Others expressed skepticism because his experimental methods did not attempt to account for the ways in which each component of his program affected the results. Ornish D. Dr. Dean Ornishs Program for Reversing Heart Disease. Ornish goes to argue that protein and saturated fat increase the risk of mortality and chronic disease. I feel passionately about doing this work because it helps transform peoples lives for the better. If anything, our attempts to eat less fat in recent decades have made things worse. And it is worth noting that among people in the study over 65, heavy consumption of animal protein actually protected against cancer and mortality. Thanopoulou AC, Karamanos BG, Angelico FV, et al. This study was widely reported and caused many to say, See, another study showing that the Atkins diet is good for your heart. It sounds good, but it is not true. Atkins R, Ornish D. Cardiology Crossfire. American College of Cardiology 50th Annual Scientific Sessions, Orlando, FL, March 20, 2001. New York: Macmillan Publishing Co; 1991:409-410. 1961;16:407-415. Its hardly surprising that quitting smoking, exercising, reducing stress and dietingwhen done togetherimproves heart health. Join the hundreds of thousands in my email community for the latest news, insight, and more, Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, Kraemer HC, King AC. Mean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), and Ornish, -2.2 kg (-3.6 to -0.8 kg). Gould KL, Ornish D, Scherwitz L, et al. Am J Med. To address this issue, a recent National Institutes of Health study that I cited in my oped put people in a metabolic ward where they could actually control what people were eating and then measured the effects. What happens to changes in blood pressure, cholesterol and weight are important only to the extent that they affect the underlying disease process (for example, degree of atherosclerosis, blood flow to the heart, cardiac events, changes in prostate cancer), which is what we documented. Whats more relevant to the discussion is this fact: During the time in which the prevalence of obesity in the U.S. nearly tripled, the percentage of calories Americans consumed from protein and fat actually dropped whereas the percentage of calories Americans ingested from carbohydratesone of the nutrient groups Ornish says we should eat more ofincreased. 2002;113:30-36. Presented at the American Heart Association Annual Scientific Sessions, Orlando, FL, 2003. Reductions in total cholesterol, LDL-C, triglycerides, and total-to-HDL cholesterol ratios were significant only in patients who were following either a 10% fat diet or a 15% fat, calorie-controlled diet. I would love to be able to tell you that these are health foods, but they are not. Ornish told Reuters, There has been a bit of a backlash against not only just low-fat eating, but healthy living in general. 1986;232:34. David Perlmutter, MD, FACN is a board-certified neurologist, Fellow of the American College of Nutrition, and five-time New York Times bestselling author. High-protein diets may cause loss of calcium and decreased levels of urinary citrate, leading to osteoporosis and kidney stones (52). Int J Obes Relat Metab Disord. BACKGROUND: Third, shes confusing the USDA data (which I cited in my oped) and the National Health and Nutrition Examination Survey (NHANES) data (which looked at the percentage of calories). N Engl J Med. They lost 24 pounds during the first year and kept off more than half of that weight 5 years later and had 2.5 times fewer cardiac events than the control group. Am J Cardiol. 2002;40:265-274. 1995;274:894-901. This argument raises two interesting points: First, it contradicts Ornishs claim that hes not really against fat, just certain types of fat. This is not true, as I wrote about years ago in my Newsweek column. Some people are able to handle more simple carbohydrates and/or more cholesterol and saturated fat in their diet than others. The effects of weight loss on the activity and expression of adipose-tissue lipoprotein lipase in very obese humans. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. This does not confer the same risk of atherosclerosis as in Americans with low HDL levels who are consuming a high-fat diet (41). (All groups consumed about the same amount of protein.) Goldstein JL, Brown MS. Cholesterol and cardiovascular disease. A randomized trial of a low-carbohydrate diet for obesity. There are no data showing that the physiologic reduction of HDL-C levels with a low-fat diet is detrimental, especially in that LDL-C usually decreases more than HDL-C (42). Ornish D. Concise Review: Intensive lifestyle changes in the management of coronary heart disease. Esselstyn CB Jr. Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). I'm not aware of a single study showing that a diet high in red meat can reverse the progression of coronary heart disease. J Am Coll Nutr. Whole-grain consumption and risk of coronary heart disease: results from the Nurses Health Study. For those simply trying to lose weight or lower their risk factors moderately, less extensive changes may be required. 1998) showed an average reduction of 24 pounds in the first year. Bill Clinton is one of the more public examples of this, having lost and kept off more than 20 pounds since following the whole foods, plant-based diet I recommended for him five years ago (including salmon once a week). Clinical Nutrition and Dietetics. As evidence for these causal claims, he cites a handful of observational studies. The New York Times Sunday Magazine, July 7, 2002. Pounds lost on Atkins diet may quickly return. In other words, when you have less garbage, you need fewer garbage trucks to remove it, so a reduction in HDL on a low-fat diet is not harmful. If ones looks at the right data, he says, its clear that our countrys metabolic ills can be blamed on our increasing consumption of red meat and bad fatsboth of which, he says, are proved to be unhealthy. Please refer to the appropriate style manual or other sources if you have any questions. The two doctors had much in common: they both made millions from their best-selling books; Atkins graced the cover of Time while Ornish, Newsweek. They write new content and verify and edit content received from contributors. Question 12 options: his core , muscle memory, his progression , specificity training, Kim is conditioning. A wide body of scientific evidence links the consumption of animal protein, saturated fat, and cholesterol with CVD, cancer, and other chronic illnesses (47-51). So even when we look at the data Ornish likes, we still dont see reason to blame Americas ill health on unprocessed red meat and saturated fats. Science. Saunders; 1998. In contrast, there was a statistically significant reduction in LDL-cholesterol in the Ornish group but not in the Atkins group after one year. In my numerous debates with Dr Atkins, we agreed that many Americans eat excessive amounts of processed foods high in simple carbohydrates, including sugar, high-fructose corn syrup, white flour, white rice, and alcohol. Bell EA, Rolls BJ. History tells us its not going to be spinach. Again, we dont know because his studies have not been designed in a way that can tell us anything about the effect of his diet alone. Bazzano and her associates concluded that going on a low-carb diet is better than a low-fat one for those wishing to lose weight. This was clearly stated in my New York Times oped: Moyer wrote: Nutrition is complex but there is little evidence our countrys worsening metabolic ills are the fault of protein or fat. Samaha FF, Iqbal N, Seshadri P. A low-carbohydrate diet as compared with a low-fat diet in severe obesity. He should know better. Thus, dietary fat is not responsible for obesity. In fact, per capita consumption of fat has risen by 10 Ib/year since 1975, whereas per capita consumption of simple carbohydrates has increased even more, by 20 Ib/year (5). ", The recent multicenter PREDIMED trial also supports the notion that fat can be good rather than bad. Am J Med. The other way people get too many calories is by consuming too many simple carbohydrates. Earlier this year a panel of experts from U.S. News & World Report rated the Ornish Diet as the number-one diet for heart health for the fifth year in a row (that is, all five years they have been doing rankings). People have a spectrum of choices. Ornish D. The case for low fat. One-year effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in decreasing body weight and heart disease risk. Interaction of dietary cholesterol and triglycerides in the regulation of hepatic low-density lipoprotein transport in the hamster. Risk assessment tool for estimating 10-year risk of developing hard CHD (myocardial infarction and coronary death). Judging the quality of a study by the number of patients is like judging the quality of a book by the number of pages. Increased whole grain intake was associated with decreased risk of CHD in 75,521 women followed for 10 years (13). His famous 1990 Lifestyle Heart trial involved a total of 48 patients with heart disease. Eat more meat, butter and eggs, theyre good for you (prominently pictured on the cover of their books), all those experts have been wrong. This has been repeated so often in the echo chamber of modern media that its become a meme. which types of nerves carries stimuli away from the brain?, In planning his fitness goals, Alonso wants to make sure that he improves his fitness without pushing himself too hard too fast. The point here is not that Ornishs dieta low-fat, whole food, plant-based approachis necessarily bad. Leaf A, Weber PC. Fung TT, Hu FB, Pereira MA, et al. Energy density of foods affects energy intake across multiple levels of fat content in lean and obese women. I dont usually respond to ad hominem attacks, but when I read Melinda Wenner Moyers article Why Almost Everything Dean Ornish Says about Nutrition Is Wrong, I felt a need to set the record straight. In: Cowdry EV, ed. The mechanism of the effects on HDL-C levels of changing from a high- to low-fat diet differs substantially from the mechanism explaining the differences in HDL-C levels between individuals who are eating a high-fat diet. Also, in a randomized controlled trial, ketogenic diets such as the Atkins impaired cognitive performance in higher order mental processing after only 1 week (61). Over and over, Ive seen patients with coronary heart disease so severe that they cant walk across the street or work or play with their kids or make love or do much of anything without getting severe chest pain become pain-free after only a few weeks of making these diet and lifestyle changes. All consumption estimates are imperfect, of course, including the U.S. Department of Agriculture (USDA) data he cites. The American Cancer Society 1996 Advisory Committee on Diet, Nutrition, and Cancer Prevention. He began the Lifestyle Heart Trial, a controlled study of the effects of a low-fat diet and stress-management regime on a small group of heart disease patients, implementing a unique approach to treating heart disease that he developed in the late 1970s while he was still a student. This optimal diet is based predominantly on fruits, vegetables, grains, and legumes in their natural, unrefined forms. DISTINGUISHING BETWEEN RISK FACTORS AND ACTUAL MEASURES OF DISEASE. Taubes G. The soft science of dietary fat. Dean Ornish, MD WebMean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), A more healthful and evidence-based choice is to substitute simple carbohydrates with complex (unrefined) carbohydrates including whole foods such as fruits, vegetables, legumes (including soy products), and whole grains (such as brown rice and whole wheat flour). WebNo two doctors represent opposite sides of THE DIET WAR spectrum better than Dr.s Atkins and Ornish. If you would like to visit their site, please use 2002;5:110-118. Ornish moved to San Francisco in July 1984 after accepting a teaching position at the University of California School of Medicine. 2001;4:171-177. Eating a high glycemic index food along with mostly low glycemic index foods may reduce the overall glycemic load of the meal. Second, there was no statistically significant difference in either systolic blood pressure or diastolic blood pressure after one year in comparing the groups. Effect of 6-month adherence to a very low carbohydrate diet program. Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction: A Randomized Trial Michael L. In other words, when you change the type of food, you dont have to be as concerned about the amount of food. First, shes again perpetuating the myth that when we cut out fat, we began eating foods that were worse for us. As the USDA data show, were eating more fat, not less. WebDr, Atkins vs. Dean Ornish and John McDougall - USDA Debate from 2000. These surges may cause a reactive hypoglycemia, increasing hunger and a desire to eat more simple carbohydrates in a vicious cycle, sometimes called carbohydrate cravings. In addition, excessive insulin enhances the growth and proliferation of arterial smooth muscle cells, promoting atherosclerosis (9). In other words, the diet I recommend causes weight loss, not weight gain. Dean Ornish, MD, is founder and president of the non-profit Preventive Medicine Research Institute and is Clinical Professor of Medicine at the , e gradually, what is Alonso thinking about? I have no horse in this race. Insulin may also raise the secretion of lipoprotein lipase, increasing the uptake of fat into cells, leading to weight gain (10). Also, C-reactive protein and creatinine clearance were significantly lowered only on the Ornish and Weight Watchers diets. But what about the claims Ornish makes about the success of his own dietdo they hold up to scrutiny? 1972;56:359-364. WebIn contrast to these studies, and most others, on the lack of influence of calcium intake on fracture risk, the authors of this study conclude calcium is the problem and this is based on findings in only 74 people with fractures following a vegan diet. HDL is important only to the extent that it affects atherosclerosis and myocardial perfusion, it is not a disease. The efficacy of intensive dietary therapy alone or combined with lovastatin in outpatients with hypercholesterolemia. To understand better the mechanism of this phenomenon, Breslow and colleagues studied the turnover of HDL apolipoproteins (apo) A-I and A-II in 13 subjects on two contrasting metabolic diets. WebDr. An example of the half-truth of saying that anything that raises HDL-C is beneficial whereas anything that lowers it is harmful came at the November 11, 2003 annual scientific session of the American Heart Association. N Engl J Med. Its almost certainly healthier than the highly processed, refined-carbohydrate-rich diet most Americans consume today. These are rich in fiber, which enhances satiety without adding significant calories. These include a whole foods, plant-based diet low in refined carbohydrates, moderate exercise, stress management techniques and social support. DESIGN, SETTING, AND PARTICIPANTS: The abstract did not mention that people lost the most weight on the Ornish diet, it was the only one to significantly lower LDL-C, and it was the only one to significantly lower insulin (even though one of the main premises of the Atkins and Zone diets is their purported effect on insulin). Ornish D. Dietary treatment of hyperlipidemia. The information on this website is intended to supplement, not replace, the advice of a trained health professional. 2003;138:460-467. Fiber from whole grains, but not refined grains, was inversely associated with all-cause mortality in 11,040 postmenopausal women followed for 11 years (16). In contrast, control group patients following a 30% fat diet showed more progression of atherosclerosis after 5 years than after 1 year. We also published an analysis showing that improvements in dietary fat intake, exercise and stress management were individually, additively and interactively related to coronary risk. Ive never said that protein is evil. In my oped, I clearly stated that its better to consume plant-based proteins than animal-based proteins, especially red meat. It was terribly misleading when this abstract made it appear as though the Atkins diet is better for your heart. Adherence in his study to each of the diets was only 20 to 30 percent after one year, so its hard to make any conclusions at all. Most Americans consume a diet high in saturated fat and cholesterol, so those who are able to increase HDL-C in response to this diet are at lower risk than those who cannot, since they will be more efficient at metabolizing excessive dietary fat and cholesterol.