Esselstyn Premier Study Diet

[LuckyToBeAlive]

Hi Jeff,

I'm under the impression that the diet eaten by the participants in Dr. Esselstyn's premier study--198 participants, published in the July 2014 issue of the Journal of Family Practice--was indeed vegan:

Foods prohibited: Initially the intervention avoided all added oils and processed foods that contain oils, fish, meat, fowl, dairy products, avocado, nuts, and excess salt. Patients were also asked to avoid sugary foods (sucrose, fructose, and drinks containing them, refined carbohydrates, fruit juices, syrups, and molasses). Subsequently, we also excluded caffeine and fructose.

Am I mistaken?

Thanks.

[JeffN]

I'm under the impression that the diet eaten by the participants in Dr. Esselstyn's premier study--198 participants, published in the July 2014 issue of the Journal of Family Practice--was indeed vegan:

Foods prohibited: Initially the intervention avoided all added oils and processed foods that contain oils, fish, meat, fowl, dairy products, avocado, nuts, and excess salt. Patients were also asked to avoid sugary foods (sucrose, fructose, and drinks containing them, refined carbohydrates, fruit juices, syrups, and molasses). Subsequently, we also excluded caffeine and fructose.

I am not sure what you mean by Dr Esselstyn’s “premier” study as the only “premier” study I know of is an NIH funded study on lifestyle change and blood pressure.

https://www.nhlbi.nih.gov/research/reso ... remier.htm

There is also no level called premier in the evidence hierarchy. The 2014 Esselstyn study was a collection of case reports which are considered, “the lowest level on the hierarchy“ and are considered anecdotal (as we will soon see).

https://www.ncbi.nlm.nih.gov/pmc/articl ... rt=classic

In regard to the 2014 study by Dr Esselstyn, yes, they were asked to follow a diet free of animal products. And, based on asking them whether or not they were adherent, they were split into those who were adherent and those who weren’t. Of the 198 patients, 177 claimed adherence.

However, there was no attempt to quantify exactly what and how much they ate using standardized food intake or adherence measures. All we know is that they said they were adherent (anecdotal) and we know that people often say things that are not true, especially in regard to diet intake.

For example, if you check out my thread on how many vegans there really are, surveys over the last 25 years has found that about 1 to 1.5% of the population claims to be vegan. Yet, the most recent one (done by an animal welfare group) found that only .44% could really meet the definition of vegan when using a stricter definition. I also discuss how a food industry study was misrepresented by a vegan group to say the amount of vegans had grown 500%, which was not true. Nor do I think they even read the full report.

viewtopic.php?f=22&t=53755

There is also no detail in this 2014 Esselstyn study in regard to what medications they were on and how much, which is a key issue.

So, we don’t know the exact details.

Am I mistaken?

The number would be 177 and of those 177, no one knows for sure.

In Health
Jeff

[LuckyToBeAlive]

By "Esselstyn's premier study" I mean first in importance among Esselstyn's studies. I believe the publication I referenced is Dr. Esselstyn's only arguably scientific study on the effects of his recommended diet. In that respect it's certainly--in my mind--premier relative to the anecdotal studies documented in his book and the follow-up articles you cited where, as you observed, skim milk and no-fat yogurt were allowed.

Thank you for confirming that the diet recommended to participants in Dr. Esselstyn's most important study of the effects of his diet was indeed vegan.

[JeffN]

Thank you for confirming that the diet recommended to participants in Dr. Esselstyn's most important study of the effects of his diet was indeed vegan.

The diet recommended to the patients, was void of animal products but also had several other restrictions.

"we encouraged them to take a multivitamin and vitamin B12 supplement. We also advised the use of flax seed meal, which served as an additional source of omega-6 and omega-3 essential fatty acids.

Foods prohibited.

Initially the intervention avoided all added oils and processed foods that contain oils, fish, meat, fowl, dairy products, avocado, nuts, and excess salt. Patients were also asked to avoid sugary foods (sucrose, fructose, and drinks containing them, refined carbohydrates, fruit juices, syr- ups, and molasses). Subsequently, we also excluded caffeine and fructose."

This was not just any vegan diet and I think it would be a disservice to leave out these important clarifications in any description of the diet.

Also, to be clear, while this was recommended to the study particpants, we just don't know what was consumed.

By "Esselstyn's premier study" I mean first in importance among Esselstyn's studies. I believe the publication I referenced is Dr. Esselstyn's only arguably scientific study on the effects of his recommended diet. In that respect it's certainly--in my mind--premier relative to the anecdotal studies documented in his book and the follow-up articles you cited where, as you observed, skim milk and no-fat yogurt were allowed.

I would strongly disagree.

The 2014 study you are calling "premier" is anecdotal with no measurement of medications, diet or dietary adherence. It seems the only reason you are referring to the 2014 study as "premiere" is because they were asked not to eat any animal products while ignoring all the points I made about the weaknesses of the study. I would call that a clear case of vegan "confirmation bias" and it is not how science works

Of the 2 studies, I would consider the first one with its 5 and 12 year follow up and the more comprehensive intervention, to be of a higher scientific quality and value.

In Health
Jeff