Tag Archives: Dean Ornish

Breaking the SAD Cycle: Mark Bittman’s VB6 (Vegan Before 6:00) Diet Plan


I’m a Bittman fan all the way, but I admit my first reaction to the concept of this book was skepticism. In my experience working with patients, some of the worst nutrition decisions tend to be made at dinner (after 6pm). Could being vegan until 6pm and then opening the flood gates to whatever you want to eat really be a good approach? However, with more thought I became curious (plus I heard there were recipes in the book and Mark Bittman always has great recipes) so I bought a copy.

My curiosity grew as soon as I began reading. It’s ironic to me that the foreword to this book was written by Dean Ornish, MD. After all, Dr. Ornish is the doctor whose philosophy when I began reading his literature in the mid-90s was that drastic diet and lifestyle change were the best (and really only) approach to successful outcomes in the long run. Little changes didn’t provide results quickly enough to maintain a patient’s motivation. This logic stuck with me through my med school days as I worked with patients and saw firsthand what worked and what didn’t. Ultimately, I netted out that people are individuals and for some small changes are all that’s possible, for others, jumping in with both feet does the trick. It seems Dr. Ornish has come back to center as well as he states,

If you eat vegan before dinner and indulge yourself afterward, you’re likely to notice great improvements in your health and well-being without feeling deprived. As you start to feel better and notice how much healthier you are, you’re likely to find yourself in a virtuous cycle in which you may want to do even more.

This book is really a description of Bittman’s personal journey to find the bridge between health and his love of eating. It’s just the right balance of science, personal testimony, and practical DIY tips. As a doctor whose primary tool is food, I appreciate the time Bittman takes in this book to walk the reader through how we (collectively as a society) have gotten to this place of high-calorie, processed food that is largely absent of nutrition. Bittman’s description of the Standard American Diet (which he dubs “SAD” through most of the book),

…food that either contains no nutritious value whatsoever—like soda—or foods that are loaded with chemicals and so highly processed that even though they might contain some nutritional value, they bear little resemblance to their origins.

He provides the reader with a 28-day plan to get started and (thankfully for those of us who have all but given up hope of ever having time to cook on a regular basis) he provides a list of “wildcards” (page 120), super quick vegan meals that can either be quickly thrown together at home or found on the go in a restaurant or even in a pinch at a friend’s wedding reception.

To be a healthy vegan, a diverse mix of whole nuts, seeds, grains, vegetables and fruits is essential. Eating in this way quickly breaks down the confines of the Standard American Diet and provides a crash course in nutrition 101 as a result. If you’re looking for a way to engage with the power of food as medicine but are not sure you’re ready to swear off your go-to comfort foods, this book is an approachable guide told through a voice that’s done it and is living the benefits eating vegan before 6:00 can provide.

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Weekly Health Tip: A Big Fat Question


Brought to you by Deepak Chopra, MD, Alexander Tsiaras, and TheVisualMD.com

After our recent post about the dangers of trans fats (Weekly Health Tip: Why Trans Fats Are the Bad Guys) , a reader named Merrymaven posed a very good question: How does one reverse the effects of trans fats? Those of us who ate margarine, commercial baked goods and other trans fat-laden foods before we knew how harmful they could be can certainly change our habits now. But what about the damage trans fats may have done already? There is some evidence that such damage can be improved. In a study in Italy, patients at high risk of heart attack or stroke followed the Mediterranean diet, which is high in olives and olive oil, fresh produce, healthy grains and fish, while another group followed a different diet. After two years, those on the Mediterranean diet had fewer signs of inflammation in their arteries. In a smaller but lengthy trial in the U.S., the Ornish Lifestyle Heart Trial, men with moderate to severe coronary artery disease followed an extremely low-fat vegetarian diet. They also participated in exercise and stress management programs, and other far-reaching lifestyle changes. A control group was taking medication to lower their blood lipids. After 5 years, the men who had changed their diet and lifestyle had decreased narrowing of their arteries. Those of the control group had worsened. It seems that changing our ways can have a real impact.

Now the big fat question is, What should I eat? There is no universally successful menu plan for perfect heart health just yet. Researchers have found evidence of improved cardiovascular health among study subjects who followed low carbohydrate diets, or low fat diets, or low calorie diets. Some common factors among the most successful plans are eating plenty of fresh fruits and vegetables, and forgoing saturated and trans fats in favor of monounsaturated and polyunsaturated fats–including olive oil and other plant oils, nuts, seeds and fish rich in omega-3 fatty acids. Beyond that, seek balance and variety among the foods you know are healthful. Diets that severely restrict certain food groups over long periods of time are hard to sustain. Keep reading nutrition labels and thinking carefully about what you put in your body, and get plenty of exercise. Such choices improve your odds of avoiding heart disease, no matter what choices you made in the past.

See how one person’s lifestyle makeover improved his health:

TheVisualMD.com: I Need a Miracle

Why Health Care Reform Won’t Reform Health Care

Like most people, I was encouraged and energized by President Obama’s stirring speech to Congress last week. With rare candor, he told the truth about the three C’s of reform: costs, coverage, and character. The last C was the most emotionally charged. Staring lawmakers and citizens in the eye, the President essentially asked, "Is America a society that squanders $900 billion on a dishonest war but refuses to spend the same amount to give its citizens affordable health care?" Because of the massive counterefforts by lobbyists and the resistance of the right wing, we’re holding our breaths on the answer to that question.

But let’s say the light prevails and the Democrats deliver a bill that gives insurance access to millions of previously uninsured Americans. As great as that victory would be, health care won’t be reformed. Isolated voices like Andrew Weil (writing at the Huffington Post and in his book,Why Our Health Matters, and Dean Ornish (writing as the medical editor at huffingtonpost.com and in his book,The Spectrum), and former Health, Education, and Welfare Secretary Joseph Califano are telling us why.

Here are the basic points that aren’t being addressed:

1. Prevention, the key to future health, isn’t being followed enough.
That’s why Americans are getting more obese and sedentary every year. That’s why sugary drinks are now the single largest source of calories in the average diet. Alcohol and tobacco still account for 35% of all medical expenditures. Leading causes of bad health — obesity, heart disease, and Type 2 diabetes — could be rolled back by sensible prevention guidelines that people simply aren’t following.

2. Supply and demand for doctor care is upside down. Patients aren’t demanding the bulk of the $700 billion in unnecessary tests and procedures performed every year in this country. Doctors are creating the demand to cover their backs and increase their income. Even conscientious doctors who put the patient first are caught in lockstep habits, calling for unnecessary tests because that’s what doctors do in this country.

3. Without a public option, there’s no real incentive for insurance companies to lower their costs.
The free market isn’t free when the consumer is presented with noncompetitive insurance plans that basically aim at corporate profit and when Wall Street dictates how corporations must be run in order to survive.

4. To borrow a phrase from Secretary Califano, we’ve become a "sick-care system" that puts all its efforts in developing newer drugs and offering more surgery once a person is ill. Doctors are not trained to keep people healthy. They are also strongly tempted to perform needless procedures that do not extend life span, such as hysterectomies, lower back surgery, heart bypass, and balloon angioplasty.

5. We are addicted to the sick-care system, and no money is being allocated in any of the reform bills in Congress to breaking this addiction. Massive public education was successful, over a long period of time, in getting people to quit smoking. Now we need the same massive public education to get them to adopt prevention. Will doctors, insurance companies, and big pharma do the job for us? Well, did big tobacco do the job of ending smoking? Without government action, the private sector will push drugs and surgery because prevention doesn’t show up as profit on their bottom line.

I regret having to walk in the shadow this way. President Obama brought a good deal of light to the whole muddled issue of health-care reform. He spoke truth and balanced it with political realism. He chastised the political reactionaries who want to kill reform by using lies, fear, and misinformation. We’re better off for having heard the speech. But costs won’t go down and Americans won’t be healthier until the five points listed above are dealt with. Right now, health-care reform has been couched in terms of economics first and morality second, with little thought to what should really come first: turning sickness into wellness.

Published in the San Francisco Chronicle


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Integrative Medicine: Dean Ornish Speaks Out

Last week I attended the Institute of Medicine’s Summit on Integrative Medicine, sponsored by The Bravewell Collaborative. While I found many speakers at the conference extremely exciting, it was marrying science and practice to focus on PREVENTION, in the powerful keynote address of Dr. Dean Ornish that was the highlight for me. 

Almost everyone interested in health has heard of Ornish. He is a “voice” here on intent.com. For over 30 years, he has been extolling the virtues lifestyle changes, including diet, for healing individuals who are sick, obese and have heart disease. He is the author of six best-selling books.
Ornish’s is founder of the Preventive Medicine Research Institute in California. His drugless and surgery-free program is now covered by Medicare and Highmark and available in hospitals across the country, where thousands of people are using it preventively. Why? Because his studies show that with proper lifestyle changes, prostate, breast and other cancers are not only reversible, but preventable, as well. Furthermore, by changing what we eat, how we deal with stress, and how we spend our time, we can “turn on” disease-preventing genes and “turn off” genes that promote cancer and heart disease! 
So what do we need to do to regain our health and stay well? Here is Ornish’s plan in a nutshell:
  • Improve Nutrition – Eat mostly plants: predominantly fruits, vegetables, whole grains, legumes, soy products, nonfat dairy, and egg whites in their natural forms, as well as some omega 3 fats. Many foods have better anti-inflammatory properties than drugs! Did you know that pomegranate juice can reverse heart disease, and that turmeric when combined with black pepper reduces Alzheimer’s by increasing the bioavailability of the anti-inflammatory ingredient curcumin over 2000%!
  • Avoid & Manage Stress – Begin a daily practice of stretching, meditation, deep breathing, progressive relaxation, and imagery. Develop a routine of listening to and watching videos for guided meditation and yoga   Did you know that chronic stress decreases brain volume, and that meditation enhances immune function?  
  • Add Exercise – Alternate aerobic exercise with strength training. Work with a trainer to find the program that is best for you, and change the Frequency, Intensity, Time and Type (The FITT principle) as you change. Did you know that exercise increases brain volume?
  • Include Psycho-social Support – Connect and communicate with those who understand, listen to and have time to speak with you. Loneliness is one of the major triggers for illness, while intimacy promotes healing.  With nurturing relationships, you’ll feel better and live longer regardless of your health issues.  Did you know that support groups double the life expectancy of some women with breast cancer?
 Integrative medicine is transformational! The Ornish program works and is easier to comply with than medication because it changes so many variables at once, and you feel better quickly. Run out and buy Ornish’s book The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health!
How far we have come in our understanding of how to integrate traditional and complementary medicine, and to make the patient, not his/her disease, the focus of attention. Ornish truly demonstrates the difference between Illness and WEllness. It’s the I and the WE!
To listen to the whole talk and other speakers, as well. go to http://www.imsummitwebcast.org/

The Doctors’ Prescription: Oz, Weil, Ornish, and Hyman Talk Turkey to Senatorial Leaders

Not every health problem is an emergency. Unless you wait around and do nothing until it becomes one.

And that’s what we’ve done —as individuals and as a nation, now in the throes of a health care system in crisis with ballooning waistlines and ballooning costs. Supplying coverage to the 47 million uninsured Americans is a clear mandate. But as Senator Tom Harkin told the assembly of health leaders and policy makers convened at the Summit on Integrative Medicine and the Health of the Public, sponsored by the National Academy of Sciences’ Institute of Medicine, it’s time to make prevention and public health "the centerpiece of health care reform."

Assuring access to effective low cost/proactive health care has sequeed from private choice to public necessity. For a full webcast of this ground-breaking summit to be available soon, go to: http://www.iom.edu/?id=59924

This week as President Obama set aside $634 billion for health care, with a strong, new emphasis on preventive care, a quartet of famous doctors offered Senators Michael Enzi, Harkin, and Barbara Mikulski their prescription for the health of the nation as health care expenses consume 16.5% of the gross national product.

"American must find new ways to address the poor health record and staggering expenditures gripping our country," urged Dr Mehmet Oz, MD, the cardiac surgeon, author of the popular You: health book series, and frequent Oprah guest.

He pointed out that we spend twice as much on health care as European countries, but are twice as sick due to high rates of chronic disease.

"Integrative Medicine can offer low-cost alternatives to pharmaceutical drugs and surgery for many conditions that now drain our health care resources," offered Dr. Andrew Weil, MD. A noted physician author, Weil directs a pioneering training for medical students at the University of Arizona Center for Integrative Medicine. Their approach emphasizes "proven, low-risk, low cost interventions, progressing to high-cost interventions only when the severity of conditions demand them."

Dr. Dean Ornish who has studied how lifestyle changes impact health outcomes gave figures, "Last year $2.1 trillion was spent on medical care, with 95% of it spent treating disease after it occurred. Many of these diseases, including heart disease, diabetes, prostate and breast cancer, and obesity account for 75% of these health care costs, although studies show they are preventable and reversible through lifestyle changes."

Oz agreed that "lifestyle choices drive 70% of the aging," advising Congress to shift policies to combine the best of modern medical practices with integrative approaches to "harvest the natural healing powers of our bodies."

Bestselling physician author, Dr Mark Hyman, MD, urged that "We must change not only the way we do medicine, but also the medicine we do."

He set forth a new paradigm of personalized, patient-centered health practice, based on a systems biological model called Functional Medicine, which tracks how the triad of environment, lifestyle, and genes interact to produce health imbalances which cause "the signs and symptoms we call disease."

Designed for acute illness, trauma, and end-stage disease, acute care medicine is "the best in the world," Hyman acknowledged. "But it’s the wrong model for chronic illness, because it doesn’t address why people are sick (or seek out) the underlying mechanisms and causes."

"That’s why we’re witness to a first ever decline in life expectancy," he concluded.

Oz is convinced by the success of his popular books (co-written with Michael Roizen, MD) that Americans are crying out to "play a greater role in their own wellbeing." In addition to addressing the widespread chronic disease in the U.S., Oz wants people to learn health from childhood on. His HealthCorps trains teens in public service by teaching healthy lifestyle to their peers.

Oz argued that we need to incorporate integrative approaches into the conventional health care economy, via insurance company reimbursements. He envisioned simple credentialing for all practitioners and research money for these therapies.

New drugs and high tech surgical procedures aren’t the only kind of medical breakthroughs, said Ornish, "One study projected nearly $81 billion in annual savings due to preventive programs."

For the complete hearing, go to: http://help.senate.gov/Hearings/2009_02_26/2009_02_26.html

The Senatorial leaders who serve on key committees were receptive and impressed. Now comes the tough job of translating critically needed health proposals into public policy.

Quoting Abraham Lincoln in a 1862 address. Senator Harkin told the Health Summit audience, "The dogmas of the quite quiet past are inadequate to the stormy present.. we must disenthrall ourselves so we can save our country."

The doctors all agreed on the prescription. The supporting science is clear. But will a nation addicted to unhealthy lifestyles and a fix-it medical model, overcome the denial about the health system breakdown in time to do the right thing?

For more on integrative health care, sign up at: www.health-journalist.com


Alternative Medicine is Mainstream

Co-authored by Dean Ornish, Rustum Roy and Andrew Weil
In mid-February, the Institute of Medicine of the National Academy of Sciences and the Bravewell Collaborative are convening a "Summit on Integrative Medicine and the Health of the Public." This is a watershed in the evolution of integrative medicine, a holistic approach to health care that uses the best of conventional and alternative therapies such as meditation, yoga, acupuncture and herbal remedies. Many of these therapies are now scientifically documented to be not only medically effective but also cost effective.
President-elect Barack Obama and former Sen. Tom Daschle (the nominee for Secretary of Health and Human Services) understand that if we want to make affordable health care available to the 45 million Americans who do not have health insurance, then we need to address the fundamental causes of health and illness, and provide incentives for healthy ways of living rather than reimbursing only drugs and surgery.
Heart disease, diabetes, prostate cancer, breast cancer and obesity account for 75% of health-care costs, and yet these are largely preventable and even reversible by changing diet and lifestyle. As Mr. Obama states in his health plan, unveiled during his campaign: "This nation is facing a true epidemic of chronic disease. An increasing number of Americans are suffering and dying needlessly from diseases such as obesity, diabetes, heart disease, asthma and HIV/AIDS, all of which can be delayed in onset if not prevented entirely."
The latest scientific studies show that our bodies have a remarkable capacity to begin healing, and much more quickly than we had once realized, if we address the lifestyle factors that often cause these chronic diseases. These studies show that integrative medicine can make a powerful difference in our health and well-being, how quickly these changes may occur, and how dynamic these mechanisms can be.
Many people tend to think of breakthroughs in medicine as a new drug, laser or high-tech surgical procedure. They often have a hard time believing that the simple choices that we make in our lifestyle — what we eat, how we respond to stress, whether or not we smoke cigarettes, how much exercise we get, and the quality of our relationships and social support — can be as powerful as drugs and surgery. But they often are. And in many instances, they’re even more powerful.
These studies often used high-tech, state-of-the-art measures to prove the power of simple, low-tech, and low-cost interventions. Integrative medicine approaches such as plant-based diets, yoga, meditation, and psychosocial support may stop or even reverse the progression of coronary heart disease, diabetes, hypertension, prostate cancer, obesity, hypercholesterolemia, and other chronic conditions.
A recent study published in the Proceedings of the National Academy of Sciences found that these approaches may even change gene expressionin hundreds of genes in only a few months. Genes associated with cancer, heart disease, and inflammation were downregulated or "turned off" whereas protective genes were upregulated or "turned on." A study published in The Lancet Oncology reported that these changes increase telomerase, the enzyme that lengthens telomeres, the ends of our chromosomes that control how long we live. Even drugs have not been shown to do this.
Our "health-care system" is primarily a disease-care system. Last year, $2.1 trillion were spent in the U.S. on medical care, or 16.5% of the gross national product. Of these trillions, 95 cents of every dollar was spent to treat disease after it had already occurred. At least 75% of these costs were spent on treating chronic diseases such as heart disease and diabetes that are preventable or even reversible.
The choices are especially clear in cardiology. In 2006, for example, according to data provided by the American Heart Association, 1.3 million coronary angioplasty procedures were performed at an average cost of $48,399 each, or more than $60 billion; and 448,000 coronary bypass operations were performed at a cost of $99,743 each, or more than $44 billion. In other words, Americans spent more than $100 billion in 2006 for these two procedures alone.

Despite these costs, a randomized controlled trial published in April 2007 in The New England Journal of Medicine found that angioplasties and stents do not prolong life or even prevent heart attacks in stable patients (i.e., 95% of those who receive them). Coronary bypass surgery prolongs life in less than 3% of patients who receive it. So, Medicare and other insurers and individuals pay billions for surgical procedures like angioplasty and bypass surgery that are usually dangerous, invasive, expensive, and largely ineffective. Yet they pay very little — if any money at all — for integrative medicine approaches that have been proven to reverse and prevent most chronic diseases that account for at least 75% of health-care costs. The INTERHEART study, published in September 2004 in The Lancet, followed 30,000 men and women on six continents and found that changing lifestyle could prevent at least 90% of all heart disease.

That bears repeating: The disease that accounts for more premature deaths and costs Americans more than any other illness is almost completely preventable simply by changing diet and lifestyle. And the same lifestyle changes that can prevent or even reverse heart disease also help prevent or reverse many other chronic diseases as well. Chronic pain is one of the major sources of worker’s compensation claims costs, yet studies show that it is often susceptible to acupuncture and Qi Gong. Herbs usually have far fewer side effects than pharmaceuticals.
Joy, pleasure, and freedom are sustainable, deprivation and austerity are not. When you eat a healthier diet, quit smoking, exercise, meditate and have more love in your life, then your brain receives more blood and oxygen, so you think more clearly, have more energy, need less sleep. Your brain may grow so many new neurons that it could get measurably bigger in only a few months. Your face gets more blood flow, so your skin glows more and wrinkles less. Your heart gets more blood flow, so you have more stamina and can even begin to reverse heart disease. Your sexual organs receive more blood flow, so you may become more potent — similar to the way that circulation-increasing drugs like Viagra work. For many people, these are choices worth making — not just to live longer, but also to live better.
It’s time to move past the debate of alternative medicine versus traditional medicine, and to focus on what works, what doesn’t, for whom, and under which circumstances. It will take serious government funding to find out, but these findings may help reduce costs and increase health.
Integrative medicine approaches bring together those in red states and blue states, liberals and conservatives, Democrats and Republicans, because these are human issues. They are both medically effective and, important in our current economic climate, cost effective. These approaches emphasize both personal responsibility and the opportunity to make affordable, quality health care available to those who most need it. Mr. Obama should make them an integral part of his health plan as soon as possible.
Dr. Chopra, the author of more than 50 books on the mind, body and spirit, is guest faculty at Beth Israel Hospital/Harvard Medical School. Dean Ornish, M.D., is Clinical Professor of Medicine at the University of California, San Francisco. His most recent book is The Spectrum (Random House, 2007). Mr. Roy is a professor at Penn State and Arizona State University. Dr. Weil is director of the University of Arizona Center for Integrative Medicine.


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