American Society for Nutrition

A Conversation With Advances and Controversies in Clinical Nutrition Keynote Lecturer Dr. Dean Ornish

The American Society for Nutrition's Medical Nutrition Council is pleased to present Advances and Controversies in Clinical Nutrition 2012, which takes place June 22-24 in Chicago. The conference is designed for all health care professionals with an interest in clinical nutrition, including physicians, diabetes educators, nutritionists, dietitians, nurses, pharmacists, and physician assistants. More information on the other exciting presentations at the conference as well as details on how to register can be found at the conference web site.

This year's meeting will feature many respected names in the field, including Keynote Speaker Dean Ornish, MD, founder and president of the Preventive Medicine Research Institute in Sausalito, CA. Dr. Ornish is one of the leading voices in clinical nutrition and a pioneering researcher in the use of dietary and other lifestyle changes to reverse the progression of severe coronary heart disease, prostate cancer, and other chronic illnesses. He is the author of six best-selling books, including New York Times' bestsellers Dr. Dean Ornish's Program for Reversing Heart Disease; Eat More, Weigh Less; Love & Survival; and his most recent book, The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health.

Dr. Ornish recently talked to us about his current research and previewed his upcoming lecture on June 22.

Interviewer: Could you tell us about your current research focus?

Dr. Ornish: From a research standpoint, we are continuing to collect data showing the powerful impact changes in diet and lifestyle can have on health. Many medical professionals used to believe that new drugs or devices were required to have a significant impact on clinical health, but we are finding that very simple, low-tech and low-cost interventions are just as (or more) powerful. Our data shows not only how quickly and dynamically these changes can impact health, but also the mechanisms by which they do so. Thus far, we have published data showing the effect diet and exercise can have on reversing cardiovascular disease and diabetes as well as early-stage prostate cancer. We found that over 500 genes associated with these conditions were favorably affected in just three months, upregulating or turning on disease-preventing genes, and downregulating or turning off genes believed to lead to prostate and colon cancer. In one study that we did with Dr. Elizabeth Blackburn, we found that we can inhibit angiogenesis in men with prostate cancer through changes in diet and lifestyle, mimicking the action of pharmaceutical angiogenesis inhibitors like bevacizumab (Avastin). In fact, we have found so much evidence supporting the efficacy of these interventions that, after 16 years of review, we received Medicare coverage for our program for reversing heart disease. We are now in the process of training, credentialing, and certifying registered dietitians and nutritionists as well as exercise physiologists, clinical psychologists, physicians, nurses, stress management specialists, and other health care professionals to receive coverage through our program. I encourage anyone who is interested in becoming certified to visit www.Ornish.com. We are continually collecting data on all of the patients participating in our program, and are seeing 89 percent to 90 percent adherence at many sites. We are also seeing drastic reductions in costs at a time that they are desperately needed in the healthcare system. Blue Cross/Blue Shield, for example, saw that they were able to cut costs for heart disease treatment in half in the first year of participation in our program and by an additional 20 percent to 30 percent in years two and three.

Interviewer: Do you believe Americans underestimate the role of nutrition in maintaining overall health and, if so, how can we change that mindset?

Dr. Ornish: We are beginning to see the limits of surgical and pharmaceutical interventions just as the dynamic efficacy of lifestyle and nutrition are becoming increasingly well-documented. I think that, as these two types of evidence continue to accumulate, physicians and patients alike will have an easier time believing that simple choices can make powerful changes in their health. Already, the public is realizing that diet is important not only for what we exclude but for what we include. There are hundreds of thousands of protective substances in fruits and vegetables, in legumes, and in soy products. This growing awareness makes it an exciting time to be in the nutrition field.

Interviewer: How can clinicians best help their patients make lasting lifestyle changes?

Dr. Ornish: The best way, of course, is to educate patients. Most patients have a great deal of trust in their health care providers. Unfortunately, with the way that managed care has evolved, healthcare providers are often limited to 10 to 15 minutes with each patient, which is not enough time to have the kinds of in-depth discussion that proper education requires. It's a profoundly unsatisfying way to practice medicine for both patients and providers. What our program tries to do is develop a more effective way to manage these interactions where healthcare professionals work as a team instead of just as an individual. The wonderful thing about the Medicare coverage is that it will pay for these team-based interventions where physicians can be reimbursed directly for offering training with other members of the team either in their office or in another facility, making this approach financially viable. Under this model, the patient receives education not from their primary care physician but from the other members of the team—dietitians, exercise physiologists, etc. —with the physician's supervision. This approach allows clinicians to leverage their time in ways that provide patients with a much higher quality of care that addresses the causes of the disease rather than just the symptoms.

Interviewer: What do you believe are the most promising areas of nutrition research in terms of improving overall health?

Dr. Ornish: Having spent 35 years of my life doing research, what I really feel is important now is putting into practice what we already know. At this point, researchers are converging on what constitutes healthier eating and living, which has resulted in a number of recommendations that I will be talking about in my lecture. No matter how much science we have, it cannot be sustainable unless we have coverage. That's what makes Medicare coverage of our program such a breakthrough. Going forward we will now not just be investigating the mechanisms by which dietary and lifestyle interventions work, but also collecting data on every patient that participates in our program, giving us a dataset initially of hundreds of thousands and, ultimately, millions of patients.

Interviewer: What is one message you'd like to tell Americans about nutrition?

Dr. Ornish: Your body has a remarkable capacity to heal itself much faster and much more effectively than we previously realized if we address the underlying causes of most chronic diseases, which can be done by making lifestyle changes in how much we eat, how much we exercise, how we respond to stress, and the emotional support we receive.

Interviewer: What other topics do you expect to address in your keynote lecture?

Dr. Ornish: I want to talk about the spiritual dimensions of health and healing. It's not enough to focus on behaviors or to give patients information; we need to work at a deeper level. If information were enough to change diet and lifestyle nobody would smoke. We have to think about why people eat too much and abuse substances. When we address that level, patients are much more likely to retain and adhere to the changes that they need to make.

May 2012

Interview with Dr. Dean Ornish

Interview with Dr. Dean Ornish