with Dr. Caldwell Esselstyn



Meet Joe Inga, a New York City firefighter with Engine 72 in the Bronx. Joe decides to buck the firehouse culture by doing something as nutty as eating plant based! That’s right – no meat, no dairy, and nothing with a face or a mother. As you can imagine, change is hard. But Joe is on a mission and damn the torpedoes! Between being a new father, battling addiction, and recently coming face to face with his own mortality, Joe needs support. In Season 1 we’ll follow Joe’s ups and downs as he moves towards becoming the plant-strong man he knows he can be!

Season 1, Episode 1: Meet Joe, Rip & Essy

Also meet Rip’s dad, the world renowned Dr. Caldwell B. Esselstyn, Jr., from the Cleveland Clinic and learn how he trekked upstream against all the naysayers to discover the causation of heart disease and how our fork can be our most powerful ally in halting and even reversing the #1 killer of Americans!

Hear why you should care about nitric oxide and the four reasons it’s critical for cardiovascular health. Discover what foods have the highest antioxidant value, plus why and how you should eat them. And most importantly, understand all the life-saving benefits to eating a plant-strong diet from the man who pioneered the research.

Dr. Caldwell B. Esselstyn, Jr. is the author of the New York Times bestseller Prevent and Reverse Heart Disease. Dr. Esselstyn was a researcher and clinician at the Cleveland Clinic for more than thirty-five years. In 1991, he served as the president of the American Association of Endocrine Surgeons and organized the first National Conference on the Elimination of Heart Disease. In 2005, he became the first recipient of the Benjamin Spock Award for Compassion in Medicine. Dr. Esselstyn and his wife, Ann Crile Esselstyn, have followed a plant-based diet for more than thirty years. They work together to counsel patients in Cleveland and at the farm in Upstate New York where Dr. Esselstyn grew up.

Transcript of Episode 1: Meet Joe

Rip Esselstyn: I got this email and I want to read it to you. It says, "Rip, good evening! My name is Joe Inga. I am a huge fan of yours and the documentary Forks Over Knives."

Joe Inga: I was having some major personal issues. I was battling addiction with alcoholism and I kind of was in denial over the whole thing. I didn't realize that I have this issue and I actually ...

Rip Esselstyn: "I am an FDNY firefighter assigned to engine 72 in the Bronx. I am 5'6" and weigh over 210 pounds with extremely high cholesterol and triglyceride numbers."

Joe Inga: I actually was home one day and I saw on Netflix they had just put on the Forks Over Knives documentary so I put it on and I set up in my chair when it happened. I was like, this is unbelievable.

Rip Esselstyn: "Over the past seven years I have adopted a whole food plant-based diet on several occasions, usually once a year for 90 days as a cleansing method."

Joe Inga: But it's very difficult to do in my line of work so I ended up fading from that.

Rip Esselstyn: "I really would like to adopt this program regularly but I desperately need your help as a fellow firefighter."

Joe Inga: If I was climbing a ladder but I wasn't in the shape or I was groggy or I was tired or I wasn't in the shape that I should have been in, I've got two kids at home you know?

Rip Esselstyn: "As a fellow firefighter and the only one I know who does this as well I could use your input on handling these situations since you are familiar with them. Thanks and keep up the good work."

Rip Esselstyn: The crazy thing is that most firefighters, they don't die fighting fires. They die of heart disease. It's also the number one cause of death for Americans so if you are eating the standard American diet it's coming after you too.

Rip Esselstyn: I'm Rip Esselstyn, the founder of Engine2, and I want to help Joe. I want to give him the support and the information and the motivation that he needs to make the decisions that are going to save his life and I want to give them to you too. So welcome to plant strong.

Rip Esselstyn: What was it about Forks Over Knives that hit you, that made you sit up in the chair as you said?

Joe Inga: Just the science behind it. Just it all made sense. I had heard briefly about it and everybody as always, you should eat your fruit and vegetables or whatever. I come from an Italian background so we love our pasta, we love our sausage and our meatballs and stuff like that but it was kind of the science behind it. But then with most things you hear about it there's another study says this and then this another study that says this. I started buying the China study book and I started buying these other books and the Engine2 book and I started reading them and started cross-referencing online to see if it was legit. I was like, "You know what? It seems okay. Let me try it." That first time I did at the results I got were unbelievable. It blew my mind.

Rip Esselstyn: Yeah.

Rip Esselstyn: No doubt about it, there is something super special about the amount of research and data that unequivocally backs a plant-based diet and when it comes to heart disease and the prevention and reversal of heart disease the bulk of that was done by my father, Dr. Caldwell B Esselstyn ,Jr. He literally wrote the book on the prevention and reversal of heart disease, it's called Prevent and Reverse Heart Disease, after trudging upstream for decades to show that this is a food created disease. It is born of our own making and what we are putting into our mouth for breakfast, lunch, and dinner day after day, week after week, month after month, year after year. Then all of a sudden at 42 you have angina, you have your first small heart attack, or in many cases the first sign of heart disease which is sudden death 50% of the time, which is absolutely tragic because it doesn't need to be that way. So here's my dad.

Caldwell E.: It was in the late 1970s when at the Cleveland Clinic I was the chairman at the breast cancer task force and head of the section on thyroid and parathyroid surgery. I got increasingly disillusioned with the fact that for no matter how many women I was doing breast surgery I was doing absolutely nothing for the next unsuspecting victim and that led me to do a bit of a global review. In this global review it was apparent that there were cultures where breast cancer rates were 30 and 40 times less frequent than the United States, for instance like Kenya. If you looked at rural Japan in the 1950s breast cancer was very infrequently identified, yet as soon as the Japanese women would migrate to the United States by the second or third generation, still pure Japanese-American, they now began to experience the same rate of breast cancer as their Caucasian counterpart. Perhaps even more compelling might be the information from Japan. In 1958 how many autopsy proven deaths were there from cancer of the prostate in the entire nation of Japan?

Rip Esselstyn: No idea.

Caldwell E.: 18. The most mind-boggling public health figure I think I've ever heard. 20 years later in 1978 they were up to 137, which still pales in comparison to the 28,000 who will die from prostate cancer in this country this year, but somewhere along that timeframe I began to feel that there would be much more bang for the buck if we could look at the leading killer of women and men in Western civilization, which is coronary artery disease, cardiovascular disease, because in this global review it was apparent that there were multiple cultures where cardiovascular disease was virtually nonexistent and the common denominator became that for those individuals, the fact that they were eating whole food plant-based nutrition essentially without oil.

Caldwell E.: The dream I guess that I began to cultivate at that time was that if we could somehow get people to eat to save their heart they would at the same time be protecting themselves from the common Western cancers of breast, prostate, colon, and perhaps pancreatic.

Rip Esselstyn: What was the aha moment? Why 1984? Why not 1979?

Caldwell E.: Listen, remember I grew up on an Aberdeen Angus and a dairy farm and I was a cholesterolaholic. Although I knew I was going to do the study and I kept putting it off and putting it off and putting it off. When in 1984 in April mummy and I were at a surgical conference in New Haven Connecticut and the papers were so boring, the weather was rotten, but always at the end of these meetings they have a banquet and at the banquet this waitress put a plate in front of me. The roast beef was so enormous it was draped over the sides. I just looked at that and shook my head and Anne said, "You're not going to eat or roast beef?" I said no. Anne's mother, at age 52, had died of breast cancer and two weeks after that meeting in New Haven Anne's sister came down with breast cancer and that's when she looked at me and said, "I'm with you." It was in April 1984 that we decided ourselves that we had to do this for at least 10 months or a year before I could then go to cardiology and ask for these patients to start the research project which I had been dreaming of starting.

Rip Esselstyn: So you started pushing this boulder up the hill back in 1984 and I can't imagine that along the way it didn't feel extremely lonely. You must have felt like you were the only person that was doing this. I know that you got ridiculed, made fun of, people called you names. I rubber you getting in the mail wood chips. People saying, "What are we going to go eat, twigs and berries?" The comments were endless and nonstop. What allowed you to persevere?

Caldwell E.: I think it was very apparent, what I mentioned earlier, within 15 months of starting this without any of those statin drugs or anything else we suddenly had rock solid irrefutable science that the pain would go away in their leg, it would disappear. We could absolutely now reverse heart disease. I was not going to let that go.

Rip Esselstyn: So after you had that. That was the nugget and the goal that allowed you to-

Caldwell E.: We saw the reversal of the disease.

Rip Esselstyn: So you were convinced now, I'm on the right path and this is it. I'm going to show it again and again and again.

Caldwell E.: Right.

Rip Esselstyn: Grandpa, your father, was such an amazing, towering figure, kind of in some ways larger-than-life. I remember you telling the story about how growing up on the farm he was just a beast of a man that could carry, what was it 80 pound bags in each hand?

Caldwell E.: Cement.

Rip Esselstyn: Cement. 80 pound bags of cement in each hand. You tell a story about how he went to the carnival and took ... Can you tell that story? Because I think that in some way that helped shape your tenacity, your sense of purpose, your sense of truth and honor.

Caldwell E.: They used to have the professional football team from Yale come up to the farm to train with them and one of the things they did for recreation was they would go to the carnival, the local carnival, usually at the end of the summer. The carnival always had a strong man who would ask anybody from the audience to step up and challenge him. So dad stepped up, got into the ring with him, and before he knew it the guy had him in a stranglehold and he had to tap out. That was in front of these other guys on the team. But dad didn't let it go there. He found out where the carnival was going to go next and he left Yale and drove up to where the carnival was going next. No other members of the team there, but when the guy called out in the audience dad once again stepped up, got in the ring, and absolutely flattened the guy. Grabbed him by the arms and just wrenched him right down to the canvas.

Rip Esselstyn: Made him scream uncle.

Caldwell E.: But it was really ... He just didn't like the idea that he was going to be taken down by this guy.

Rip Esselstyn: Yeah, I love that story.

Rip Esselstyn: So let's jump into your health, alright?

Joe Inga: Okay.

Rip Esselstyn: So how old are you?

Joe Inga: I am 34.

Rip Esselstyn: 34. In your email you were 5'6". I believe you said you were 210 pounds, which makes you overweight no doubt about it.

Joe Inga: Very overweight, yeah.

Rip Esselstyn: Any medications for that?

Joe Inga: No.

Rip Esselstyn: You said you had high cholesterol.

Joe Inga: I refuse to take statins. I have been issued statins in the past and refused to take them. I kind of try and alter my diet a little more rather than take the statins because there are side effects that I don't want to deal with that when I have been on them I haven't felt right so I just kind of don't take them. Every year when I go for my medical they do a medical evaluation and they give you that ... I can't run with the number is called, the one through six number or one through seven number that calculates your risk, so every year I get flagged for triglycerides, cholesterol, and that number, and then they say that they might take me off-line and I do it again for 60 to 90 days, always with the intention to continue, but end up going back because it's very difficult adjustment to make. You know, it really is a lifestyle change, and I've done that probably five or six times and just this recent time I'm trying to take care of myself a little bit better and one day, just on Thursday, I was like you know what let me watch Forks Over Knives, let me watch Engine2 Rescue again. I think Plant Nation was the other one, so I binged for a day and the next day was the day I sent you an email. That was the day I started it.

Caldwell E.: So I looked for 24 patients, but these were patients who were ... As my late brother-in-law used to say these were Essy's walking dead. They had failed their first or second bypass, they had failed their first or second angioplasty. They were too sick for these procedures or they had refused. There were five who were told by their expert cardiologist that they wouldn't live out the year, but I'm happy to say that those five made it beyond 20 years. Half the planet Earth doesn't even have coronary artery disease, right? The idea was to try to mimic the type of nutrition that we were essentially seeing in these nations where disease was really virtually nonexistent. Then we wrote them up and reported this at 12 years and that study made it about the longest that I know of of its type.

Caldwell E.: It was very exciting to see the long-term effect and benefits that whole food plant-based nutrition could endow with these patients who are so seriously ill with 12 years of follow-up. I don't see how you're ever going to make a lifestyle change in a 10 or 15 minute office visit, but when you give a patient your time you are showing them respect and also when you give them time they have an opportunity to begin to get their arms around the science in a vocabulary that they can grasp and appreciate the importance of the basic science of how this disease was initiated, developed, and also how they can be empowered as the locus of control to halt and reverse their disease.

Rip Esselstyn: What kind of feedback are you getting from the guys at the firehouse?

Joe Inga: Not very good ones. Like you said, we are very big. We are big tough guys. We're big tough fireman. We eat meat. It's not an easy thing to do in the firehouse. In the firehouse, especially New York City, the kitchen and cooking is probably the biggest part of firehouse culture and if you're not eating what the guys are eating it just kind of ... It just has a negative connotation to it among the guys and trying to adapt that and then if they make something and I have to bring in my own or modify it becomes a little-

Rip Esselstyn: There's a little bit of tension.

Joe Inga: -stressful, a little tense. Yeah.

Caldwell E.: When you think about the people who are critics that's wonderful. Imagine if nobody was criticizing you at all? It would just be so dull.

Rip Esselstyn: So in some ways you embraced the criticism. You thrived on it.

Caldwell E.: Absolutely. It was so exciting because people who are criticizing, you knew that they had never experienced this with their patients at all. How would anybody who was a physician who had to change their way of patient aid, have their disease go away, why would they be resistant to it?

Rip Esselstyn: So you have a program when it comes to preventing and reversing heart disease. It's a low-fat, whole food, plant-based eating regime. What would you say to individuals that say this program is to austere, it's too hard. It's impossible to do. What would you say to them?

Caldwell E.: I love that question because when you think about the diet that is the most severe, strict, extreme, austere, draconian, it's the one that 97% of Americans are eating every day that guarantees that before they die they will have some sort of horrible chronic illness but also think about it this way. The diet that we are asking patients to follow, which is always marvelous whole grains, from your cereal bread, pasta, rolls, bagels, and 101 different times of legumes and beans and lentils, all these marvelous red, yellow, and green leafy vegetables. Some sweet potatoes, white potatoes, and also fruit. This is kind of the type of food that is eaten by half the planet Earth that never has cardiovascular disease.

Caldwell E.: For instance, if you were to hang out your shingle in Okinawa, rural China, central Africa, the [inaudible 00:18:04] Indians in northern Mexico or the Papua highlander you're not going to do any cardiovascular surgery. Why? They don't have cardiovascular disease. Why? Because they are all thriving on a whole food, plant-based nutrition essentially without oil. So when people say that it's austere or some doctors say, "I can't get my patients to do this." It's really this. It's not that the message is wrong, it's how the messages it articulated. If you think you are going to have somebody listen in 10 or 15 minutes and make this kind of has a nifty lifestyle change it's not going to happen.

Rip Esselstyn: One of the things that I have always been impressed with with your thinking and the way you counsel your patients is that you are always coming up with new things. So for example, if I remember correctly when you started this in 1984 you also allowed a little bit of no fat dairy products in the program and then at some point you decided, okay, we're not doing that anymore. Right?

Caldwell E.: Right.

Rip Esselstyn: Then you at some point I think in the 90s or early 2000's you decided we are really got to hammer the green leafies. That wasn't initially part of the program, if I'm not mistaken. So you added the green leafies. Then you started taking away some of the bread products. So can you just kind of talk about how you-

Caldwell E.: That evolution?

Rip Esselstyn: Yeah, the evolution. You're always searching for the newest, the latest, the greatest, but it has got to be grounded in some sort of science.

Caldwell E.: The dairy business was increasingly clear after I had a chance to talk with my good friend Colin Campbell, and that's when he made me aware of how powerful casein, which is the leading protein in dairy, was problematic. There was a further study out of Harvard that showed clearly that casein was a great contributor to accelerating cardiovascular disease. That was sort of the background in the dairy and there were multiple papers that were coming out along that time showing that dairy could be rather mischievous, as we say.

Caldwell E.: Now as far as the green leafy vegetables, that's something just within the last six and a half or seven years. For a couple of reasons. When we first see these patients and they are having a lot of chest pain or angina I want them to try to imagine that they can somehow have their head get inside one of their coronary arteries and if they were able to look at the plaque they would see an absolute cauldron of oxidative inflammation. Right? So we need antioxidants. No. Don't go down to the health food store and buy a jug of pills that says antioxidant because it doesn't work and it's going to be harmful. Therefore I want them to get their antioxidants from food. Fair enough. What food? Food that is high in what we call ORAC value. O-R-A-C. Oxygen radical obstructive capacity.

Caldwell E.: This means that if somebody is having raspberries, blueberries, strawberries, blackberries on their morning oat cereal that's a terrific start, however nothing, nothing can trump the antioxidant value of green leafy vegetables so I now ask them to chew. Not smoothies, not juicing. I asked them to chew a green leafy vegetable six times a day roughly the size of their fist. After it has first been boiled in water 5 1/2 to 6 minutes or steamed so it's nice and tender. Then I ask them to anoint it with several drops of a delightful balsamic vinegar. Why? Because the acetic acid and the vinegar has been shown to restore the nitric oxide synthase enzyme contained within the endothelial cell that is responsible for making nitric oxide, which is what we want. Therefore they are going to chew this alongside their breakfast cereal, again as a mid morning snack, again with her luncheon sandwich. That's three. Afternoon, four. Dinner time, five. And of course God, I adore when they had that evening snack of kale, six.

Rip Esselstyn: Why are you such a pain of chewing your green leafies as opposed to ... The biggest that probably ... One of the biggest fads going right now, which is to drink green smoothies.

Caldwell E.: I should back up a little bit and state the whole reason we do that is what because what we are totally after here is restoration of nitrous oxide. Because all experts in this field will agree that where this disease has its inception, its onset, its beginning, is when we have progressively injured the life jacket and the guardian of our blood vessel, which happens to be that delicate innermost lining, the endothelium. What makes the endothelium so remarkable is this magic molecule of gas that it produces, nitric oxide, which is responsible for the salvation and protection of all of our vasculature.

Caldwell E.: For example, because of this wonderful functions. What are the functions? They are, nitric oxide will keep all those cellular elements within our bloodstream flowing smoothly like Teflon rather than Velcro. Number two, nitric oxide is the strongest blood vessel dilator in the body. When you climb stairs the arteries to your heart, the arteries to your legs, they widen. They dilate. Nitric oxide. Number three, nitric oxide will protect the wall of the artery from becoming thick and stiff or inflamed and protect us from getting high blood pressure or hypertension. Number four. Number four is the absolute key. A safe and normal amount of nitric oxide will protect us all from ever developing blockages or plaque.

Caldwell E.: Literally everybody on the planet who has cardiovascular disease, whether they are from London, Berlin, Chicago, New York, or Cleveland or Seattle. If they have cardiovascular disease it is because by now, in the preceding decades they have so severely trashed, injured, compromised, and turned their endothelial system into a train wreck. They don't have enough nitric oxide left to protect themselves, but the good news here is this. This is not a malignancy. This is a completely benign foodborne illness. Therefore once you can get patients to understand this and have them never again pass anything through their lips that is going to further taken already train wrecked endothelial system and make it worse then what happens is this is not a malignancy. The endothelial cells recover. Make enough nitric oxide so you can halt disease progression and often see significant elements of disease reversal.

Caldwell E.: So coming back to the greens and the chewing, the other reason for the chewing is that when they are in their mouth and you are chewing that green is a nitrate. That nitrate is going to be mixing, as you chew, with the facultative anaerobic bacteria that reside in the crypts and grooves of your tongue so that as you are chewing those bacteria will reduce that nitrate in your mouth to a nitrite. Now when you swallow the nitrite it is further reduced by your gastric acid to more nitric oxide. So you here you have the greens, both for the endothelial cell and through your gastrointestinal tract restoring what we really need, which is nitric oxide. At the same time the greens will enhance the capacity of your bone marrow to make more endothelial progenitor cells, which are the ones that replace our senescent, injured, worn out endothelial cells.

Rip Esselstyn: It's kind of magical how that happens.

Caldwell E.: Yeah, but it's the science.

Rip Esselstyn: What are some other benefits that happen when you eat this way to save your heart? For example-

Caldwell E.: Your diabetes goes away. Your hypertension goes away. Your risk for stroke goes away. Your risk for vascular dementia and goat dementia goes away. Ulcerative colitis, Crohn's disease, rheumatoid arthritis, lupus, multiple sclerosis, allergies, asthma. We have never had in medicine a weapon in our toolbox that is so powerful. There is no ridiculous expense. There is no ridiculous side effects. You are simply treating the organism the way it was supposed to be nourished. I should mention also that obesity goes away because obesity is such a rascal. All that inflammation, the increased risk of diabetes and heart disease and cancer.

Rip Esselstyn: I want to ask you this because it's the number one question that everybody when you are following a whole food plant-based diet gets asked. Where in the world do you get your protein eating this way?

Caldwell E.: Well, if you are eating whole food plant-based nutrition it's impossible to really be protein deficient. There is protein and grain. There is protein in beans and legumes. There is protein and vegetables. There is protein and potatoes. There are also a number of professional athletes who increasingly recognize that when you're eating a whole food plant-based nutrition you have not only greater stamina but your recovery time is reduced.

Joe Inga: One of the reasons why I went on this was there was a recent incident in October that really woke my eyes up to a lot of things. One of my best friends, Tom Corcoran, he's a firefighter in our firehouse. Him and I were working in a different fire house together and he had the roof position in the ladder truck and we got called to a fire on the top floor on of the building and he went up the ladder and he fell off the roof 35 feet and broke his back. This happened while I was in the engine. I kind of saw him. I didn't see him directly fall but I heard it and I can still hear the ring of the cylinder in my head constantly and I look around the corner and there he is laying there.

Joe Inga: I dealt with a lot after that. I have been on the fire department and around a long time, my whole life tween my dad and on this fire department. You hear of line of duty funerals. You hear of these accidents. You have these injuries, but that's always going on someplace else. You're never directly affected by it. When this happened I was so in shock. I was like, this has never happened before. It just blew my mind that in a split second something like this could happen and it was a complete freak accident. It wasn't a heart attack or health-related, but it was a quick realization of things can go south very quick and I was a direct eyewitness to it.

Joe Inga: From that point after I was dealing with that and some other things I kind of made it a point to, I'm going to take better take care of myself because I have always kind of felt safe and I have always kind of felt I'm okay. Maybe we are not the busiest company in the city, so I may be big, I may have high cholesterol, but I'm not getting myself into these situations. Then I'm all of a sudden faced with situation and I'm going, I'm not prepared for this so I'm going to try to make my best effort to start trying to hit the gym or change my diet or try and be the best I can be because the thought runs through my head that if something were to happen, if I was climbing a ladder but I wasn't in the shape or I was groggy or I was tired or I wasn't in the shape that I should have been in, I've got two kids at home, you know? And that kind of got the boat all rolling on a lot of this.

Rip Esselstyn: Yeah. Like my father said, people need focus. They need help to change their lifestyle. Joe needs that help. Join us every episode as we talk to members of the plant-based movement that can help Joe and you to stay the course, to maintain a lifestyle that will keep you plant strong.

Rip Esselstyn: How much of what is happened to you in the 12 ... What was a 12 days you said?

Joe Inga: Almost 3 weeks.

Rip Esselstyn: Three weeks. What is happened in the three weeks.

Joe Inga: I've lost about 16 pounds. My energy levels have been way up. Usually I'm always drained, I'm always groggy. I've been working a lot the last couple of weeks. I've only had one day off in the last two weeks, so I've been working a lot but I've been not needing naps, not feeling groggy, not needing the coffee, so my energy level is up. When I put on my equipment everything feels lighter. I'm walking more upright. My back pain and my knee pain is starting to go away. It's just unbelievable, and I started seeing those results within the first week.

Rip Esselstyn: If you're enjoying the guests on my podcast come spend the weekend interacting with all of us at our 8th Annual Camp Plant-Stock event. Dance with my sister Jane. Hike with my mother Anne. Share a meal with my father Essie and spend time with all of our dynamic speakers. Drs. Dean and Ayesha Sherzai, the authors of the Alzheimer solution. Paul de Gelder, the host of Shark Week. Dr. Jim Loomis, from the Gamechangers documentary. Dr. Cyrus Khambatta and Robbie Barbaro of Mastering Diabetes. Dr. Saray Stancic as featured in the documentary Code Blue and my buddy John Mackey, the CEO of Whole Foods market and many, many, many more. Pick and choose from a robust variety of talks, enjoy plentiful plant strong buffets, taken the mountain air, and start the day with an invigorating morning dance party. Come celebrate what it means to live plant strong.

Rip Esselstyn: I am Rip Esselstyn and I want to thank you for listening. My hope is that this podcast has inspired you to take control of your health through a plant strong lifestyle. I also want to thank my co creator of the podcast, Scott Battishill with 10-Percent Media, Laurie Kortowich, my producer extraordinaire and Engine2 director of events. Tina Nole and Larj Media for podcast production and creative direction, and Brandon Curtis for never minding living in the barrel and everything in between. Thanks for Whole Foods market for giving me a platform for the last decade. Special thanks to Joe Inga for your courage to take control and change your life and for allowing us to share your story along the way. Lastly I want to thank my father and mother, Dr. Caldwell B. Esselstyn Jr. and Anne Crile Esselstyn and all the plant strong pioneers who have been pushing this boulder uphill for more than three decades. As they say, we are standing on the shoulder of giants.

Rip Esselstyn: If you're digging the podcast I want you to rate us, I want you to review the show, and I want you to spread this message with friends and family. We want to get this message out to as many people as possible. Join us on all of our social channels, either on Engine2 or Rip Esselstyn, whether it's Instagram, Facebook, or Twitter. Until next time, peace, Engine2, and keep it plant strong.

Ami Mackey