Vascular Disease Explained – How plants are related to endothelial function, heart health, and erectile dysfunction

My father-in-law loved telling the story about picking his son (my brother-in-law) up from his SATs back in the late 80s.  My father-in-law didn’t consider himself “book smart” and his kid was a straight-A student.  When he got in the car, my dad asked him, “Well?  How did it go?  Was it hard?” My brother-in-law wasn’t known for his lengthy discussions and answered nicely and innocently, saying,

“Not really.  It’s only hard if you don’t know the answers.”

It might seem like a stretch, but this same logic rings true for me as I’ve embarked on my own search for a healthier life – specifically trying to avoid obesity and chronic disease.  Not just every day ailments, but the long-term diseases that claim the lives and greatly reduce the enjoyable years of most of our friends and family members.  I say “enjoyable years” because I’ve come to understand that our ultimate goal should not be just adding years to life, but also adding life to years.

For a long time, I didn’t know the answer to that question.  But now I believe I do…  So what is it? <I’m not going to make you wait until the end for a dramatic reveal like the 5 o’clock news>  The answer is simple: healthy, happy blood vessels.  More specifically, happy healthy endothelial cells.  I must give credit to Dr. Caldwell Esselstyn from the Cleveland Clinic who is largely responsible for shedding the national spotlight on the importance of our blood vessels.  The ugly buzzword is “Heart Disease”, but really, that just ends up being the final nail in the coffin, the result of decades of abuse upon our endothelial cells which line our blood vessels.  And invariably, our bodies have long suffered from unhealthy blood vessels for years and years prior to the final catastrophic event.

Imagine a large sewer pipe flowing beneath a road.  Think of a diameter of about 3 feet, similar to the one that Andy Dufresne crawled through on his quest for freedom in Shawshank Redemption.  Those are your heart’s main arteries responsible for all of the blood feeding this massively important heart muscle.  Inside of these large pipes, there are huge pillows, the same size as the ones you sleep on at night.  They are soft, comfortable, and clean.  These pillows are responsible for allowing your blood vessels to pump, bend, and generally do what they’re intended to do.  These pillows release all kinds of helpful chemicals that keep your blood vessels happy and supplying life-giving blood to all of the cells in our body.  There are smaller pipes and smaller pillows in other areas of your body of course, but the same mechanism is at play.

From eating a high fat diet (often mistakenly called a high protein diet), heavy in animal foods and processed foods, you can develop a layer of plaque.  Picture it behind those pillows.  It builds up and pushes against the pillows until it finds a weak point.  The pillows blow out into the central section of the pipe, and clotting factors in the blood create a blockage.  Blood flow stops and you’re in trouble.  If this happens in your heart, it’s called a heart attack.  In your brain, it’s a stroke.  Or mini-versions in your brain, laying the groundwork for dementia.  Improper blood flow and plaque formation in your penis, it’s erectile dysfunction.  Different names, essentially the same disease.  Some sooner, some later.  With healthy endothelial cells, the plaque never finds its way into your bloodstream, and your blood vessels remain strong, stretchy, and happy.  Preserve the pillows and you’re on your path to freedom.  Destroy them and you’re on your way to a life of disease and disability.  Or all too often, sudden death.

Everything you put in your mouth either helps or harms these pillows. Furthermore, some things are REALLY good or REALLY bad.  Most of you can probably sort your diet from the past 24 hours into 2 columns pretty easily.  The only way to win this game of health is to have almost all of your diet fall into the list of helpful or REALLY helpful, greatly reduce the harmful, and completely ELIMINATE the extremely harmful.  See the Q&A below for hints on what to eat.

This is actually an amazingly convenient answer because if you work hard to stay true to a lifestyle that avoids one type of vascular disease, you get to avoid them ALL!  Yes, 100%.  They are all products of decades of attack on our endothelial cells (aka pillows).  Dr. Esselstyn has a wonderful lecture which he boldly named “Make Yourself Heart Attack Proof”  – and it should be required viewing for the entire country.  His explanations are entirely backed by scientific evidence.  While it may be viewed as an inconvenient lifestyle change to some, I think having open heart surgery or spontaneous premature death is significantly more inconvenient.

I could go on and on and on, and maybe I’ll write another guest blog soon, or feel free to ask questions in the comments below and I’ll be happy to chime in with answers.  But getting back to the original story about my dad and brother, here are some common questions I get asked frequently and I know the answers to:

1. What’s the key to avoiding heart disease, our #1 killer? Healthy blood vessels.
2. What’s the key to avoiding stroke, dementia, Alzheimer’s, erectile dysfunction, etc? Healthy blood vessels.
3. How do I know if my blood vessels are healthy? Most directly, a total cholesterol under 150, without medication which just confuses the impact of this number.
4. How do I obtain a total cholesterol under 150 without medication? Plant-based diet without oil and limited processed foods.
5. I’m really active, can I out-exercise a bad diet?  Nope.  Dr. Esselstyn’s research has shown that most marines in their mid-late 20s, in the best shape of their lives, had evidence of heart disease upon autopsy.  If they have heart disease, I rest my case.
6. My doctor said that my cholesterol is under 200, and that’s good, so isn’t that enough? Probably not.  Many Americans have heart attacks with cholesterol levels between 151-200, but if you’re under 150, you can feel very comfortable.
7. Can I still eat some meat? Some eggs?  Some cheese?  And still get my cholesterol under 150?  I highly doubt it, and I wouldn’t recommend trying.  Dairy (including eggs) and meat act like little razor blades floating through your blood vessels, damaging your endothelium on a daily basis.  Once you pop those pillows they no longer protect you.
8. How do I repair my endothelial cells? Eat plants.  As many as you can.  Green leafy ones are most potent, but all of them are fantastic.  Potatoes, beans, rice, fruit, oats, berries, raw nuts, all veggies, seeds, hummus, etc.
9. What about moderation? It’s ok if you can tolerate a moderately reduced chance of dying spontaneously.  Or a moderately reduced risk of Alzheimers.  Is a hard boiled egg just sooooo worth it?  No, not to me at least.  Imagine you have a scab on your shin and for 99% of the day you leave it alone, but the other 1% of the day, you pick at it.  Will it ever heal?  These are your endothelial cells under attack every day.
10. Is there any good news?  YES!  The same plant-based diet reduces the risk of all cancers, essentially cures most diabetes, and is great for the environment.  And you’re not alone.  In 2014, 1% of people identified as vegan.  In 2017, it’s at a whopping 6%!

So in conclusion, it’s true that if you know the answers, the questions aren’t that tough.  It’s not about perfection, and no one is or should be judging us on our decisions, but I truly believe that we owe it to ourselves and our families to make the best decisions that we can.  We are fortunate to live in a day and age where we have been enlightened to these facts, despite the cultural attempts and biases trying to keep us eternally confused.  It may not be easy, but it sure is simple.

No one wants to be sick.  No one wants to be fatigued.  We all have cravings and face challenges every day.  So hang in there and strive for that “lightbulb moment” when it all starts to make sense and you find your way of understanding.  For me, the way I explained some of these points was the way that it made sense to me.  I hope it will help some of you along on your journey. Good luck and good health – both are in our control!