Why is it that the only diet proven to reverse heart disease is not recommended as the standard diet everyone should eat? : nutrition

Sorry for the overly long post.

So essentially, I read How Not To Die by Dr. Michael Greger last year and some of the things in that book blew me away. Don’t get me wrong, the book is absolute propaganda for a whole foods plant based diet and it has loads of cherry-picked studies so it definitely should not be taken at face value. However, one thing that stood out to me was the research into reversing heart disease with a whole foods plant based diet. Dr. Dean Ornish and Dr. Caldwell Esselstyn are two of the doctors that have successfully stopped or even reversed heart disease from progressing further in their patients through lifestyle and diet intervention.

Here you can see one of Dr. Esselstyn’s first studies on this;

Of the 22 participants, 5 dropped out within 2 years, and 17 maintained the diet, 11 of whom completed a mean of 5.5 years of follow-up. All 11 of these participants reduced their cholesterol level from a mean baseline of 246 mg/dL (6.36 mmol/L) to below 150 mg/dL (3.88 mmol/L). Lesion analysis by percent stenosis showed that of 25 lesions, 11 regressed and 14 remained stable. Mean arterial stenosis decreased from 53.4% to 46.2% (estimated decrease = 7%; 95% confidence interval [CI], 3.3 to 10.7, P < .05). Analysis by minimal lumen diameter of 25 lesions found that 6 regressed, 14 remained stable, and 5 progressed. Mean lumen diameter increased from 1.3 mm to 1.4 mm (estimated increase = 0.08 mm; 95% CI, -0.06 to 0.22, P = NS). Disease was clinically arrested in all 11 participants, and none had new infarctions. Among the 11 remaining patients after 10 years, six continued the diet and had no further coronary events, whereas the five dropouts who resumed their prestudy diet reported 10 coronary events.

Here you can see Dr. Ornish’s study;

In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography. The average percentage diameter stenosis regressed from 40.0 (SD 16.9)% to 37.8 (16.5)% in the experimental group yet progressed from 42.7 (15.5)% to 46.1 (18.5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61.1 (8.8)% to 55.8 (11.0)% in the experimental group and progressed from 61.7 (9.5)% to 64.4 (16.3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.

Yeah I’ll admit that the populations are low in both studies but I dont see why the results wouldn’t be similar for larger populations, and Dr. Ornish has successfully put thousands of people through his program for Reversing Heart Disease since the study.

A whole foods plant based diet seems to have all the other benefits of diets like Keto, Mediterranean, Paleo etc., such as helping with weight loss, lowering blood pressure, glycemic control in type 2 diabetics, protective effects against cancer, heart disease and all cause mortality and it is suitable for all stages of life, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes according to the American Dietetics Association.

I can’t find the exact amount, but here says [1/4 people die to heart disease every year in America](https://www.cdc.gov/heartdisease/facts.htm](https://www.cdc.gov/heartdisease/facts.htm) and the [WHO estimates 31% of people in the world die of heart disease every single year](https://www.who.int/health-topics/cardiovascular-diseases/](https://www.who.int/health-topics/cardiovascular-diseases/) so we can assume these figures are somewhat accurate. How are people not more concerned about the number one killer in the world when in most cases it clearly can be prevented? Why is it that the only diet ever proven to prevent this disease is not the standard recommended diet? Am I missing something?

As you’ve probably gathered by now, I follow a vegan diet and try my best to eat only whole plant based foods. I want it to be clear that I have not always been vegan, I only went vegan less than a year ago when researching about diet and health. I’m not trying to start an argument, I’m genuinely just trying to start a dialogue.

I’m curious as to why this isn’t common knowledge at this stage, since some of the research in preventing heart disease goes back the whole way into the 90s. Is the research bogus? Is there some other reason that I have missed? Am i wrong to suspect that a whole foods plant based diet is optimal for human health? I’m posting here since I know that the people who follow this sub follow many different diets, so if I have been in an echo-chamber or if I have been relying on false research you will hopefully be able to show me. Thanks for your time.

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