Dr. Dean Ornish, the Father of Lifestyle Medicine on Reversing Chronic Disease, Alzheimer’s

and so when you change all of these things the blood flow improves even before the blockages have a chance to reverse we found in just three and a half weeks there was a 400% improvement in blood flow to the heart as measured by PET scans but in the over longer period of time after a year even severely blocked arteries became as really less clogged in over five years there was even more improvement than after one year you're listening to a second opinion your trusted source engaging at the intersection of policy medicine and innovation and rethinking American health dr. Dean Ornish is considered by many to be the father of lifestyle medicine pioneering programs that have been proven to reverse life-threatening illness with a four-point plan eat a plant-based diet move more stress less and love more Dean and I have known each other for about four decades dating back to our time together as interns at Massachusetts General Hospital then Dean's ideas were considered a bit out there a bit on the edge today they are mainstream today they are fact we're finding they may be fundamental to treating even our most challenging diseases such as Alzheimer's Dean is a cardiologist the founder of the preventive medicine Research Institute and yes a best-selling author you will absolutely love his latest book where he puts it all together with a unifying principle the title undo it L simple lifestyle changes can reverse most chronic diseases which he co-authored with his wonderful wife and I'm your host to Senator Bill Frist welcome to a second opinion being artists should spend 40 years that we've known each other in different capacities I want to get to that shortly but before our listeners and for our viewers let's just start right in you have a 40 year history of being the pioneer and probably the better word is the father of lifestyle medicine how did you earn that moniker and I know I know well how you did through the peer-reviewed literature and all but what does it mean the father of lifestyle medicine well first thanks for having me on your podcast it's great to have an excuse to suspend this much time talking together I got interested in doing this lifestyle medicine is a field where we use lifestyle changes not only help prevent disease which we all know but to treat it often even reverse it and I think our unique contribution has been to use these very high-tech expensive state-of-the-art scientific measures to prove the power of these very simple and low tech and low-cost interventions you know we often think that it has to be a new drug a new laser or something really high-tech and expensive to be powerful but these simple lifestyle changes a Whole Foods plant-based diet that's low in fat and sugar moderate exercise for a half an hour a day like walking and some strength training various stress management techniques like meditation and what we call social support or to reduce it to its essence to eat well move more stress less and love war the more diseases we study and the more underlying mechanisms we look at the more scientific evidence we have that how powerful these simple changes are how wide-reaching they they can be and how quickly we can measure improvements in ways that really matter to people the four components that you put together the one that you add sort of uniquely to what is basically common sense and I say that recognizing and we'll talk more about it the sophistication the peer review though the long journey that you have put in to document from a scientific standpoint but the fourth component that of the sort of more social connectedness isolation and you you summarized it frequently under love LOV and where did that come from and how didn't you first one sort of incorporate that into the the other for that one of the four yeah good question well love is one of those four-letter words we don't talk much about it medicine you know newton cardiology or cardiac surgery now the heart is the symbol of love and you know study after study has shown that people who are lonely and depressed are three to ten times more likely to get sick and die prematurely from virtually all causes when compared to those who ever since in love and connection community and I don't know anything in medicine that has that far-reaching an impact it in part it's because that affects our behaviors you know in doing these studies I had we spent a lot of time with the study participants and I get to ask them like you know teach me something why do you smoke why do you overeat why do you drink too much why do you abuse substances why do you you know spend so much time on video games why do you use opioids these behaviors seem so maladaptive to me and they look at me they go they're not maladaptive you don't get it you don't have a clue these behaviors are very adaptive because they help us deal with our pain or loneliness our depression I think the real epidemic or pandemic in our culture and so much of the world is the breakdown of the social networks that used to give people a sense of love and family and connection and and church and synagogue and and and intimacy with each other you know 50 years ago most people had a an extended family that they grew up with they had a neighborhood with true through generations of people that they grew up with they had a church or a synagogue or a mosque or something that they went to on a regular basis and and today many people don't have they had a job they felt secure that they've been out for 10 years or more and today many people don't have any of those things and we pay a real price for that and you know when people say things like I mean we've learned that information is important but it's not usually sufficient to motivate most people to change their behavior I mean there were nobody would smoke it's not like I say hey no I want you to quit smoking did you know it's bad for you and you go gee I didn't know that I'll quit today gonna say everybody knows it's on every pack of cigarettes but people say things to me like I've got 20 friends in this pack of cigarettes and they're always there for me nobody else is you gonna take away my 20 friends what are you gonna give me or food fills that void or fat points my nerves and numbs the pain or alcohol or opioids or other drugs numb the pain or you know video games numb the pain they distract me or working all the time is something we've all used to distract ourselves from pain and so I've learned that it's the information is important but we need to work at a deeper level and when we work at that level then we find that people are much more likely to make and maintain lifestyle choices that are life enhancing than ones that are self-destructive now you have with me and for those who are watching this - the viewers I have in my hands here a book and my wife the love of my life is a little bit upset with you because for the last three nights I've stayed up till about 2:00 in the morning your book in the book is Dean Ornish and an orange we'll come back to that and the book is undoing how simple lifestyle changes can reverse most chronic diseases and then that brings me and you have this circle here is there a central organizing thesis that you've had over the the last 40 years then you've continued to refine and develop and develop and build the very best sort of the scientific background and proof purpose is it is it well how do you summarize that central organizing principle yeah it's a this unifying theory that we present in the book you know with all this interests in personalized medicine it wasn't overly 43 years of doing these studies it wasn't like there was one set of diet and lifestyle recommendations for reversing heart disease in other word for diabetes etc it was the same for all of them and so that got me thinking like why is that and they're kind of hit me like oh because you know you and I and all doctors were taught to to view heart disease and type 2 diabetes and proxy cancer and hypertension and so on is different different diseases different diagnoses and different treatments but what we're learning is that there really to me and what the kind of radical idea that we present in this book is that they're really the same disease more than we thought manifesting and masquerading in different forms and I say that because they all share the same underlying biological mechanisms things like chronic inflammation changes an immune function and oxidative stress and telomere length and gene expression and angiogenesis and a pitocin and so on and each one of these in turn is a direct function of what we eat how we respond to stress how much exercise we get and how much love and support we have and it's one of the reasons why for example as you know you often find the same patient will have what are called comorbidities they'll have high blood pressure and be overweight and have high cholesterol and have type 2 divide diabetes and have heart disease or why entire cultures like in China 50 or 60 years ago they had such low rates of all these chronic diseases and then when they start to eat like us and live like us they started to die like us and they that now that you know heart disease and type 2 diabetes kill more people around the world and a Scindia malaria combined and so when we were looking at that way radically simplifies what we tell people and it also helps us to see that if you're trying to reverse disease it's like the pound of cure it takes a lot that's why we found these same lifestyle changes we first did you know I was I got interested in doing this work when I was a medical student at Baylor College of Medicine in Houston and I was on Michael DeBakey surgical service so I'm sure you probably knew and you know we cut people open we bypassed for clogged arteries he tell them they were cured and more often than not they go home and do the same things that had caused the problem the first place you know each on food and it's just that exercise and so on and then we come back he come and then we cut them open again sometimes multiple times and so for me that became a metaphor they were literally bypassing the problem without also treating the cause when I lecture sometimes I had a cartoon drawn many years ago doctors busily mopping up the floor around the sink is overflowing that no one's turning off the faucet now bypass surgery in stands and so on can be life-saving in a crisis but they don't really treat the underlying cause sometimes you didn't even walk with form you know drugs and surgery and had their place but we also need to treat the underlying cost and by the way just as an aside because you knew him dr. DeBakey was was was really ruthless that's to his students and he'd say what what were you son I said I'm starting my third year he goes and it'll be so much harder to bust you out of here with these weird ideas you have you know the needle if you didn't move your hand fast enough out of the field that kind of thing ya know about four or five years ago I got this call from him and he said hey Dean this is Mike DeBakey and here that guy's you know he had this kind of distinctive Louisiana accent and I the new is him and I hadn't heard from him in decades and he said you know those ideas that Houston gave me such a hard time about you know meant 30 years ago 40 years ago I said oh yeah I remember very well he said that's what's kept me alive all these years I love it I love it I love it before it for our listeners pleasure to make he just like you are the sort of pioneer the father of lifestyle medicine he very much is a cardiac surgery my field and the larger vessel vascular surgery but that's very interesting but take just a little bit further through that because you're not just a rest of cardiac disease and again we'll come back because as you said it's multifactorial and all these other chronic diseases but going back to my field cardiac disease in dr. DeBakey you're not only stopping it or slowing it down but your program is reversing it and that's unheard of that's I mean that's it ordinates not now but it was 10 15 years ago tell us about that well this was back in 1977 I was a second-year medical student medical student I decided to take off a year and one of the nice things about being in Texas is they let you do things they wouldn't let you do it at Harvard for example it's much like oh yeah this weird idea go for it you know you won't it won't work but you learn something so we'll support it so I took ten the chief of cardiology Tony Robert Miller and Tony gada who was the chief of Medicine at the time donated a testing I went it to every hotel in Houston and the last one gave us ten rooms for a month and so I put 10 men and women who had severe heart disease and who hadn't had surgery and they got better and they don't really felt that her but they were about it we found that there eight of the ten people showed improvement in their their blood flow to the heart is measured by thallium scans which was a new test at the time it was also my first experience that when you're doing something that everybody thinks is impossible it gets held to a different standard people though that's impossible you're the test must be wrong I said well these are the tests we use to send people to surgery every day why are they so you you did the test we analyzed the test why are they no longer good well you know must be you know you can't be true so you didn't have a randomized control group I said well that's true but eight of the ten people got better how often do you see that well that's beside the point you didn't have randomized control group so I went back to school finished medical school then did a second study this time we did have a randomized control group replicated that published in the Journal of the American Medical Association and they went on to Boston to do my medical residency and so everything that we've done over the last 40 years people thought was impossible and that to me is what the whole point of research is to redefine what's possible and by doing so we can give at this point millions of people new hope and new choices and empower them with things that they can do to begin healing themselves so what so with the heart disease so I've done hundreds thousands of heart operations in my life and I'm like dr. DeBakey in the sense that we bypass we jump around the lesion the lesion stays there the blockage in the vessel itself but what you have proven is that through your program and I'd like you to describe the the discipline behind your program that blockage actually begins to go away melt that's right leave it to me being a cardiac surgeon when you first presented it I said no way no but explain that to our listeners well we use quantitative arteriography to measure the blockages and cardiac PET scans the misra blood flow and the most definitive study on the lifestyle hard rock which we also published in JAMA after I moved here from Boston in 1984 and you know our bodies have a remarkable capacity to begin healing if we simply stop doing what's causing the problem it's also been founded we used to think that the the more severely blocks an artery was the more likely was to cause a heart attack and so the the Balkans is that the surgery was generally done around lesions or blockages that were 50% or greater but we now know there's actually but those are the blockages they tend to cause an general chest pain because the the supply can't keep up with the demand you know the blockages keep the blood flow from getting to the heart where it needs to feed itself but it turns out the twenty to thirty percent blockages that actually more likely to cause death because they can go from twenty to thirty percent you could get bleeding into the lining of an artery called plaque hemorrhage and goes suddenly to a hundred percent blocked or a blood clot can come and clog in there there's also as you know blood your body can grow its own bypasses you know what to call collaterals and they tend to be much smaller in diameter than they epicardial are the big arteries that feed the heart and they tend to get clogged up with fat and sludging and small little blood clots like when thrombi and others and so when you change all of these things the blood flow improves even before the blockages have a chance to reverse we found in just three and a half weeks there was a 400 percent improvement in blood flow to the heart as measured by PET scans but in the over a longer period of time after a year even severely blocked arteries became measurably less clogged in over five years there was even more improvement than after and so when you make these changes as to the degree that you make them your body continues to improve but the reason we were first to prove that you could react to reverse heart disease is that most people didn't go far enough I mean I'd love to be able to tell people that moderate changes can reverse disease but they generally don't there may be enough to prevent it but not to reverse it the ounce of prevention and pound of cure so we ask people to make what some people would call really extreme changes to follow a plant-based diet you know fruits vegetables whole grains legumes soy products very low in fat very low in sugar very low in refined carbs you know the old joke is am I going to live longer is it just gonna seem longer if I eat that way you know but make sure that's delicious as well as being nutritious you know meditation and stress management for an hour a day half an hour a day of exercise and participating in a support group and then the support group wasn't just how people say on the diet it was really to create a safe environment much as when you grow up in a family an extended family or a neighborhood with two or three generations of people they really know you they don't just know you know your your facebook profile you know there's a study that I cite in the new book that the more time you spend on Facebook the more depressed you are because it looks like it's not an authentic intimacy it looks like everybody has this perfect life Here I am in front of the Eiffel Tower and Here I am you know my kids doing great it doesn't show people posting here's my kid you know addicted to drugs but here's you know the problems I'm having in my marriage or whatever but that's what you know and when you grow up that you know 50 years ago in an extended family they know you that we'll just know your good stuff they know your demons they know your darkness and you know that they know and they know that you know that they know and they're still there for you and there's just something very primal about being you know seen in that way warts and all and so in our support groups and I kind of stumbled into this we create a safe environment in which people are encouraged to talk about what's really going on in their lives without fear that someone's gonna judge them or criticize them or reject them and it's incredibly powerful because many people have no one that they can do that with and being able to do that in a in a supportive environment is the part of the program people generally have the most apprehension about or the most like skepticism about it and yet invariably it's what they feel the most powerful aspect of it and it's the reason why we're getting unprecedented levels of adherence now training hospitals you know Medicare as you know is now covering our program in part things to you when you were the Senate Majority Leader but we had you know twenty members of the Senate from the most liberal Democrats the most conservative Republicans and thirty or forty members of that house the heads of the AARP and you know most other organizations took 16 years but you know we finally were able to do that even that's one of the does demonstrate that bipartisanship does occur right know and well-being can bring people together good but you go a little bit further in terms of the program how many weeks is it you said it's a very disciplined program and then we'll come to the adherence you know a year later are people still on it or is it just too tough because it's counterintuitive the tougher you had made or more disciplined you have made the program there as guarantors is is number one higher or compliance and then a year later that compliance is still there so tell us a little bit more about that yeah it is encouraging that was back I think when people talk to each other Republicans and Democrats said these are just human issues you know we had Bill Clinton he was president and new game in between speaker the house came together a few things that they came together around you know you came together with Harry Reid I remember was the Democratic time and you know we put our differences aside and said these are things that can benefit everyone and I'm deeply grateful that did take us 16 years but you know my persistence is my probably my best and my worst quality but but but it did and now that Medicare's paying for it Edna's covering in all 50 states Blue Cross Blue Shield and then most of the major insurance companies remain so what does it do so what are they covering well you're different I push much a great story and only you could have pulled it off to have government reimbursed for it a lifestyle was the first or of lifestyle reimbursement by Medicare ever in the history and then to have the commercial payers you mentioned too but most of the commercial payers now pay for your particular lifestyle program they paid for some others as well but yours was the first and the one that is most commonly reimbursed what are they actually reimbursing good question well thank you for your kind comments and again thank you for your support back then it means the world to me and your friendship so what we're doing with what they're paying for is 72 hours training traditional cardiac rehab is just an hour of exercise 36 different times this is includes the hour of exercise when people come for four hours to get an hour we actually provides exercise an hour the support gridlock we were talking about an hour of a group meal with a lecture and an hour of stress management they do that twice a week for nine weeks for a total of 72 hours or they can come to a retreat for 12 days 6 hours a day to get to 72 hours and they're reimbursing it at a high enough level to make it financially viable you know just to digress a moment through my new nonprofit preventive medicine Research Institute in the early 90s we trained 53 hospitals and clinics around the country and it worked we got bigger changes in lifestyle better clinical outcomes bigger cost savings better adherence anyone ever shown but remember the site's closed it down because we didn't have the reimbursement and that was kind of the painful lesson that doesn't matter how good it is clinically if it's not reimbursable it's not sustainable that's why we ended up spending 16 years with Medicare but now it is and so we've been training hospitals and clinics around the country and we're getting those same kind of outcomes 90 excuse me 94% of the people finished 72 hours of training and a year later eighty-five to 90 percent of the people are still following it and that's an not just in places like UCLA in Los Angeles but in South Bend Indiana or in South you know a Salinas Arkansas or some placing you know places that people would think would be really challenging and as you say it's counterintuitive like and that's much higher than people do it for distributional cardiac rehab which is just exercise and a whole lot easier and the question is why is that and whatever we've learned is that to the degree you make these lifestyle changes you benefit you feel better your angina tends to go away and for someone who can't walk across the street without getting chest pain or make love with their spouse or play with their kids or go back to work without pain and within a few weeks I can do all those things then they say you know I like eating junk food but not that much because what I gain is so much more than what I give up and not years later it's not about living to be 86 instead of 85 that didn't really motivate most people you know you under 85 it's about well I can do things I couldn't do before I you know one of the examples outside of the new book is a guy named dr. Robert Roy Hertz who's an internal medicine doc and he had such a massive heart attack that he was told that the only thing that could save his life would be a new heart a heart transplant and so he went to our program in our nine we program at UCLA a reversal program to get in better shape for the surgery but he improved so much his heart began pumping so much better is it reduction fraction the percentage of heart as you know that it pumps with each we went from 11 to 15% to 30% now he couldn't literally get out of bed or walk even walk a few steps without getting angina now he's chopping wood he's working full-time he's doing all those things and didn't eat the heart transplant which it's kind of the ultimate high tech low tech like contrast like what's the more radical intervention here our translator eat well move more stress less and love more so our bodies really have this amazing capacity and if what you get is more than what you give up if your chest pain goes away you think more Creator the year brain can grow some in the new brain neurons through a process of neurogenesis you're breaking it bigger in just a few months your skin gets more blood you look you know your heart gets blood Lord your sexual organs get more blood flow the same way that drugs like viagra work and for all these reasons for many people what they and many people are told that you know once you get put on medications to lower your blood pressure or your cholesterol your blood sugar that and they say doctor how long do I have to take these the doctor usually says forever it's like how long do I have to mop up that floor and the same things that were flowing forever well one and I just turn off the faucet and the faucet the cause to a much larger degree that we had realized our the lifestyle choices and again I want to make sure that people listen don't make any changes in your medication without your doctor's approval but you'll find that if you really follow this program your blood pressure may get so low your blood sugar may get so low your cholesterol levels is so low that your doctor is able to reduce or often discontinue many of these medications that people were told they'd have to take forever and maybe avoid surgery that they probably wouldn't be able to you know again the book undo it by Dean our nation and and Ornish an unbelievable book and it is complete and as I said it's kept me up for the last three nights just because I love you to love it so much throughout the book and throughout our relationship over the last thirty years you've always stressed the importance of being able to prove to do a controlled trial the blinded trial the science of it you are among the most published people that I know when I've spent you know 20 years in academic medicine publishing a lot but you've always published in peer-reviewed journals and there are a lot of lifestyle books out there and you go into a library and you know you can find them and you can pick them up a theme that distinguishes yours is this relentless commitment to prove to science to analysis to documentation and then having that affirmed by your peers the other scientists many of whom start off as doubters you know a lot of cardiac surgeons say you're gonna run me out of business I'm not gonna I'm not gonna I'm not gonna endorse you so you've come over huge barriers but talk a little bit about the importance of having that substantiation through the scientific literature well that's true and by the way a number of cardiac surgeons recommend the book because they say if I'm gonna operate on you I don't want you to come back I want you know because every time you have to redo it you know it's a lot harder with all the scar tissue and adhesions and so on but yeah I'm a scientist because and it's hard doing these studies it's hard to raise money for them people generally don't want to support a study if everybody thinks it's impossible is like why should we waste our money and I say well that's what makes it interesting without the funding you can't prove that works and I don't think it's gonna work I don't want to fund it so it's always a struggle but as you say we published in the journal the AMA the New England Journal of Medicine the German American College of Cardiology The Lancet circulation all the major journals because to me that's the whole point of science is to help people say is this true or not you know what works what doesn't from home and under what circumstances and so it's really hard to do it but I think it's worth doing because if we show that something does work like reversing our artists disease and then we can get it out to people then we can empower people with information that can really give them new hope and new choices so after we did the reversing heart disease studies and and I - we've showed that the same lifestyle changes could reverse type 2 diabetes high blood pressure high cholesterol we did the first randomized trial with Peter Carroll who is the chair of neurology at UCSF and bill fair when he was the chair of urology at Memorial sloan-kettering Cancer Center we always try to work with the top people in the field and has it's it has more credibility and it makes it easier to get published and we showed for the first time that these same lifestyle changes could slow stop and even reverse the progression of men who had early-stage prostate cancer which is particularly important now that there are two randomized trials published in the New England Journal showing that only one out of 50 men who has early-stage prostate cancer actually benefits from the surgery or the radiation the others often end up either impotent or incontinent or both for no real benefit but if the choice is between doing nothing and doing something those guys want to do something once they've been diagnosed with prostate cancer we can give people a third alternative now he showed these same lifestyle changes could change the gene expression in a study we did with Craig Venters and as you know was the first to decode the human genome we found that over 500 genes were changed in just three months in effect turning on our upregulated with good genes and down-regulating or turning off the bad ones particularly the genes that cause these same mechanisms that are part of this unifying theory the genes that control chronic inflammation oxidative stress changes in in the microbiome and telomeres in the and gene expression and so on we've written about telomeres and you have documented it and so tell us what what a telomere is we're all looking for the Fountain of Youth and some some way and and if you change lifestyle as you have laid out in those four points tell us a little bit about the impact it has on on telomeres and what it what is a telomere good question telomeres are the ends of it as you know are the ends of our chromosomes that regulate how long with it they regulate cellular aging then there is sometimes like into the plastic tip on the end of a shoelace that keeps your shoelace women traveling they keep our DNA from unraveling and as we get older as they replicating they tend to get shorter and shorter and as our telomeres get shorter our lives get shorter and the risk of premature death from a wide variety of conditions from heart disease to diabetes the most prostate breast colon cancer even Alzheimer's are directly linked to the link directly linked to the length of our telomeres so Elizabeth Blackburn who got the Nobel Prize for discovering telomeres had published a paper with Alyssa Apple showing that women who were under chronic emotional stress because they were taking care of kids with autism the more stress they felt and the longer they felt that way that shortened their telomeres were and when they compared the high stress and the low stress women they found that the stress women had 9 to 17 years shortening of their life span based on the shortening of their telomeres you no big deal but what was even more interesting to me was that it wasn't the woman's it wasn't an objective measure of stress you could have two women in very similar life situations but it was how they were perceiving the stress that and those that were meditating and eating healthy and exercising and had love and support could buffer the effects of that stress and so I didn't affect them as much so I had lunch with him I said you know if bad things make your telomeres shorter maybe good things can make them longer so we did a study together and we found and we published this in The Lancet and we found that after just three months the telomerase the enzyme that repairs and lengthens telomeres increased by 30% and over a five-year period we found for the first time any intervention could actually lengthen telomeres when compared to the control group that got shorter and when The Lancet editors published this they sent out a press release and they called it reversing aging at a cellular level so again it's just another example it was the same lifestyle program that can do all these different things we're now in the process of doing the first randomized trial to see if they say my cell changes may be able to reverse Alzheimer's and I think we replace with Alzheimer's very reminiscent of where we were 43 years ago we did our first study on heart disease in other words the same biological mechanisms are in play less intensive lifestyle interventions like the pointers I mean the finger study and the mind study came out a few years ago showed that they could slow down the rate at which you got worse whereas all the drug trials they spent billions of dollars looking for the magic bullet drug and none of them that really worked the lifestyle changes could at least slow down the rate at which got people worse my thesis my radical theory again is that if less intensive interventions can slow it down maybe more intensive interventions can reverse it just like we found with these other diseases like heart disease and others so we're midway through the trial I can't really talk about the benefits except to say that I'm cautiously optimistic that this will work and if it does work and it's still a big if it'll you know and people are more afraid of Alzheimer's than any other disease because when you lose your memories who lose everything my mom died of it she was brilliant it was really tragic to see her beautiful mind decayed and so I have a personal interest them is I have one of the Alzheimer's genes the apoe4 genes and so you know when now when James Watson and Watson and Crick who discovered DNA was one of the first to get his genome sequence he said I want to know everything except the a bowi for gene because why would I want to know if I have a disease that I can't do anything about you know whereas now if we can show that we could reverse it and let me a much smaller step to show we could prevent it and then with all the new tests that are coming out to diagnose Alzheimer's some of them you know 20 years before they've become clinically apparent that won't give people a lot of runway to say okay I'm gonna start making his lifestyle changes because I don't want to get that and it'll prove my life in so many other ways and the only side effects were good ones dane for something like the you started with the heart you demonstrated that and you try to go and disease by disease organ by organ and now you've come with this unifying theory theory hypothesis that it always coming down to this sort of basic mechanism and now you're doing the Alzheimer's you're entering into it some promising early data how long will it take to something like that tape to demonstrate is it a year or five years or do you set the the foundation and other research people pick it up when do you think you'll start getting some definitive data from this studies we'll probably have a study finished in another year and a half or so but the intervention is only we're taking people we're taking a hundred men and women who have early Alzheimer's randomly divided into two groups half of them get the program for for 20 weeks and half a dome three times a week and by the way they've been coming in person three times a week but we're finding by necessity we have now been doing it all virtually and so we've learned and I didn't think this was going to work I mean I said what we have to try because what else can we do with the coronavirus and everything and so we've been meeting three times a week virtually for four hours at a time so you get an hour of stress management virtually an hour of exercise class virtually an hour support group virtually and now every group meal right so these are people who actually never met each other in real life and it's working you know we're getting just as good outcomes virtually as we had in person which makes it the implications if this does work to be able to scale this you know worldwide at a fraction of the costs are really profound and you know if there is a silver lining to the coronavirus this might be it so we test people the beginning we test them after 20 weeks after 21 weeks in the control group crosses over they get it for 20 weeks and then we test both groups again at 40 weeks and then now we'll test them again after an initial 40 weeks I don't you know I've been speaking at a coronavirus I think so much of the emphasis has been on avoiding it which of course is important you know through you know you know sequestering people at home and wearing masks and gloves and hand washing and so on that's important of course but the other half of the equation is how our body interacts with the the the coronavirus engines you can't always avoid it but not everybody who is exposed to it gets it not everybody who gets it dies from it you know we have asymptomatic - mild - really severe cases and so our immune function is one of the things that these same lifestyle changes can help boost as well one study that's probably worth mentioning getting back to where we started with love is Sheldon Cohen it did a study published in the journal the AMA was surprised me where he this is in the early 90s and I don't know how he got this room the human studies committee or got people to volunteer for it but they actually dripped rhinovirus and coronavirus a little a less invasive one than the one that we're dealing with now into volunteers noses you can paint us to be in this study but anyway and a hundred percent of them got infected but not everybody that got infected developed the signs and symptoms of a cold and they found that those that had six or more social contacts meaning a phone call or a visit from a friend it could just be a phone call over a two-week period compared to those that had two or fewer those that had six or more interactions with a friend where 4.2 times less likely to actually get sick than those that didn't even though they were all infected and so you know it's not just running into the wrong bug it's how our body interacts with it and these same lifestyle changes that can help prevent and reverse heart disease and diabetes and prostate and probably breast cancer and hopefully Alzheimer's are also ones that boost our immune function as well I think the the corona virus is radically changing our lives and in waves at this point we don't even know totally what it is but I think just in our conversation today we talked about isolation loneliness and the the treatment today before we have antivirals which hopefully change here in a few weeks and and a vaccine which hopefully will change within a year is social distancing now what sort of tricks of the trade have you developed over the last few months to encourage people to to get outside of being alone there's a lot of people are listening and sheltering now but also a lot of people darn fortunate enough to have wonderful spouses or children and they're probably listening to us and saying well now what sort of things can I do and get out in your book you have a whole chapter on this and so I'll encourage people to read the book but share with their listeners and our viewers some of the tricks of the trade yeah well thank you my wife and is as brilliant as she's beautiful and has a whole section she wrote probably half the book on things that people can do and you know as we talked about when we started the social isolation itself makes you three to ten times more likely to get sick and die prematurely from pretty much everything unless you buffer that by reaching out to other people and these technologies they can isolate us you know you've we've all seen pictures of people at their family table they're all on their iPhone you know nobody's talking to each other but they can also bring this together just like we're having this conversation pick up the phone you know send a meal over to a friend volunteer if you can't to help other people anything that takes you out of the sense of being alone and isolated and connecting with other people either literally or virtually is healing you know even the word healing comes from the root to make whole you know Yoga comes from the Sanskrit meaning to yo to unite to bring together these are really old ideas that were rediscovering the disciplined sort of more radical way of addressing these four issues you've been a champion of and I understand that the compliance in the short term or they're sticking with it is because if I had to start adjusting my diet a little bit I don't really feel a lot better a month later or two much later or six months later but if I just my diet to a plant-based diet and incorporate the other three factors with your life I'll plan I feel better than a week or maybe a few days or two weeks so that's enough to keep me going but what about in a year or two years are people able to maintain this sort of fairly discipline fairly strict to four point plans yeah well the conventional wisdom has always been that small gradual changes are easy and big rapid ones are hard but sometimes even though it's counterintuitive it's just the opposite that when you make small changes you don't really feel that much better as you indicated but you still have the hassle not being able to do and eat everything you want so in some ways you get the worst of both worlds but when you make big changes all at once most people feel so much better so quickly in ways that really matter you know we talked about the chess fan going away for example there's a wonderful film called the game changers that came out that James Cameron the legendary director did along with Louie Psihoyos who got an Academy Award for his first documentary and by the way Louie's doing a documentary on our Alzheimer study and they they they James Cameron went on a plant-based diet about 12 years ago because but in addition to being an amazing filmmaker he's an explorer and he and he learned that more global warming was caused by livestock consumption than all forms of transportation combined so he went on a plant-based diet mainly for the environment and began to feel so much better he's you know in his early sixties he's making avatars two three and four at the same time now he's got so much energy that he really became a proponent of this so he made this film with James hip Wilkes and others that focus on elite athletes who raise their game when they went on a plant-based diet it became mixed martial artists national champions and bodybuilders and you know Arnold Schwarzenegger's and they're talking about how why he's on a plant-based diet and but this is one great scene in there of these three guys in their mid-20s and they feed them a single meat based meal and at night they measure the frequency and hardness of erections they have when they sleep which as you know as a normal guy function and then they did the same thing a day later and gain the missing a single plant-based meal and did the same thing again and by the way the meat based film was organic and you know grass-fed beef and all that kind of stuff after the single meal the plant-based meal all three guys had three to four three to five hundred percent more frequent erections and ten to 15% harder erections than after the single meat based meal in fact the film crew went on they sign off cashews you know again it's a graphic example of how dynamic his mechanisms are how much you gain for many people is so much more than what you give up and as you know being a cardiac surgeon if you have problems with erections you probably have problems with your heart as well because they if your sexual organs are getting in that blood flow chances are your heart and your brain aren't either because it's the same mechanisms that affect all of these things and it shows how quickly you can get better and then obedient reframes the reason for change from fear of dying which is not sustainable to joy and love and pleasure and feeling that literally are it does that I mean that story does the energy it's a cute story that grabs your attention but also it really does reflect what's going on medically the inflammatory process blood vessels throughout the body itself and also the immediacy of it which was the surprising thing - to me that it can have that much of immediate effect after after those diets by the curt's people you're watching this try it for a week and you'll feel so much better and then it comes out of your own experience they don't have to be this diet Wars it's like oh I get it you know what I gain is more than what I give up yeah oh and by the way it's not all or nothing if you you're trying to reverse a life-threatening condition it really is kind of all-or-nothing that's what it takes to reverse disease but if you're just trying to say healthy lose a few pounds I wrote a book ten years ago called the spectrum which was based on the finding and all of our studies that the more you change the more you improve in every way we can measure including even telomere length or gene expression or the amount of blockages in your arteries it's and so it's the ounce of prevention a pound of cure what matters most is your overall way of eating and living unless you have a product disease and the more you change the more you improve but if you indulge yourself one day it doesn't mean you cheated or you failed just eat healthier the next you don't have time to walk five miles one day do it a little more the next you know I'm time to meditate for an hour do it for a minute the more you do it the more you improve the better you feel and the more you'll want to keep doing it I love that common-sense approach and and in in the book you talk very much about that and the guilt that comes and you've written about that I think was in the same book from ten years ago when people go on diets and everybody listening to us I'll bet you everybody has gone on a diet in the last six months of some sort and and the guilt that people feel after that and not coming through and you work through that both in the book and until people know it's not the best approach and if you do this four point plan you avoid that that's let's close so we've known each other for probably 40 years and firstly progress and got looking back kind of embarrassing but that's alright I'm feeling good you're looking good is I sound like pretty good for 96 everything but we were in Mass General together and then I guess we with me surgery you medicine and then I guess after that it was really you come into Washington when I was in the United States Senate and I was focusing on health in health care so again with that crossing in the past we we came early on and then 10 years later you really did what I thought would be impossible discuss it so hard and that is get the CMS the Medicare reimbursement and the code itself for lifestyle what did we call the comprehensive lifestyle what was it called yeah it was well they did they created is called doctor knee Norris's program for reversing heart disease under a new category called intensive cardiac rehabilitation you know we've had a great history together and to be able to continue that today and being able to share again just a fantastic book undo it and how simple lifestyle changes can reverse most chronic diseases stress less love more eat well move more for or straight forward discipline principles really thank you for everything you're doing for humanity and being a great model for the scientists for clinicians who do want to make it impact beyond just the patient's they're taking care of but domestically globally which is clearly what you're accomplishing thank you you know I want to say that we wouldn't have the medical coverage you're being very modest you were the Senate majority leader at the time and working with mark McClellan and others you you really made a big difference and but more than that I treasure our friendship and I just really appreciate the chance to be with you today so thank you good thing thank you very much and I look forward to continuing this conversation with you many many times thank you very much thank you Carrie this episode of a second opinion was produced by Todd Schlosser the motors creative group and snapshot interactive you can subscribe to a second opinion on Apple podcast Spotify or wherever you are listening right now you can also watch our interviews on youtube and on our website and be sure to rate and review a second opinion so we can continue to bring you great content you can get more information about the show its guests and sponsors at a second opinion podcast calm that's a second opinion podcast.com a second opinion broadcast from nashville tennessee the nation's Silicon Valley of health services where we engage at the intersection of policy medicine and innovation

Channel: A Second Opinion Podcast

Views: 29,209

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Length: 44min 53sec (2693 seconds)

Published: Mon Jun 08 2020