Chronic Disease
Type 2 diabetes, heart disease, and high blood pressure can get better. Sometimes much better.
If you have one of these, you were probably told you would manage it for the rest of your life. For many people that is not true. These diseases are driven mostly by how we eat and live, and when that changes, the disease often changes with it. Many people get their numbers all the way back to normal, and most get somewhere worth going.
Book a Consultation →What these conditions have in common.
High blood sugar, high blood pressure, high cholesterol, and clogged arteries look like four different diseases. They mostly share one cause. A diet heavy in meat, dairy, oil, and refined food, combined with too little movement, overloads the body's ability to handle fat and sugar. Insulin stops working well. Arteries stiffen and fill with plaque. The liver makes more cholesterol than the body can clear.
Medication can hold each number down, and sometimes that is necessary. But the pills do not touch the cause, which is why the doses tend to go up over the years instead of down. Change the cause, and the numbers follow.
What the research shows
This has been tested, and it works.
The best evidence is for diet, and the best diets are the ones built around whole plant foods: vegetables, fruit, beans, whole grains, with little or no meat, dairy, or added oil. In a randomized trial, people with type 2 diabetes who ate this way lowered their HbA1c three times as much as those on the standard diabetes diet, and 43% were able to cut their medication (Barnard, Diabetes Care 2006). In the British DiRECT trial, which used a structured weight-loss program in ordinary family practices, 46% of people with type 2 diabetes were in remission after one year, off all diabetes drugs, and 86% of those who lost 15 kg or more (Lean, Lancet 2018).
For the heart, the Lifestyle Heart Trial put people with serious coronary disease on a low-fat vegetarian diet, moderate exercise, and stress management. After one year their artery blockages had measurably shrunk, while the comparison group's had grown. At five years the gap was wider, and the lifestyle group had less than half as many cardiac events (Ornish, Lancet 1990). At the Cleveland Clinic, Dr. Caldwell Esselstyn followed 198 patients with established heart disease who switched to a whole-food plant-based diet. Over the next 3.7 years, the 177 who stuck with it had one cardiac event among them (Esselstyn, J Fam Pract 2014).
For blood pressure, the DASH trial fed people a diet rich in fruits, vegetables, and low-fat foods and held their salt and weight constant. Blood pressure fell within two weeks. In those with hypertension, it fell by 11 points systolic, about what a single medication does (Appel, NEJM 1997).
Diet has the biggest impact on your health, but it is not the whole plan. Regular walking improves insulin sensitivity on its own. Sleep that is short or broken raises blood sugar and blood pressure the next day. Chronic stress does the same. So we work on all of it, in the order that makes sense for you.
How it works
Three steps.
Book a consultation
We meet by video for an hour. I go through your history, your medications, your labs, and how you actually live.
Get a plan
You leave with a written plan: what to eat, how to move, how to sleep, and which labs we will repeat and when.
Follow up
We check in regularly, adjust the plan, and lower medications in step with your other doctors as your numbers improve.
From the medical literature
Cases doctors have written up.
Behind every trial are real people. Here are a few whose doctors wrote up what happened.
A 60-year-old man with chest pain on exertion and a positive stress test declined medication and catheterization and switched to a whole-food plant-based diet instead. Within four months his angina was gone. His weight, blood pressure, and cholesterol all fell, and he stayed off cardiac medication.
Massera et al., Case Reports in Cardiology, 2015 · Read the reportA 77-year-old woman with severe three-vessel coronary disease and unstable angina was referred for bypass surgery. She chose a whole-food plant-based diet instead. Her angina resolved. When she went back to a conventional diet some months later, the angina came back.
Journal of Geriatric Cardiology, 2016 · Read the reportA man with heart failure, an ejection fraction of 35%, and an 80% blockage in his main coronary artery declined bypass and valve surgery and adopted a plant-based diet. His symptoms improved and his ejection fraction rose, the first such case reported in the literature.
Journal of Geriatric Cardiology, 2017 · Read the reportIn a cardiac wellness clinic on the US East Coast, 59 patients with type 2 diabetes were counseled to eat a high-fiber, low-fat, plant-predominant diet as part of routine care, with no calorie counting. Many reduced their medications; a number reached full remission.
Panigrahi et al., Am J Lifestyle Med, 2023 · Read the reportWhat is possible
What most people can expect.
Blood sugar and blood pressure usually move within weeks. Cholesterol follows within a month or two. Weight comes off more slowly. Medication comes down as the numbers do, never ahead of them.
Some people reach full remission. Most who stick with it end up far better off than when they started, because the cause itself is being treated.
Ways to work together
Ways to work together.
First Visit
A one-hour first visit by video.
$45.000 CLP · US$50
Plan of 5 Follow-Ups
Five 30-minute follow-up visits after your first visit, while you make the big changes.
$105.000 CLP · US$115
Follow-Up Visit
A 30-minute check-in to review progress and labs.
$25.000 CLP · US$30
Group Program
Small online groups working through the same changes together.
Video visits for patients located in Chile. Booking and payment through Encuadrado.
Video visits for patients located in Chile. Booking and payment through Encuadrado.