Ornish diet

Definition

The Ornish diet was developed by Dean Ornish, M.D. Ornish was the first physician to demonstrate that heart disease can be reversed by natural methods, including specific dietary and lifestyle changes. Before Ornish published his clinical studies of patients whose cardiovascular problems were improved by diet and other means, doctors believed that heart disease was irreversible.

Origins

It took Ornish several published studies before conventional medicine would accept his position that simple and inexpensive treatments, including diet, exercise , and stress reduction, could reverse heart disease. Ornish believed that therapies for heart disease should confront the roots of the problem—high-fat diets , stress, and sedentary lifestyles—instead of more expensive and risky heart surgery. Beginning in 1980, Ornish studied 48 people with severe heart disease. Half of them were assigned to a control group and were treated by conventional methods, while the other half participated for three weeks in Ornish's program of an ultra-low fat diet, yoga, meditation , social support groups, and no cigarettes. The diet that Ornish designed was similar to the regimen developed in the 1970s by Nathan Pritikin to combat heart disease, which is still used in several clinics. Both diets emphasize foods that are very low in fat and yet filling, including high-fiber grains and legumes (beans and peas).

Over the course of the study, Ornish's group experienced improvement in symptoms and significant drops in cholesterol and blood pressure. Ornish published the results in the prestigious Journal of the American Medical Association, and his study was met with controversy. To convince his critics, Ornish set up a long-term controlled study. After one year, patients treated with Ornish's methods showed convincing results: 82% of them had significantly less blockage in their heart arteries and there was a drop of 91% in reported chest pain . After that study was published in the British medical journal Lancet, Ornish became internationally famous, and the Ornish diet was adopted by many heart disease patients. Ornish now serves as president of the Preventive Medicine Research Institute in Sausalito, California, and as a professor at the University of California.

DEAN ORNISH 1953–

Dr. Dean Ornish was born on July 16, 1953, in Dallas, TX. He attended Rice University and University of Texas at Austin, where he received his B.A. in 1975. He went on to graduate from Baylor College of Medicine in 1980 and completed his internship and residency at Massachusetts General Hospital and Harvard Medical School.

In 1989, Ornish began issuing data showing that the atherosclerotic patients he had been treating without drugs or invasive surgery had reduced the overall blockages in their arteries. That attention became international in 1990 with the issuance of the physician's best-selling book, Dr. Dean Ornish's Program for Reversing Heart Disease: The Only System Scientifically Proven to Reverse Heart Disease without Drugs or Surgery.

Ornish provides readers with information to help them make the comprehensive lifestyle changes he advocates. Among the alterations Ornish recommends is the incorporation of stress-management techniques such as meditation , imagery, breathing, and yoga exercises into their lives. Ornish also offers suggestions for healthier methods of coping with the emotional pain he believes everyone experiences in one form or another.

Although Ornish's lifestyle recommendations are similar to those advocated by most cardiologists, his prescription for health is much stricter. However, his research patients, all seriously ill at one time, have reduced their arterial blockages without the aid of pharmaceuticals or invasive surgical techniques.

Founder and president of the Preventive Medicine Research Institute of the University of California at San Francisco, Ornish believes there is a link between the causes of depression and heart disease and that bypasses and angioplasty only treat the symptoms, not the causes, of heart disease. Furthermore, he believes that having deeply intimate, loving relationships can be invaluable in preventing and treating heart disease.

Benefits

The Ornish diet, when used in a holistic treatment program, has been shown to lower blood cholesterol levels and reverse atherosclerosis , or obstruction of the arteries, making it a dietary therapy for heart disease, strokes, high blood pressure, and high cholesterol. The Ornish diet has also been shown to be an effective weight loss program, and is recommended as a preventive measure for heart disease, strokes, diabetes and other conditions related to high fat consumption. The Ornish diet is an easy and inexpensive form of treatment as well as a preventive measure.

Description

Heart disease develops when arteries that supply the heart with oxygen become narrowed due to the buildup of plaque on their walls. Plaque deposits are caused by cholesterol, a type of fat found in animal products and also made by the body from saturated fats in the diet. The narrowing of arteries is called atherosclerosis, a condition that develops over many years. When the coronary (heart) arteries become too blocked to supply the heart with enough oxygen, a heart attack occurs.

The first principle of the Ornish diet is to eliminate cholesterol, so all foods containing cholesterol and saturated fats are removed from the diet. Saturated fats are found in meat, dairy products, oils, nuts, seed, and avocados, which are all forbidden by the Ornish diet. Furthermore, the level of fat in the diet is reduced to only 10% of the total calories. This level is much lower than the diet recommended by the American Heart Association, which recommends up to 30% of calories from fat. The typical American diet consists of up to 50% fat. The Ornish diet is vegetarian, since cholesterol-containing meats are eliminated. The diet allows the use of egg whites and nonfat dairy products; technically it can be classified as a lacto-ovo-vegetarian diet.

Another feature of the Ornish diet is the ratios assigned to fat, protein, and carbohydrates, respectively. The typical American diet is 45% fat, 25% protein and 30% carbohydrates, with nearly 500 mg of cholesterol per day. The Ornish diet is 10% fat, 20% protein, and 70% carbohydrates. The Ornish diet consists mainly of complex carbohydrates, commonly called starches. Complex carbohydrates are present in fruits, vegetables, grains, and beans. Simple carbohydrates include sugar, honey, and alcohol, which tend to be "empty calories," because they contain lots of calories but little fiber or nutrients. The Ornish diet restricts but does not eliminate simple carbohydrates. The Ornish diet also emphasizes high-fiber foods, which includes most complex carbohydrates. High-fiber diets have been shown to reduce cholesterol and have other beneficial effects.

The Ornish diet is slightly lower in protein than the American average, and lower protein intake has been shown by research to have potential health benefits for Americans. For those worried about the lack of protein in a vegetarian diet, the Ornish program teaches ways to ensure an adequate supply of complete proteins in the diet. Proteins are said to be complete when the body can fully utilize them. They can be obtained by combining grains with legumes (beans) or grains with nonfat dairy products. For instance, complete proteins in the Ornish diet are obtained by combining rice and beans, tofu and rice, pasta and beans, baked beans and wheat bread, or oatmeal with nonfat yogurt over the course of a day. Egg whites are another source of protein on the Ornish diet.

Another principle of the Ornish diet is that people are allowed to eat as much food as they wish, as long as the 10%-of-calories-from-fat rule is maintained, and as long as only approved foods are eaten. By allowing people to eat as much as they like, the Ornish diet reduces the risk of binge eating, to which many dieters resort when forced to restrict calories. Many diets have been shown to fail when calories are restricted.

To summarize, the Ornish diet excludes cholesterol and saturated fat, including all animal products (except egg whites and nonfat dairy products), nuts, seeds, avocados, chocolate, olives, and coconuts. Oils are eliminated except a small amount of canola oil for cooking, and oil that supplies omega-3 essential fatty acids . The Ornish diet also prohibits caffeine , but allows a moderate intake of alchohol, sugar, and salt.

It should be noted that Ornish himself states that his diet alone is not sufficient for reversing heart disease, but is only one part of an overall program that includes exercise, yoga, meditation, stress reduction, and lifestyle changes. In fact, Ornish calls some of his work "opening the heart" therapies, because patients are encouraged to confront emotional aspects of their healing as well as physical concerns like diet and high cholesterol.

Preparations

Ornish states that one emphasis of his program is increasing the awareness of eating habits and the ingredients of food products. Those beginning the Ornish diet can prepare by becoming thoroughly familiar with Ornish's list of recommended and prohibited foods, and by learning to read food labels and count calories. Another preparation dieters can make is determining their ideal weight for their particular height and body type. Daily calorie and fat allowances can then be derived from this ideal weight. Ornish has authored or co-authored several books that provide hundreds of recipes consistent with the diet.

Precautions

The Ornish diet is not a substitute for medical care of cardiovascular disease. Furthermore, the Ornish diet is designed to be used in conjunction with a holistic health program that includes exercise, yoga, meditation, lifestyle changes, and stress reduction. As with any diet program, research continues on its effectiveness. Critics of the program maintain that Dr. Ornish has not produced sufficient clinical research to support his claims and that a diet high in carbohydrates will drive up insulin levels, increasing the risk of diseases such as diabetes. A 2003 study comparing low-fat diets to low-carbohydrate diets reported that obese patients lost more weight on the low-carbohydrate diet compared to a fat and calorie-restricted diet. They also appeared to have lower triglyceride levels and improved insulin sensitivity.

KEY TERMS

Plaque

—A deposit, usually of fatty material, on the inside wall of a blood vessel. Also refers to a small, round demyelinated area that develops in the brain and spinal cord of an individual with multiple sclerosis.

Those considering the Ornish diet should check with their physician and remain alert to recommendations from organizations such as the American Heart Association for diet and exercise guidelines.

Resources

BOOKS

Ornish, Dean, M.D. Dr. Dean Ornish's Program for Reversing Heart Disease. New York: Random House, 1990.

Ornish, Dean, M.D. Eat More, Weigh Less. New York: Harper-Collins, 1993.

Ornish, Dean, M.D. Stress, Diet, and Your Heart. New York: Holt, 1982.

PERIODICALS

"A Low-carbohydrate as Compared with a Low-fat Diet in Severe Obesity." Journal of the American Academy of Physicians Assistants (August 2003): 10–11.

Byrnes, Stephen."Keeping Up with Nutritional Research." Townsend Letter for Doctors and Patients (July 2003): 119.

ORGANIZATIONS

Preventive Medicine Research Institute. 900 Bridgeway, Suite 200. Sausalito, CA 94965. (800) 775-7674.

Douglas Dupler

Teresa G. Odle