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Clarifying the Confusion: Dr Esselstyn Responds

QUESTION: “I recently read thisinterviewand it seems like DrEsselstyn is now saying to completely avoid all sugars. I also went toPlantstock where I thought he said boiling is the best way to cook kale.In addition, they served kale at every meal and in his talk, he said tomake sure we are consuming 6 servings per day.  Does this mean I haveto eat 6 servings of kale a day?   Lastly, in thisinterview, it seems likehe is saying that for the best results in losing weight, avoid most allgrains, cereals and potatoes. Are any of these true?”

Answer: In order to clarify these issues, I spoke with Dr Esselstyn and here are hisresponses to each one.

In regard to how to cook veggies and if boiling was the best way...

"Cook vegetables anyway you choose…steam, boil, steam-saute… Yourchoice. We find boiling kale and collards keeps them green and they cookfaster. Places that serve kale to big groups boil it!"

In regard to eating "kale" 6x a day.

"I recommend greens (which includes broccoli, cauliflower, bok-choy, Swisschard, kale, collards, beet greens, mustard greens, turnip greens, Napacabbage, Brussels, sprouts, broccoli, cauliflower, cilantro, parsley, spinach,arugula, etc) 6 times a day for those specific people who have significantcardiovascular issues, especially angina. I have never said "kale" itself 6times a day but "greens," as in the jingle. Six times a day is not for everyonethough it would be good for everyone to include greens in their diets as muchas possible. Not just a few spinach leaves."

In regard to eliminating potatoes, grains, cereals, etc for weight loss...

Dr Esselstyn meant that for those of you who are having trouble losingweight, to reduce or eliminate the calorie dense & more processedcarbohydrates made from flour products like bread, bagels, crackers, drycereals, etc and to focus more on the foods lower in calorie density. Hecompletely & fully supports the inclusion of intact whole grains & potatoes (ofall varieties) even for those needing to lose weight.

In regard to eliminating all sugars...

“I am surprised that so many have said that I was absolute. I would preferthat people know that eating sugar is something that has the potential toinjure their endothelial cells, however, with that note of caution most peoplewill sensibly restrict their sugar intake without having to regard it as absolute.

I have always been reticent to give any specific number or percentage, aseating should be spontaneous and not developed from a calculator. I wantpeople to have the knowledge that fructose can injure and merely ask as afavor to their endothelial cells that they sensibly restrict it.”

Now, it is not for me to put words in his mouth or speak for him and he is notone to give a specific guideline, but the guideline I have always used whenworking with Pritikin, Dr McDougall and with Dr Esselstyn, is no more than5% of calories. Now, the 5% is not a recommendation or a goal to achievebut a guideline for an acceptable maximum limit similar to the TolerableUpper Limit.  For those few who are very sensitive and find that at ~5% ofcalories, they still have high TG's or high blood sugars, then they may needto be more restrictive

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