“When diet is wrong, medicine is of no use. When diet is correct, medicine is of no need.”

—Ayurvedic proverb

Still groggy from being sedated, Paul Chatlin lay on a gurney contemplating the worst news of his life. After months of chest pain, he had just undergone a diagnostic heart catheterization, and it showed a right artery that was 100% blocked, two others at 65%, leaky valves, an enlarged heart, and a heart murmur to boot. The doctors said he needed a heart bypass, and fast. The only question was, would it be a triple or a quadruple? At just fifty-six, his life was in immediate danger.

Unfortunately, Chatlin’s predicament is anything but rare in America today, where more than three hundred thousand people get heart bypass surgery every year, often in their fifties and sixties. Many won’t live out the next decade. And even for those for whom heart disease is not a death sentence, it is often a life sentence, a harbinger of physical decline and increasing debilitation. Killing more than 375,000 Americans a year, heart disease remains the number-one cause of death in the United States. It is also the leading cause of death worldwide, taking more than 17.3 million lives annually.¹ Sadly, precious few among those millions are ever given the choice that Chatlin’s doctor gave him, just minutes before he was wheeled into the operating room: “Would you consider plant-based nutrition as an alternative to bypass surgery?”

Chatlin, a telecommunications consultant from the Detroit suburbs, had no idea what “plant-based nutrition” meant, but he knew that anything was preferable to a heart bypass. His own father and several other men in his family had never been quite the same after their surgeries. He looked up at his doctor and said, “Yes.”

Chatlin didn’t know it, but he had won the lottery that day. He was already lucky, thanks to a family connection, to be a patient at the world-famous Cleveland Clinic—one of the top facilities in the world for the treatment of heart disease. Even more remarkably, out of the hundreds of doctors he could have been assigned to, he had ended up with one of only a handful who were familiar with, and who advocated, plant-based nutrition. As Chatlin lay on his gurney, his doctor got out his phone and dialed his mentor, Caldwell Esselstyn, MD, and despite the late hour, “Essy” took the call.

Dr. Esselstyn’s message to Chatlin that night was short and sweet: “Go home. I’ll give you a call tomorrow morning.” He did just that, at eight a.m., outlining his unconventional approach to heart disease: a plant-based nutritional program that treats both the symptoms and the underlying disease itself. Chatlin listened carefully. Chance may have opened a previously unseen door, but now it was up to him to walk through it. And the first step, he recalls, was “taking 95% of the food in my kitchen and donating it to charity.”2 Then he went shopping—in the produce section.

For those accustomed to a Standard American Diet, switching to plant-based nutrition involves a radical remaking of what’s on the plate and in the pantry. It means changing a lifetime of habits, learning new skills, and developing new tastes. As we’ll discuss in chapter 12, some people do best with a slow, step-by-step transition, while others choose to go all in, all at once. Chatlin belonged to the latter group, at least in part due to the severity of his disease. He changed his diet, immediately and completely. And his health changed just as fast. Within three weeks his angina (chest pain) disappeared. Over the next year his cholesterol level dropped from 309 to 122, he shed more than forty pounds, and his energy levels improved significantly.

As you might imagine, with a story like this to tell, you would be hard-pressed to find a more passionate evangelist for the benefits of a whole foods, plant-based diet than Chatlin. But his tale is hardly unique—particularly not among patients of Dr. Esselstyn.

Clinical Pioneers of Plant-Based Nutrition

Caldwell Esselstyn did not train as a cardiologist. In the late 1960s, however, an accident of alphabetical proximity meant that this thyroid surgeon shared a locker at the Cleveland Clinic with René Favaloro, the celebrated Argentinian cardiac surgeon who performed the first heart bypass surgery in 1967. Esselstyn and Favaloro talked at length about the causes and consequences of heart disease. Favaloro’s innovative approach to surgery would go on to affect tens of thousands of lives over the next decades, but did little to address the underlying issues that put people on the operating table in the first place. Esselstyn, on the other hand, grew increasingly disillusioned with the conventional approach to “America’s silent killer.”

Heart disease, like other common American diseases, including breast cancer, prostate cancer, colon cancer, and diabetes, has been found to be rare in parts of the world that eat more traditional diets. But once those same regions adopted more Western-style diets, with higher levels of animal products and processed food, disease rates skyrocketed. This was true not just in China but in Japan and in parts of Africa. Researchers also noted that when individuals moved to regions of the world where these diseases were prevalent, they would soon develop the same problems as the communities around them. This tells us that the problem is not genetics, as many believed. Genetics may load the gun, as they say, but diet pulls the trigger.

Research also shows that heart disease is not just a problem of the elderly. Autopsies of fallen soldiers in Vietnam and Korea revealed that heart disease was common even in the young—80% of the young American troops showed signs of it in their arteries. (It was largely absent in the Asian soldiers.)3 Studies have shown that by the age of ten, nearly all children show fatty streaks on the arteries, the first signs of arterial damage, and that these may even begin developing in the womb.⁴ Heart disease does not just appear right before a heart attack. Most Americans already have it. As Esselstyn reviewed all this research, he began to wonder. Could heart disease be stopped? And could it be done through diet?

He was not the first to ask these questions. In the late 1950s, a young man named Nathan Pritikin had been diagnosed with heart disease at just forty-two years of age. Through a long experimentation with diet, he eventually reversed his disease. In 1975, he opened up a “longevity center” in California to share his regimen, which was essentially a whole foods, primarily plant-based diet, along with exercise every day. Pritikin’s patients got better—a lot better! Risk factors for heart disease improved across the board, cholesterol went down, and arterial function and blood flow improved, along with a host of other health transformations. Pritikin’s work attracted a great deal of attention in his day, but without medical credentials or controlled trials, he was never fully accepted by the establishment. Since his death, more than 100 studies in peer-reviewed journals have validated the program’s effectiveness. Meanwhile, however, the task of scientifically demonstrating that diet and lifestyle change could reverse heart disease was being taken up by an independent-minded young physician from the Lone Star State.

Dean Ornish, MD, had been curious about how diet and lifestyle—a whole foods, plant-based diet, moderate exercise, yoga and meditation, and social support (love and intimacy)—might impact heart disease since his medical school days. In fact, he conducted his first small study in 1977 after his second year at Baylor College of Medicine in Houston, asking Dr. Antonio Gotto, the chief of medicine there, to refer heart patients to him so he could conduct an experiment to see whether yoga and a vegetarian diet could reverse heart disease. This was long before the days when there was a yoga studio on every other block—such ideas were part of the just-emerging counterculture. His skeptical supervisor asked, “Should I say I’m referring patients to a swami?” but Ornish won him over by calling it “stress management training and dietary changes” and got ten participants enrolled.5 This was the heyday of bypass surgery, so the only patients who were referred to him were those who were too sick to undergo surgery or had refused it.

Eight of the ten participants showed significant improvement in blood flow to the heart after only one month. This was the first study showing that heart disease could be reversed by lifestyle changes alone.6

Ornish completed medical school in 1980 and began a new study—this time, a randomized controlled trial of forty-eight patients. After only twenty-four days, the patients who made comprehensive lifestyle changes showed improvement (reversal) in their heart disease, whereas those in the randomized control group got worse. This, the first randomized controlled trial showing that lifestyle changes alone could reverse heart disease, was published in the Journal of the American Medical Association.

The results of these two studies were both statistically significant and clinically significant, and Ornish published his first best-selling book on the topic in 1982.

After completing his medical training at Harvard Medical School and Massachusetts General Hospital, he moved to Sausalito, California, became a clinical professor of medicine at UCSF, and established the nonprofit Preventive Medicine Institute to continue the research. In 1984, he launched the Lifestyle Heart Trial.

Back in Cleveland, Esselstyn was also developing a study. He had encountered some resistance from the establishment. Most senior cardiologists at the Cleveland Clinic, he writes, “did not believe there was a connection between diet and coronary disease.”⁷ Nevertheless, in 1985, the Department of Cardiology agreed to participate in his first proposed study. It would refer patients to him—primarily those for whom bypass surgery or angioplasty had failed, and several who had been told there was nothing more that could be done for them. Esselstyn’s hypothesis was that plant-based nutrition could reduce their cholesterol levels to below 150 mg/dL (closer to the level seen in those traditional cultures that had no heart disease) and in so doing, slow or halt the disease process. By 1988 a cohort of twenty-four people with severe, progressive coronary artery disease was eating a very low-fat, plant-based diet under his supervision.

From a dietary standpoint, Ornish’s and Esselstyn’s studies were very similar. However, unlike Esselstyn, who instructed patients to continue their medications, Ornish did not use cholesterol-lowering medications in his study. Moreover, he stipulated other lifestyle changes in addition to the nutritional component, including relaxation techniques (yoga and meditation), moderate exercise, smoking cessation, and participation in a support group—interventions he believes are also critical to the success of the program. His study included forty-eight patients who were randomized into two groups: twenty-eight of the patients made the recommended diet and lifestyle changes, while the other twenty served as a control group, following standard medical treatment and dietary advice from the American Heart Association.

Ornish’s work was the first to be made public. In 1990 he published the one-year results. Most of the experimental group reported a complete or nearly complete disappearance of chest pains. But patients not only felt better, they were better. When measurements were taken of their narrowed arteries using angiograms (a form of arterial X-ray), 82% showed an increased diameter (reversal). Only one patient who had poor adherence showed significant progression (worsening).

The implications of these data were revolutionary: coronary artery disease not only could be halted through lifestyle change, it could be reversed. This group also showed a 37.2% reduction in LDL or “bad” cholesterol. In contrast, patients in the usual-care control group, who made more moderate changes in lifestyle, reduced LDL cholesterol levels by only 6%, had a 165.5% increase in reported frequency of chest pains, and showed progression (worsening) in narrowing of the coronary arteries.8

Five-year results from the study continued to turn conventional wisdom about heart disease on its head. The experimental group showed further improvements in arterial blockages (an average of 8% improvement) and experienced 2.5 times fewer cardiac events than the control group, whose measurements worsened by 28%. There was a dose-response correlation between adherence to Ornish’s lifestyle program and changes in their coronary arteries—at any age. Also, there was a 400% increase in blood flow to the heart in the experimental group patients when compared to the randomized control group as measured by cardiac PET scans. These results were published in the Lancet and the Journal of the American Medical Association, two of the most prestigious medical journals in the world.⁹

Meanwhile, Esselstyn was getting similarly impressive results from his own study. After five years, average cholesterol levels among those who adhered to the program were almost halved. Among those patients on whom he was able to conduct follow-up angiograms, none showed further narrowing of the arteries, and approximately 70% showed evidence of reversal. Most significantly, no new cardiac disorders or other evidence of heart disease progression occurred during the twelve years of the study, compared with forty-nine incidents among those same patients prior to the study. Among patients who dropped out of the program and returned to their regular diet, there were thirteen new cardiac incidents, including one death.¹⁰

In 2006, Esselstyn launched a second, larger study, this time following 198 patients who adopted his plant-based nutritional program. In 2014 he published the results: of those who complied with the diet, 93% experienced improvement in angina symptoms. And only one patient experienced a major cardiovascular event due to recurrent disease (a stroke)—demonstrating that his diet was protective for 99.4% of patients who followed it. In comparison, among the twenty-one participants who did not adhere to the program, thirteen experienced further cardiac events, including two deaths.11

Ornish’s and Esselstyn’s studies represent a dramatic medical breakthrough. Until that point the best that drugs and surgical treatments could do was manage heart disease. They ended up doing something few even believed was possible: they showed that heart disease is reversible. And they did it with lifestyle interventions that had no negative side effects. Simply by stopping eating foods that were clogging up their arteries and instead eating healthy plant-based fare (and in Ornish’s program, practicing relaxation techniques, exercising, and participating in a support group), their patients began to heal—at any age. Their remarkable turnarounds show that it’s never too late when it comes to heart disease.

It’s hard to overstate how significant this research is. It takes the suggested correlations of observational science such as The China Study or the Adventist Health Studies and puts them to the test in controlled clinical settings, showing the extraordinary power of whole plant foods to succeed where the best of modern medicine has fallen short. So how were these groundbreaking results received by the nutritional establishment and the general public? Initially, Ornish recalls, “We had a lot of opposition to our work because it didn’t fit within the conventional paradigm.”12 But without question, the last decades have seen a massive uptick in our culture’s general appreciation of the role of diet in heart disease. Ornish has become a hero to many and something of a health celebrity, thanks in part to some high-profile patients like Bill Clinton. In 2010, Medicare agreed to offer coverage for Ornish’s program and most insurance companies now do so as well. Others, like Esselstyn, have confirmed the viability of this approach and added their own significant evidence to the mix.

Recently the American College of Cardiology had its first plant-based president, Dr. Kim Williams, who remarked upon assuming the position: “Wouldn’t it be a laudable goal… to put ourselves out of business within a generation or two?”¹³ Williams chaired a six-hour symposium on lifestyle medicine, the first ever at the ACC, at its most recent annual scientific session in Chicago, with Ornish as a speaker, and several hundred cardiologists attended, with many more being turned away at the door.

However, people like Williams are still the exception, not the rule. When it comes to the overall medical establishment, remarkably little has changed. It’s almost as if someone found a cure for our number-one killer, and no one noticed or cared. Far too many people still don’t seem to have gotten the memo, and unfortunately this includes many doctors. The majority of medical professionals and institutions still operate as if we do not have evidence that a whole foods, plant-based diet can prevent and reverse heart disease—the cause of hundreds of thousands of deaths and billions of dollars in healthcare costs annually, not to mention untold suffering across the nation and globe. And culture in general seems to view heart disease as if it were a natural and even inevitable consequence of old age, rather than a preventable foodborne illness.

Yet Ornish is hopeful that a shift is beginning. “There has been a convergence of forces that I think are finally making this the right idea at the right time,” he says. “The limitations and costs of conventional drugs and surgery are becoming increasingly clear, the power of lifestyle change is also much more well-documented, preventative measures are becoming increasingly incentivized in today’s healthcare system, and Medicare and most of the commercial insurance companies are making it more financially sustainable and attractive for physicians and other healthcare professionals to offer our lifestyle medicine program.”14

We hope that the next decade proves Ornish’s optimism to be well founded. As Dr. Greger puts it, “The fact is, there’s only one diet ever that has been proven to reverse the number-one killer of men and women in this country—a whole foods, plant-based diet. So shouldn’t that be the default recommended diet until proven otherwise? Even if that’s all it could do—reverse heart disease—the whole debate should be over!”¹⁵

And yet, amazingly, that’s not all it can do. Ornish has recently had promising results using his program in a randomized controlled trial with early-stage prostate cancer patients and hopes to undertake a similar trial with early-stage breast cancer patients. A whole foods, plant-based diet has been shown to significantly affect a whole host of other chronic conditions, including type 2 diabetes (see chapter 6), colon cancer, Alzheimer’s disease, high cholesterol, high blood pressure, and Parkinson’s disease.

The Big (Saturated) Fat Debate

It’s impossible to raise the issue of a nutritional answer to heart disease without running headlong into the debate over dietary fat and its relationship to cholesterol. As you know from chapter 1, we don’t love the idea of focusing on individual nutrients like saturated fat instead of whole foods, given that we don’t eat nutrients, we eat food. However, for the sake of helping you navigate nutritional concepts that you’ll inevitably be confronted with, let’s take a moment to talk about saturated fat.

Official American dietary guidelines encourage us to reduce our consumption of this particular type of fat because of long-established links to heart disease. What that means, in practice, is reducing consumption of animal products, like red meat, chicken, fish, eggs, butter, and milk, since saturated fat is rarely found in significant amounts in plants (coconut oil and palm oil being notable exceptions).

Consumption of saturated fat has been shown to raise LDL (or “bad”) cholesterol, which represents a significant risk factor for clogging the arteries. Other foods that raise LDL cholesterol include trans fats (a type of processed unsaturated fat found in animal products and hydrogenated vegetable oils) and dietary cholesterol (cholesterol we consume when we eat animal foods). A whole foods, plant-based diet reduces each of those three to minimal levels, which goes a long way toward explaining its success in treating heart disease.

The connections between saturated fat, cholesterol, and heart disease were first made in the late ’70s and early ’80s, the discovery being largely driven by the work of American scientist Ancel Keys, who noticed a strong correlation between populations that consumed a lot of saturated fat and high rates of heart disease. His research, and others’, led to the framing of saturated fat as deeply implicated in heart disease. This categorization was not undeserved, but people fell into the common trap of blaming everything on a scapegoat nutrient rather than on actual foods. Over time, saturated fat was reduced in the public mind to just “fat,” and an obsession with “low-fat” foods followed.

Unfortunately, nutrition is inevitably more complex than that. Fat in itself is not good or bad for you—but certain foods are good or bad for you. High saturated fat content is a likely marker for a poor diet, high in animal foods and highly processed foods.

Some years after Keys’ work was published, studies began to question whether saturated fat was the singular evil it had been made out to be. Sure enough, they found that other factors were implicated in heart disease as well. Some fingered refined sugars and highly processed foods. Others pointed to animal protein. But too quickly the reasonable message that “saturated fat isn’t our only problem” became the dangerous message that “saturated fat isn’t a problem at all,” which, on the cover of Time magazine, got translated into the 2014 headline “Eat Butter!”

Over the last few years, you may well have encountered such articles, declaring that saturated fat has been exonerated, or that its link to heart disease is unproven, and therefore we should just go back to enthusiastically enjoying meat, butter, and other high-saturated-fat foods without concern. Popular authors Nina Teicholz and Gary Taubes have been among the most outspoken promoters of this point of view, along with celebrity doctor Mark Hyman.

These conclusions are based on a few highly criticized and problematic studies, and the overall science does not back them up.16 Yale’s David Katz clarifies the issue, writing, “We do, indeed, have evidence that saturated fat is not, and never was, our lone dietary peril. Excesses of calories, sugar, refined starch, sodium, and transfats—among others—share in that indictment.”¹⁷ However, he strongly criticizes people who “take just such evidence and pretend it suddenly means lard is manna from heaven.”¹⁸ He goes on to point out that all of the world’s best diets, associated with the best health outcomes, including the Blue Zone diets, are notably low in saturated fat, due to minimal animal foods. In other words, you don’t need to worry about saturated fat if you simply eat whole foods, mostly plants.

Currently the best scientific evidence we have tells us that meat, eggs, cheese, dairy, and yes, the saturated fats and animal proteins that go along with them should be minimized in a healthy diet—along with highly processed food and added sugars. Our recommendation is to limit animal products to 10% or less of your calories. Those who already have advanced heart disease or certain other conditions may want to more significantly cut back on animal products, in line with Ornish’s and Esselstyn’s recommendations. Ignore the noise; focus on whole foods, follow the sober science, and you’ll enjoy a healthy heart for a long time. Oh, and Ancel Keys, promoter of a Mediterranean-style diet rich in fruits and vegetables, may have had the last laugh. He retired to his Italian home, near the Mediterranean Sea—and lived just two months shy of his 101st birthday.

A Rising Tide

We are hopeful that in the not-too-distant future there will come a day when someone like Paul Chatlin does not have to win the lottery to hear about the benefits of a whole foods, plant-based diet and be offered it as an alternative to surgery. The medical establishment is changing gradually, doctor by doctor. But as Ornish reminds us, the establishment is never where real change begins.

Among those working hardest today to raise awareness of the healing power of a whole foods, plant-based diet and help people stick to it is Chatlin himself. As his own health began to turn around, he made a promise: he was going to do something to give others the opportunity he’d been given. “When I first started my journey, I called a hundred and fifty doctors’ offices to let them know about the power of plant-based nutrition,” he recalls. “I got one call back.”19 Finally, in 2014, he found an integrative cardiologist, Joel Kahn, MD.

Kahn, who practices in Detroit, had been eating a plant-based diet himself since the late ’70s, but it was only when he stumbled upon Ornish’s research in The Lancet, just after he completed his advanced cardiology fellowship, that he made the connection between the food on his plate and the patients he saw every day. “At first I thought it was nonsense!” he remembers. “I’d just spent seven years learning to treat heart disease with balloons inserted into arteries, and here’s this guy I’ve never heard of saying he can do it with diet.”20 But he was intrigued. He read the article twenty-five times, and then started telling all his patients to read it.

Chatlin invited Kahn to partner with him in forming a support group for heart disease patients who wanted to make the transition. They scheduled their first meeting for a cold February evening at the hospital where Kahn worked. “The room was designed to hold sixty people,” he recalls, “but we ended up with more than double that number packed in. To this day, I have no idea where they all came from.”²¹ The next month, 150 people showed up. The medical establishment may not have been open to Chatlin’s message, but patients were. And they told their friends and loved ones about it.

Today, the Plant-Based Nutrition Support Group (PBNSG) has close to three thousand members—men and women, young and old, who are using a whole foods, plant-based diet to lose weight, reverse heart disease or diabetes, control hypertension, get off medications, and much more. “We started out as a cardiac support group,” Chatlin recalls, “but then I realized it was selfish of me to think that that’s all it should be, so I expanded it.”²²

Monthly meetings, featuring talks by luminaries in the field, are often attended by several hundred to a thousand members. In addition PBNSG offers small-group local meetings, nutritional tours of grocery stores, and community walks. It works with local restaurants to get more plant-based options on menus, and is developing a plant-based nutrition curriculum to be taught in medical schools. “I realized there wasn’t much hope for change with established physicians. I decided to focus on future doctors,”²³ Chatlin says. Medical students from five Detroit metro-area colleges can now get credit for attending PBNSG lectures, and Chatlin makes sure every one of his distinguished guests, who have included T. Colin Campbell, Caldwell Esselstyn, Joel Fuhrman, John McDougall, and many more, speaks at a local medical school as part of his or her visit.

In a medical world that does not yet embrace the power of plant-based nutrition to heal and cure the chronic diseases of our sick nation, PBNSG meetings provide encouragement and camaraderie. Members talk, laugh, swap stories and recipes, listen to speakers, and share their struggles and their successes. Many have remarkable stories to tell.

There is Shannon Farrell, a forty-seven-year-old cardiac nurse who found herself, in her mid-thirties, in a downward spiral of health problems including diabetes, Hashimoto’s thyroiditis, and severe heart failure. One doctor told her she had fewer than five years to live. Through transitioning to a plant-based diet, Shannon lost eighty-five pounds, reduced her daily medications from twenty-six to just four, reversed almost all of her conditions, and ran her first half marathon this year. “I need to get a new passport photo,” she says, “because people don’t believe I’m the same person!”

There is David Henderson, who at age sixty-five was overweight and short of breath and felt he was “living on borrowed time.” His father and one set of grandparents had had massive heart attacks; the other set of grandparents had had massive strokes. David was sure he was next—until he learned about the power of plant-based nutrition and started to change his diet, “one meal at a time,” as he puts it. PBNSG supported him through a sixty-five-pound weight loss. “I have much more energy now,” he says, “I used to be out of breath just dragging my trash cart back up my drive. Now I can run up like I was a teenager! Sometimes I ask myself, whose body is this? And all I did was change my diet.”

Detroit might seem an unlikely frontier in our country’s efforts to stem the tide of obesity, diabetes, heart disease, and other foodborne epidemics. But spend a few days there and you might start thinking differently. A growing crop of plant-based cardiologists, nutritionists, medical centers, and restaurants—including Dr. Kahn’s GreenSpace Café, the largest plant-based restaurant in the Midwest—is dedicated to helping people improve their health through the power of whole plant foods.

This quiet revolution is not occurring just in Detroit’s wealthy suburbs. Head across the infamous 8 Mile Road and into the recently revitalized downtown and you might run into Akua Woolbright, PhD, a nutritionist who works with Whole Foods Market’s Whole Cities Foundation. Woolbright has spent the past three years taking her message to Detroit’s diverse communities, speaking at churches, street fairs, beauty salons, and barbershops, and, more recently, in a new teaching kitchen, where every class is filled to capacity.

“People don’t want a watered-down message,” she says. “They don’t just want to hear, ‘Eat a few more vegetables.’ From my first day here, this community demanded the hard science.” What does she tell them? Eat real food. Eat plants. And cut out the processed food that’s poisoning you. “You can’t keep eating a hot mess and then throw some goji berries on top and think that will make you healthy! To achieve health and wellness, you must make a bold change to a whole foods, plant-based diet. There are no shortcuts.”24

Woolbright has witnessed similarly powerful results to those reported by her neighbors at PBNSG. People are losing weight, getting off medications, reversing chronic disease, and taking control of their health, many for the first time in their lives. Inspired by these successes, Woolbright and her colleagues at Whole Cities Foundation now train and mentor other advocates to take the message to communities like Chicago’s South Side and New Orleans’ Ninth Ward.

Detroit is a reminder that in America bad eating habits and their deadly results cut across race, class, and income, afflicting young and old, rich and poor, urban and rural, native and immigrant alike. So it is fitting, perhaps, that a city once considered a microcosm of our nation’s deepest problems is discovering, in the nutritional power of real food, a pathway to healing.

Our national health crisis is significant, and it is deeply entangled with our institutions. Industry, government, education, and healthcare each play a part in reinforcing unhealthy patterns. However, the change that is needed will not start at the top. As our friends in Detroit and thousands of others across the country are demonstrating, change starts with individuals who want to be healthy and want to know the truth about how to get there. It starts with people who experience the power of food as medicine and begin to tell other people about it—not just their families and friends, but their doctors, their local restaurants, their children’s schools, and their corner stores. Slowly but surely, plant-based whole foods are becoming more widely available, and it’s happening because America’s consumers are beginning to ask for it. Pioneers like Dr. Ornish and Dr. Esselstyn, among others, have given us the proof of what’s possible. It’s up to all of us to do our part by embracing our own health potential and encouraging our friends and family to do the same.