Ann, Jane and Caldwell Esselstyn, The Prevent and Reverse Heart Disease Cookbook

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Ann Crile Esselstyn is a relentlessly energetic and creative advocate for the plant-based, whole-food way of life. She has devoted herself to inventing recipes to prevent and reverse heart disease in support of the research of her husband, Dr. Caldwell Esselstyn, Jr. Ann never stops looking for ways to bring that important agenda to delicious life, devising ever more practical and powerful ways to shop, cook, and engage even the most reluctant eaters in the plant-perfect diet.

Ann is the author of the recipe section of Dr. Esselstyn’s bestselling book, Prevent and Reverse Heart Disease, and co-author of The Prevent and Reverse Heart Disease Cookbook with her daughter, Jane Esselstyn. She is a graduate of Smith College and holds a Masters in Education from Wheelock College. Ann taught English and History for 27 years at Laurel School in Cleveland, Ohio, where she received the Hostatler Award for Outstanding Teaching. At the same time, she juggled the raising of four children. When not in the kitchen, Ann counsels patients, lectures around the world on how to prepare and eat plant-based foods, and spends time with her ten plant-based grandchildren.

Jane Esselstyn is a fresh and charismatic voice on the plant-based, whole food diet. She brings her perspective and passion as a long-time health and sexuality educator to creating on-ramps to the plant-based way of life. Jane is an avid and inventive designer of plant-based recipes and the co-author of The Prevent and Reverse Heart Disease Cookbook with her next door neighbor and mom, Ann. She is also the author of the recipe section of her brother Rip Esselstyn’s most recent book, My Beef With Meat.

Jane has worked as a science, outdoor, and health educator for over 25 years. During her years teaching sex ed to middle school kids, she has developed a powerful curriculum around healthy sexuality and development in the digital age. A tireless champion for kids and their health, Jane brings remarkable clarity, compassion, and humor to the most difficult conversations-for kids and parents alike. Jane met her husband and fellow educator, Brian Hart, while working as a field instructor for Outward Bound. They have three plant-based children. Jane graduated from the University of Michigan, where she competed nationally as a recruited swimmer and rower, and earned a B.S in Nursing from Kent State University.

Caldwell B. Esselstyn, Jr., received his B.A. from Yale University and his M.D. from Western Reserve University. In 1956, pulling the No. 6 oar as a member of the victorious United States rowing team, he was awarded a gold medal at the Olympic Games. He was trained as a surgeon at the Cleveland Clinic and at St. George’s Hospital in London. In 1968, as an Army surgeon in Vietnam, he was awarded the Bronze Star.

Dr. Esselstyn has been associated with the Cleveland Clinic since 1968. During that time, he has served as President of the Staff and as a member of the Board of Governors. He chaired the Clinic’s Breast Cancer Task Force and headed its Section of Thyroid and Parathyroid Surgery.

In 1991, Dr. Esselstyn served as President of the American Association of Endocrine Surgeons, That same year he organized the first National Conference on the Elimination of Coronary Artery Disease, which was held in Tucson, Arizona. In 1997, he chaired a follow-up conference, the Summit on Cholesterol and Coronary Disease, which brought together more than 500 physicians and health-care workers in Lake Buena Vista, Florida. In April, 2005, Dr. Esselstyn became the first recipient of the Benjamin Spock Award for Compassion in Medicine. He received the Distinguished Alumnus Award from the Cleveland Clinic Alumni Association in 2009. In September 2010, he received the Greater Cleveland Sports Hall of Fame Award. Dr. Esselstyn received the 2013 Deerfield Academy Alumni Association Heritage Award In Recognition of Outstanding Achievement & Service, and the 2013 Yale University GEORGE H.W. BUSH ’48 LIFETIME OF LEADERSHIP AWARD.

His scientific publications number over 150, “The Best Doctors in America” 1994-1995 published by Woodward and White cites Dr. Esselstyn’s surgical expertise in the categories of endocrine and breast disease. In 1995 he published his bench mark long-term nutritional research arresting and reversing coronary artery disease in severely ill patients. That same study was updated at 12 years and reviewed beyond twenty years in his book, Prevent and Reverse Heart Disease, making it one of the longest longitudinal studies of its type.

Dr. Esselstyn and his wife, Ann Crile Esselstyn, have followed a plant-based diet for more than 26 years. Dr. Esselstyn presently directs the cardiovascular prevention and reversal program at The Cleveland Clinic Wellness Institute.

The Esselstyns have four children and ten grandchildren.

TRANSCRIPTION:

Caryn Hartglass: Hello everybody, we’re back. I’m Caryn Hartglass and you’re listening to It’s All About Food here on September 2^nd, 2014. I want to bring on my next guests. We’ve got the Esselstyns, talking about the new The Prevent and Reverse Heart Disease Cookbook. So who have I got there?

Jane Esselstyn: You’ve got Jane and Ann, and I believe my dad’s on the phone as well.

Caryn Hartglass: Okay so you’re Jane?

Jane Esselstyn: I’m Jane.

Ann Esselstyn: And I’m Ann.

Caryn Hartglass: And Ann. I’m trying to differentiate the sound of the different voices. And Dr. Esselstyn?

Dr. Esselstyn: Yes, thank you.

Ann Esselstyn: You can tell it’s him.

Caryn Hartglass: I can and that resonant baritone voice. How are you all doing?

Jane Esselstyn: Well we’re great. We’ve been reading about amazing you.

Caryn Hartglass: Amazing me? Well thanks for reading. You know, Ann and Dr. Esselstyn, I met you about ten years ago when I was Executor Director of EarthSave International. I had you come out and speak to my chapters here in New York, and people are still talking about it. You were both so wonderful and made a big difference in a lot of people’s lives, so thank you for that.

Dr. Caldwell Esselstyn: Thank you.

Caryn Hartglass: And you continue to be amazing, so let’s have an amazing half hour shall we?

Ann Esselstyn: Great!

Caryn Hartglass: Okay so you’ve got this great cookbook with lots of easy ways to get people healthy and it’s a continuation of Dr. Esselstyn’s wonderful book Prevent and Reverse Heart Disease. This is all good news and more people are getting it but unfortunately not everyone is getting it.

Jane Esselstyn: True.

Caryn Hartglass: And this is the frustrating part. I just want to talk briefly about some of the things going on in the world today and then maybe we can get into the delicious recipes you’ve got going to inspire people to do what is so easy, wonderful and good for us. Number one, Dr. Esselstyn; you were part of President Bill Clinton’s move to a healthier diet. That made a lot of press and that was really exciting. But he’s kind of gone… he’s not following your recipes exactly. Dr. Mark Hyman is recommending fish and eggs, and he can’t get quality protein with plant foods. How do you feel about that?

Dr. Caldwell Esselstyn: Well I respectively disagree.

Caryn Hartglass: Oh good!

Dr. Caldwell Esselstyn: I think the data are really quite clear that animal protein adds a dimension of injury so that the life jacket and guardian of our blood vessels, which happens to be that single-layer-thick delicate [2:58] called the endothelium. And the endothelium manufactures that absolutely marvelous molecule and gas called nitric oxide. Nitric oxide is our great savior but anybody who has cardiovascular disease, whether that’s a stroke or a heart attack – the reason we have it in the first place is they have so-successfully over the preceding decades progressively trashed and injured the endothelial carpet that they no longer have sufficient nitric oxide to really protect themselves. And also, there’s a remarkable separate venue of research from the Cleveland Clinic by Stan Hazen and his team that clearly shows that in people who are omnivores or eating meat posses the type of intestinal bacteria flora that can metabolize those products into a very aggressive, faster disease causing molecule called TMAO.

Caryn Hartglass: Oh I loved that research when it came out.

Dr. Caldwell Esselstyn: So that’s my comment.

Caryn Hartglass: Okay, unfortunately people are always looking for a reason to eat animals. Some doctors give them reasons whether they are justified or not unfortunately. Then the other thing is that you probably know the two articles on salt that just came out in the New England Journal of Medicine that are completely contradictory and it’s driving everybody crazy. One said we need between 3000 mg and 6000 mg of salt, and the other one said we should get under 2000 mg.

Dr. Caldwell Esselstyn: Well actually, the body has a remarkable way of preserving sodium in people’s kidneys. Really, you’re probably going to get all the sodium you need with food. On the other hand, if your food is cooked without salt and you think it’s a little flat with flavor, there’s absolutely no harm in sprinkling, using a salt shaker, for a little added salt. You’re not going to get very much at all from that. I’m really not going to get involved in that wrestling match over sodium because that’s really reducing it to what I call, actually what my good friend Colin Campbell calls it, reductionism, where you focus on one single small item.

Caryn Hartglass: Yes.

Dr. Caldwell Esselstyn: The body, when you come right down to it, is a symphony of really hundreds of thousands of reactions going on at all the same time. When you think about the people like the Okinawans who are documented to have the longest-lived citizens of anywhere else on the planet. You just know that they’re not just sitting there every day counting and wrestling with their sodium. They are just eating it, rather what we call sensibly. If you have something that tastes good and is not overloaded with salt, you are probably going to be quite safe.

Caryn Hartglass: Well I really appreciate the fact that in this cookbook you did not include the calorie breakdown and the nutritional breakdown. It’s all part about what you just said. I don’t know how anybody could sit down and prepare a meal thinking about the numbers of what they’re getting and what they’re not getting.

Dr. Caldwell Esselstyn: Eating has to be an absolutely joyous experience and you don’t want to eat with a calculator.

Caryn Hartglass: Right. Okay so let’s talk about the joyous experience here. Now, when did you all start eating this way?

Jane Esselstyn: I know I was just starting college when they started to eat this way so they were probably…

Dr. Caldwell Esselstyn: April of 1984.

Caryn Hartglass: This is Jane speaking?

Jane Esselstyn: And my dad.

Caryn Hartglass: Right, obviously. So Jane, what was your reaction when this happened?

Jane Esselstyn: Well I had a phone call. I was talking to my brother who was in high school. There are four of us within four years and my brother who was still home said “Mommy and daddy have changed the way we eat around here. No meat, dairy, sugar, fat, oil or salt.” When they first started it was this big swath. Well I just said what are you guys eating then?

Caryn Hartglass: What are you eating?

Jane Esselstyn: It was sort of befuddling at first like it is for most people.

Ann Esselstyn: The amazing thing, this is Ann, is that they all went off to college and they took our breakfast which was oats just without cooking them. You know, dry oats with alternative milk and whatever, and started spreading that among their friends. Incredibly, all our children, all four and all our ten grandchildren, are all plant based. It’s wonderful. When they were growing up, they were nourished and then they drank water.

Caryn Hartglass: Right. Well that’s the way it should be and that’s the way it’s the most successful. My heart goes out to people who want to change their diet but people in their family, their spouse, their children or parents, give them a hard time and don’t support them. So your whole family as a pact is just a great model.

Ann Esselstyn: Thank you.

Caryn Hartglass: Yes!

Ann Esselstyn: One of our nieces was abroad this summer and she was arguing with a family, a very famous rock star and her family, about eating vegan. Just the more she argued the more she became absolutely focused and convinced. It was so cute to have a fifteen year old just fighting out there with people who are clueless.

Caryn Hartglass: Yes, clueless.

Ann Esselstyn: Or they were defending what they thought was true and what works for them.

Caryn Hartglass: So there are many people now that are using the word trend with this kind of eating, that it’s very trendy. We know it’s not trendy, in fact…

Ann Esselstyn: How can this be trendy because it’s the same thing? Nothing has changed. It’s been like this how many years? Thirty, I mean there’s no trend.

Caryn Hartglass: I’ve been doing it for almost thirty years myself.

Jane Esselstyn: Well you know it’s so interesting, last night we were watching a documentary about – do you remember the ice man that was found in the glacier maybe a decade or so ago? They recently did some research on him in Europe. My husband was watching this and he’s like “Jane get over here! Look, they found the iceman had calcification in his arteries and that he was lactose intolerant all from his DNA!” And you know what? We aren’t supposed to drink milk. I mean no one past the age of weaning drinks milk. Lactose intolerance is not a disease; it’s how we’ve always been. So that whole part of the equation is not trendy, it’s pretty much the DNA. That this guy was young, hiking around this glacier for whatever reason with heart disease from his diet seemed quite interesting.

Caryn Hartglass: Yes.

Jane Esselstyn: So I’m trying to debunk the trend by saying that for five thousand years this has been the way.

Caryn Hartglass: And when people talk about the Paleo Diet too, which is just crazy because there’s so many different variations of Paleo and so many different ways you can cheat.

Ann Esselstyn: When you look at Paleo bread…

Dr. Caldwell Esselstyn: I think the thing that is pushing plant based nutrition is that increasingly now, there is really some hard science coming out in cardiovascular disease and how it can be reversed, diabetes and how it can be reversed, obesity and how it can be reversed, and hypertension and how it can be reversed. Just to name a few of those common chronic killing diseases that in truth, never exist with plant based nutrition.

Caryn Hartglass: What do we do, Dr. Esselstyn, with the doctors that don’t know this or don’t support it?

Dr. Caldwell Esselstyn: Well the interesting thing is that takes a while. For instance tomorrow, I’m giving a ground rounds in a hospital in Akron. Increasingly in the past year I’ve had an opportunity to get cardiology ground rounds in Boston, in New York City, and over the last several years in 19 different academic institutions. The word is out. I think what really is going to crystallize this rapidly is when you have large insurance situation like Kaiser Permanente on the on the west coast and elsewhere. When they really tumble to this and get their constituents to begin to eat plant based food, to protect them from having all these procedures such as stints, bypasses and angioplasty. And all the drugs that are consumed for this disease; when they find that this disease, which is nothing more than a food borne illness cardiovascular disease can be vanquished, their savings will be enormous. Then they will be able to reduce their premiums hopefully.

Caryn Hartglass: Well that’s the American capitalist ways and when it all comes down to the bottom line, that’s how we’re…

Ann Esselstyn: But another think I think and this is Ann. I think the patients in time are going to begin to show the doctors the magic of eating plant based nutrition. I mean so often we hear from patients that my doctor can’t believe it, “Well what are you doing? I’ve never seen this before.” I think there’s a huge teaching possibility in those patients.

Caryn Hartglass: Yes. Now let’s move to delicious foods. I love the dedication. You mentioned all of my favorites, all the dark leafy green vegetables that make up my life. And I really…

Ann Esselstyn: You need to hear that dedication; he can give you that dedication right now.

Caryn Hartglass: Okay, this book is dedicated to bok choy, Swiss chard, kale…

Ann Esselstyn: You got to do it, say it.

Caryn Hartglass: Oh yes, okay.

Dr. Caldwell Esselstyn: Bok choy, Swiss chard, kale, collards, mustard greens, turnip greens, Napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley, spinach, arugula and asparagus.

Caryn Hartglass: That’s nice; we need to write some music to that now.

Ann Esselstyn: Well my favorite thing, we have the most wonderful Avery Publishing Company and I just love that they put that idea so perfectly out there in that dedication.

Caryn Hartglass: Well I know dark leafy greens saved my life and they’re just a powerful food. I have learned to just love them in so many ways

Ann Esselstyn: And we have lots and lots of recipes in the book with greens incorporated in things like if you’re making pizza, you can put mixed kale in the pizza sauce before you spread it on the first layer of pizza. You don’t even know it’s there because the pasta sauce dominates.

Caryn Hartglass: You can put kale in everything including cake.

Ann Esselstyn: How about kale cake with blueberry frosting? I wanted that on the cover!

Caryn Hartglass: I think that might take a little while for people to try that one but kale goes with everything and it should, why not? Okay, I’m moving through this book here. So one of my favorites; I really like simplicity and when a little light goes on. So you grill pineapple rings?

Ann Esselstyn: Yes.

Caryn Hartglass: What a great idea that is.

Jane Esselstyn: They’re amazingly sweet and surprisingly delicious.

Caryn Hartglass: And putting that with a burger, so good!

Jane Esselstyn: So good! Not the beef burger, but the beet. The cool thing is in the beet burger that they have got the whole beet and all the beet grains in them. They are just the powerhouse of nutrition. And a little bit of hope behind that recipe is that my parents actually were served that beet burger with a grilled pineapple by three college students who were excited about eating a plant based diet and they had a chance to make a meal for my parents. That’s what they made, isn’t that amazing?

Caryn Hartglass: It is amazing but it just takes a little openness.

Jane Esselstyn: Yes.

Dr. Caldwell Esselstyn: When we have guests, I think it’s important to share with you, one of the favorite meals that I first tumbled too when I was really thinking about all of this. It’s so basically simple and it’s simply rice and beans, then a tremendous variety of toppings that you can put on top of that. Everything from tomatoes, peas, corn, water chestnuts and scallions, and top it off with delicious salsa or tamari and you’ve got an absolute feast.

Ann Esselstyn: One of our favorite recipes in the book is something called sofrito black beans with this incredible mango lime salsa. It’s just gorgeous and delicious.

Caryn Hartglass: Okay this is my favorite subject. I love talking about food, I love eating my food, and I love creating new food and reading cookbooks on plant foods. I don’t think there’s anything better on the planet to do with your time. So many people unfortunately don’t cook and don’t want to cook.

Jane Esselstyn: Well they should cook.

Caryn Hartglass: They should. What are we going to do with them? Do we just try and hope they learn where their kitchen is?

Jane Esselstyn: Well I haven’t pointed out the amount of time they have had to have their nails done or watch the sixteen shows that they’ve been watching or the tattoo of the Last Supper on their back they had just printed up. They have time. The priority sometimes takes a skillet to the head to get you into the kitchen. Something happens or you certainly don’t like the feeling or the shape or the size or the pathology of what’s happening with your body. For some people, it’s like any change – some people are just go off the cliff. Some people make their way there.

Caryn Hartglass: Yes, cooking and preparing food does affect your nails and how they look.

Ann Esselstyn: Well you know what I think. I do think that young people today, especially males, are so much more into cooking than when I was young.

Caryn Hartglass: Yes.

Ann Esselstyn: I mean unfortunately my husband isn’t a cook. He’s a fabulous dishwasher which makes up for it but our grandchildren, our older grandchildren, are cooking and that’s cool.

Caryn Hartglass: Well it’s really important to find the kitchen and learn how to make a few meals. Not just because it’s good for you, because it is, but I think it also helps to understand what goes into your food and know what you’re eating. People don’t even know what’s in their food.

Jane Esselstyn: Yes I mean what was Michael Pollan’s recent book… Cooked: A Natural History of Transformation?

Caryn Hartglass: I don’t remember the title.

Jane Esselstyn: Just get in the kitchen. I was like “right on, he’s right!”

Caryn Hartglass: Now what do you do when you are going out to eat.

Ann Hartglass: What makes you think we go out to eat?

Caryn Hartglass: Okay, somebody travels in this family…

Dr. Caldwell Esselstyn: There are three reasons to go out to eat. One, is you don’t have to do the dishes; two, is the ambiance; and three, is the companionship. But you never ever go out to further destroy your endothelial cells.

Jane Caldwell: No, but let me say that more and more you can get wonderful food when you go out. We also have found that if we’re going somewhere that is a fairly good place, if you call ahead, they will shock you with what they can create. One of our favorite places is just the Currito Burrito at the Cleveland Airport where we can get rice, beans, broccoli, corn and just a whole pile of good things.

Caryn Hartglass: That’s right. As long as you know what to leave out, a burrito is an incredible food.

Jane Caldwell: Well I don’t even get the bread; I just get it in a bowl.

Caryn Hartglass: Well there you go.

Ann Caldwell: It’s just wonderful. I mean I look forward to going to the airport.

Caryn Hartglass: Okay now, one of the things that you’re known for in The Prevent and Reverse Heart Disease Cookbook is the fat. No oils and little or no nuts.

Dr. Caldwell Esselstyn: Well the problem with the oils is that the oils would, there are actually some excellent peer-reviewed scientific publications. Oils have been shown to injure endothelial cells. We’ve seen it with patients when we want to stop the oil, often we will see their chest pain rapidly begin to disappear. So we certainly don’t want to have people consuming something that is going to injure them. Especially when you think about, there is really no mineral in oil, no fiber in oil and maybe a tiny bit of vitamin E but other than that, oil is fat. And the fat is dangerous fats. Now the other thing you mentioned was nuts. Now here I will confess to being guilty. When my patients have so-injured their endothelial cell mass that they can’t make enough nitric oxide to protect themselves, the actual additional saturated fats that comes from nuts, it’s something I certainly don’t want them to have. The problem with that is, how many people do you know will eat one nut? In other words, if I ever said people should have one nut, that’s not what they would hear. It will be Dr.Esselstyn said nuts are fine.

Caryn Hartglass: And it will open the can…

Dr. Caldwell Esselstyn: So they’re in the glove compartment, the work bench, the bathroom, the bedroom, the kitchen and everywhere. They’re in all kinds of food. I have never felt guilty in asking people not to eat nuts.

Ann Esselstyn: But you know what, in our book, there are no nuts.

Jane Esselstyn: There are no nuts. We are adhering to that guideline. No nuts in any of the sauces or dressings or recipes. We don’t need them.

Ann Esselstyn: I think it really separates our book from everything that’s out there today. I mean that two-thirds a cup of cashews will make a creamy sauce. But we don’t have that and you don’t miss it. We have really amazing things without those nuts.

Dr. Caldwell Esselstyn: It always comes down to what are the outcomes. What are you getting for results? We just published in July our results with some two-hundred patients and the 90% who were adherent to our program. These patients who were ill, with advanced cardiovascular disease, totally vanquished any recurrence of their disease and 99.4% of the patients over the next close to four years.

Jane Esselstyn: And they did so by eating this way. So that’s why we thought we had to write this book. We had to get more recipes out there because honestly, we have gotten better and better with our recipes and our flavor profiles the longer we’ve eaten this way. The only reason we can eat this way, as a family of twenty people now, is because it’s easy, it tastes great and it’s not a burden. Yes, it’s loaded into our hard drives, into our minds and our kitchens but it’s just so simple.

Caryn Hartglass: Well I know that the people, when you tell them not to eat animal foods, that’s like one step, what am I going to eat? I can’t imagine not eating this, that and the other thing. Then when you say no oil, a lot of people just freak out. “What! No oil?” But it’s not hard to do and it’s just all benefits.

Ann Esselstyn: I agree, we have got and I think a truly exciting chapter. I don’t even know how many salad dressings because I think once you’ve figured out a salad dressing that you like that has got no oil in it, you are set. First of all, just imagine the calories that you’re not having if your thinking that way. That is just a triumph I think in this book, just an amazing variety of salad dressings.

Caryn Hartglass: The more I restrict from my diet, the more varied it comes.

Jane Esselstyn: Well said!

Caryn Hartglass: Which seems kind of counterintuitive but it’s so true.

Jane Esselstyn: It can open you wide up to everything that’s out there when you turn yourself the other way.

Caryn Hartglass: Hello herbs, spices and vinegars, and all the fruits and vegetables that are out there.

Jane Esselstyn: Don’t get my mom going on vinegars, oh my goodness. She is like the acid queen; vinegar on everything!

Caryn Hartglass: The acid queen!

Jane Esselstyn: But we discovered the flavored vinegars and they’ve become the salt.

Caryn Hartglass: Yes, actually sometimes, aside from ume shiso vinegar which is just loaded with salt, vinegar can taste salty in a way when you are used to not having salt.

Jane Esselstyn: Or sweet. It occupies your tongue. Your tongue is happy when it gets a hit.

Caryn Hartglass: Well we’ve come to the end and I really appreciate having the family here on the show today, you are all wonderful.

Dr. Caldwell Esselstyn: Thank you.

Caryn Hartglass: Thank you so much.

Ann Esselstyn: Well you’ve been wonderful!

Jane Esselstyn: You’re wonderful, thank you.

Caryn Hartglass: We’re all wonderful!

Ann Esselstyn: I think it’s how we eat.

Caryn Hartglass: Yes, I totally agree. When you love your food, you’re just full of love. Okay, take care.

Jane Esselstyn: Thanks, bye-bye.

Caryn Hartglass: Thanks. Well that was the Esselstyns; Ann Esselstyn, Dr. Caldwell Esselstyn and their daughter Jane Esselstyn. I’m Caryn Hartglass and you’ve been listening to It’s All About Food. Join me at www.responsibleeatingandliving.com, that’s where I live. Send me an email at info@realmeals.org and remember, have a delicious week.

Transcribed by Stefan Pavlović, 10/17/2014