Customer Reviews

Dr. Dean Ornish's Program for Reversing Heart Disease

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While we appreciate that Mr. Bayan took the time to comment on our work, we are concerned that inaccurate statements he has made may discourage some people from making changes in diet and lifestyle that we have proven to be lifesaving.

For the past 24 years, the non-profit Preventive Medicine Research Institute and the University of California, San Francisco, School of Medicine have conducted research scientifically proving, for the first time, that the progression of even severe coronary heart disease can begin to reverse by making comprehensive changes in diet and lifestyle, without drugs or surgery. These studies have been published in leading peer-reviewed journals such as the Journal of the AMA, The Lancet, the American Journal of Cardiology, New England Journal of Medicine, Circulation, and others.

Mr. Bayan alleges that the diet we have proven to be so beneficial is "dangerous" for some patients because both HDL and LDL may decrease and triglycerides may increase. HDL and triglycerides are only potential risk factors for heart disease, they are not diseases. When we measured the actual severity of heart disease using state-of-the-art measures such as computer-analyzed coronary arteriography and cardiac PET scans, patients showed continued improvement over time, even in patients like Mr. Bayan whose HDL decreased or triglycerides increased. Also, cardiac events were 2.5 times lower in the group who followed the program compared to the control group who made more moderate changes in diet (30% fat, 200 mg cholesterol). [reference: JAMA. 1998;280:2001-2007.] Clearly, lowering HDL by changing diet did not harm these patients. LDL cholesterol decreased by an average of almost 40% during the first year, and none of the patients who adhered to the diet showed an increase in LDL.

As Dr. Connor wrote in the New England Journal of Medicine, "There are no data showing that the physiologic reduction of HDL cholesterol levels with a low-fat diet is detrimental. Diet-induced lowering of HDL cholesterol does not confer the same risk of atherosclerosis as do low HDL cholesterol levels in Americans consuming a high-fat diet." [ref: N Engl J Med. 1997;337(8).]

It is true that one can eat an unhealthful low-fat diet if it is high in simple carbohydrates such as sugar, white flour, alcohol, and many popular fat-free desserts. Such a diet may cause a shift to the more harmful pattern B LDL subclass that Mr. Bayan mentions.

But this is not the diet we recommend for reversing heart disease. Other studies have shown that a diet high in fruits, vegetables, grains, beans, and other complex carbohydrates (which is the diet we recommend) actually cause a shift AWAY from the pattern B LDL subclass to more beneficial patterns [ref: Kenney JJ, et al. Very-low-fat diets do not necessarily promote small, dense LDL particles. American Journal of Clinical Nutrition. 1999;70(3):423-5.]

Patients whose triglycerides increase are counseled to be even more mindful in reducing their intake of simple carbohydrates and increasing their exercise. Also, for many years we have recommended that patients take 3 grams/day of fish oil, which also helps to lower triglycerides. In the Multicenter Lifestyle Demonstration Project, we found that triglyceride levels, which initially increased slightly but not significantly, then fell significantly in years two and three. [ref: American Journal of Cardiology. 1998;82:72T-76T.] Almost 80% of people who were eligible for bypass surgery or angioplasty were able to safely avoid it by making these diet and lifestyle changes instead.

We respect the work of Dr. Robert Superko and often refer patients to his lipid laboratory for testing. Again, we have found that patients with small dense LDL also show reversal of heart disease on the program recommend.

The program that we recommend includes a reversal diet for those with heart disease and the prevention diet for others. The prevention diet may be higher in fat and cholesterol than the reversal diet and is tailored to the needs of the individual rather than offering one diet for everyone. The prevention diet may include some oils, fish and other animal products for some people.

Switching from saturated fats to monosaturated fats is better, but for reversing heart disease or lowering cholesterol it is better to avoid all oils other than fish oils. Olive oil is 100% total fat and 14% saturated fat. The more olive oil you consume, the more saturated fat you consume, the higher your plasma cholesterol. The studies showing that olive oil lowers cholesterol are only when substituted in equal amounts for butter or oils that are higher in saturated fat. Also, olive oil has almost none of the beneficial omega-3 fatty acids.

The bottom line is this: patients in our studies with severe heart disease reported a 91% reduction in angina (chest pain) within one month, and most became pain-free. They not only felt better, they were better. We measured improved blood flow within one month as measured by thallium scans and radionuclide ventriculograms, reversal of coronary artery blockages (atherosclerosis) within one year, even more reversal after five years, and 2.5 times fewer cardiac events (e.g., heart attacks). It works.

When my doctor suggested cholesterol lowering drugs last year, I decided that 34years old was too soon to start taking drugs. My cholesterol was 266 (& that's after cutting out most red meat and pork fat -and no hamburgers). I was motivated to try to improve the health of my arteries and heart. I want to be around for my ten year old's retirement party!

I followed Dr Ornish's diet program for 6 month's then had my cholesterol levels tested again. Everything improved: cholesterol down to 210, triglycerides went from 389 to 217 and my ratio improved 24%. I never skipped a meal. I never went hungry. Secondary benefit: I lost 14 pounds and two inches around my waist without trying. I did not exercise enough so I am trying to increase my exercise now. I probably exercised an average of once a week.

By the way, Dr Ornish included a chart that demanded that you eat at least a certain amount of fat in your daily diet. I liked that the book is filled with studies by major US universities. This is not 600 pages of rambling prose but a how to book to reverse heart disease. If you want someone to hold your hand, call your Mom. If you want a "How to Reverse Your Heart Disease" manual, buy this book. ... Stop reading reviews and buy, read and try it.

We're using this book in our clinic as a text book for reversing many illnesses. Based on the premise "you are what you eat", we've witnessed our patients not only lose weight but also put many diseases such as diabetes, MS, diabetes, fibromyalgia, CFS, EDS, diverticulitis, arthritis, and some forms of chronic pain into remission. Many of our patients are following Ornish's plan and losing a "person". They like the new person they're discovering! One of our current patients started on the program Sept. 1999 (3.5 months ago) and weighed in last week 57 pounds less! With the help of this "text" people are learning to eat better and take control of their lives. Their weight and disorders are disapearing naturally. Thank you Dean Ornish from Cary, NC!

My husband, who is a physician, and has a family history of heart disease, and I, an RN, began diligently following the reversal diet of the Ornish program in January, incorporating the recommended supplements, exercise and meditation. Since then, in a period of two months, he has lost 30 pounds, his cholesterol, and LDL have significantly improved, his HDL has not, and his already high Triglycerides have risen significantly by 30%. The previous post by the Ornish group states: "HDL and Triglycerides are only potential risk factors for heart disease, they are not diseases" If they are potential risk factors..then my concern is that my husband may still be high risk since he still has the potential risk factors. The Ornish group also states in it's post, "It is true that one can eat an unhealthful low-fat diet if it is high in simple carbohydrates.... Such a diet may cause a shift to the more harmful pattern B LDL subclass that Mr. Bayan mentions" We have been following the Ornish reversal diet/program diligently and have seen " a shift to the more harmful pattern B LDL subclass that Mr. Bayan mentions" They also state that "Patients whose triglycerides increase are counseled to be even more mindful in reducing their intake of simple carbohydrates and increasing their exercise." We have not been eating simple carbohydrates, "such as sugar, white flour, alcohol, and many popular fat-free desserts", and my husband has been exercising almost every day. They also state: "Also, for many years we have recommended that patients take 3 grams/day of fish oil, which also helps to lower triglycerides" We have been taking 3 grams/day of fish oil, along with the other recommended supplements, and his triglycerides rose 30%.

I must confess I am confused, and while I do believe the Ornish program may work for some people, I am concerned about the safety of this program for my husband specifically. We are going to pursue the cholesterol subclass testing mentioned by Mr. Bayan. I have also posted several questions to the Ornish website about my concerns...but have not received any feedback n this phenomenon as of yet, or reassurance that these test results are not something to be concerned about. We plan to work with our cardiologist on exploring what we can do to lower his triglycerides and raise his HDL, since poor levels of both are still considered "potential risk factors" I do not wish to "discourage some people from making changes in diet and lifestyle that we have proven to be lifesaving", because I do believe for some folks the Ornish program may be just the ticket. My question, until I do more reading and have more information, is whether it could be risky for some who may not respond the same way. Until I have more information and answers to my questions, I cannot whole-heartedly know if it's for everyone. And I would certainly advise folks who are interested in trying this program, to do so with medical supervision, as is advised by the Ornish group. Just as a side note..I have really enjoyed eating the Ornish reversal diet. We have both very much enjoyed the recipes, the meditation, yoga and exercise. I like the total comprehensive approach dealing with the whole person. I've also lost 25 pounds on this program..and for that reason alone, would very much like to continue with it, as I have more to lose. I have not yet had my cholesterol re-tested but plan to soon. Still..we have some home-work to do to figure out why my husbands triglycerides and HDL are not responding, what we can do about it, and to figure out whether it's even a problem that they're not. As we have both been otherwise delighted with this program, we are both very disappointed to get caught on this snag.

I'm 25, male, very physically fit, and ate a better than average diet. I was therefore shocked to find out that my cholesterol levels were at very unhealthy levels. I only had my levels checked due to family history. My doctor told me that I would definitely need to go on medication to control my cholesterol. I refused to start medication-for-life at age 25, so she suggested trying Ornish's diet plan for one month, but warned that she didn't think I'd drop far enough, and that medication would likely be inevitable. So, I bought this book and set out to try the my new diet. At first, I must admit it was hard... I had to give up things I liked. But, within days I had this new source of energy I'd never had before. My workouts lasted longer, I ran farther and biked harder. I lost 12 pounds in one month, even though I was eating almost non-stop. I was already amazed and convinced I'd stay on the diet regardless of it's effects on cholesterol. Today, I went for my results after the first month. My total cholesterol had dropped from 339 to 228, my LDL had dropped from 266 to 163 and my triglyceride count had dropped from 129 to 99. My good cholesterol only dropped 2 points, from 47 to 45, keeping it perfectly within the healthy range. While I still need to come down a little - it's only been one month so far, and I've gone from "needs medication immediately" to "doesn't even need to consider medication." If your doctor wants to put you on cholesterol lowering medication - do yourself a favour and try this out first!

Before starting this program, I had Stage 1 hypertension, cholesterol of 288, and was 50 pounds overweight. I also had a cardiac scan and got a calcium score of 27. Since I am only 38 years old, and have a strong family history of early heart disease, I was a bit overwhelmed with the direction of my health. The Cardiologist suggested the Ornish program. Within 6 months, I lost 54 pounds, my cholesterol is down to 119, my BP averages 109/70, and my cholesterol/HDL ratio is now 3.7. I look better, and feel better too. The "diet" does take some adjustment, but not as much as I thought. I also thought I'd never be able to eat out, but that didn't happen either. I still eat out 3X/week, but just feel better that I am making smart choices. While no "diet" is 100%, and while some things others have said in their reviews tend to concern me, no other program has ever helped me get my BP, cholesterol and weight under control as well as Ornish. They can say what they want, but I know I am healthier and will be less likely to "go" from a heart attack at 42 like my father.

I have just finished reading the reviews on this book and am quite concerned at some of the negative descriptives used. I can certainly understand that for some people, the program may not be effective and might even possibly be life threatening. However, to go as far as "warning" people to stay away from a program all together that may ultimately prove life altering and life saving to them is irresponsible and irrational.

I am assuming from the negative reviews that those persons may have expected the Ornish program to be a "fix all" for anyone and everyone that comes across it, yet all over his book he is quite specific about the kinds of people who the program was tailored for. Still, everyone is different and his suggestions throughtout that it may be helpful to many more also are logical. All person's genes and chemical make-up are not the same. That is why BEFORE going on any specific program, one should ALWAYS consult with their personal doctor and after deciding on a program, continually be monitored afterward.

This is still NO guarentee that any specific program will work or wont work.

So what if the people in the studies were "hand picked" by Ornish? Please point out even one medical study where participants WERENT handpicked by their respective researchers?

So what if much of what is published in this book might be teachings handed down from Ornish's "spiritual" guide? Ornish writes about his own personal experiences which is a responsible thing to do since the book is about HIS program and HIS studies about it. Nowhere does it state in the book that you cant fit your own in.

After reading this book and following the program I can state that for myself it has been very helpful to me. Being a person who has suffered from reduced circulation in my legs due to smoking and having been overweight as well as pre-diabetic, the benefits of this program have been substantial in a relatively short period of time. However, I can also see where any change in diet, quitting smoking and raised activity level might benefit me. I just happened to chose to follow this one and it has worked for me.

I especially enjoyed that I didnt have to buy other program items or pay for weekly meetings although the option does exist online since the publication of the book.

On the negative side, the book has not been updated since 1996 and there are important updates that I feel a new printing could/should address (see below). I would have also liked to have seen "negatives" discussed such as the increase in flatulence and increase in bowel movements. These practical negatives arent really "negatives". However, finding out all of a sudden that the new way you are eating has "side-effects" and you are standing in front of 10 members of the board when you figure it out is very embarassing. I would love to have seen more discussion on these types of things.

As for updates;

Some people cannot have soy and certain vegetables in their diets and the issue was never brought up in the book that I can remember (please correct me if I am mistaken). I am not one of these people however my sister and father cannot ingest soy at all. Many people that take certain heart/blood medications CANNOT have soy and/or must avoid certain fruits and vegetables (cranberries and blood thinners dont mix). This is a critical update I think should be addressed.

I would also like to see discussion on weaning/coming off of meats and refined carbs. During my first week, I would become "lightheaded" during this adjustment. Having some apples and peanut butter around during the first week or two just in case is highly beneficial and could be life-saving, especially if you are in a safety sensitive occupation such as I am (truck driver). When this "withdrawal" period is over, the peanut butter can go. I think that this also is a critical update that needs to be addressed.

Despite the very few negatives I experienced, I cannot say that this program/book is "bad" and to be avoided. On the contrary, it is a choice that you must make and to not consider it might be cheating yourself out of something that could possibly save your life. You must do the research and take into consideration that you might know yourself best (unless you have lived in ignorance and denial of yourself). No doctor, book author, researcher and/or any kind of medical professional could ever replace the knowledge you have of yourself.

Be responsible, use your head and think objectively. Everything is not for everyone.

I am a 70-year-old physician who was hospitalized for his first and only heart attack at age fifty-three. My Dad had his first heart attack at age forty-two and died at age forty-nine after his second heart attack. My brother had a massive heart attack in his fifties. Except when placed at the time of a heart attack, I am skeptical that the placement of stents in heart blood vessels are more valuable than a placebo. I read this book because I happened to see Dr. Ornish, the author, interviewed on Nova when I was at home convalescing from my heart attack. I was very doubtful about the validity of what I was hearing from the author (none of my physicians had mentioned Ornish's approach); however, I thought that I would be dead in a few years and had nothing to lose by trying Ornish's program. Two months after going on the diet described in the book, I was astounded when the hospital laboratory reported that my cholesterol had dropped by one third. I suspected that the hospital laboratory had made an error; a similar result a week later amazed me. I had been a little overweight. On the Ornish diet, I ate all that I wanted; and my weight dropped by more than ten percent. I discovered later that deviations from the Ornish diet caused rapid increases in the cholesterol in my blood. I have adhered rigorously to his diet and have had no heart problems, strokes, or other diseases related to arteriosclerosis. It is very profitable for cardiologists to insert stents. For most patients, it would be much more valuable to follow the diet and other changes in life style that are described in this book. The text is short and fun to read. Since my heart attack seventeen years ago, I have given over fifty copies of this important book to friends with cardiovascular diseases.

His book deserves to be read by all. It is easy to comprehend yet so compelling. As an emergency medicine physician I regularly recommend it to patients who are presenting in the ER with chest pain and have fear of having coronary heart disease. But his low-fat diet recommendation is just the beginning of his recommended lifestyle change. His recommendation of reducing stress is just as fascinating.

Dr. Ornish builds a strong case for his diet and stress reduction plan, both in his review of the research that preceeded his study and in regard to the results of his clinical trial. I think the reason his work is often misunderstood is that he calls for major dietary and life style changes in order to REVERSE cardiovascular disease, something that had not been demonstrated prior to his research.

I am cooking a soup inspired by one of his recipes right now in my kitchen: chick peas, leeks, and tomato juice soup seasoned with sage and thyme.

As I read some of the negative reviews of his book I began to realize that many readers may have confused the mediators for cardiovascular disease with the actual disease process. Thus his diet does cause weight loss, does reduce cholesterol, does reduce high blood pressure but these are all mediators for cardiovascular disease. A person might try other diets for weight loss or to lower blood pressure, but reversing cardiovascular disease requires more effort. The amazing accomplishment was that he actually demonstrated a reduction in cardiovascular disease in his patients with this approach.

I can not immagine a single heart attack victim in this country not going on this diet immediately. I was convinced by his data and the logical consistency of his approach.