If you love cheeseburgers and television, you probably won’t love Dr. Dean Ornish’s new diet and exercise plan. But the Spartan lifestyle espoused by this Sausalito physician has apparently become the darling of some dieters with unhealthy hearts.
Scientific proof of the value of his program as a way to unclog arteries was published earlier this year in the medical journal Lancet. And on Oct. 1, Random House published Ornish’s book outlining the plan, “Dr. Dean Ornish’s Program for Reversing Heart Disease,” which is already in its sixth printing.
A spate of other studies, some published just last week in the Journal of the American Medical Assn., is finding that diet and medication can undo the damaging effects of cholesterol in the arteries. But Ornish’s program includes no cholesterol-lowering medication.
At the crux of his program is a very low-fat diet of mostly fruits, vegetables and grains. It outlaws caffeine and discourages alcohol use. No more than 10% of total calories consumed each day can come from fat. (In comparison, the American Heart Assn. advises consumers to minimize fat intake to 30% or less of total calories.)
Moderate exercise is another integral part of the plan, with Ornish advising no more than a brisk 30-minute walk each day. Stress-reduction techniques such as meditation and group support meetings also play vital roles in the Ornish regimen.
In his study of 41 patients with heart disease, 22 patients were assigned to an experimental group that followed his plan. The other 19 patients followed their doctors’ more conventional orders. Within a year, the arteries of 10 of these 19 control patients appeared to be more blocked. But 18 of the 22 experimental patients had significant unblocking of the arteries.
There were other improvements as well. “Chest pain diminishes within a few days (of beginning the plan),” said Ornish, an assistant clinical professor of medicine at the UC San Francisco School of Medicine. “After one month, we recorded increased blood flow to the heart and more efficient cardiac pumping.” One 75-year-old man who could barely walk across the street without experiencing chest pains now hikes at an altitude of 8,000 feet for six hours at a stretch with no discomfort, Ornish said in a telephone interview.
Some experts in the field say Ornish’s work demands further study. Those who don’t dispute the wisdom of Ornish’s plan, which also includes a more lenient “prevention” diet option, do question its ease of execution.
“You can meet your nutrient needs (on the Ornish plan), but you must be judicious about selecting foods,” said Linda Van Horn, a registered dietitian and associate professor of community health and preventive medicine at Northwestern University Medical School, Chicago. And she wonders how long followers will persevere. “Social issues are the biggest problem,” Van Horn said. “It would be almost impossible to be a social creature, to eat in a restaurant or go to a person’s home, because so much of this diet depends on preparing things at home or advance planning.” Still, she added, it’s not impossible.
Ornish acknowledges that his plan doesn’t appeal to everyone, nor is it needed by everyone. “If your (blood) cholesterol level is below 150 (milligrams per deciliter), whatever you are doing is probably fine,” said Ornish. For those who decide to try his plan, Ornish tells them: “It’s not easy, but it’s worth it.” For motivation, he tells patients to focus on immediate benefits. He wants patients to focus on “the joy of living, not the fear of dying.”