Lifestyle: Your Prescription For BP Health

Rip Esselstyn

Hey, Laurie, I’m doing fabulous. Thank you.

Laurie Marbas, MD, MBA

I say that is a wonderful way to get started. Today I want to speak to your expertise, which is all about mindset and community and overcoming challenges because you have such a unique background as the son of Dr. Esselstyn and then a fireman and just an athlete. It’ll be fun to see how some of your answers to these questions will help a lot of people.

Rip Esselstyn

Fire away. Let me tackle it.

Laurie Marbas, MD, MBA

The first question is: why is mindset such a critical component when committing to lifestyle change, for example, chronic disease management or improvement? Why do you think that is such a critical piece?

Rip Esselstyn

I would say that mindset is not only critical for trying to control chronic diseases; mindset is, to me, everything in life. If you can get the attitude and mindset around just about anything that you want to pursue in this life, that is, to me, 90% of the battle. I’ve been working with people consistently since about 2009 when I wrote my first book, The Engine 2 Diet, and I enlisted 72 guinea pigs to try out this lifestyle because I wanted to see with my own very eyes the efficacy of what can happen when you eat a whole food plant-based diet. The caveat that I had was that you could not be a participant if you did not agree to do a couple of things. You had to agree to not cheat for 28 days. You had to agree to keep a food log of every morsel that you put in your mouth. You had to also let me know how much you were sleeping and how much you were exercising. Any issues that you were having? What was the most difficult thing? I wanted to write about it. In some ways, I weeded out people that I knew would not be successful because, they had to sign a contract with me that they would not, to the best of their ability, knowingly cheat and go out and have a McDonald’s cheeseburger or something like that. They keep this food log for accountability and course corrections. Laurie, it was invaluable not only for them but also for me to see how everybody was not only complying but so enthusiastically engaged. Again, to me, this is all like you go into this, and you have to have the mindset. One of the things we’ve talked about is how important it is to have community, or in the case of many people, like a coach, somebody that can be there, or, let me take a step back. It’s so funny because I wrote this book so long ago, but I insisted that everybody have a fire buddy. That’s because, as a firefighter, you never, ever go into a burning building by yourself. You have to always be paired up with somebody. I kind of made the analogy: I don’t want any one of you to go into this whole plant-based lifestyle feeling like you’re alone. Not only do I want you to have a fire buddy, but remember that these people were on two paths. They have to decide: do I want to take the fast track and do the firefighter program for 28 days? Or do I want to do the slower track and do the fire cadet? But both ones got you to the endpoint. For the last two weeks, you’ve been eating only whole, plant-based foods. In some ways, I let them choose which path was very empowering for them. But again, everybody has a fire buddy that you can lean on when you’re like, I can’t do this anymore. You can pick up that phone. You could call them. Then they also had me as a coach, kind of a motivational coach who was making sure that they were doing this correctly. Laurie, the results that we got in 28 days were nothing shy of jaw-dropping. The average weight loss we had was 15 pounds for the guys and nine and a half pounds for the girls. Unfortunately, that’s just because men typically have a little bit more mass, and therefore they may have a tendency to have a higher resting metabolic rate. But the fact is, that’s pretty good. In the 28 days following this, the average drop in total cholesterol was 35 points. The LDL was 24 points. The average. I told you about the weight loss; the average drop in blood pressure was ten on the systolic and five on the diastolic, which is great. And by eating these low-fat, low-sodium plant-based foods, they were hitting all their markers. I want people to know because this is a summit about hypertension. That is, the average American, and maybe you’ve talked about this with other speakers, Laurie, is getting somewhere between 3000 and 5000 milligrams of sodium a day. On my engine-2 programs, on the engine-2 seven-day rescue program, we’ve asked if we- want them to be getting somewhere around 1500 milligrams a day or below that. We know that just naturally occurring sodium in their spinach, their Swiss chard, and their oats and portabella mushroom mushrooms is going to yield about 500 milligrams. So if they can just keep the added sodium from their bread and there, if they’re eating whole grain crackers and pasta sauces, if they can learn to kind of keep that the number of calories per serving to the milligrams of sodium that are per serving, if they can keep that as close to a one to one ratio, then they’re going to hit a home run when it comes to that. A little fact is that there’s a study that was conducted; it’s called the Global Burden of Disease Study. It involved over 300 institutions across 50 different countries. It concluded that elevated blood pressure is the number one worldwide risk factor for death, resulting in fatal heart attacks, strokes, and other catastrophic organ failure. that little white substance, Laurie, that’s in every packaged, boxed, and canned food that’s out there. If you go to out-of-town restaurants, forget about it. All bets are off when you cook. Do not use it when you cook. Only do a little bit when you want to topically salt your food if you feel like it needs it. But it’s incredible what you can do when you dial back that sodium. Then the other thing I want to say is that sugar is guilty; don’t think that sugar is not guilty as well. Back around the time of 1976, I was just reading this: the average American was consuming four pounds of sugar a year.

Laurie Marbas, MD, MBA

In 1976.

Rip Esselstyn

1976, a day today, 2023. It’s 160 pounds per person per year.

Laurie Marbas, MD, MBA

How is that even possible?

Rip Esselstyn

It’s because it’s 30 added teaspoons a day and 80% of our food is adulterated with some sort of sugar. There are so many different names that we have for sugar that are out there, and here’s a little thing that can be helpful for your audience. According to the new label guidelines, you have to list added sugars. On the nutritional facts panel, you go down to sugars, and below that, all say, including however many grams of added sugars, and just so your audience knows, four grams equals one teaspoon. If it says, Let’s say you’re eating coconut yogurt. It says, including 16 grams of added sugar, that’s four teaspoons. then you go down the list and you’ll see,  cane sugar, cane sugar, you’ll see maple syrup, you’ll see brown rice syrup, molasses. It’s crazy. But so sugar plays a very significant role in elevating blood pressure as well. Of course, all the added oils and fats—the saturated fat that clogs our arteries—make all of our vessels work harder. That also contributes to the hypertension. But that wasn’t your question. It was a mindset, so if you feel like it, this is going to be difficult. Like Laurie, I was playing pickleball this morning with a gentleman, and he said, Rip, I read all your books. I just don’t think I can do this. I’m like, listen, it’s that old quote. If you think you can, you can. If you can’t, you can’t. I’m like, listen, let’s just start by you hitting a home run with your breakfast in the morning, all right? Do oatmeal with fruit, a small handful of, like, walnuts, and then some chia seeds or ground flaxseed meal and do that. Let that be the kind of touchstone that gets you going every morning, and then see if you can do something great for lunch and dinner, and so he’s going to start with that instead of his scrambled eggs and bacon and all that kind of nonsense. But you, everybody, have your mindset. We know some of us, like some of us, have it, and some of us are a little bit more challenged. If you’re more challenged, find that fire buddy. It’ll do this with you. Find a coach that can help you, and then find a strong community. We’ve got a strong community on Facebook that’s 35,000 strong, and there’s no judgment. Everybody’s there just to support everyone. We lay it all out there. You don’t need to not tell the truth, because we find that the truth is very helpful for everyone. It’s very liberating. 

Laurie Marbas, MD, MBA

There are so many beautiful nuggets in that lovely discussion that you just had. The things that came to mind were just kind of getting back to the mindset, and I want to ask a specific question, but we’re self-efficacy, accountability, and a coach, which is like a guide. Just guiding you along and giving you the education that you need to be successful. But my question would be, why do you think we make things so hard? It’s something we have to spell out for some people. Like, you’re exactly. I had patients go, well, I’ll try the doctor. I was like,  you’ve already failed. What do you say you’re going to try? You’re leaving the room. You’ve already said in your head that you’re not going to. I need to understand what you can do today, tomorrow, and the next day. But why do you think we make things so hard? This is just changing the food on our plates. Why do we want to do this?

Rip Esselstyn

There’s a confluence of things going on there. Food is part of our culture. There are just so many traditions that we have that are so deeply rooted in so many different households. Like, you know how many times I’ve heard, I don’t think I can do this. I’m Italian. I’ve got to have my olive oil, mine, whatever, or I’m Greek. You’re not telling me I’ve got to forget olive oil. I’m Greek, I’m Italian, and I’m French. There are so many memories, too, that are associated with food, the smell of food, and all that. I just think what we need to do and what we’ve been able to do in the Esselstyn household, starting with my parents, is start new traditions. It is so incredible. I’m going to be going home here shortly to celebrate my dad’s 90th birthday, and there are going to be 45 assistants, cousins, nieces, and nephews. I can guarantee you that not one of them is going to be whining and complaining about us having mashed potatoes and gravy and big old salads and turkey and planting strong apple pies, pumpkin pies, all these things. Everybody’s going to love it. Everybody’s going to make a dish, and so this has now become very easy for the whole Esselstyn tribe. It’s what’s expected. and it’s just a beautiful thing when you’re not going to be marked. You’re not going to be belittled for the way you eat. That’s another thing. You try and do this, and you’re going to be the odd person out wherever you are, whether it’s the Thanksgiving feast, Christmas, or birthday parties. You got to be with that. You have to have thick skin. I can tell you there is probably no tougher place on the planet to be a whole food plant-based junky than at a firehouse in Austin, Texas, which is the land of beef. You do talk about an oxymoron. a bunch of firefighters going plant-based in Texas. But what? We were able to do it because we knew, in our hearts, that this was the path for us to be on. If we wanted to be the healthiest, best, and strongest versions of ourselves, because, let’s face it, when you’re a firefighter, the people that call and pick up 911 and are having an emergency expect a superman or a superwoman to come and answer them when they’re in need. The fact of the matter is, and this is sad, Laurie, that close to 85% of paid and volunteer firefighters across the United States are overweight or obese. They’re dealing with pre-diabetes, type 2 diabetes, and all these things because the culture at the fire houses across not only our country but the globe is so meat-centric. It’s so it’s got such a strong masculine toxicity associated with it. But I want you guys to know that if I can do this at a firehouse in Austin, Texas, it took me six years before I was able to make any progress on getting these guys to convert. Six years ago, I was hanging in there, but I never gave up. It’s anybody who can do this. It’s never too late. Let us at Fire Station 2 in Austin, Texas, be a shining example that any house in this country can do it. It just goes back to Laura’s initial question. You’re going to have to get her out. You’ve got to get the mindset and the support behind it. It is just amazing how one person can flip a whole family, a whole community, or a whole country. I look at what my father was able to do with his groundbreaking research on heart disease. He is leaving behind a legacy like no other. This is now out there. This is like he’s got the most profound before and after angiography.

Laurie Marbas, MD, MBA

Evidence.

Rip Esselstyn

Thank you. Evidence on the face of the planet shows that you can do this. He’s done it again, and it took somebody outside the field of cardiology to show the cardiologist that this was possible. So, my heart goes off to Dean Ornish and my father for being such trailblazers and disruptors when it comes to the number one killer of men and women in this country. I’ve kind of taken a bunch of tangents from that.

Laurie Marbas, MD, MBA

I wouldn’t know that all of it’s fantastic. Heart disease is so closely tied to hypertension. So one more question before we break into the conversation would be, we’ve spoken about changing your mindset and stuff, but what are the strategies to solidify that long-term commitment like? Is there anything in particular, especially during the challenging times of the holidays? And, as you said, luckily for you, your parents have said this, and the family has engaged in that and embraced it. But I’m curious, what would you suggest for something like how you were stuck in there for six years, which is amazing? How can you help others stick to it?

Rip Esselstyn

For how long? It’s important, and everybody always talks about, well, what’s your why, like, why did you decide to do this, and why is this important to you? You need to have a reason that is so big and powerful and beyond yourself that when it gets hard, because, let’s face it, it’s going to get hard at times for me. Now, I’ve been doing this for 36 years. It’s an absolute snap. I don’t even think about it. But for those starting, find out why you are going to do this so that you can do it even if you are being pressured into a bunch in a firehouse. I’ll give you an example. When I first came out as a firefighter, I was at the Animal House. It was fire station one in downtown Austin, Texas. There were 18 guys there. We had a ladder truck and two fire engines. Then we also had an EMS unit—18 guys. What is going to allow you to do this when you have 17 people saying, “Oh, my, making fun of you by calling you names, saying you will never be able to do this as a firefighter? The last vegetarian that came through here didn’t even last a month. What are you thinking? You don’t eat any food; you eat what food eats. How do you expect to be a firefighter if you’re eating twigs and berries? We should just tie you up to the tree outside and have you just eat the grass.”  It was brutal, and for me, I just want to be a crusader for the advancement of all things—whole food, plant-based. I want to do my part as a human being to make a difference when my time comes, and I have helped as many people as I can. That drives me. But there are so many different reasons. One of the people on my team, his wife, died of cancer. The last thing she said was, I want you to be able to live for the both of us and play with our grandchildren. They didn’t have grandchildren at the time. He now has grandchildren. He is living so he can eat this way because he has heart issues, high cholesterol, hypertension, and all these things. It’s all vanished. He’s down on 50 pounds. He’s like an incredible shining example. He’s getting on the floor, playing with his grandchildren, and doing all the things that he thought he would never be able to do into his mid-late sixties. One of the things that I love about people who are doing this for animals is that there’s a reason that’s much bigger than themselves. That is, they don’t want to do anything to be complicit in the murder of 80 billion animals every year. Wonderful. Fantastic. I love it. We talk about how the number one cause of global greenhouse gas emissions is animal agriculture. The data varies. It’s as low as 16% of all global greenhouse gas emissions and as high as 82%. But it’s fair to say that those numbers are astounding. If you consider yourself a true environmentalist, and we know what’s going on now with planet Earth screaming for help, you can’t go a day without reading about a drought or a forest fire. A population has had to retreat from where they were living because it’s now flooded. It’s down and ugly. If you’re a true environmentalist, another great reason is to drop the meat, the dairy, and all that jazz. Find a reason, and you can latch on and not crumble when 17 angry firefighters come after you.

Laurie Marbas, MD, MBA

I had such an interesting vision in my head when you said that. This does so well. Thank you so much for joining us today, and I hope you join our conversation. Insightful and engaging. If you’re a summer purchaser, stay here because we’re about to dove deeper into this conversation. If you’re not, please click on the button below or to the side and get access to the rest of the conversation. 

Now, if you are watching this, thank you for being a valuable member of the community. If you want to continue with a couple more questions, Rip, then I’ll let you go. But what advice do you have for someone who might experience some setbacks or moments of doubt in the journey like me? This is just getting to it? We spoke about their why, but let’s say that maybe they fell in love with the Thanksgiving holiday dinners, and they do it when they don’t feel well like a lot of people do. Why even keep going? How do you help someone jump back on the horse, so to speak?

Rip Esselstyn

I’m going to give you a couple of quotes now that I love one. One is from Winston Churchill, and the other is from Babe Ruth. Winston Churchill has a quote, and it’s five, five, never, never, never, never, never, never give up. So if you fall, you just get back up. Never, ever give up. If you were like Laurie, if we were, what kind of car do you have?

Laurie Marbas, MD, MBA

Laurie has an old 2014 Buick Enclave and a 2007 Jeep Grand Cherokee.

Rip Esselstyn

Let’s say you’re driving that Jeep Grand Cherokee down the highway and that front tire goes flat on you. What are you going to do? You’re going to pull it over. You’re going to get out of the fast lane and pull it over. What you’re going to do is get out the jack and fix it, or you may call Triple A or something like that, but you’re going to fix that flat.

Laurie Marbas, MD, MBA

I know how to use the jack. 

Rip Esselstyn

Yes. But what you’re not going to do is get out a big old knife, and you’re not going to slash the other three tires. Because you’re so pissed off and upset that you’ve got a flat tire. Flat tires happen in life. They do. Sometimes they’re very unexpected at the most, an opportune time. It’s snowing outside. It’s 110 degrees outside. You’re on a freeway, all these things. But you deal with it. You fix it, and then you move on. That’s what I want all of you to do. The other quote is from Babe Ruth. I love it because I’m a very competitive person. I love athletics. It’s hard to beat someone who never gives up. So that’s just my attitude. Again, it goes back to the whole mindset thing, but just don’t ever give up. I want you all to know that, as trying and difficult as this may get for you, you’re going to have some challenging moments and times. This path is the path that you want to stay on and figure out. If you ever take a little detour here and there, just get back on the right path, because it truly is the one that has the most enlightenment and will allow you to get copious amounts of food for breakfast, lunch, and dinner and snacks when you need it without having to starve yourself, without having to make and weigh and measure your food, without counting calories, and doing all these things that most people think they need to do when it comes time for them to lose weight. I’m sure Laurie’s talking about this with somebody else, but there’s a thing called calorie density. The beautiful thing about whole plant-based foods is that because of the water and the fiber that’s in them, their calorie density is about 600 calories per pound, down to about 100. If you can say that and stay in that sweet spot between 106 consistently, you will have almost an impossible time ever gaining weight. What will happen is that you’ll just find your body in that sweet spot where it wants to be, like when you were a freshman in college, and stick with it. If you have to lose 80 pounds, my bet is it’ll take you a good year if you’re doing this consistently. I was just reading today about a gentleman who attended, ah, one of our immersion programs. His name is David Honoré. I write about him in The Engine Seven-Day Rescue book, and he lost eight pounds in seven days when he was with us. He dropped 80 points on his total cholesterol in seven days. His blood pressure came down; ten over ten is systolic and diastolic, but guess what happened? It gave him the confidence that I wanted to do this long-term. So a year later, he was down 80 pounds, Laurie. His blood pressure was down, like another 20 over ten. He was no longer who he was; he was pre-diabetic. The most exciting thing was that he would never wear flip-flops because his feet were so swollen and, according to him, just ugly. Now he proudly wears round flip-flops because his feet are so beautiful. He used to be an opera singer, like a beautiful opera singer on the side. But he said that when he gained all the way, he just didn’t have the wind and everything to do it. So he’s now back to being an opera singer. All this to say that it’s all yours for the taking. Just don’t give up. Don’t give up on all the noise, the distractions, the Keto, the lions, the carnivores, the Atkins, and the Paleo. This is a detour that you do not want to take. Because it will bankrupt your health. Yes. You may lose some weight in the short term, but it will bankrupt you and is not a wise decision. Be strong. Be Plantstrong.

Laurie Marbas, MD, MBA

Which is fantastic. It’s a beautiful place to end. But could you just speak a little bit about where people can find you, and we’ll have it in the show notes? But I love to talk about your food and everything available for people.

Rip Esselstyn

plantstrong.com is where you can go, and you can see the whole ecosystem that we offer from Coaching Meal Planner, our food line. We’ve now got close to 47 different products across about 12 different categories to help make people’s journey that much more convenient and easy. This way, you can rest assured that you don’t have to read the label and make sure that the sodium isn’t too high and that there’s no added oil or sugar. We are as clean and flavorful as you can get and are still whole-food plant-based. Then, Laurie, we’ve also got the Plantstrong podcast that drops every Thursday. That seems to be very comforting for a lot of people who are trying to stay plugged into the community. We have some of the best doctors, like you. We have scientists, we have nutritionists, and we have testimonials. We have athletes; we have celebrities. That’s always kind of a nice thing for people to tune into. And then, on Instagram, you can go to @ripesselstyn on Instagram, @goplantstrong on Instagram if you want to stay plugged in that way as well.

Laurie Marbas, MD, MBA

Fantastic. Thank you. Thanks to everyone for listening. We’ll tune in to our next conversation.