Heart Disease Reversal For Over 50 Years At The Pritikin Center

Danine Fruge, MD

It’s truly my pleasure. Thanks for having me.

Joel Kahn, MD, FACC

It’s absolutely critical that you be here. I will just say Dr. Fruge is medical director at the Pritikin longevity center in Miami on the grounds of beautiful Doral Country club. I’ve been there. It’s quite remarkable. She’s a medical graduate, Louisiana. State University School of Medicine has been treasurer of the A. M. A. L. S. U. Chapter. State Chair of L. S. U. Medical Society Florida hospital resident research award and former president of Woman in Medicine. 20 years at the Pritikin lifestyle center. She had a family history of heart disease and decided to put her chips into lifestyle medicine rather than other forms of medicine. She has done the Disney marathon and paddleboarding and cycling and hiking. This woman walks the walk and talks to talk both and has had to plant modify all these great Cajun French recipes that her husband brought to the relationship. So she knows how it is to adopt an American culture that promotes disease into her family, which includes herself, her husband and three sons undoubtedly very active. So tell us, first of all, maybe first before you ask any other question, Pritikin, the actual center has been around for almost 50 years who was Nathan Pritikin just gives a short mile.

Danine Fruge, MD

So Nathan Pritikin was clearly a man before his time. He was a pioneer in the field of longevity medicine and particularly in the reversal of heart disease. He originally learned about this through epidemiological studies for the United States Government after World War Two. He found that the food rationing during the war directly correlated with heart disease going down as soon as the war was over, people went back to eating their typical I guess way they had heart disease go right back up. And this was revolutionary because at that time there was not any common idea that food did anything for you. It was more or even exercise for that matter. So he basically to get your affairs in order. There’s nothing we can do for you. It’s in your family. Good luck.

Joel Kahn, MD, FACC

Wow. And I know he trained as an aerospace engineer in fact had a vibrant business in coastal California as an aerospace engineer. But here we are in a reverse heart disease summit talking about a pioneer really a generation before. Dr. Ornish, Dr. Esselstyn, Dr. Fuhrman and others that preceded, you know, my own interest in lifestyle and reversing heart disease. Incredible. So how has in this 50 year history where there’s actually been a physical center of teaching and lifestyle and inpatient lifestyle change. Originally in Santa Monica, California. Originally actually in Santa Barbara, then Santa Monica. And now for many years of Miami, how over the years has it held onto the original teachings of Mr. Nathan Pritikin. And how has it sort of modified over the years?

Danine Fruge, MD

That’s a fantastic question. We still are true to the roots which are plant based daily the exercise. We’ve added mindfulness. We’ve added sleep medicine, we’ve added rest and rehabilitation because the times have gotten so much more difficult for people to manage the part of the nervous system, the fight or flight. So we’ve added that. What we’ve kept is Nathan’s original research that he did on himself. He actually changed his food to be able to reverse his heart disease. He had four kids and his wife and he cooked recipes and he literally checked his cholesterol every single week. Just like we do here we’ve added more than the cholesterol. Of course we look at blood sugar and liver and kidney and uric acid and we look at C. R. P. S. And we do a full thorough evaluation of how does food really affect the individual person week by week. 

Joel Kahn, MD, FACC

Incredible and I apologize for the pause. I was so overcome by the equality of what you just said. I want people to realize we’re talking about a physical place. Imagine walking into a resort which it is with palm trees and pools and golf courses and beautiful hotel rooms that can be an option but not mandatory to stay in. But then we go over to this beautiful building because again when I visited it where there is a demo kitchen and a very large dining hall and a very large fitness center and a large medical clinic. How many people at the Pritikin center in Miami are actually, they’re in a given full work day now that the pandemic is pretty much quiet it down.

Danine Fruge, MD

Well we’re seasonal. Just like most of South Florida is we have our snowbird season, which were full underway. We can go up to 90 people, you know, in a week’s time. Our low season might be about 40 when it’s hot.

Joel Kahn, MD, FACC

How many people actually work at the center?

Danine Fruge, MD

Just about 100 to take a whole team approach. You know, we have the whole full kitchen that really goes to great lengths to make healthy food taste good and I didn’t know if people would really adapt to that. But being a critic in 20 years, I’ve seen people not only get the results, but they say, you know, I like eating this way now this is my new normal and I like it.

Joel Kahn, MD, FACC

So not everybody listening today knows that in 2010 our health care system in the United States recognize the Pritikin program in something called intensive cardiac rehab and said you can go to Miami after your bypass, after your, after your heart attack or if you’re having angina stable, you can go before your heart attack much better way to go and spend a week and do it. All people have heard of cardiac rehab. Not all have heard of intensive cardiac rehab and your insurance company after appropriate authorization will pay for the medical aspects of that. So tell us about the intensive cardiac rehab program please. Sure. I would be happy to.

Danine Fruge, MD

But I want to just say one little thing about how Nathan figured out about aerobic exercise even before the great Kenneth Cooper coins the word aerobic, okay. At that time he was told Nathan, you better not walk too far, you might find yourself faced up on the concrete, you better nap, you better take elevators. He actually saw some research on dogs and treadmills and saw how it increases blood flow to the heart collateral circulation in particular. So once again, he defied modern medicine at the time, which said, you know, food and exercise won’t do a thing. You can’t change this. He did a stress test on him every single week and that was the beginning of cardiac rehab. He actually said his heart disease would have reversed faster had he been able to do the pace of cardiac rehab. We do today.

So, intensive cardiac rehab is the pinnacle. I think Nathan would be very, very pleased at how that’s come out of his original work. I see our intensive means we do 72 sessions as opposed to 36 with general cardiac rehab. It’s a totally adversative with not only the exercise portion, but also teaching in the label, reading, teaching, the cooking, teaching the mindset in an outpatient basis We originally lobbied in to try to get discovered by insurance and have it at the Miami center, which we did for the beginning and everyone trained with us. We put all the hospital cardiologists, nutritionists, exercise staff, at the Pritikin longevity center here in Miami. However, in looking nationwide, the decision was made to now have it based out of individual hospitals. So currently we’re not actually running I see are out of Miami anymore now we’re running it through about 30 hospitals across the nation. Growing all the time. This was more advantageous to the patient. They could stay with their home cardiologists especially if they just had a heart attack and they felt more comfortable being in their own environment. And so they do it in many, many, many, many hospitals throughout the U. S. Where people can find a way to have that covered by insurance. It’s the exact same knowledge that pretty can use to reverse his own heart disease. It’s the same that we teach at the mother center where we are. 

Joel Kahn, MD, FACC

It’s fantastic. So people will spend 72 hours learning about plant based nutrition mind body medicine. But they’ll actually do the traditional cardiac rehab, which is perhaps a recumbent bike treadmill, a lightweights, be monitored very, very carefully. Again, I’ve been in the gym at the beautiful Pritikin Center in Miami and see you know that it’s a medically equipped gym and very carefully supervised. I will say I served as medical director of cardiac rehab at my very large hospital in suburban Detroit through 2011. And when we heard word that the Pritikin center had been approved. 

I agitated as a longtime plant based supporter to no success, I moved on to a different situation But quickly thereafter, ST. Joseph Mercy Hospital in Ann Arbor, about 45 minutes away from where I am right now and then their sister hospital in an area called Livingston County. Both put in the program I visited. I know the medical director. It’s changed, I refer to it. It’s changed lives. I tell people, you know, for 12 weeks or eight weeks just drive the extra 45 minutes because the education you’re going to get and the fact that it’s approved originally by Medicare. But now it’s extended to many, many other insurances. So fantastic stuff. Tell us about, you know, the experience with diseases because you may visit the Pritikin center in Miami and insurance won’t pay for it. But you might go for high blood pressure and what are you going to do for that person that says, I’m going to come in for a week or two. I need desperately a lifestyle change. I mean they’re going to see medical doctor.

Danine Fruge, MD

Absolutely. In fact, I think one of the best parts of the Pritikin program is the face to face time you get with the doctor who customizes everything for you. This is not to say that they lose touch with the doctor home. Of course we’re going to, you know, continue to have them follow up with their doctor. But this is an educational immersion program is in a resort setting where it’s a lot of fun. You don’t realize how much you’re absorbing in your habits, which is the thing that people find most difficult on their own in their home environment. We take you out of the rat race and you come for a healthy vacation, so to speak. But you’re learning and you’re learning so much that it becomes the new normal, very practical people say when I want results that come to Pritikin and this may be heart disease. Like I see are right, I see our does things for heart disease that is coronary artery disease. It’s been approved also for congestive heart failure. So we see a lot of folks with heart failure have to go back into the hospital, get loaded up with salt loaded up with fluid. We teach a way to eat healthy, where the salt is much lower to where the breathing is better. 

The weight comes off as you mentioned type blood pressure. That’s one of the claims to fame, 83% leave without medication. And this is sometimes people on four or five medicines leave on to somebody on two or one might leave on a half dose. Now, should they be off of the rest of their life? That’s gonna simply depend on whether they eat the way that their body needs them too. But the exciting thing is they get to see it in their own body day after day after day for two weeks. That’s our general program. Two weeks where you’ll get all of the lectures we recommend especially for someone’s first visit that two weeks gets you the fundamentals. And then the second week would be our action plan. How do you take all this great knowledge and experience home into your own environment take? So while to change the standard American diet, when you’ve grown up a certain way, we have a very full occupancy during holidays. Right now, during the winter season, we get very full people enjoy spending the holidays or even in the summer because that’s when we run our specials. So it turns out that there’s so many things that people learn and they don’t realize how much easier it makes the rest of their life. Doctors oftentimes will email us. And actually asked, what did you tell my patient? I’ve been telling them that all this time. 

And I said, well, it’s just a lot easier doing it in a group where everybody’s got the same mindset, it’s kind of enthusiast, you get motivation from seeing the person who’s sicker than you and say, wow, if I don’t change something that’s gonna make me in a few years or you might get motivation from somebody’s in their eighties or nineties who is really doing great and you’re like, wow, I never met anybody of that age that has this much mental awareness, cardiac. And then, you know, seeing the heart disease reverse hearing people who were told they were going to die. And here they are, 20 years later, they didn’t restenosis assistant. They didn’t clog their bypass. Because the truth of the matter is if you don’t change, those aren’t cures. You’re just going to clog the new one the way you clogged the original. So when people see all of this inspiration, it really flips the switch to where they I think say to themselves, there must be some kind of fool not to make these changes. 

And when it becomes the patients An idea and not the doctor, that’s what I love to see. It all comes full circle. The person says, is what I want to do. This is my health investment. This is worth it to me. So, it’s a really rewarding thing to see. Even type two diabetes, which I was not taught in school could reverse. I’ve seen that go into remission. And it’s quite fascinating that the same thing that helps your heart we believe is helping prevent dementia and cutting down on some of the what we used to call age related conditions. Now we think they’re more lifestyle than genetic in some cases. So it’s very, very rewarding that if you decide to take these steps, you can have a whole different experience of your current everyday life with energy being feeling better in your own skin and also the longevity, your risk of having chronic disease complications. Really plummets, Very rewarding to watch people discover that and live it.

Joel Kahn, MD, FACC

So you tossed out an absolutely amazing statistic that 83% of people that go through the two week program with an issue of high blood pressure will reduce or some eliminate their medicine while they are there. And obviously as long as they adhere to the program at home now, you know that because the Pritikin center is a research center, well, more than 100 medical publications. We’re not just taking this from your mouth, which is a very honest and ethical and esteemed mouth. But anybody can go to pub med dot gov National Library Medicine and go back to the what the 1980s maybe even the 1970s and see some early publications,

Danine Fruge, MD

70s even. Yes, Nathan Pritikin original study was on the veterans in California was a big study and as a matter of fact He was on 60 minutes, he’s been in the Congress, he’s recorded, there’s been so many land breaking really research that has shook the world to say, Wow, this really works. Cardiologists actually wanted to know where could they send their patients to learn what Nathan was teaching Nathan said. Well, send him on to the Pritikin Center and that’s where it was born back in the 19 seventies, incredible, incredible.

Joel Kahn, MD, FACC

And you know, let’s talk a little bit more about Nathan because he is so amazing. It was. And anybody can read like the book I have in front of me the Pritikin promise 28 days to a longer, healthier life by Nathan. Pritikin. And then there are many other books by other writers for the Pritikin center. But Nathan, you know, kind of gambled it all. He knew that he could reverse heart disease and when he passed away and around 1985, I recall tell everybody what he did with a request after life for his autopsy results. 

Danine Fruge, MD

He wanted it made public and the reason he wanted to make it public is because he knew he didn’t have disease anymore and he knew he used Have pretty serious disease. He wanted to show as a man, almost 30 years older, 30 years older, his arteries were clean, there was no heart disease. Thus proving his life’s work was very legitimate and evidence based.

Joel Kahn, MD, FACC

And if I recall again, I believe his autopsy, which of course he couldn’t have predicted during life. He was putting it out there that I have enough confidence that I’ll publish my autopsy postmortem. And it was, I think in the new England Journal of Medicine, which got a lot of attention and a lot of eyeballs is a very prestigious medical journal.

Danine Fruge, MD

Right, 

Joel Kahn, MD, FACC

Wow, wow. So we talked about something. People are, you know, clearly interested, 83% reduction or elimination during the stay in blood pressure medicine. What happens over two weeks stay on average? Of course we know people vary to wait. Let’s take that one. 

Danine Fruge, MD

Yes. So originally when people come in, we tell them weight loss is a side effect of healthy lifestyle. So your goal is not to try to dehydrate yourself, not try to starve yourself because we see in long term studies this does not maintain or sustain over a lifestyle a like a person’s lifetime, they generally don’t continue if you just focus on weight. So when people actually lose weight and pretty, again, it is not our focus to say, oh, you have to lose a pound a week or 10lbs a month or everybody is at their own pace based on their abilities. Some people are able to go faster, some people a little bit less, but everybody loses weight. The first certainly is when we drop salt, since water follows salt, like a sponge, people do, what’s the medical term? We diaries, which is we let go of all that fluid that kind of bloats you up and you know, makes your rings tight and the sock lines and so people are like, wow, I feel so much better in my body. 

Even my joints feel less stiff, which is quite fascinating. That’s a whole other talk for another day, but it appears that healthy lifestyle may have a role to play in the experience of the aches and pains of aging. So I think in general, people do are they are satisfied with their weight loss. But I want to really dispel the myth that we’re a fat farm, that maybe what some people have said. But we’re really not about just focusing on weight loss per se. Weight loss does come. And the best thing is this might be the last time you lose that last 25lbs you’re not going to yo yo up and down. So I just encourage people don’t put the focus just on the weight, but on what you’re eating and your body’s metabolism becomes more efficient and you enjoy food. 

Still, there’s no more of this emotional stress eating because you have a different relationship with food. Once you see food as medicine, you no longer see food as good or bad. Okay, and so all of these things tend to work themselves out. So I don’t put a whole lot of attention on, on the scale, although we do measure and people do want to know and they do this way. I’ll say it’s variable from in a two week visit, maybe somewhere between at the low side. 5lbs at the high side, maybe 10 or 12, depending on if it’s a man or a woman, how big we are, how much we, you know, we’re loaded up to begin with. 

Joel Kahn, MD, FACC

What might happen in two weeks to a total cholesterol, LDL cholesterol before and on discharge from the program.

Danine Fruge, MD

So we actually focus more on the triglyceride because that’s the immediate effect of eating. It’s a really fantastic to see blood pressure changes first. triglycerides the second, the triglycerides can go down, get this sometimes 33 to 50% in seven days. I came from a cardiac hospital. I would have never believed such results had a patient brought them to me. So, any doctors out there, if you’ve seen the pretty calm patient, they didn’t cheat. No, we don’t add statins to the food. I’ve been accused of that. We’ve been accused of putting blood pressure medicine in the food because people cannot believe that these numbers are real, they’ll say. But when I was 18 I had a cholesterol problem. Oh, I was already starting to show blood pressure in my twenties. 

I got the white coat syndrome, Which we all know probably happens more than in the Doctor’s office. So it is actually significant. We find that these folks never probably knew how to eat when they were 18. Think about it, how did we eat when we were young? We just did whatever we wanted to do. So, a lot of people who thought there was no way they could get lower numbers. See these amazing reductions. And as you know, triglycerides don’t really have much effect from statins. Statins don’t really work that well. So we see a huge effect from the food just within a week. The LDL can take away little bit longer. We do recommend people stay on their statins for the time being. If you want to earn your right to come off of the statin and I say earn the right, you have to prove yourself to your doctor at home that I like the quarterly plan. You do every three months and you’re checking how you are, spring, summer, winter fall, Once you’ve passed the test, your doctor sees that you’ve maintained beautiful numbers all year round now you can start talking about maybe the medicine can be reduced.

Joel Kahn, MD, FACC

I want to share an anecdote with you in the audience. But my parents went to Pritikin in California and came back with a completely changed perspective. Goodbye Hungarian goulash, Hello tofu stir fries. And I was again just entering college and medical school and this all made an impact on me and my own very long relationship with plant based diets. But they were invited there by friends of theirs who were just a couple of years older. Those friends are still alive at age 96 93 very vibrant and I think my mother ate dinner with them last night. But the female part of that relationship said to me a couple of years ago at age 89 you know, I have followed the Pritikin center program. Food so carefully for 45 five years. 

I want a calcium score, heart ct scan calcium score and I argued with her. You know, you’re doing wonderful. You look great. You have absolutely no symptoms. And she said to me, it’s $99. I just need a prescription. I’m very curious. I want to know. She is undoubtedly probably the oldest female ever shown to have a calcium score of zero. Of course you have a lot of 45 year old And there are zero but 89 and now I’m not going to retest her in 93. I’m pretty confident. She’s state zero. But it is an anecdote. I’ve never written that up and I don’t know for sure. That’s the oldest calcium score zero, winner of cardiovascular health. But sort of like Nathan’s own story. You always need a little bit more proof and there’s just more and more to share with you. So it’s made a big impact.

Danine Fruge, MD

That’s inspirational. Thank you so much. The more we hear stories of real living people who are doing it, the more people realize, wait, if they can do it, maybe I should try and there’s a lot of evidence out there. So it’s very exciting to meet real people who have done it.

Joel Kahn, MD, FACC

I just want to talk a little about the website because I get emails regularly and their website is Pritikin.com. P R. I. T. I K N dot com. And I am sure that there’s a place for anybody listening to sign up and get free newsletters. I don’t find them sales leads. So nobody needs to get too worried. You guys have a library of resources for people to check out. Why don’t you talk about that a little bit? 

Danine Fruge, MD

Yes. So we have a fantastic new updated website. There’s sections for professionals to look at the research and anybody really who wants to look at the research. There’s articles all the time. We call it the Pritikin perspective. You get to see what other people have said, who have come and their success stories. Again, more real world people. You get to meet your program advisor and you ask any questions, you’re right. It’s, we don’t do any kind of a high pressure sale. The program speaks for itself. What we do is we have people come in and they’ll do an exercise treadmill test, they’ll get their blood, they get time with the doctor. That is, you know, quite frankly, a lot of facetime where you can customize what their goals are rather than problem list. We call it goals because people have health goals and this is a health investment and then we figure out how best to customize prediction for each and every individual’s goals. I will also point out and the team of doctors that I work with are fantastic. 

We will all teach what is the most important, probably priority of those health goals and will show, so what is the most practical way to achieve that in the real world. We have dining out experiences. We have grocery store shopping trips, where you can put your label reading class to real work in the real world where you can practice ordering and eating with one of our nutritionists to see how to overcome some of the hidden things that you might think are healthy. And I actually really think that that’s valuable. And people say that’s really a shock and awe type of situation, A lot of folks are really, really trying to eat healthy and when they learn weight that isn’t healthy, that doesn’t have what I thought in it or that does contain you mean that’s not really 00 doesn’t mean zero on the food label. How is this possible? And people are really, really shocked. So I’m very proud of the educational piece that people will get from the website, tons of articles, lots of resources, that’s all free and then if they come for a visit the education is just, that’s why I work there. 

I actually lived two hours away. I literally drive to come to this place because it is so amazing. It is just absolutely, I can’t think of any better way to put it all together with our nutritionist or exercise staff are cooking school, our mindfulness behavioral health psychologist to help people find easy ways to break through some of those places where they were previously stuck and make it in a way that you know, it’s fun and enjoyable to the point where people say I can do this. My favorite words that anybody can say is, wow, I can’t believe I could do this, but now I do believe I can do this, this has changed my life. And that’s just the most rewarding thing. Any doctor can hear. 

Joel Kahn, MD, FACC

The passion is using the honesty is using the sincerity is using and I think a lot of people really appreciate that and did not know that there’s this many decades history of lifestyle and heart disease reversal and you know, not everybody can go to, you know, I see our program, not everybody can go to True North and amazing program when we have interviewed Alan Goldhammer and all and you know, people need to know that this amazing program is, is alive and well and if people don’t want to stay at the resort. But are either living nearby in Miami or all, Maybe it’s an economic thing. Can they stay at a nearby hotel or maybe they live two minutes from the Pritikin and just be very good students for two weeks of driving and coming.

Danine Fruge, MD

Well, typically we recommend people stay at the resort because what we find is once you go back to your home environment, things fall apart when you’re in our hotel room. Should don’t have to worry about what happens if the food calls your name in the middle of the night when you don’t really feel like getting up through the traffic and getting to work out when you can just walk out of your villa across the beautiful golf course area and the pools and you see all the lush environment and you say, you know what, this is what I deserve. So we have not found when people live at home and try to do it in and out patient that it’s as effective. Sure. I think that people can learn really anyway, that they’re open to, but there is something quite magical, quite phenomenal about just being immersed in it. And I think that it’s a gift that you can give to your loved one to yourself. It was a gift that your parents gave to you. My parents gave to me the gift of learning about health at a young age. 

So I think that sometimes it’s worth that one time one shot, even if you couldn’t come more than once just to see, you know, what do I need to know, I need an owner’s manual for this body, This is the only one I got, it’s a classic at this point we need to be able to protect it. If somebody is working on something that is a more difficult health goal, we’ve had people stay a couple of months believe it or not and you know, literally change their mobility, change their whole situation, work from there. Some people get hotel rooms in work. Some people will come back at three months or six months or annually. A lot of my patients in their nineties I met in the seventies and they literally came back every year and they credit why they’re hanging out with younger people able to do things younger people do rather than their peers who have often unfortunately passed on. They credit just getting the mindset, getting the reset, getting the refresh. So I think staying at the resort, it’s probably worth it for most people to get that immersion experience.

Joel Kahn, MD, FACC

If somebody listening right now, they can go to the website, the website will have a way to contact or apply or speak to an advisor about arranging a visit in the next few months. Right?

Danine Fruge, MD

We have something, we call a medical application, just kind of like applying to college but a lot easier and you give us a little bit of your background and we make sure we customize the program for you. In the past we weren’t sure about people with chronic kidney disease because some people’s kidneys weren’t able to handle. Someone quite frankly, their fruits and vegetables, their body had to be very carefully monitored. People that are on insulin insulin pumps. So we know how to monitor this now. After all these years with our nutrition team and our award winning chefs, we’ve been able to customize programs. Somebody did not fill out an application. They just show up cold like you would to any hotel, we wouldn’t be able to design the best program for you. So we tried to take everyone we can and give everybody a chance so that they can have the most bang for their buck, so to speak.

Joel Kahn, MD, FACC

I just want to ask your last question. You do believe that heart disease is a reversible condition.

Danine Fruge, MD

Listen, I can’t believe I’m this old and I’m saying this. But when I was in medical school I knew as a former athlete that there was much more could be done in the field of lifestyle. I knew it. I absolutely knew it, but we weren’t allowed to say it. And now we’re living in the time where we can actually say these diseases. Yes, they can go into remission. But due to people like Nathan Pritikin and the research of Dean Ornish and many of the other greats we have seen this is actually reversing disease. We even had a ophthalmologists come, he saw retinopathy get better. I didn’t even know that could happen. Quite, quite phenomenal buddy living in this day and age.

Joel Kahn, MD, FACC

Well, I agree. And I’m more excited practicing cardiology and medicine than any time in the last 33 years of my career. So thank you so much for taking the time for sharing the passion, the experience of history and the results. I think for a lot of people they’re going to be fired up to check out Pritikin.com and hopefully there will be a lot of people will meet you face to face as medical director. So thank you so much for your kindness.

Danine Fruge, MD

Absolutely. Thank you for having me and just everybody come on down. It’s a great experience. Thank you so much, Doctor come for doing this fantastic summit to get the awareness out that this is something you don’t just have to give up on. You can definitely do it well.

Joel Kahn, MD, FACC

It was a better summit because it included you. So thank you.

Danine Fruge, MD

Thank you.