Dean Ornish, M.D. at TEDxSF (7 Billion Well)
Dr. Dean Ornish: Turn Back the Clock on Heart Disease
Lifestyle changes actually undo damage to the heart for patients in Dr. Ornish's heart disease reversal programs.
By Jennifer J. Brown, PhD
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Dean Ornish, MD, cardiologist, author, and healthcare reformer, firmly believes you can reverse heart disease with a disciplined program of exercise, meditation, diet changes, and more. And he's proven his point many times over.
Dr. Ornish is the founder and president of the non-profit Preventive Medicine Research Institute and a professor of medicine at the University of California, San Francisco. He is the author of six books, including Dr. Dean Ornish's Program for Reversing Heart Disease; Eat More, Weigh Less; Love &Survival; and his most recent book, The Spectrum.
Ornish's program to reverse heart disease is working for former President Bill Clinton and countless others with heart disease. It brings together doctors, nurses, yoga and meditation teachers, exercise physiologists, dietitians, and psychologists, who work together with participants on supervised exercise, stress management through yoga and meditation, emotional support, and nutrition counseling as part of a group meal. After 72 hours of training, people in the program go into a self-directed community where they support each other in continuing the healthy habits learned.
Everyday Health talked with Ornish about the latest developments in his lifestyle approach to turning back the clock on heart disease and other conditions.
Everyday Health:What’s different about your Program for Reversing Heart Disease when compared with traditional modern medicine?
Dr. Ornish:The traditional treatments for heart disease are drugs and surgery. More recently that’s been changing to some degree. In a 2012 consensus statement, the conclusion was that the mainstay for coronary heart disease should focus on eliminating all unhealthy behaviors. That’s really exciting to me! That’s a big change.
There’s a convergence of forces that really make this the right idea at the right time. Limitations of high tech medicine have become increasingly clear, especially in the area of cardiovascular disease.
At the same time, we’ve been publishing studies now for 37 years — randomized trials — where we’re able to show for the first time that lifestyle changes alone can not only slow the progression of disease but can actually reverse it in most cases.
EH:When you talk about disease reversal, is this the same as a cure?
Dr. Ornish:I think cure is too strong a word. I would prefer to say that instead of getting worse and worse — the so-called natural history of heart disease, which is not at all natural — that people can get better and better in most cases. The power of these very simple and low-cost interventions is becoming increasingly well documented.
A randomized trial showed that the heart disease was improving in terms of the blood flow and the function of the heart. Then in the Lifestyle Trial there was some reversal in blockage of the arteries…whereas the control group got worse and worse.
We found that these same lifestyle changes that can reverse heart disease could stop and reverse disease in men with early stage prostate cancer, could reverse type 2 diabetes, could change gene expression in over 500 genes, and most recently we found that we could actually lengthen telomeres, the ends of our chromosomes that control aging. Telomeres were longer by about 10 percent in people who went through our lifestyle program, and shorter in the control group.
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EH:Do lifestyle choices affect even our genes — meaning we’re not stuck with what we inherited?
Dr. Ornish:Exactly. Our genes are our predisposition but our genes are not our fate. I can’t tell you how many people I’ve heard say, "Oh, I’ve just got bad genes and there’s nothing I can do about it," when in fact, you can!
Bill Clinton — whom I’ve been working with since 1993 — when his arteries clogged up, his own cardiologist held a press conference and said it was all in his genes, and lifestyle had nothing to do with it. Because I’ve been working with him so closely I knew it had everything to do with it! And so I sent him an email and told him as much. We met a few days later and now he’s been following a largely plant-based diet based on my recommendation and he’s doing really well.
I think it’s really empowering ... knowing that it’s not all in our genes. If your mother and father and sister and brother and aunts and uncles all died early from heart disease, you’re genetically more likely to get it. But what that means is you just need to make bigger changes to keep that from happening.
EH:If your Program for Reversing Heart Disease qualifies for reimbursement, will it be accessible to more people?
Dr. Ornish:Absolutely. Now it’s available to everyone who needs it. If it’s reimbursable it’s sustainable.
We began training sites in 1993, through our nonprofit called the Preventive Medicine Research Institute. When we trained over 53 sites, we showed better clinical outcomes and after a year, 85 percent adherence to a lifestyle intervention — which is unheard of — and 50 percent cost savings. Yet we learned a very painful lesson. If it’s not reimbursable, it’s not sustainable.
Now that Medicare began covering my program, anyone we train and certify now has Medicare coverage. Wellpoint recently agreed to cover and make our program not only available, but to encourage their members to follow it. And we’ve had thousands and thousands of healthcare professionals who want us to train them — so we recently partnered with HealthWays to be able to do that.
EH:What are your views on how stress management like yoga and meditation helps the body heal?
Dr. Ornish:Chronic emotional stress can make things worse in so many ways. It can worsen blood pressure, it can worsen the blockages in your arteries, it can precipitate irregular heart rhythms, it can make you more likely to have cardiac death and that’s just your heart! So when we teach people these techniques, this allows them to quiet down their mind and body to experience more of an internal sense of peace and joy and well-being, and to realize in many ways that it is our natural state.
I studied yoga for many years with a teacher named Swami Satchidananda. People would say, "what are you, a Hindu?" And he would say, "No, I’m an Undo." The idea is that your body has the remarkable capacity to undo a lot of the damage if you simply stop doing what’s causing the problem. We may do a whole campaign on, “Undo It."
People say things like, "You know, I used to have a really short fuse and would explode easily before, and now that I’ve gone through your program my fuse is longer. Things don’t bother me as much. I can actually get more done, more accomplishment with less stress, and have more fun doing it."
EH:That’s without medication.
Dr. Ornish:Without the medication. Depression is very closely tied to that. I wrote a book in 1998 called Love and Survival and it reviews what were then hundreds and now thousands of studies — people who are depressed and lonely and isolated are 10 times more likely to get sick and die prematurely than those that have a sense of love and connection and community. I don’t know any kind of medicine that has that powerful an impact.
And so our program isn’t just about managing stress, it’s about creating a sense of community and bringing people together. Our support groups provide a safe environment where people can let down their emotional defenses and talk openly and authentically about what’s really going on in their lives without fear that someone’s going to make fun of them, or judge them, or reject them. We’ve found that we could cut depression scores by half — which is better than the antidepressants.
These simple lifestyle changes work even better at a fraction of the cost, and the only side effects are good ones.
EH:If someone heard about your program and wanted to be treated by a physician or a team who’s been trained in the way you practice medicine, how would they find such a doctor?
Dr. Ornish:If you go to our website, Ornish.com, a section lists the sites we are training — some of the most prestigious institutions, Beth Israel Medical Center in New York, the Cleveland Clinic. We’ve been contacted by literally thousands and thousands of healthcare professionals and hospitals who want us to train and certify them. Healthways really has the vision, the integrity, the resources, the relationships to scale this very quickly. Although we’ve only been working with them for a few months, we’re moving quickly.
We have the strong support of some of the most conservative member Republicans, some of the most liberal Democrats and everything in between. These are profoundly human issues that we can empower people and give them new hope and new choices that they didn’t have before.
EH:What is your newest project that you’re passionate about?
Dr. Ornish:Well I have a 4-year-old girl and a 13-year-old boy, and I’m very, very happily married. My wife is a yoga and meditation teacher. So having time to embody the core values that I’m trying to teach others, which I haven’t always done as well as I’d have liked in the past, is really fun.
Working with Healthways has been a dream because it’s allowing us to create a new paradigm in healthcare, and I’ll continue to do research. One of the exciting things about working with Healthways is that they’re as data driven as we are. We can have huge studies of large numbers of people making profound changes in their lifestyle and we can look at all kinds of interesting things.
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