HEART DISEASE: Lifestyle, Diet Changes Reverse Disease
A five-year follow-up study of a radical heart disease treatment regimen showed sharply better results than a less rigid plan endorsed by the American Heart Association, bolstering groundbreaking claims by Dr. Dean Ornish that diet and lifestyle changes can significantly reduce artery blockage without the need for cholesterol-lowering drugs. In a study published in today's Journal of the American Medical Association, Ornish found that heart disease patients who adhered to a extremely low-fat vegetarian diet, meditated daily to relieve stress and avoided smoking experienced fewer cardiac problems such as heart attacks and bypass surgeries over a five-year period than a control group following the recommendations of the AHA. The 48 study participants all suffered from "moderate to severe" heart disease.
Yoga And Veggie Burgers
The Ornish program required participants to cut meat from their diets, consume fewer than 10% of calories from fat and ingest less than 10 milligrams of cholesterol each day. In addition, participants were required to walk for 30 minutes each day, meditate and practice yoga for one hour and refrain from smoking (Squires, Washington Post, 12/16). Ornish and his colleagues at the University of California-San Francisco found that under his program, patients saw a 3.1% reduction in coronary artery blockage, compared to an 11.8% increase in blockage in patients on the AHA regimen. Additionally, patients on the Ornish program had decreased angina and lower levels of low-density lipoprotein cholesterol. Ornish concluded that there was more continued improvement "after five years than after one year in the experimental group. In contrast, in the control group, coronary arteriosclerosis continued to progress and more than twice as many cardiac events occurred" (Ornish et al., JAMA, 12/16 issue).
Extreme Measures
Dr. Robert Eckel, head of the AHA's nutrition arm and a medical professor at the University of Colorado Health Sciences Center, "term[ed] Dr. Ornish's approach as 'a very extreme program' that few people could be expected to follow." He noted that as Ornish's program was significantly more strict than the AHA diet, which recommends that heart disease patients lower intake to 30% daily calories from fat and less than 200 milligrams of cholesterol, the AHA program "is an eating plan that 'almost everyone can live with.'" He also charged that Ornish enrolled only "a very small group" of participants, and even those were selected voluntarily. Without randomized patient selection, Eckel warned that Ornish's patients were "motivat[ed] to succeed" and might not accurately reflect most heart patients. Eckel did concede, however, that the "benefits of the Step II (AHA) diet are thin." He said, "We have a lot of theory and not much hard science" (Winslow, Wall Street Journal, 12/16). Ornish countered, "Whether someone wants to change their diet is a very personal decision. But our study shows that if you make only moderate changes your heart disease will get worse." The Post reports that 40 health plans currently pay for the Ornish program, which includes a week-long excursion to the Preventive Medicine Center at a cost of $2,900. In contrast, hospitals offer the year-long program for nearly $7,000. Ornish said, "That's still a whole lot cheaper than the $30,000 to $40,000 for bypass surgery" (12/16).