It started with a bet between buddies. In mid-2003, fireman Rip Esselstyn and a colleague at Austin, Texas' Central Fire Station settled the debate of who had the lower cholesterol levels by jumping into the car to have their blood tested at a pharmacy. But for a third fireman, James "JR" Rae, who tagged along for the ride, the results of his own test were jarring: The 33-year-old, who had a family history of heart problems, had a cholesterol level of 344 mg/dL, putting him at dangerously high risk for coronary heart disease. Concerned about his friend's health, Esselstyn designed a fireman-friendly, plant-based diet to lower JR's cholesterol. In support of their colleague, the rest of Engine 2 followed the diet as well. JR's cholesterol dropped to 196 mg/dL, within the normal range, after three weeks. After this singular success, one fireman's diet--now formally dubbed the "Engine 2 Diet" or less formally, the "E2 Diet"---began to take off.
Behind the Diet
With his cap of silver hair and affable countenance, the fit, 6-foot, 2-inch-tall Esselstyn resembles the archetypical firehouse hero plucked from a child's imagination. But at one time, the former professional triathlete was just another all-American boy consuming the all-American diet of burgers and steaks. Influenced by the research of father cardiologist Caldwell B. Esselstyn, M.D., who used a plant-based diet to cure advanced heart disease, Esselstyn modified his own eating habits in the late 1980s. It wasn't until 1994 that he acknowledged the ill-effects animal proteins had on health and phased out low-fat yogurt and lastly, fish, which he ate in moderation until 2000. "A lot of people think animal protein is healthy," he said. "In reality, it's very acidic in nature---it leeches calcium from the bones." Nor is dairy a good absorbable source of calcium, Esselstyn says; it inflames the arteries and is harsh on kidneys and liver, creating the "perfect environment for tumors and cancers to thrive." By removing the classic culprits from the American diet, the E2 diet reduces not only risk of coronary heart disease and cancer but stroke, diabetes, Alzheimer's disease and medical conditions related to obesity.
The Engine 2 Diet's popularity is testament how a grass-roots effort can take off when backed by substantive results: two pilot studies were conducted on the diet using recruits from Austin firehouses with favorable results. The results of the second pilot study indicated that participants' cholesterol levels dropped by an average of 50 points, with an average weight loss of 12 pounds. As the diet's success stories made their way to the mainstream media, Esselstyn was approached by major newspapers, as well as National Pubic Radio. After the New York Times published an article about the diet, literary agents soon came calling.
"I had the epiphany that as a firefighter---not as a doctor or a nutritionist---that I was uniquely positioned to reach a segment of America that would have missed the message otherwise," Esselstyn says.
The "Engine 2 Diet" book, published by Wellness Central, hit the New York Times Best Seller List in May 2009, three months after its release. The E2 Diet draws kudos from Preventive Medical Research Institute founder Dean Ornish, M.D., as well as cycling legend Lance Armstrong, who has consulted with Esselstyn about how to make modifications to his own eating habits.
What is the Engine 2 Diet?
The Engine 2 Diet is comprises two 28-day programs: the "Fire Cadet" and "Firefighter." Those participating in the Firefighter program hit the ground running, incorporating all aspects of the diet into meals and snacks. Cadets ease into the plan by gradually eliminating food types. Week one entails excluding dairy, including all milk, regardless of fat content, as well as cheese, which Esselstyn describes as "the greatest source of saturated fat." Processed and refined foods---white breads and pasta, chips, white rice and soda---are also verboten.
During the second week of the Engine 2 Diet, participants in Esselstyn's program part company with eggs and meat, including fish and seafood. The third week of the Engine 2 Diet requires cadets to give up extracted oils---even olive oil, the least threatening source of monounsaturated fat. Week four is a period of maintenance and discovery, as the palate gains appreciation for the plant-strong diet, a transition Esselstyn describes as a shift from "dietary extravagance to dietary excellence."
The Final Ingredient
The diet incorporates physical activity, a vital component to weight loss and overall good health. Esselstyn's simple stretches and low- to moderate-impact cardiovascular exercises can be easily performed at home. However, "exercise is not the panacea," cautions Esselstyn, who's known triathletes with cholesterol levels as high as 300. "Way too many people think they can eat what they want and burn it off."
Esselstyn points out that a meager 6 percent of the American diet is derived from plants, fruits, nuts and seeds---a dismal reminder that plant-rich diet recommendations made by the American Dietetic Association and American Heart Association go unheeded. He stresses that his goal is not to convert Americans into vegans or vegetarians, but rather introduce them to a plant-based diet to "reprogram the palate to appreciate the real taste in foods, as opposed to the salt on top of the fat on top of the sugar on top of the fat that's in fast foods."
The Firemen's Challenge
"Real men eat plants---they don't eat meat," is the Rip Esselstyn motto. He's often asked how he managed to get a bunch of male Texas firefighters whose palates were passionate for pizza, burgers, fajitas and ice cream to adopt the Engine 2 Diet plan.
"I fed them what they wanted," he says. Blackbean/oatmeal burgers and baked sweet potato fries were substituted for medium rare burgers and oily french fries. Portabello mushrooms and an array of fresh, grilled vegetables served on corn tortillas were ushered in instead of beef fajitas. Chocolate Silken tofu-based mousse replaced bowls of ice cream. When asked what food Engine 2 dieters find it most difficult to give up, Esselstyn says, "Everybody's a little different. A lot of men cannot give up steak ... for most women--and a lot of men---it's dairy, specifically cheese," which he describes as "highly addictive." Cheese contains low levels of casomorphins, a derivative of animal proteins that have the same effects as opiates like morphine and heroin.
Bereft of "quick start" phase that promises rapid weight loss in return for restrictive portion sizes and meticulous calorie-counting, "The Engine 2 Diet" book instructs aspiring pound-shedders and those cholesterol concerns how to transform family favorites and comfort foods like lasagna, meat loaf, chocolate chip cookies and brownies into hearty but healthy versions of their original incarnations through ingredient substitution. Esselstyn also preaches the importance of eating a good breakfast. An admitted morning meal afficionado, he says one of his favorite meals is "Rip's Big Bowl," an assortment of three whole-grain cereals (raw, old-fashioned oats, Grapenuts or a similar substitute, and Uncle Sam's cereal or another "clean wheat cereal") combined with sliced banana, blueberries, raisins, grapefruit, walnuts, flax seed meal and soy or rice milk.
Challenge for Americans
Can the average American, trained from birth to accept meat, dairy and fats as integral components of daily meals---and processed and refined foods for the sake of convenience---be persuaded to drop the Twinkie and put down the fast-food cheeseburger, or is the E2 vegan diet too radical?
"The standard American diet is what's radical," Esselstyn says soberly. "Heart disease doesn't need to exist." Nor does Type 2 Diabetes, which Esselstyn points out is becoming pandemic. "These diseases are related to what we put in our mouths," he says, pointing to the $2.3 trillion dollars spent in health care costs, most attributable to heart disease, Type 2 diabetes, obesity, and breast and prostate cancer.
In a review of "Engine 2 Diet," ADA registered dietician Jim White states that decreased cholesterol and weight loss are "foregone conclusion(s)" if the diet's strategies are followed, but describes Esselstyn's hope that Americans can retrain their taste buds to resist unhealthy foods as "optimistic." White says Esselstyn's "friendly, positive and emphatic approach may motivate readers to take a stern look at their food intake and try to at least incorporate some plant-based meals into their diets."
Esselstyn concurs that getting most Americans to relinquish their favorite foods may not be possible, but urges dieters to complete the 28-day challenge.
"I want people to give it the good ol' college try," he says. "By doing that, you get to see first-hand how good you can feel. You decide after that how plant strong you want to be. My bet is that you'll be forever changed."
