Plants vs. Genes: Is Food More Effective Than Medicine?

My husband has a scary family history of early (and fatal) heart disease. His dad was dead at 43 from a heart attack, leaving behind six young children. When we got married, I knew I was up against not just genes but also the lifestyle of a finance consultant with a heavy schedule of international travel. Still, I thought, “Not on my watch." I write about this stuff all the time. I know how to eat right, the way the American Heart Association says. I’ll keep those bad genes from getting the upper hand. Turns out this is not as simple as it sounds. 

Ten years of AHA eating--low-fat and fish faithfully twice a week— kept the scary genetic pre-dispositions at the door. But then, suddenly news of a new set of dietary guidelines arrived: The ones from the American Diabetes Association, and we had to switch it up to more fiber, less carbs, and we did the best we could to follow the rules.

Another ten years of that approach brought us to the perhaps inevitable worrisome EKG at his annual check-up. A day later came the stress test and angiogram; the next day found us in the heart surgeon’s office. Two weeks later, I was cooking for a recovering quadruple bypass patient. This time, it was war: Plants versus genes. I was determined the plants would win.

It’s hard for a medical writer who works primarily with physicians to step away from official guidelines. To take matters into my own hands and treat my patient with extreme medicine: Plant-based food, and only plant-based food.

Medical authority and hierarchy are important to my clients, for good reason. But following the formal dietary guidelines for heart health clearly hadn’t worked. Or had they? Maybe they had kept things from progressing faster or being worse when the bad news did arrive. Moving to a fully plant-based diet felt intuitively right, but I wanted objective evidence. Was plant-based nutrition really the right way to go?

The internet was full of stuff on the health benefits of plant-based eating, but an awful lot of it was selectively cited research, scantily sourced opinion, and yes, even vegan evangelism. Where were the evidence-based studies from reputable, peer-reviewed journals? Fortunately, I know how to search the medical literature to find the studies, and I know how to evaluate them for quality. I found what I was looking for, but it made me realize how difficult getting good information can be for other people who don’t browse through PubMed for fun. 

I’m a big fan of nutrition results that come out of big, long-running prospective studies, like the Nurse’s Health Study at Harvard and the Adventist Health Studies from Loma Linda University. These studies have their drawbacks, but they’re based on large numbers of real people in the real world, not lab rats or people participating in restrictive, short-term dietary studies. More importantly, doctors respect these studies and take their conclusions seriously.

One of the first studies I came across appeared in the very mainstream, very respected journal  Diabetes Care in 2009. Based on results from the Adventist Health Studies, the article concluded that a lacto-ovo or vegan diet sharply reduced the risk of type 2 diabetes. Here was the sort of solid evidence I was looking for—something authoritative I could show to a primary care physician or cardiologist to justify a plant-based diet. 

As the chief and only cook in our house, moving to plant-based nutrition was up to me. My family history consists of five generations of good, imaginative cooks—I know my way around the kitchen. I was looking forward to the challenge, but the switch was disappointingly easy. Living in the foodie Hudson Valley helps. Organic produce is just across the road at our local community supported agriculture farm, and I know the free-range hens who provide our eggs personally. The hard part was giving up dairy products. I get crabby if there’s no milk for my coffee, and my husband loves cheese. We’ve compromised on this. The small amount of milk we use comes from a local dairy co-op—we can visit some of the cows grazing in a pasture just a couple of miles away. We’ve cut back on cheese, but eliminating it just isn’t realistic. 

It's been nine years since I sat for hours in the dread-filled atmosphere of a hospital waiting room. In that time, my husband has done extremely well with his patched-up heart. All four of his grafts are clear, with none of the cholesterol plaques that completely blocked his left anterior descending artery (the aptly named widow maker) and partially blocked three others. His prediabetes symptoms vanished within a few months of switching to a plant-based diet. Within two years, he was back to his weight on our wedding day. He still takes medication to control his cholesterol, but the dose is low. His blood pressure is now under control with just one drug. 

Is plant-based eating the only reason he’s healthy today? Perhaps not but it's definitely helped. A few years before the surgery, he had retired early from the Wall Street rat race. After surgery, cardiac rehab turned the man who hated to get sweaty into a gym rat. Stress reduction and fitness definitely are playing a positive part, but in the battle against his heart disease genes, plant-based eating is winning.