Dr. Dean Ornish developed his lifestyle program decades ago, which is famous for being the first program to be scientifically proven to reverse heart disease, way back in 1990 . The same program has been shown to reverse (or undo, as Dr. Ornish likes to say), other important chronic diseases including type 2 diabetes, early stage prostate cancer, obesity, depression, and some auto-immune diseases. The program includes healthy eating, exercise, stress management, and support groups. The program has helped thousands of people who have gone through it at various centers around the US. In a book written from 2019 that I’ve just read, Dr. Ornish and his wife Anne (who is also his partner in the lifestyle program work), teach us the details of how to use this program ourselves. I was excited to be able to read about this and review the book below. But first some background.
The healthy eating part of this program is a low fat, whole-food plant-based diet. The criticism has been made that this program does not prove that the eating part is what caused the reversal, it could be the other three components (for heart disease at least, the criticism was refuted by the research results of Dr. Caldwell Essestyn, who used a similar diet but omitted the other 3 components from his study ). But Dr. Ornish has always adamantly refused to allow the program to be broken down into its components, insisting it is a holistic program and the components work together in a synergistic way. If you read about the healthy and long-lived Blue Zones populations, many of whom live more rural, traditional lifestyles, you will see that Dr. Ornish’s program closely resembles what they naturally do in their lives. Dr. Ornish has enough scientific results that he has managed to get the program approved by Medicare in the US, as well as several private insurance companies. Health care costs in the US are now approaching $4 trillion annually, about 20% of our gross domestic product. It is widely agreed that about 80% of these costs are for conditions related to lifestyle. So if programs like Dr. Ornish’s can prevent or reverse them it would have a huge benefit financially because this is a lot cheaper than conventional medical alternatives. Preventing type 2 diabetes in the first place is obviously “an ounce of prevention”, compared to the “pound of cure” of treating advanced complications of the disease.
But many of us can’t get motivated to change until we get a wake up call. I ate reasonable healthy most of my life, for example, but didn’t take it that seriously, until I had to get a heart valve replaced at the age of 64. For many others, the wake up call is a something like a diagnosis of diabetes or heart disease, or, more drastically, a heart attack. I had about 20 people in my cardiac rehab class after my valve surgery, most of whom were there recovering from heart attacks. We were all motivated to change and eager to learn how.
That is why it is great that even if we wait till a “pound of cure” is needed, it is still possible to follow a lifestyle change like Dr. Ornish’s program to get healthy, and avoid more drastic medical procedures. Just as an example, it costs less than $10000 to put a patient through the Ornish program. It costs $70,000-$200,000 for coronary bypass surgery. And the positive results of the Ornish program last a lifetime if the patient keeps up the lifestyle change. But the results of the surgery are temporary unless the patient makes lifestyle changes in addition to doing the surgery.
One other piece of background it that the program taught at the lifestyle centers and now in the book is the strict version that is needed to reverse chronic conditions. If we’re trying to prevent these conditions, we can loosen up a little, especially on the diet, which was the point of Dr. Ornish’s previous book The Spectrum, which I discussed here.
Undo It!- The book
I have read several of Dr. Ornish’s previous books and enjoyed them. He is a good writer who explains science well at a layman’s level, as he does in this book. But here we also have the perspective of his wife Anne, who gives us practical advice on getting this to work in real life. It is a great combination. The program covers all of what I consider “the four pillars of healthy aging“, which are described nicely in the book as “eat well, move more, stress less, and love more”. First there is a chapter “It works!” describing the amazing results that have been achieved with this program for various chronic diseases. Then in the chapter “why it works” the science underlying it is explained. There follow a chapter on each of the components: “eat well”, “move more”, “stress less”, and “love more”, and finally a chapter of recipes.
I could not recommend this book more highly. It is inspiring and enjoyable to read. But it is also a complete program for a healthy and happy life. Here are some tidbits:
- Eat Well- this is a lof fat version of a whole-food plant-based diets, of which Dr. Ornish is a pioneer. The diet, and the science behind it, are described in detail along with tips on transitioning to it, and the chapter on recipes, plus an appendix on healthier versions of plant-based packaged foods that can help with the transition.
- Move Well- A complete program of aerobic, resistance, and stretching. I especially liked the simple introduction to resistance training using resistance bands, which I’ve previously discussed as an effective, inexpensive solution.
- Stress less- excellent instruction on meditation and other relaxation techniques
- Love More-this is my personal favorite, and probably least well known, part of the program. Dr. Ornish emphasized the importance of it in his book Love and Survival, where he showed the importance of the support groups in the program. Social Media is not a substitute for this. Ways to find similar support, in person, are emphasized, along with other ways to open up our hearts and love more.
This all adds up to this book being a complete manual for healthy and happy living.
As I mentioned above it can be followed a bit less strictly to stay healthy and prevent chronic disease, or more strictly to reverse chronic conditions. I am motivated to do the latter. I’m already practicing all four components, but especially in the eating area there is room for improvement. I strive to eat a healthy diet at least 80% of the time, but allow myself “special treats”, including refined foods I normally avoid (aka “junk“), up to 20% of the time. I’m going to try to get that down to less than 10%, for the next month. One other thing stressed in the book is the importance of a balanced lifestyle that emphasizes all of “eat well, move more, stress less, and love more”. I intend to work harder in all these areas. I’ll keep you posted on how it goes
- Ornish, D, “Can lifestyle changes reverse coronary heart disease?: The Lifestyle Heart Trial”, The Lancet,, 1990.
- Esselstyn C, “A way to reverse CAD?”, J Fam Pract., 2014.