18663 Ventura Blvd, Suite 202, Tarzana CA 91356

Sunday, May 24, 2009


I spend a lot of time talking to my patients about lifestyle change. I truly believe that a patient is not treated by pills alone. If a person commits to a healthful lifestyle, he or she will live longer. And I believe that people can change.

But change does not come easy. It comes a few small steps at a time.

I don't expect a patient with out of control blood pressure and lipids, who does not exercise, and who eats no fruits or vegetables, to come back to me a month later having become a vegan who exercises five days a week and with normal blood pressure and cholesterol. If he or she returns to me a month later with an improved blood pressure, perhaps a pound or two lighter, and is now eating a salad every now and then and walking two days a week, I consider that success, and we can improve even further from there.

Diet change is especially tough. Someone who consumes a lot of meat and not many fruits and vegetables cannot overnight adopt a plant-based diet. A great way to start is to give up beef and aim for two vegetarian meals a week. Then give up dairy, and try new things like soy milk and rice milk and hemp milk. And then another change towards eating healthfully, and another....

I can recall a time back in college when a grilled cheese sandwich, a large order of fries, a 24-ounce Coke, and a large ice cream sundae was a normal dinner. At that time, I thought that by putting on my Rollerblades a couple of days a week for a few minutes to get to my classes that I was exercising enough. I was overweight and had so little energy. It took years and many small steps along the way to become a healthier person.

Small steps can be the key to long-term success. Celebrate small successes, and keep moving forward.
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Cheryl said...

I love your blog and find you very inspirational! I am a 31 yr old Canadian with a congenital heart defect (transposition of the great vessels) and I am just starting to put two-and-two together about diet and exercise as part of the puzzle for health and longevity. Thanks for putting your own experiences, thoughts and ideas out there ;o)

Anonymous said...

I was wondering, on the sheet of information that you give your patients about what foods are unhealthy, where you disclose your participation in triathalons, if you've ever thought about also disclosing the fact that in college you could hardly run half a mile? The dramatic improvement you've made in your health could really inspire your patients. -victoria

Minority Report said...

On the other hand, healthy diet and lifestyle don't necessarily lead to positive changes in blood panels, either. It is very possible to eat a healthful vegetarian diet, exercise regularly, maintain a reasonable body weight, and still have lousy cholesterol numbers. That would be me. Having tracked my numbers for a dozen years and watching them stay constant or get worse despite the oscillating lifestyle changes, I told my doctor "Enough with the data collection, enough with the wait and see, enough with the generic lifestyle advice. It's time to give pharma a chance." I'm on Simvastatin, back to eating vegetarian food what tastes good (I've been one all my life), and giving the meds a try. If they do for me even half of what they do for others, I'll be quite happy. I am also a lot calmer now that I've dumped the time-consuming, costly, diminishing-returns exercise and chucked the calorie-tracking.

VeganHeartDoc said...

Minority Report, You are right, sometimes medications are needed. But please do not give up on a healthy diet and exercise. They are a very important part to you remaining healthy. Even if the numbers that you see, like blood pressure and cholesterol, did not change with lifestyle alone, there are other nontangible benefits to staying active and eating well.

Minority Report said...

We need a cap-and-trade for cardio like they're proposing for carbon. A market where the sedentary (yo!) can buy/sell health credits with the active (you). ;-)

Sean said...

Hey Doc! I've been fortunate to follow you via your blog and Facebook since you have moved on from your training on Rochester. Congrats on your recent PR in the San Diego marathon. I set one myself last weekend in Ottawa for my second marathon.

I really enjoyed this particular post. As you know, I tried to go vegetarian some time ago, and found it difficult. I think you're right when you suggest that small changes over time are more realistic. I think we need to realize that habits are hard to change and sometimes we have more success making small changes. I for one have slowly reduced my red meat intake. I now rarely eat any. Several days a week I eat only vegetarian and even vegan (!!) diets.

I think that the labels sometimes make things hard. Certainly eating meat only a few times a week is better than several times a day. It may not matter so much that you can label yourself as a vegetarian or vegan if you are trying to make positive changes in your lifestyle. The same could be said of exercise.

I think it is also important to realize that all aspects on healthy living, dietary, exercise, psychological, etc. work in concert to keep us as healthy as we can possibly be. While I exercise regularly, I ran my last marathon at a weight that was borderline obese. Certainly I have an opportunity to make changes to complete the circle to improve my health, my longevity and my happiness.

Anonymous said...

Just found your inspiring blog today.

I can relate to the toasted cheese, french fries and a coke meal. In college, that was a favorite lunch at the cafeteria. I am a 54 year old female. I have switched from the SAD to an almost entirely vegan diet during the past 3 months. The only exception is an occasional shake of parmesan cheese on my wholewheat pasta and kale and white bean soup or a swipe of mayo on my bean burger. :) I am gradually added new foods such as soy milk and TVP to my diet as well as lots and lots of dried beans, fruits, and veggies. I avoid sugar and white flour as much as possible and limit the olive oil and canola oil in cooking and dressings.

I have been rewarded by a better cholesterol test results although there is still plenty of room for improvement. I have lost 15 pounds with about 20 more to go. At my doctor visit last week it was determined that there is no improvement in blood pressure, in fact I have to increase my medication - again. My physician and I are both disappointed with this, but are trying to just control it with medication. I was told that since it is a familial trait that may be the cause. I am hoping to see an improvement in the future.

Thank you for providing another source of information.