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Dr. Dean Ornish's Program for Reversing Heart Disease
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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.
The first section of the book concerns itself with several case histories and is quite interesting--everyone loves a story.
The second section deals with the lifestyle changes Ornish believes will prevent and reverse heart disease. Chapters 7, 8, and 9 concern themselves with getting in touch with your emotions, your interpersonal relationships, and your relationship to a Higher Power. Chapters 11 and 12 deal with quitting smoking and exercising more. All of these things are certainly helpful in regaining and maintaining one's health.
It is in chapter 10 where the advice goes bad. This chapter concerns itself with diet. There are so many errors in it that it is difficult to know where to begin but a brief synopsis will be attempted.
Dr. Ornish says that there are two diets presented in the chapter: the Reversal Diet and the Prevention Diet. The Reversal Diet is for treating and reversing heart disease, while the Prevention Diet is for, well, prevention of heart disease. Ornish says that, "Both diets will substantially reduce your risk of developing other degenerative diseases, including obesity, high blood pressure, stroke, osteoporosis, diabetes, gallstones, and cancers of the colon, breast, and prostate." (P. 254) Ornish also claims that the diets will help you "to enjoy life more."
Of course, the diet he recommends is an ultra-low-fat regime that is almost 100% vegan. On page 256, he says that the Reversal Diet is "very low in fat and cholesterol," containing less than 10% calories from fat. The diet also excludes foods high in saturated fats such as "avocados, nuts, and seeds." Egg whites and nonfat dairy products are allowed. The bulk of the diet is made up of complex carbohydrates, fruits, and vegetables.
Dr. Ornish's advice shows his lack of knowledge about lipids (fats and oils) and research has not borne out his claims about low-fat diets being good for heart disease. In the first place, avocados, nuts, and seeds are not "high in saturated fats" as he claims. Their fat content is mostly from oleic acid, a monounsaturated fatty acid, and linoleic acid, a polyunsaturated fatty acid. Very little of the fat content of nuts, seeds, and avocados comes from saturated fatty acids (see MG Enig "Know Your Fats," Bethesda Press, 2001, 291-2). Additionally, a comprehensive review of the available trials has shown the ineffectiveness of low-fat/cholesterol diets in both treating and preventing heart disease (L Corr and M Oliver. Eur Heart J, 1997, 18:18-22; (b) G Taubes. Science 2001 Mar 30 291:5513 2536-45). In fact, such diets actually INCREASE risk factors for heart disease (DM Dreon and others. Amer J Clin Nutr, 1999, 69:411-8; F. Jeppesen and others. Am Jnl Clin Nutr, 1997; 65:1027-1033).
Furthermore, vegetarian diets do not protect against heart disease. A study of vegans showed that vegan females had higher rates of heart disease than non-vegan females (Ellis, Path, Montegriffo. Amer J Clin Nutr, 1970, 32:249-255). Vegetarians in India suffer from high rates of coronary artery disease--higher than meat-eating Indians (EA Enas. J Indian Med Assoc 2000 Nov;98(11):694-5, 697-702; SL Malhotra. Brit Hrt J, 29:895-905, 1967). Some studies have also shown that vegetarians have higher homocysteine levels than non-vegetarians and homocysteine is a known cause of heart disease ((a) Herrmann, Schorr, Purschwitz, Rassoul, Richter. Clin Chem, 2001, 47(6):1094-10; (b) D Mazzano and others. Thromb Res 2000 Nov 100:153-60).
The high carbohydrate diet Ornish recommends will drive insulin levels up and keep them elevated. Hyperinsulinemia is also another probable cause of heart disease (I. Zavaroni and others. New Eng J Med, 1989, Mar 16, 320:11:702-6).
Ornish makes a lot of other bizarre claims in this chapter--all without any supporting documentation. For example, he mistakenly says that, "Sugar is not very strongly linked with coronary heart disease; the real culprits are saturated fats and cholesterol." (P. 257). This statement directly contradicts meticulous research on sugar and heart disease (J Yudkin. Lancet 1:296-297, 1971). Additionally, careful reviews have shown that saturated fats and cholesterol do NOT cause heart disease (U Ravnskov. The Cholesterol Myths. New Trends Publishing, 2001).
Ornish claims that excess dietary protein causes osteoporosis when actually such notions have been shown to be false--when protein is consumed as real meat as opposed to isolated amino acids ((a) H Spencer and L Kramer. J Nutr, 1986, 116:316-319; (b) Amer J Clin Nutr, 1983, 924-929; (c) J Nutr, 1988, 118(6):657-60).
On page 267, Ornish says that, "Many anthropologists believe that our ancestor's were primarily vegetarian." No supporting references to the "many anthropologists" are given. This statement also flies in the face of accepted nutritional anthropological data which clearly shows that humans evolved as omnivores and that meat and animal foods made up a significant part of our forebears' diet (HL Abrams. J Appl Nutr, 1979, 31:1,2:43-59).
On page 268, Ornish claims that "as early as 1900 two thrids of the protein in the typical American diet came from plant foods." Again, no supporting references are made for this untrue statement. Did he look at any cookbooks from that time? If he did, he'd see lots of recipes for meat, fish, shellfish, and wild game. Recipes invariably included butter, cream, or lard as well--at a time when heart disease was rare!
And on and on it goes. If you'd like to read what dietary factors figure into heart disease, you should look into my book "Diet & Heart Disease: Its NOT What You Think," Kilmer McCully's "The Heart Revolution," and Christian Allan's "Life Without Bread." For a thorough debunking of Dr. Ornish's dubious claims, see Uffe Ravnskov's "The Cholesterol Myths." All of these book are available off of amazon.com and would be better investments of your money.