For decades, the mother and daughter team Ann Crile Esselstyn, MEd, and Jane Esselstyn, RN, have been passionate about sharing the health benefits of a plant-based diet because of such a diet's transformative and life-changing effects. Here they share practical ways to follow this diet and how clinicians can share these benefits with their patients. They also talk about their excitement regarding their new plant-based cookbook.
Q: Why are you so passionate about the work you do in educating people about a plant-based diet?
Ann Crile Esselstyn, MEd: Because it works. Plant-based eating significantly changes peoples' health. My husband's (Caldwell Esselstyn, MD) work in this area has shown that people with cardiovascular disease who thought they could never regain their health see the magic in changing to such a diet. Many have never had a cardiac event after following the diet. I, personally, have been following this diet for more than 35 years and have reaped the health benefits.
Jane Esselstyn, RN: Whole-food plant-based eating fills a person with vitality and energy and a clear head and empty bowels—it is truly transforming. We see time and time again the more a person is compliant with the diet the better their health outcomes and people find they are able to be compliant with such a diet because it makes them feel good.
I stopped eating meat at 15 years of age when training with a national champion swim team. I was living in California and started eating beans and rice for the first time and came home as a vegetarian. Then at 18 years of age, my brother called and said my parents had taken a weird turn and were following plant-based eating—a term coined by T. Colin Campbell, PhD, the Jacob Gould Schurman Professor Emeritus of Nutritional Biochemistry at Cornell University, Cornell, New York.
The key ingredients are to eat plants—vegetables, whole grains, beans, and fruit. Just to clarify, plant perfect means no meat, no dairy, no avocados and no oil, and this program is an anchor in the midst of a raging sea of ideas that don't really work. A plant strong diet is the same but with the allowance of some avocado and some nuts.
Ann: With all of the junk food temptations today, people can get in just as much trouble by getting into the vegan junk food world—coconut oil, sugar, salt, etc. By just eating vegan you are not necessarily making it a healthy diet unless you really pay attention.
Jane: Exactly, people can eat doughnuts, potato chips and fake breakfast meat and no vegetables and eat junk food all day and say they are vegan. There is a rural town in Uganda where they eat all the right food, but we realized they were eating greens cooked in palm oil, for example, and therefore still have diabetes and cardiovascular disease, etc.
Q: What have you learned over the years of doing this work in terms of what is most important for clinicians to know and share with their patients?
Ann: Education is key. Once people understand that certain foods will hurt them they can start to make changes. People must read the ingredients of anything that they buy. It is wiser to make ones' own food because so much packaged food is laden with bad ingredients.
Jane: There is undeniable and irrefutable data regarding the health benefits of a whole–food plant-based diet. The American College of Lifestyle Medicine (https://lifestylemedicine.org/) has board certification for clinicians, and patients are demanding to understand more about how lifestyle and especially diet can improve their health and well-being. Clinicians should not be scared to be educated or to educate. As an RN, I let patients know they are doing a lot of things right and that they can do this. The attitude of the clinician is very important. Clinicians should not make changing over to a plant-based diet negative, daunting or overwhelming.
The Esselstyn Foundation's aim is to bring information about the prevention and reversal of disease for people who wouldn't otherwise see this information such as medical students who many now have plant based clubs, and they want more information. The Foundation offers information and presentations to medical students and residents, medical providers, teachers, YMCAs, fitness groups, churches, etc.
Q: Tell us a little bit about your new book and why you focused on women?
Jane: Together, my mother and I wrote “Be A Plant-Based Woman Warrior: Live Fierce, Stay Bold, Eat Delicious,” which started by busily writing down the delicious food recipes that we eat and create. My mother is the one that gave this movement legs, and took my father's theory and gave it color and flavor and deliciousness and set it out to the world. She really is the one to thank in her lifelong efforts, and she is a daily dose of motivation.
The reason we focused on women is because the majority of people who think about food and make food are women, and we are really the ones who drive health outcomes. Women are so often uncomfortably tied to their identity and body, so I love being unburdened by how much I eat without thinking about calories.
Ann: This book would go nowhere without Jane. She wrote the recipes—it's been so much fun. We live next door to each other and during the process of writing the book, Jane would come over with recipes and many iterations of various foods and months of brownies, which my husband and I appreciated. In our cookbook, our editor made sure to point out which recipes are heart friendly.
Jane: The book came out in August 2022 and was the number one best seller in low-fat cooking in preorders on Amazon. At this writing, our publisher has already had to go into second printings. It is a beautiful book that speaks to people, and a friend told me that this is how she wants to live and wants this for her family and loved ones.
Q: Ultimately, how would you like to see the knowledge you have about a plant-based diet truly integrated into clinicians' practices?
Jane: The plant-based movement is gaining traction in both the integrative and more mainstream medical world. Kim Williams, MD, the previous head of the American College of Cardiology said, “There are two types of cardiologists, those who are plant based and those who have not read the literature.” There is also a doctor at Mayo Clinic who focuses on a plant-based food approach, who is flooded with patients and appointments.
Ann: When cardiac rehabilitation starts talking about plant-based diets we will have made great headway. We have adapted to the option of a pill or a procedure and do the easier thing than change our lifestyle, but a few minutes in the kitchen can change ones' life. Plant-based eating is a secret passage to life and health, like falling down the rabbit hole in “Alice in Wonderland,” where so many of the common health issues are all gone and the food is all good.
Q: What are three top tips for clinicians in terms of educating themselves and their patients about the benefits of a plant-based diet?
Ann: Give your patient more than 15 minutes to discuss their eating patterns and make recommendations. Refer patients to health coaches or to people who are knowledgeable in this area and offer lectures in their practices. Education is so important. Success completely depends on people's attitude, and we hear people say they like the process and have fun. One doesn't have to be hit with a horrible disease, though illness makes it easier for people to want to change.
Jane: There is exciting information, and we are always learning. It is helpful for clinicians to say to their patients, “I'm learning as a doctor and I want to learn with you how a whole-food plant-based approach can truly improve health and well-being.” Clinicians should not say vegan or vegetarian because this scares people away. Clinicians should partner with their patients emphasizing that there are always new ways forward, and let's do this together and see what we can discover.
Doctors and patients should spend time making their own food—they can make sweet potatoes or rice while doing other things like watching TV. People can cook, and spend time in the kitchen—a few minutes can change their whole life.
Robynne Chutkan, MD (https://robynnechutkan.com/) is doing astounding work on the microbiome—showing the encouraging link between fiber and the immune system and how that can even help COVID. It is important to point out that fiber is in plants, not from manufactured fiber bars.
Q: Any final advice for clinicians?
Jane: When people are unburdened by disease their well-being and mental health can be much improved. We had no intention of writing books and now we have written seven books. We also offer many events, an annual women's conference, Well, Now Camp!, and I offer individual counseling and sometimes do this with my mother.
Ann: My husband and I have four children and all follow a plant-based diet. In addition, we have 10 grand children who are also followers. Family members influence other members and the same is true for the general population, that when people observe the effects of a plant-based diet it is very powerful and can be life-changing.
