Study: What a Difference Lifestyle, Diet Changes Can Make
Thank you for the article about my work (“A Slow Change of Heart,” March 10). I am concerned that some statements in it may discourage some people from making changes that may benefit them since the article did not contain the following scientific data.
In the Lifestyle Heart Trial, a randomized clinical trial, we measured the severity of heart disease using state-of-the-art tests: cardiac PET scans and quantitative coronary arteriograms. These patients showed some overall reversal of the progression of heart disease after one year and even more improvement after five years. There was a dose-response correlation between adherence to the lifestyle program and changes in atherosclerosis after one year and after five years. In other words, the more closely they followed the diet and lifestyle program, the more they improved.
The progression of coronary heart disease was stopped or reversed in 99% of patients (Journal of the American Medical Assn., 9/20/95). All but one patient lost weight from baseline to five years. The relatively small amounts of improvement (reversal) in coronary artery blockages (measured by angiography) were accompanied by substantial improvements in coronary blood flow (measured by PET), helping to explain why these patients reported a 91% reduction in frequency of angina (chest pain) after one year and a 71% reduction after five years. There was a 50% reduction in cardiac events (heart attacks, deaths, bypass surgery and angioplasty). Most patients have continued to adhere, and they continue to do well 10 years later.
Clearly, this program is not for everyone. My colleagues and I prescribe cholesterol-lowering drugs (or angioplasty or bypass surgery) to patients who are not interested in making comprehensive lifestyle changes or to the few who do not respond adequately to lifestyle changes alone.
Having seen what a powerful difference comprehensive lifestyle changes can make in the lives of so many people, it would be most unfortunate if readers were discouraged from making these changes out of concerns not supported by the scientific data.
DEAN ORNISH, M.D.
Sausalito
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Had Shari Roan journeyed to Santa Monica to the Pritikin Longevity Center, she would have found a thriving program begun by Nathan Pritikin. Faced with a life-threatening illness, Pritikin sought ways to develop his wellness to fight off the malady. He discovered that the program he devised, based on diet, wholesome foods and exercise, served not only his own needs but also those suffering from cardiac problems.
His clinic opened in Santa Barbara more than 20 years ago, then moved to larger quarters in Santa Monica as awareness of his successful program grew.
Of course, Pritikin, being a scientist and businessman, but not an M.D., was scoffed at by the medical establishment and the American Heart Assn. And though many of his core findings are now meeting with grudging acceptance, Pritikin himself has never been acknowledged for leading the way. Nor by Dr. Ornish, it would seem.
MARK MILLER
Santa Barbara
