Photo courtesy of Anna Wolf
A Lifestyle Program for Preventing and Undoing Chronic Disease
A Lifestyle Program for Preventing and Undoing Chronic Disease
“Like most physicians, I was trained to view heart disease, diabetes, prostate cancer, and other chronic illnesses as different from one another,” says Dean Ornish. “Different diagnoses, different diseases, different treatments.”
Ornish is the president and founder of the nonprofit Preventive Medicine Research Institute and a clinical professor of medicine at UCSF. Forty-some years ago, he started using lifestyle interventions to help patients reverse heart disease. As he saw patient after patient get better—get well—he asked himself this: Could his protocol help people with other chronic diseases?
He spent the next decades researching chronic health conditions and conducting studies on the effects of his protocol, later with the help of his wife, Anne Ornish.
The most important thing they learned: Diseases share many common origins and pathways, and they tend to respond to the same interventions. Those interventions form the basis of their book UnDo It! and the nine-week Ornish Lifestyle Medicine program. The program is thorough and also simple at its core: Eat well, stress less, move more, love more.
A Q&A with Dean Ornish, MD, and Anne Ornish
Dean: Because the underlying biological mechanisms that affect our health are so dynamic, when you make the lifestyle changes described in our book UnDo It!, it’s likely you will feel these changes very quickly. Often these changes can begin in as little as a few days, which helps reinforce that these choices are worth making—not just to live longer but also to feel better in the ways that matter most. It reframes the reason for making these changes from fear of dying (which is not sustainable) to joy of living (which is).
As one begins to feel the benefits, it starts to establish a deep trust within. You will begin to connect the dots between what you do and how it makes you feel: When I eat well, move more, stress less, and love more, I feel good to the degree that I’ve made these lifestyle changes. When I don’t, I don’t feel as well.
Even if you already feel pretty good, chances are you’ll feel even better within a few days of making these changes. There are a variety of improvements that often take place, including greater circulation, which benefits the brain, the skin, the organs, and many other functions. Your brain will benefit from receiving more blood, which can help you think more clearly and give you more energy. You may notice you won’t need as much sleep as before. Your brain can grow an abundance of new brain cells in just a few weeks—and get measurably bigger. Your skin can benefit from increased blood flow, giving you a glow. Your sexual organs will also receive increased blood flow, so potency and orgasms often increase. What you gain is so much more than what you give up—and you’ll notice this quickly, which makes it sustainable.
Dean: There are four. Each serves as a healing modality that improves a key aspect of your health, whether each is done on its own or all four are done together. When done together, they have a powerful synergistic effect, amplifying the benefits. The effects of doing the program as a whole are greater than the sum of the parts. The four components are:
- Eat well: A whole-foods, plant-based diet, naturally low in animal protein, fat, sugar, and refined carbohydrates. High in flavor—primarily fruits, vegetables, whole grains, and legumes in their natural, unprocessed form.
- Move more: Moderate exercise, such as walking and strength training.
- Stress less: Practices like meditation and gentle yoga can enable you to do more and stress less.
- Love more: Love and intimacy can transform loneliness into healing. People who feel lonely, depressed, and isolated are more likely to get sick and die prematurely from virtually all causes compared to those who have strong feelings of love, connection, and community.
Each of these directly affects the biological mechanisms that cause a variety of chronic diseases. Which is why our research has been able to show, that these lifestyle changes can reverse many different chronic diseases.
Dean: Personal empowerment by giving new hope and new choices. The more you change, the better you’ll feel, and the more improvements we can measure.
In the book, we present a unifying theory: Most chronic diseases are really the same disease manifesting and masquerading in different ways. As we looked at the research, we were surprised that lifestyle changes had such far-reaching impacts that they could help to undo such a wide range of chronic illnesses.
Like most physicians, I was trained to view heart disease, diabetes, prostate cancer, and other chronic illnesses as different from one another. Different diagnoses, different diseases, different treatments. But they’re really not as different as they seem. They share many common origins and pathways. The reason that these same lifestyle changes are beneficial in reversing so many chronic diseases is these diseases all share so many common underlying biological causes, mechanisms, and pathways.
In our research, there wasn’t one set of lifestyle recommendations for reversing heart disease and a different set for reversing prostate cancer, diabetes, and other chronic illnesses. It was the same lifestyle medicine program for reversing all of these. Also, the more closely people adhered to this program, the more they improved in every way we measured and the better they felt—at any age. These findings are giving many people new hope and new choices.
An important implication of this theory is to stop seeing chronic diseases as being fundamentally different from one another. We can begin viewing them as diverse manifestations and expressions of similar underlying biological mechanisms, all of which are affected by the lifestyle choices we make every day—for better and for worse.
Dean: A whole-foods, plant-based diet—that consists of vegetables, fruits, whole grains, and legumes as they come in nature—is low in substances that cause disease and contains hundreds of thousands of substances that have protective, anti-cancer, anti-heart-disease, and anti-aging properties. Things like cholesterol, saturated fats, and animal proteins can contribute to the expression of a disease. On the other hand, phytochemicals, bioflavonoids, retinols, isoflavones, and lycopene, among others, help protect our bodies.
The old saying “an ounce of prevention is worth a pound of cure” is true. It usually takes a lot more changes in diet and lifestyle to reverse a disease than to prevent it. It takes bigger lifestyle changes to reverse—or undo—many chronic diseases. Moderate lifestyle changes won’t be able to do that.
If you don’t have a chronic disease and are otherwise healthy, what matters most is your overall diet. If you indulge yourself one day, just eat healthier the next. If you don’t have time to exercise one day, do a little more the next. Our earlier book The Spectrum describes this approach in more detail.
Dean: I have found aerobic exercise, strength training, and stretching to be the most beneficial for overall long-term health. I tell people to find a type of exercise they enjoy doing in each of those three categories. Do what you like—if you like it, you’ll do it regularly. Make it a “playout” rather than a workout.
Anne: Stress isn’t a by-product of what we do; it’s how we react to what we do. We can’t always change what’s happening to us, but we can try to control how we react to things. Eating well, moving more, and loving more will help reduce your stress load. You’ll begin to notice that potentially stressful situations won’t bother you as much, giving you a greater degree of freedom to react to the same situation in more productive and healing ways.
Chronic emotional stress shortens our telomeres—the ends of our chromosomes that regulate cellular aging—and as our telomeres shorten, our lives may shorten. For example, caring for a child with autism or a parent with Alzheimer’s disease can be highly stressful, often for many years. It’s hard to change the external stressors when your child or parent needs you for their survival on a daily basis. But again, we can work to manage our reactions to these stressors even when we can’t change the situation that we’re in.
In one study, researchers studied caregivers of parents with Alzheimer’s disease or children with autism and found that the more stress women reported feeling, the shorter the length of their telomeres. Women with the highest levels of perceived stress had significantly shorter telomeres, corresponding to a reduction in their life span of nine to seventeen years.
But the researchers found that it wasn’t an objective measure of stress that determined the effect on their telomeres. It was how they reacted to the stress. Their perceptions of stress were more important than what was objectively occurring in their lives. In other words, if you feel stressed, you are stressed.
Although these women were in very similar life situations, they had dramatically different outcomes. Those who practiced stress-reducing elements—similar to the ones outlined in the lifestyle medicine program—were able to help buffer their stresses so that it didn’t affect their telomeres and health. In contrast, the women who didn’t make the lifestyle changes showed a significant shortening of their telomeres. This is a very significant finding—not to blame but to empower.
When you practice lifestyle-medicine techniques such as meditation and walking on a regular basis—even for just a few minutes a day—your proverbial fuse gets longer. Meditation and other stress-management techniques change our gene expression—turning on genes that keep us healthy and turning off the ones that cause us to get sick. They dilate our arteries and allow more blood to flow, they lengthen our telomeres and reverse aging at a cellular level, they reduce inflammation and other mechanisms that cause chronic diseases, and they enhance our immune system. Each of our program’s interventions activates the mechanisms that keep us healthy and helps turn off the ones that cause us to get sick.
We often hear patients tell us that before going on the program, they had a short fuse and would easily explode. But after implementing these lifestyle changes, they found that they weren’t as bothered by things as they used to be and their fuses were now longer.
So while we can’t always avoid stress, we can empower ourselves with healthier and more productive ways of responding to it. You have more control over how you respond to stress than you may think you do, and this knowledge will allow you to be able to get more done, with less stress.
Anne: The need for authentic connection and community is primal, as fundamental to our health and well-being as the need for air, water, and food. Intimacy—anything that brings us closer together and away from isolation and loneliness—is healing. It can be the romantic love of a partner or the platonic intimacy of a friend, a child, a parent, a sibling, a teacher—even a pet.
The word “intimacy” comes from the Latin “intimatus,” which means “to make oneself known.” “Health” comes from the root “to make whole.” These are old ideas whose power we are rediscovering.
Many, many studies have shown that that people who feel lonely, depressed, and isolated are three to ten times more likely to get sick and die prematurely from virtually all causes than those who have strong feelings of love, connection, and community. I’m not aware of anything that has such a powerful impact on our health and survival.
There is an epidemic of loneliness, isolation, and alienation in our culture. One third of the people in industrialized countries are lonely, and 40 percent of adults in the US report feeling that way. Suicide rates have increased by 25 percent in the past twenty years.
When you genuinely practice being more compassionate and loving on a regular basis—with everyone from strangers and acquaintances to your friends and family, as well as with yourself—it helps boost your health and well-being.
Anne: Many people think that spending time with their friends, family, and loved ones is a luxury that can be done only after all of the other important stuff. But what our research and others’ have shown is that this is the important stuff.
When I ask people why they want to change their lifestyle, they often say, “I want to live longer.” And when I ask them why, they respond, “Wow, no one’s ever asked me that before—I want to watch my kids grow up, make love with my partner, go back to work…” When I can help people get in touch with what is meaningful for them, it makes their lifestyle choices much more likely to succeed. If it’s meaningful, it’s sustainable.
Dean: When you make big changes in your lifestyle, you’re likely to notice improvements quickly, which makes them changes worth making—not just to live longer but to feel better. For example, someone who is struggling with bad heart disease might not be able to walk across the street or make love with their partner or play with their kids without getting chest pain. If, within a few weeks of making these lifestyle changes, their pain is gone and they find that they can now do all of these activities, the resulting joy is a much more sustainable motivation than trying to prevent something bad, such as a heart attack, from happening years down the road.
Dean: Many people have changed their lives for the better simply from reading this book. We provide the program across the country, and Medicare and many insurance companies are covering my nine-week program to reverse heart disease at sites throughout the country. [Editor’s note: For more information on where the program is offered, check here.]
Anne: I worked to create Empower as a learning-management system to help train doctors, nurses, meditation and yoga teachers, exercise physiologists, registered dietitians, and psychologists throughout the country, who offer our lifestyle medicine program. It allows us to train the trainers and exponentially multiply our impact. It offers the tools and necessary community support to help guide participants through foundational courses and support people who are transforming their suffering into health.
Dean: Although heart disease is often thought of as a men’s disease, more women are affected by heart disease than men. It’s the same treatment plan for both, yet women may be able to reverse heart disease even more easily than men can, so it’s especially beneficial for them.
For example, many men and women are prescribed drugs to lower their blood pressure, cholesterol level, and/or blood sugar and are told that they have to take them for the rest of their lives. Yet when people follow our lifestyle medicine program, many are able to reduce or even discontinue these medications (under their doctor’s supervision, of course).
The guiding principle of our lifestyle medicine program has always been based on addressing the underlying causes of illnesses on many levels simultaneously. As an analogy, if you have a rock in your shoe, don’t blame the stone, take painkillers, get surgery to cut the affected nerve, or wear thicker socks. Take out the rock.
Each of the program’s four components has profound and dynamic effects on all of these shared mechanisms that cause us to get sick and enable us to heal. Because of this, we can often begin to undo what has been a lifetime of damage. Our bodies often have a remarkable capacity to heal, and when we work at this causal level, they can heal much more quickly than we had once believed.
Dean Ornish, MD, is a bestselling author and the founder and president of the Preventive Medicine Research Institute. He is a clinical professor of medicine at both UCSF and UCSD. He received his MD from the Baylor College of Medicine and completed a fellowship in medicine at Harvard Medical School and an internship and residency in internal medicine at the Massachusetts General Hospital. He developed Dr. Ornish’s Program for Reversing Heart Disease and is directing the first randomized controlled trial to determine whether comprehensive lifestyle changes can reverse the progression of early Alzheimer’s disease.
Anne Ornish is the digital director of Ornish Lifestyle Medicine and the vice president of program development at the nonprofit Preventive Medicine Research Institute. She created the Ornish Lifestyle Medicine’s digital platform and Empower, a learning-management system that trains health care professionals throughout the country, provides foundational courses for participants, and offers tools for sustainable, healthy living.
This article is for informational purposes only, even if and to the extent that it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.