areas are receiving very little blood flow to the heart, whereas the brighter ones are receiving the most blood flow.
The picture at the lower left revealed that much of this patient's heart was not receiving adequate blood flow, as shown by the large dark areas. One year later, in the lower-right-hand picture, you can see that most of the darker areas are now gone, replaced by brighter ones, showing substantially more blood flow.
These tests were read by scientists who did not know which group the patient was in--in other words, whether or not the patient had changed his or her lifestyle. This helped prevent any possible bias from affecting how the studies were read and interpreted.
Amazingly, 99 percent of patients on our program were able to stop or reverse the progression of their heart disease. There were also 21/2 times fewer cardiac events such as heart attacks, bypass surgery operations, angioplasties, and hospital admissions.
We found a direct correlation between the amount of change in diet and lifestyle and the amount of change in these patients' coronary artery disease after one year and also after five years.
In other words, the more people changed, the better they got. This is a theme that I will be repeating throughout the book, and it is one of the foundations of The Spectrum.
Similar findings were published five years later by Dr. Caldwell Esselstyn and his colleagues at The Cleveland Clinic. In a follow-up medical journal article, he reported that none of the patients who remained adherent to the nutrition and lifestyle program showed progression of their coronary heart disease.
The program works in the real world.
When I first began conducting research as a second-year medical student in 1977, the idea that the progression of heart disease could be reversed was thought to be impossible by most doctors. They thought that, at best, diet and lifestyle changes might slow down the rate at which the disease progressed, but it could only get worse over time. Equally improbable was the belief that most people would be able to change their diet and lifestyle.