Dr. Mercola Interviews the Experts This article is part of a weekly series in which Dr. Mercola interviews various experts on a variety of health issues. To see more expert interviews, click here. Dr. Dean Ornish, clinical professor of medicine at the University of California, San Francisco (UCSF), is perhaps best known for his pioneering work in how to use food and simple lifestyle strategies to improve health. This is also the topic of his new book, "Undo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases." Ornish is well-known for arguing that high-protein and high-fat diets contribute to America's ever-growing waistline and incidence of chronic disease. We obviously share different positions on this issue. Since critiques of Ornish's diet can be found in various places on the internet,1 I decided to focus on what, in my view, is his major contribution to health, which is facilitating an aggressive lifestyle modification program to lower the risk of disease and have it paid for by insurance companies. It is virtually impossible for most to have the foundational cause of their disease process reverse in the typical 10- to 15-minutes' doctor visit. So, he took 16 years to get his lifestyle program approved by Medicare and many insurance companies, which allows access to the tools necessary to change the causes of most disease. Once a person has the foundation in place, it will be easy for them to research the high versus low-fat debate and try it for themselves and let their body tell them which position is correct. But the important point is that most of their destructive health habits will be changed at that point. For the past four decades, Ornish has directed clinical research showing you can reverse not only Type 2 diabetes and high blood pressure but also coronary heart disease — even severe cases — through lifestyle changes that can be boiled down to "Eat well, move more, stress less and love more." Simple Lifestyle Changes Can Reverse Most Chronic DiseaseOne of Ornish's studies also demonstrated that these same lifestyle changes can slow, stop or reverse the progression of early-stage prostate cancer, and probably breast cancer as well.
Since the early 90s, Ornish, through the Preventive Medicine Research Institute, a nonprofit organization, has been training hospitals, clinics and physician groups around the U.S. Despite the program's early success, many sites ended up closing down due to lack of insurance reimbursement. As noted by Ornish, "If it's not reimbursable, it's not sustainable." Changing the Reimbursement ParadigmTo address this problem, they started reaching out to insurance companies. A few, including Mutual of Omaha and Highmark Blue Cross Blue Shield agreed to cover the program but, by and large, it was difficult to get the insurance industry onboard.
It took 16 years, but Medicare approved and started covering the program in 2010 — officially referred to as "Dr. Ornish's Program for Reversing Heart Disease" under its intensive cardiac rehabilitation (ICR) program2 — which allows for 72 hours of training on how to address the foundational causes of heart disease. According to Ornish, it was one of the most difficult things he's ever done.
The program, currently offered in 18 states by Sharecare, is divided into 18 four-hour sessions, which include supervised exercise, meditation and stress management, a support group (which Ornish says is part of why they're getting unprecedented levels of adherence to the program) and more. Data show 85 to 90 percent of patients going through the program are still adhering to it after one year, and have better clinical outcomes, which results in significant cost savings. According to Ornish, in the first year of the program, Highmark Blue Cross Blue Shield's costs were 50 percent lower than that of a matched control group, and Mutual Omaha cut their cost by nearly $30,000 per patient in the first year. Leveraging MotivationWhat really motivates people to make sustainable changes is not fear of dying; it's the joy of living, Ornish says, and his program acknowledges and in fact leverages this knowledge.
Twenty years ago, Ornish wrote the book "Love and Survival: 8 Pathways to Intimacy and Health," which reviewed evidence from what are now tens of thousands of studies showing that people who are lonely, depressed and isolated are three to 10 times more likely to get sick and die prematurely than those who have a sense of love and connection in community. "I don't know anything in medicine that has that big an impact," Ornish says. Through his studies, Ornish has also learned that most harmful behaviors and habits are adaptive ways to deal with emotional pain. "I've had patients say things like, 'I've got 20 friends in this pack of cigarettes. They're always there for me, and nobody else is. You want to take away my 20 friends. What are you going to give me?'" Ornish says. So, while information is important, it's not usually enough to motivate people to make permanent changes. Love — An Oft-Avoided Four-Letter Word in MedicineAs noted by Ornish, "Love is one of those four-letter words that you're not really supposed to talk about as a scientist or as a doctor." Instead, terms like psychosocial support or bonding are used, but regardless of the terms, Ornish's program is a love-based one.
The Importance of MeditationOrnish also discusses the benefits of meditation, which is part of the program. Among those benefits is finding your center so that you can empower yourself without adding stress. "My whole approach is really about addressing the underlying cause of why people get sick," he says, and a major part of the problem is that we're doing something to disturb our innate peace and well-being. The answer then is simply to stop doing that which causes the disturbance. Meditation can give you the direct experience of this part of you that is undisturbed and not stressed, and provide the mental clarity to actually notice what it is that you're doing that's causing you to feel uneasy or "dis-eased."
Intermittent FastingIn his book, Ornish also suggests making breakfast and lunch the main meals of your day, and then eating a much smaller dinner or nothing at all, so that you're intermittently fasting for at least 12 to 14 hours every day. This is similar to the kind of meal timing schedule as my peak fasting regimen. I personally believe a six- to eight-hour eating window is better, and I typically maintain a daily five- to six-hour eating window. The primary reason, from my review of the literature, is the shortened eating window is a more effective activator of autophagy and removal of cellular debris that will contribute to deadly chronic inflammation.
Removing the Distinctions Between DiseasesIn his book, Ornish presents what is essentially a unifying theory of chronic disease. He explains:
Indeed, Ornish's work reveals these diseases do not require different sets of diets and lifestyle programs. It's the same for all. According to Ornish, this is also one of the reasons why so many of these diseases are comorbidities. People who have heart disease often also have high blood pressure, diabetes, high cholesterol and/or other chronic inflammation, for example. This makes sense if they're all different manifestations of the same underlying cause. What this means too is that by implementing these healthy lifestyle strategies, you're not just preventing or reversing one particular disease, you protect yourself against all of them simultaneously. For example, Ornish completed a randomized trial with Dr. Peter Carroll, chair of urology at the University of California, San Francisco and a leading urologist, and the late Dr. Bill Fair, then-chair of urology at Memorial Sloan Kettering Cancer Center in New York, showing that the same lifestyle changes that reverse heart disease also can often stop and even reverse the progression of early stage prostate cancer. And contrary to conventional therapies, there are no serious side effects of these lifestyle strategies. As mentioned earlier, Ornish is now also studying the impact of these lifestyle modifications on Alzheimer's disease. Where to Find Ornish's ProgramIf you're interested in Dr. Ornish's program, you can get all the information you need from his book, "Undo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases." If you would like further guidance, you can find a listing of all the sites that have been trained and certified to teach the program on Ornish.com, along with support groups you can attend free of charge. At present, there are facilities offering the program in 18 states. Ornish.com also lists about 100 video testimonials, including one by Dr. Robert Treuherz, an internist whose heart disease was so severe he was on the waiting list for a heart transplant. While waiting for a donor to appear, he went through Ornish's program at UCLA.
Become a Certified Ornish Program ProviderIf you're a health care provider — be it a doctor, nurse, nurse practitioner, meditation/yoga teacher, exercise physiologist, registered dietitian or psychologist — his site also provides information on how to become a certified provider of the Ornish program.
The training, given in the Bay Area, is a combination of didactic and experiential learning where you go through the program from start to finish, just as if you were a patient. In addition to that, you attend lectures by Ornish and others to learn the scientific basis for all of the modalities, and how to incorporate the knowledge into your day-to-day life. Further ongoing training is provided both on-site and through video technologies. To maintain the quality of the program, providers are required to go through reaccreditation on an annual basis.
from http://articles.mercola.com/sites/articles/archive/2020/01/26/preventing-chronic-diseases-with-lifestyle-changes.aspx
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