Dr. Walton-Shirley,

If I recall correctly, the Ornish diet is very low fat with less than 10% of total calories derived from fat. The diet recommends avoiding unsaturated fats and nuts altogether. Most of the calories in the diet are derived from complex carbs. Is that still his position now?

I am not an MD but I enjoy reading your columns.

 Best  regards,

 Anand

Love the Dean Ornish comments and approach. The "guru" of healthy lifestyle and heart healthy diet. Lifestyle is and always will be mainstay in primary prevention. Statins are here to stay with enormous amount of data. Sterols, fish oil adjunctive in secondary prevention. Excellent editorial! You speak for the "silent majority" of clinical cardiologists and interject very practical comments. THANKS

Although Dean's style of preaching sometimes grates on me, I do think he's spot-on in many ways. Wish I'd been there for the talk, or could at least see the slides.

Thanks for a fun and informative writeup, Melissa!

Dear Dr.Walton,

It is quite obvious that you of course favour the prescribing of medicines vs.anything natural.

I always tell my Dr."just follow the money,Doc". Then both of us chuckle.

It is established without any doubt that the unlimited use of statins cause many problems. To wit: we see an increase in type 2 diabetes,there is an increase in CHF and there are many cases of memory loss. To name only a few. For more on the last item,read the book:Thief of Memory,by Dr.Duane Graveline.

But most doctors are not interrested in reading this. They prefer to rely on the mis-info told them by the Big Pharma salemen.

Just follow the money!!

Cor,

Cor,

If you can tell me where to follow (the money), please oblige!!! I can't fathom why prescribing a medication in my office would garner any profit for me. I send most of my lipid management back to their family doctors or the prevention clinic. If I control their blood pressure and their angina,  it means fewer and sometimes no further office visits, fewer tests. I don't accept payments from drug companies. I can't even remember which rep has which drug 90% of the time when they drop off samples (if we ever get any worth while, which is exceptionally rare these days). 

So, as to your comment about "show me the money"....., please do!!! 

Melissa

When a loved one gets a devastating diagnosis, someone like Dean Ornish offers hope, which is a priceless commodity in a crisis. The wife who stood helplessly by that hospital bed can open his 1996 book about everyday cooking (or his earlier work on Love and Survival) and DO something to help. He has several books out explaining the data he uses in his presentations, and a website for his Preventative Medicine Research Institute as well. He does make a living by his institute, books, and seminars, but his ideas are available freely online at his website, in the abstracts on Pubmed, and at the library in most cities.

As to the insistence that he is still a very-low-fat diet advocate, that is true for the patient population he serves. For others, his latest work advocates a spectrum of healthy choices. You choose where you want to be, knowing the consequences of your choices. You get informed about your health conditions, and take responsibility for them, doing with diet and exercise what you can to make your physician's job easier. He actually eats a little dark chocolate every day, because enjoyment is part of living a quality life.

People asked me over the course of my Ph.D. why I didn't become an MD. I told them patients would not like me very much, as I would frankly be tempted to hand out cookbooks and gym trial memberships a lot. Having a rare condition forces me to be responsible for my own health. People like Dean Ornish provide the research to make that resonsibility easier.

The low fat diet has consistently failed to stem the tide of obesity, which is instead amplified by the current profusion of recommendations for eating starchy foods, whole grains, fibre, cereals, bread, milk, yogourt and fruits. When will we learn our lessons? Now that 70% of the population is obese/overweight and 30% has metabolic syndrome? Do you think that is soon enough?

The simple solution that needs to be implemented immediately is substantial carbohydrate restriction.  All of these diseases are ones of carbohydrate excess and intolerance - the currently recommended diets are simply throwing gasoline onto a roaring fire.  When will we learn that a calorie is not a calorie, and that macronutrient distribution in the diet is critically important?  Yes that means protein and fat not carbohydrate. 

By the way, Alzheimer's dementia and many cancers, not to mention heart disease, stroke and diabetes, are all unpleasant side effects of decades of hyperinsulinism stemming from the CHO we eat (formerly me too). 

THe low fat diet fails because it is not tried. People try to keep eating the same old junk, just artifically flavored and sweetened so that they never get over the addiction to excess fat, sugar, and salt sprinkled over nutritionally deficient junk food we have been trained to ingest from childhood. Going back to the basics that both Paleos and Vegans can agree on- vegetables, fruit, and recognizably real food- dramatically improves health whether your protein is brown rice and lentils or bison and venison. Personally, the Paleo diet would cause me digestive misery due to excessive compliance in my connective tissues. I need the fiber and fluids a mostly vegan diet provides to "keep things moving". But I'm also a tall and skinny individual who burns calories easily. I simply do not process animal protein well. Carb restriction makes me sick, because the nervous and muscular systems run on carbohydrates preferentially. And my systems need a lot of carbs. Others may need something different. But Dean Ornish's studies has helped me a great deal.

I am a cell biologist and biochemist. I get my dietary advice from MDs with published research histories and reliable data. Dean Ornish fits my criteria.

"THe low fat diet fails because it is not tried."

Yes, it's called the Women's Health Initiative Trial. Look it up. 48k women followed for >8 years randomized to low fat diet vs standard US diet. No effect on cancer, mortality, cardiovascular disease, or diabetes, despite high adherence to recommendations to reduce dietary fat and extensive counselling of patients.

The only thing we have got for our return on investment in this trial ($400,000,000) and others is the big fat lie that fat is bad for us and carbs are good for us. Ergo,70% of the population is overweight or obese and 30-33% have metabolic syndrome (prediabetes). This is why population rates of type 2 diabetes and dementia are skyrocketing. 

It is great that high carb diet has worked well for you - you are likely genetic well-adapted towards CHO disposal. Most, however, are not. Please do not generalize your dietary experience to the general population, which as a whole is sick as a result of the decision to recommend CHO instead of fat (see food pyramid, USDA recommendations, most experts at AHA, ADA, CDC, etc). 

Any diet study that relies of self-reporting of food intake and exercise is useless. People, especially obese people, lie about both. Genetics does not obviate the First Law of Thermodynamics.

See my comments on the DIRECT and A to Z trials.

http://medicalmyths.wordpress.com/2008/07/16/direct-more-obese-people-lying-about-food-intake/

The WHI did not work (I knew low-carbers would mention it) because the "low-fat" group never got to their target of below 20% of calories per day from fat. They stayed at 25%. The "high fat" group was supposed to stay above 30% calories from fat (closer to the American average of 40%), but lowered theirs to an average of 29%. There wasn't enough difference between the two groups to make a difference in their cancer and cardiovascular risk, though between subgroups that came close to target there were trends toward significance. Yes, it does seem like millions of dollars down the drain. Just shows it is impossible to tell large groups of free-living humans how to eat for many years and expect them to do it consistently. Dean Ornish, Caldwell Esselstyn, Nathan Pritikin, the Rice Diet people at Duke before them, have all achieved near miracles with very sick people from implementing a proper, healthy low-fat diet. With decades of results from multiple research centers, I wouldn't dismiss them too quickly just because they upset your particular paradigm. I don't dismiss paleo as ineffective. I just can't eat it.

I repeat: a healthy low fat diet has never been tested on the large scale necessary to convince people of its value. It is hard when half the restaurants in town are fast food, when every commercial on TV shows terrible food, when ease is preferred over health, to get people to do even the simple things their grandmothers knew. The studies focused on weight loss alone indicate that any diet- low carb, low fat, whatever- that convinces people to cut out the junk is good for weight loss, diabetes, and cardiovascular health. I am not advocating white bread and sugar (the usual high CHO). I am advocating vegetables, fruit, whole grains, beans, and small amounts of animal protein and healthy fats as needed for your metabolism. These are the recommendations from ADA, AHA, the Alzheimer's Association, AICR, etc. for very good reasons. They work when implemented properly. Since the "average human" does not in fact exist, we all have to modify and adjust for our own needs. But the modern American diet and lifestyle are not working for us, healthwise. I think we can agree on that.

I would describe this type of blog post as therapeutic because it motivated me to continue the macrobiotic diet which I have just started two months ago. I've been suffering eczema in my right hand and I learned that a "cleanup diet" is all it takes to gradually cure the disease.  Dr. Dean Ornish is so full of substance. Does he maintain a blog, too?

 Thank you for this motivational and substantial article which I happen to see less of these days.

Antonette of Sonnetshaven

Atonette,

Thanks for your post and best wishes for a sustainable routine that give you health and as important-JOY!!!

Melissa