Plant-Based

Which Diet is Right for Us? The China Study & Heart Disease

By Ana Flores | May 07, 2025

T he largest study of human nutrition in history, the famous China Study, was conducted at the end of the 20th century. It lasted several decades and was conducted in 65 provinces in China on about 6.5,000 people. It also included expanded data on mortality caused by the disease, which included an incredible 100 million people and 100 disease rates.

The conclusion was that the risk of coronary artery disease decreases with increased consumption of plant foods and reduced consumption of animal foods. So, the more plants we eat, the healthier we are.

It also showed that a plant-based low-fat diet can prevent and reverse a number of chronic degenerative diseases. According to researchers, in order to fully prevent heart disease, cholesterol must be well below 150 mg/dL, much lower than recommended by the Western standards.

Their work has been confirmed by Dr. Esselstyn and Dr. Ornish, eminent physicians and cardiologists who have shown that heart disease can be prevented and cured with a whole-food plant-based diet.

I guess Poppay in those old cartoons was right and way ahead of us, when he gulped down spinach and gained super strength from it.

poppay-gulped-down-spinach

A Pioneer in Heart Treatment

A revolutionary in the treatment of heart disease and the main inspiration for this article is Dr. Caldwell Esselstyn. He was a respected surgeon, clinician and researcher at the Cleveland Clinic for over 35 years. In 1991, he was president of the American Association of Endocrine Surgeons and organized the first national conference on the elimination of heart disease.

He noticed that patients came back with the same heart problems again and again, and that none of them were really cured, but the standard treatment only worked to reduce the symptoms. Witnessing that, he decided to take on a different approach. After years of work, one of the most distinguished international heart surgeons replaced surgery with natural healing. He launched his nutritional treatment program and began working on a group of patients.

Excellent Results of Participants

Most of the patients in Dr. Esselstyn's study had already tried standard Western treatments, and had undergone multiple bypass surgeries and angioplasties without success. Their health conditions were so severe, they were told by their physicians they couldn't be saved. With little hope left, many were told to prepare for the inevitable, and to make the most of the time they had left.

The 17 patients in the study had a total of 49 cardiac episodes (such as heart attack, heart failure, arrhythmias) in the time before the study. Some had multiple bypass surgeries. Within months of Dr. Esselstyn's program, cholesterol levels, angina symptoms, and blood flow to the heart improved dramatically.

20 years later, the patients were still alive and healthy, and had no more heart disease and episodes. Those who followed the instructions to a T, achieved a complete halt in the progression of the disease and survived for more than twenty years without symptoms!

Significant Drop in Cholesterol Levels

After 5 years on Dr. Esselstyn's plant-based diet, cholesterol levels were reduced by an average of 50% - from 246 mg/dL to 137 mg/dL (above 240 is considered high risk, and below 150 is the level that is common for the people in cultures where heart disease doesn’t exist.)

This is the largest drop in cholesterol ever documented in the medical literature in a study of this type. As a result, disease progression stopped in all participants.

Evidence of Angiograms

Angiograms taken on study participants showed the expansion of the coronary arteries, and thus the reversal of the disease. That was truly phenomenal. This groundbreaking study was published in 1995 in the American Journal of Cardiology.

Diet is the Key

By abandoning the harmful standard Western diet and maintaining cholesterol levels far below those recommended throughout history as optimal can one achieve great health.

Following this principle, dr. Esselstyn removed from his patients diet everything that is known to cause or promote the development of heart diseases. He compared it to a house on fire. He said that the house was burning because the wrong foods were causing it. “When we continue to eat the food that caused the disease, it's like adding gasoline to the fire. Changing your diet will end heart disease".

What Does a Diet Program Look like?

In general it looks like this:

  • no animal products (meat, fish, dairy products, eggs),
  • no oils, not even plant oils, because they cause hardening of the blood vessels and thickening of the blood. Even nuts and avocados are not recommended.

You can eat and enjoy a large number of nutrient-rich plant foods:

  • all vegetables, especially green leafy vegetables
  • root vegetables
  • veggies of all colors - green, purple, red, orange, yellow… They are all rich in crucial antioxidants and phytonutrients.
  • all kinds of fruit
  • all legumes - beans, peas, chickpeas, and lentils of all kinds
  • all whole grains and whole grain products, like bread, bagels, pasta, rice, as long as they don't contain added fat
  • sprouts - they are a real nutrient powerhouse and can be eaten in abundance

As a part of the healing program, patients would eat a handful of green leafy vegetables and other types of veggies several times a day, as they contain high levels of nitric acid. This powerful substance cleans the blood vessels, helps dissolve fatty deposits, and restores their elasticity and function. Instead of taking a pill, patients would drink a green smoothie or eat a small salad.

Successful Heart Treatment Program

In 2008, doctor Esselstyn published a book called Prevent And Reverse Heart Disease in which he outlined this revolutionary program backed by indisputable results of a 20-year study. He proved that dietary changes can prevent and completely cure even the most severe heart diseases, including people who have suffered from them for many years.

poppay-gulped-down-spinach

The book offers the same nutritional program that allowed the patients in the study to heal and stay healthy.

Inspiring Story of the Healed ‘Widowmaker’

In addition to the examples of patients from the study, the book cites another successful case that involves doctor Joe Crowe who succeeded Dr. Esselstyn as chairman of the breast cancer task force at the Cleveland Clinic.

He suffered a heart attack in 1996 at the age of 44. The tests showed that his entire lower third of the artery infamously called the "widowmaker", was in extremely poor condition.

Because of severe damage, bypass surgery, angioplasty, or stents were not an option. Dr. Crowe, a husband and father of three, was deeply affected by this news and fell into depression.

At the urging of his colleague and friend Dr. Esselstyn, Dr Crow decided to start the healing program. He strictly followed the diet plan and refused to take any cholesterol-lowering drugs.

And it paid off. His efforts resulted in a significant reduction in cholesterol and a huge improvement in health, just as it was the case with other patients. This brought immense relief to the unfortunate doctor and his family, and it didn't empty their bank accounts, as is usually the case with standard medical treatment.

About 2.5 years after starting a plant-based diet plan, he had a follow-up angiogram that, to his amazement, showed the vascular system had healed. "Dr. Esselstyn saved my life," he declared.

"It's the most complete solution to coronary artery disease I've seen, a vivid demonstration of the power of a plant-based diet to allow the body to heal itself and prevent heart attacks."

In his book, dr. Esselstyn convincingly argues that a plant-based, oil-free diet can not only prevent and stop the progression of heart disease, but also reverse its effects.

His work over the past 25 years has shown that all this can be achieved without expensive and invasive surgical interventions and with minimal use of drugs.

It Also Helps With Other Chronic Diseases

There is ample evidence that a whole food plant-based diet helps with other common diseases such as stroke, hypertension, obesity, osteoporosis, diabetes, and brain degenerative diseases like Alzheimer’s, Parkinsons, and dementia.

It also prevents and protects against a number of other diseases, including impotence and cancer of the breast, prostate, colon, rectum, uterus, and ovaries.

Another bonus of eating plants is achieving optimal body weight and BMI with ease, which means one can maintain a desired figure without struggles, starvation, or calorie counting.

Ana is a freelance writer and seasoned vegan. She is passionate about the environment, animals, and a cruelty-free way of life. Ana also volunteers as a mentor for a local vegan challenge 22 and as a writer for Cage Undefined.