Question: Do I have to count calories?

Answer by Fuhrman: "Not at all! You only have to count calories when you eat high-calorie, low-nutrient processed foods or commercial animal products that are not natural. Even though the books may benchmark average consumption for men and women, you never have to count calories again. Of course, we all need differing amounts of calories, based on our size, activity level and genetics. This plan allows you to get back in touch with your body's instinctual sensations that tell you when you need to eat.

Natural plant foods are relatively low in calories, rich in fiber, high in water content and full of fiber, so they fill you up easily, without getting excess calories. Then, with time, your body will give you accurate signals to tell you how much it needs. You'll eat until you're satisfied, all the time!"

Q: Do I need to control portion size?

Answer by Fuhrman: "Just eat until you've had enough. You should not eat until you are uncomfortable."

[Patients received] dietary counseling and were fed a low-fat (≤ 10% of calories) diet based on minimally refined plant foods ad libitum to satiety.

Meals were served buffet-style, and participants were encouraged to eat to the full satisfaction of their appetite.

(Copied from Esselstyn FAQ in March 2019)

Nuts — What about nuts? I hear so many different opinions?

Answer by Esselstyn: "As nuts are a rich source of saturated fats, my preference is no nuts for heart disease patients. That also eliminates peanuts and peanut butter even though peanuts are officially a legume. For those with established heart disease to add more saturated fat that is in nuts is inappropriate. For people with no heart disease who want to eat nuts and avocado and are able to achieve a cholesterol of 150 and LDL of 80 or under without cholesterol lowering drugs, some nuts and avocado are acceptable. Chestnuts are the one nut, very low in fat, it is ok to eat."

Seeds (sunflower, pumpkin, sesame, etc.) Are seeds ok to eat?

Answer by Esselstyn: "1-2 tablespoons of ground flax seeds or chia seeds daily for omega 3 are appropriate for everyone to eat including heart patients, if they wish. Some seeds baked in bread or crackers is acceptable. Just don't eat handfuls."