Dr. Dean Ornish - UnDo Most Chronic Disease with these Four Simple Steps

when you make big changes and especially if you change a lot of things at the same time most people feel so much better so quickly it reframes and redefines what's possible not to prevent something bad from happening years down the road but but i feel better you know my chest pin goes away and for someone who in most cases and for someone who can't you know 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 getting chest pain within a few weeks they can do all those things and they say things like well i like eating junk food but not that much because what i gain is so much more than what i give up i'm rap esselstyn and welcome to the plantstrong podcast the mission at plantstrong is to further the advancement of all things within the plant-based movement we advocate for the scientifically proven benefits of plant-based living and envision a world that universally understands promotes and prescribes plants as a solution to empowering your health enhancing your performance restoring the environment and becoming better guardians to the animals we share this planet with we welcome you wherever you are on your plan strong journey and i hope that you enjoy the show hello my plan strong cousins and welcome to another episode of the plan strong podcast last week we had dr kim williams talking all about heart disease and i thought it was only fitting that this week on the heels of dr kim williams we bring you one of the absolute godfathers of lifestyle medicine who has also shown that heart disease can not only be prevented but in many cases reversed and that is none other than dr dean ornish dr ornish is he's literally world renowned he has been the the doctor for dr bill clinton he's made amazing inroads with michelle and barack obama he has written numerous best-selling books and he is the founder and president of the nonprofit preventative medicine research institute pmri for short and for over 40 years he and his team of researchers have demonstrated again and again and again how lifestyle medicine can reverse treat and prevent chronic disease now from the very beginning just like my father dr ornish was met with fierce criticism and skepticism which would typically cause even the strongest willed of physicians to reverse their course but because of his conviction and the overwhelming data that he has produced the only thing reversing is your chronic diseases including heart disease diabetes early stage prostate cancer and by association breast cancer and now the evidence is showing very very promising even the progression of alzheimer's now you may be asking how in the world is this possible well dr ornish wants you to do four things eat well love more stress less and move more all of which is outlined in his latest book undo it how simple lifestyle changes can reverse most chronic diseases and it was just released in paperback this week today dean and i are going to talk about the magnificent scope of his work over the last 40 years and it is awe-inspiring now before we dive in i want to speak to any physicians physician assistants nurses and nurse practitioners for just a second for the first time our retreat in black mountain north carolina which is going to be march 1st to the 6th will provide up to 20 hours of cme credits and two ceu credits for health care providers as part of the registration fee jointly provided by unc health sciences at may heck we are thrilled to reward professionals for all they learn at our immersive events and you can still join us again those dates are march 1st to the 6th by visiting planstrong.com for all the details now let's keep this show moving most importantly for today i want to provide you all with a sense of hope medicine and research is changing and as dr orner says today what you will gain is so much more than what you will give up i really hope you enjoy this conversation with a true legend and pioneer dr dean ornish dr dean ornish i want to welcome you to the plant strong podcast it is really good to see you it's virtually the last time dean that i believe that i saw you in person was at the at the game changers premiere at sundance film festival you're you're a big part of that film uh listen we we we both had a nice part in that film and that has really gone on to do phenomenal things more than i ever anticipated um i don't know if you've heard but i talked to james wilkes not too long ago and it now has over a hundred million views which makes it the really the most watched documentary of of all time amazing that's so fantastic wow yeah yeah so we we got a lot to be proud of proud of with with that helping probably uh due to that scene that you're in i'm sure that's why we know listen which takes me right into so i i definitely want to discuss the juggernaut uh body of work and research that you have done over four decades it is it has it has no comparison it's you are in a absolute league of your own it is phenomenal but before we go there i i want to know like i want to go back to your your childhood where you grow up you know what inspired you to get into medicine and what drives you what why how is it you're so bloody ambitious to do such good work well thank you um i feel like maybe we should just stop now and go while i'm ahead but uh let's see long long ago in a galaxy far far away um i was born and raised in dallas texas uh where is a three-syllable word i don't know if i can say that oh yes oh yeah and uh i was eating you know cheeseburgers and chilis and chalupas and all kinds of stuff uh three or more times a day but what really got me interested in doing this work was when i was at rice university in houston and it was around 1972 and i really wanted to be a doctor and i felt like now that i was with a bunch of really smart kids that it was just a matter of time before the admissions committee realized what a big mistake they made in letting me in that i felt like i was stupid that i didn't know anything my college roommate at the time was one of the four people that year who scored a perfect score on his sats and had a photographic memory never had to worry and i really wanted to be a doctor and i knew i had to do well in organic chemistry and the more i worried the harder it became to study and the harder it became to study the more i worried and i got kind of this downward spiral where i thought gosh you know i'm never going to mount anything and then i had the spiritual vision which was more than i could handle at the time which is that nothing can bring lasting happiness and so the combination of feeling like i was never going to mount anything but even if i did it wouldn't matter i thought you know i have a great idea why don't i just kill myself you know because dead people look like they're happy and i was really so miserable and i couldn't even sit still you know i was just constantly agitated and then a week straight went by and i literally couldn't sleep at all which is enough to make anyone crazy and so pardon me i was all set to do myself in but my uh saving grace was i got such a i was run down so much i got such a horrible case of uh mononucleosis that i literally didn't have the energy to get out of bed and meanwhile my um parents got wind that all was not well with their son and uh so they came down and saw what a wreck i was and they took me home to dallas to get to recuperate and my secret plan was to get well enough and strong enough to go out and kill myself again [Music] as crazy as that meanwhile my older sister this was in the early 70s had been in the late 60s kind of a child of the 60s and she had found that a an ecumenical spiritual teacher named swami sasha dananda really helped her and so my parents decided when the swami came to dallas to give a lecture to have a cocktail party for the swami now you can only imagine in dallas in 1973 in january of 73 how weird that was to been uh even today that we weren't in dallas but especially back then and so in walks you know central casting's idea of what a swami should look like you know long saffron robes and a long white beard and the whole bit and he gave us satsang a lecture in our living room and he started off by saying nothing can bring you lasting happiness which i'd already figured out except i was ready to do myself in and he was you know glowing so i'm like what am i missing here and he went on to say what really turned my life around it may sound like a new age cliche but it really had a profound effect on my life it really saved my life really which is that while nothing can bring us lasting happiness and health the paradox is that for the most part we already have that that is our nature for the most part to be happy and healthy and not being aware of that now we run after all these things if only i had more whatever i think i need to be happy and healthy more money more power more beauty more sex more accomplished more and more whatever then i'd be happy then i'd feel and then i'd feel good uh then i'd be peaceful and then people would love and respect me i wouldn't feel so lonely and so once i set up that view of the world which by the way so much of our culture reinforces you know whole advertising industry is really about that once i set up that view of the world what the swami taught me is that however it turns out that you feel badly because until you get it you feel stressed if somebody else gets it then you feel really stressed and it kind of reinforces this zero-sum game dog-eat-dog world mentality you know the more you get the lesser is from me so i better get it while i can but even if we get it it's very seductive in the moment it's like ah i got it now i'm happy but invariably it doesn't last it's either soon followed by either now what um i'm sure you there been times when you thought gee if i just made x amount of dollars that would do it you know or if i just got you know this article written about this work i'm doing that would do it and then that happened he's like well you know maybe a little more might be better you know just it's either now what you know one patient told me years ago that he said i can't even enjoy the view from the mountain i've climbed i'm already looking over at the next one but it's not now what it's so what big deal it doesn't really provide that lasting sense of meaning and so another patient said that the the letdown that comes from accomplishing a goal that i thought was going to really make me happy and it didn't for very long was so great i make sure i've got a dozen projects going at the same time and so the cycle continues and so what the swami taught me is that meditation and yoga and other things like that they don't bring you a sense of peace but rather they simply help you at least temporarily to stop disturbing the peace and the health and the well-being that are really already there and that may sound like you know parsing words and semantics and splitting hairs and all that but the implications are actually quite profound because if it's out there if then everybody who has something that i need to be happy and healthy has power over me and the other most important implication is that this the question then shifts from how can i get what i think i need to be happy and healthy to how can i stop disturbing what's already there that's something i can do something about not to blame myself but to empower myself so i thought okay let me give this weird stuff a try i can always go back to plan b and kill myself and you're how how old are you right now are you i was 19 right i was just in the middle of my uh second year medical school of uh college yeah at rice university and so i um transferred university of texas in austin i went on a plant-based diet you know which was a big departure for me having grown up in texas and began to meditate i couldn't even sit still long enough to meditate but i'd meditate walking around and then i got glimpses of what it meant to feel peaceful and then i could suddenly now connect the dots between what i did and how i felt and when i began to feel peaceful to remind myself or to remind myself that the meditation didn't bring me that sense of peace but at least temporarily it enabled me to stop disturbing what was already there and then the paradox was ripped when i thought i had to you know do well in organic chemistry so i could get into medical school so people would love and respect me i couldn't i was so agitated i couldn't read a headline in a newspaper tell you you know a minute later what it said but the more inwardly defined i became the more the less anxious i became and the more i was able to just function at a higher level and i ended up you know graduating first in my class and gave the baccalaureate and i said that not to brag but to say i experienced both ends of that spectrum a total dark failure like feeling like a worthless you know piece of whatever to you know being able to be very successful and so later when i was in medical school i began to realize that suffering can be a really powerful doorway for transforming our lives as you know change is hard but if you're hurting enough then the idea of change becomes more appealing and one of the reasons why i've spent so much of my adult life and over the last four decades doing research is that properly done you know with you know the best and collaborators the most respected collaborators published in the leading period journals can redefine what's possible for people and so you know they'll say gosh you know this heart disease you know i'm hurting i have chest pain i can't do all the things i wanted to do and and now you're telling me that we can reverse it and you've published all this stuff well okay that's kind of an exercise i get okay diet i get but um vegetarian diet really and and meditation and loving more are you kidding me like why would i want to do that but okay well you've got these studies showing that work let me give this word stuff a try and now medicare's paying for it so somebody must think it's worth doing and so they start to do that and as you know and as your dad knows from from all your extensive experience that these biological mechanisms are so dynamic that when you make big changes and especially if you change a lot of things at the same time most people feel so much better so quickly it reframes and redefines what's possible not to prevent something bad from happening years down the road but but i feel better you know my chest pin goes away and for someone who in most cases and for someone who can't you know 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 getting chest pain within a few weeks they can do all those things and they say things like well i like eating junk food but not that much because what i gain is so much more than what i give up and that's really the key is what you gain is more than what you give up and quickly you know fear of dying or fear of a heart attack or fear of a stroke is not really sustainable i mean for maybe a month or two after someone's been diagnosed with a heart attack they'll do pretty much anything that their doctor or nurse or a dietitian tells them but then it comes back because we all know we're going to die it's like people don't want to think about that the mortality rate is still 100 it's one per person but we don't think about it most of the time but if we talk about how much better we feel that's why i like the game changers film so much it's like it says that your academic performance improves you know the scene about the three guys who had three to five hundred percent you know more frequent erections and ten to fifteen percent harder erections at night after a single plant-based meal i mean the the film crew went on and became plant-based apparently you know after watching that thing that's why it's got 100 million views i mean it's it's it's truly game changing for a lot of people to realize that i want to take a short break from dr dean ornish and share with you an email that i received the other the other week i want you to know that we receive scores of emails every day from people that have been able to turn their health around with the power of eating plant strong and we love reading these emails we read every single one of them because it is so reaffirming that what we are doing at plant strong is having a profound impact on reshaping people's lives now this particular email is from anita and i want to read it to you because i think that it epitomizes the resiliency of the human spirit and the body's innate desire to heal itself when fueled with the proper strong foods here you go anita rights i was diagnosed with insulin resistance in the early 2000s i was told to go on a low-carb diet and to avoid eating fruit which i love and sugar i was given zero guidance from the doctors on how to do this so i picked up a popular book on low carb dieting after six months of pushing through this diet i lost a whopping five pounds how frustrating so i decided to go in a popular point counting diet that all of my friends were on i pretty much starved myself on this diet and still only lost five pounds this would be the beginning of my yo-yo dieting in 2012 i was diagnosed with hyperthyroidism and my insulin resistance was getting worse i would try many calorie restrictive and low carb diets with little to no success i would beg my doctors to give me a solution why were these diets not working then the keto diet started gaining popularity i did the keto diet for six months and felt like garbage i only lost a few pounds my energy was low my joints were killing me my lipid panel was not good and my liver enzymes were on the rise and i was starting to get a fatty liver on june of 2021 i turned 57 and had my bi yearly checkup i was experiencing heart palpitations and anxiety and my blood pressure was all over the place i weighed in at 288 pounds and my a1c was elevated i was sitting at my laptop and i searched how to reverse diabetes and the forks over knives documentary popped up i sat at my kitchen table and watched the entire film and thought well i was willing to give up bread fruit and grains to try and get healthy so why not give up meat dairy and eggs i will be honest i didn't do the diet as directed in the books because i didn't have them but i followed everything on the websites and followed rip and jane's youtube channels within a month i lost 13 pounds within 2 months i was down 22 pounds by the end of september 2021 i was down 35 pounds and by the first of november at my checkup i was down 40 pounds my a1c went from 6.2 to 5.5 my cholesterol went from 167 to 156. things were improving and i was not even following the diet 100 i was eating some vegan foods like vegan vegan cheese and such but i figured since the holiday was upon us i would relax a bit i didn't lose any more weight my heart palpitations came back and i started to gain weight on december 28th i downloaded the seven day rescue audiobook and started listening then my husband my son and i watched the rips rescue make yourself heart attack proof and now we are all doing the plan 100 i'm excited to get all my numbers down this year even more now that i'm really on track my husband has never done this 100 percent either and he has high blood pressure and my son wants to drop some pounds too all i can think about is if doing this plan half hazardly caused my blood sugar to drop my weight to drop and my lipid panel to drop what will happen when i'm all in a hundred percent we shall see but i know it's going to be amazing congratulations on taking the steps to get your health back on track we're gonna link to the resources that anita mentioned in her email including my seven-day rescue diet book the rips rescue make yourself heart attack proof episode as well as a link to join our free plant strong community i want you all to know you do not have to do this alone we are here collectively to help you now let's get back to dr dean ornish so in medical school i was learning how to do i went to baylor college of medicine in houston and i did my core surgery with michael debakey the heart surgeon who had essentially invented bypass surgery and he was really a kind of an old-school tyrant you know he was like like what year you son i'd say well i'm in my starting my third year he goes damn it's gonna be so much harder to bust you out of here now with all these weird ideas you've got and here's the kind of guy that will like stick you if you didn't move your hand quickly when you say you when you say he said you had weird ideas so you already had what what were those weird ideas that he knew you already had oh you know i was teaching yoga to the other medical students and i was a vegetarian and you know that kind of stuff okay and so uh and and i had already taken a a a year off between my second and third years of medical school to do my first pilot study of 10 men and women who had really bad heart disease this was in 1977 44 years ago and i put them in a hotel for a month it was just me and the cook and i taught the yoga classes and did everything and they got better eight of the ten people not only felt better but they were better that we used what was then a new test called thallium scans to measure blood flow to the heart uh which is now a standard test and eight of the ten showed improvement in blood flow and at that time as you know it was thought that heart disease you could only slow down the rate at which people got worse that was about the best you could do and what we found was that if you make big enough changes you can actually reverse its progression you know ounce of prevention pound of cure but it was also my first experience of how when you're doing something disruptive it's not always met with open arms and a lot of people say oh that's impossible you know you're just a medical student what do you know or how do you know the patients would have got better anyway you didn't have a randomized control group and i said well that's technically true but how often do you see patients getting better like this i say well that's beside the point you know anyway someone back to school but i'm just fascinated here like how could you be that precocious at your second year in medical school to want to do a a little pilot study with 10 people in a hotel room did like did you had you read about pritikin or what gave you the idea that heart disease could even be reversed back then a good question i never heard of pritikin at the time um but i went to these places called libraries and they had these things called journals and books and i would just got voraciously interested that like in dogs and cats and pigs and monkeys and rabbits you could cause them to get heart disease if you put them on a typical american diet or put them under stress or made them smoke cigarettes or made them sedentary but you could reverse it if you change those things i said why should people be any different they say oh no people are different so and the other thing about being a second year medical student is that you're not fully indoctrinated so i didn't know enough to i didn't know what i didn't know so you know fools rush in and all that yeah the other thing is when i decided not to kill myself of just a few years before that i i very intentionally said um i don't really know what's true i don't know what's real i'm going to lead a really messy life i'm going to um do all kinds of if it's not going to permanently damage me or hurt somebody else i'm going to try as many different things as i can and do a lot of stupid stuff and make a lot of mistakes and there's a lot of wisdom that comes from doing that there's a lot of certain fearlessness that comes from that but you know as you know from working with people who are sick or dying that when on their deathbed most people don't regret what they did they regret what they didn't do you know it's because if you do something it turns out to be a mistake you learn a lot and there's a lot of wisdom that comes from making mistakes i have a lot of wisdom because i've made so many mistakes in my life but um if you don't do it you just kind of regret it and wonder like what might have been you know what what what might have happened so i just decided that i was just going to go for it you know and i i wanted to at the end of my life i wanted to be like fully spent you know and used up so that's what kind of gave me the courage to do it and having then gotten a taste of how as you know from your work how meaningful it is to be able to empower people when they're hurting and help them use the experience of suffering as a doorway for transforming their lives for me it was depression for someone else it might be a heart attack i'm sure people have told you many times as they've told me having a heart attack was the best thing that ever happened to me hasn't anyone ever told you that before oh yeah and the first time somebody said i said like what are you nuts and they say no that's what it took to get my attention to begin making these changes that have improved but the quality of my life is so much better than i never would have done otherwise and by the way just to digress for a moment so i got a call about four years ago from dr debakey i hadn't talked to him in decades he said hey dean this is mike debakey and he had a very distinctive louisiana accent and i said to what do i i knew it was him just because i i recognized that accent he said i said to what do i have this honor he said well you know those weird ideas i used to give you such a hard time about when you were my medical student i said oh yeah i remember really well he goes that's what's kept me alive all these years and i just watch i'm 99 years old i'll be dying soon and i just wanted to know my wife got interested in what you're doing and and i just wanted to know before i died i thought wow if you live long enough you just never know that that is so awesome good for again good for him for picking up the phone and calling you and letting you know that yeah it meant a lot to me yeah yeah absolutely so in i i'd love to like if you're cool with it chronologically kind of go through some of your research your randomized control studies your pilot studies like the first one that you that i've been able to see is in 1978 where that pilot study we were able to show that in 30 days you could basically reverse and improve the blood flow to the heart right i mean 1978 that was so long ago yeah well um you know at that time not only was it thought impossible to reverse heart disease but it was thought that the blockage in the arteries was really the only mechanism that kept the heart from getting enough blood and the idea and we know that builds up over decades so the idea that you could reverse it over any period of time was not crazy but especially in in a month like how could that be there's no mechanism to explain that and we showed that it was true but we didn't really know why it was true and later other cardiologists other people like attilio mastery and others show that the arteries are not like lead pipes they're actually lined with smooth muscle as you know they can constrict or dilate the collateral blood vessels the kind of built-in bypasses that your body grows around blocked arteries are smaller in diameter that can get clogged up really easily with you know fat and micro thrombi and so on so when you eat healthier that network is able to deliver more blood to your heart uh you know there are other things that affect the the vasomotor tone and preload and afterlife all this kind of stuff and so uh over time it became clear that the blockages are just one of many mechanisms that affect blood flow to the heart and they're not they may not even be the most important and i think that's one of the reasons why there are now eight randomized trials actually more than eight but at least they have they all show the same thing that in stable men and women who've got stable heart disease that they don't work they don't prolong life they don't prevent heart attacks they don't even reduce angina uh and and and bypass surgery only does so in the most you know just a few percentage of people who are the most sick and we spend 100 billion dollars a year on these two operations that are dangerous invasive expensive and largely ineffective because they're focusing on the the blockages and the arteries and yet the real bottom line is in blockages is how much blood your heart is getting so i went back to school finished my md then did a randomized trial before starting my residency in boston um to see what would happen if we had a randomized control group and with this time we put people in a resort in the middle of nowhere just so we could have more control over what they were eating we found in the first study sometimes people were going down to the barn having pepperoni pizza and drinks in the middle of the night and in just 24 days which we scientifically pick as they said we could use it for free for 24 days we found that there was the heart the ability of the heart to pump blood as a measure of the underlying heart disease improved and it was statistically significant after just 24 days and we published that compared to the randomized control group which actually got worse during that time again it shows how dynamic these biological mechanisms are for better and for worse and so we published that in the journal of the american medical association and ended up going up to boston to harvard and mass general to do my fellowship and residency moved to san francisco in 1984 and began the most definitive study called the lifestyle heart trial which used the state-of-the-art i mean ironically we're using these high-tech expensive state-of-the-art scientific measures to prove how powerful these very simple and low-tech and low-cost interventions are and so and i i don't know about you but one of the issues i continue to struggle with and the biggest obstacle i find in doing this work is people think oh died in lifestyle that's kind of boring how powerful could that be you know it's got to be a new drug and a laser something really high-tech and expensive to be powerful and i think our unity contribution has been to use these very high-tech expensive state-of-the-art scientific measures to prove how powerful these very low-tech and low-cost and often ancient interventions can be so we use quantitative arteriography to measure very accurate reproducibly the amount of blockages in the arteries we actually flew our patients to texas where they had the best cardiac pet scanner in the world at the time to measure blood flow most accurately we looked at cardiac events and so on and we found that after one year the experimental group who made these lifestyle changes showed some reversal the arteries got less clogged which had never been shown in a controlled study before whereas they got more clogged uh in the uh in the randomized control group and then we we published that in the landsat the leading international peer view medical journal and then we're using those i mean it's hard to get funding to do studies that have never been done before and everything we've done has never been done before because they think why should we waste our money everybody knows it's impossible and it's like well let's find out you know they say well why should we waste our money we know it can't be done and it's a catch-22 without the money you can't show it works and they don't think it works they don't want to fund it so we just took this approach saying look let's just if we're doing good work somehow the universe will provide and i know that sounds so california flaky but it's it's the way i've always lived my life and the money always seems to come in somehow you know just when we most need it and so then but based on the one-year findings we were then able to get a large grant from the national institutes of health to extend the study for four more years and we found even more reversal after five years and after one year was the control group who were doing just what their doctors had told them showed even worsening more blockages after five years than after one year and we also found a 400 improvement in blood flow to the heart uh after five years when compared to the randomized control group and there were two there were um we there were 70 fewer heart attack strokes bypasses angioplasties and stents in the group that made these changes compared to those who didn't so then um we began i began thinking you know well this is going to change medical practice kind of kind of in a naive way and and uh to some degree it did but not nearly what i thought it would be and then i realized is you know that uh you know it's like follow the money you know that um that you know we get trained to use drugs and surgery as doctors we get reimbursed to use drugs and surgery so not surprisingly that's what we use you know it's like that old saying from abraham maslow the only tool you have is a hammer you see everything as a nail so i thought well if we could we went insurance company by insurance company it's very hard to get insurance companies to do something entrepreneurially or innovative that's people don't go into that world for that reason and but mutual mutual omaha was the first major insurance company to do this this was in 1986 and made the front page of the new york times and then a few others did but um and then highmark blue cross blue shield began not only covering it in 26 sites but actually providing i mean covering an html but providing it in 26 sites and they found they cut their overall healthcare costs in half in the first year and by four-fold in the subgroup of people they'd spent at least 25 thousand dollars on and then much of omaha found that they almost 70 almost 80 of the people who were told they needed a center bypass could choose our lifestyle program as a direct alternative and they cut and they saved almost 30 thousand dollars per patient in the first year and it's really important to show cost savings in the first year because the insurance companies know that a 30 people change jobs and change insurance companies every year and they say if it's going to take longer than a year why should we spend our money for some future benefit that someone else is going to get so but i knew that it's you know we could spend the rest of our lives going insurance company by insurance companies so i thought well if medicare would cover it then that would be a real game changer no pun intended and um if medicare covers it then most of the other insurance companies would so um i met with them and they basically weren't interested in doing it you know and they said oh no one will do it and i brought with me the chief medical officer of um uh what year are we in what year are we in now this was in 19 uh let me think about this because i know yeah go ahead i'm sorry where are we going because uh i know maybe it took that long but 2010 they announced coverage of their ornish program yeah this was 1994 because it took 16 years to get this done wow i mean my persistence is my best my worst quality let's put that one and so they said you know uh you know if we pay for this everybody's got a crystal ball and a pyramid is going to want to have medicare coverage and i brought with the chief medical officer mutual of omaha he said look my name is ken mcdonough i'm the senior vpn chief medical officer of mutual of omaha we're not a radical company we're mutual of omaha for christ's sake and we cover this because it's got years of randomized controlled trial data showing it's safe and effective and sat down they said well nobody's going to do this and i brought with me a guy named rick collins who was the chief of cardiology at the first hospital we trained which also happened to be an omaha he said look i i make my living doing stents and angioplasties and 90 of the people i would have operated on were able to choose this program as a safe alternative and that was it and they still wouldn't do it so that night it just happened that i was having dinner with bill clinton uh and because i've been working with him since 1993 yeah um he said how was your day and i said it really was challenging he said well maybe i can help i said well maybe you can you're the president united states you know you're the head of the executive branch and so i had some stuff with me and was just the two of us in the white house i just gave it to him i have to go through staff or anything i thought well he'll just make a call and that'll be it 16 years later we got medicare coverage and we had he was president we had newt gingrich who was a speaker of the house who hated each other and you know uh there must have been like 20 members of the senate and over 50 members of the house who all across the political spectrum all came together but it still took 16 years but they did it and that was a real breakthrough because again if you change if medicare covers it most of the other people do which has been happening now the other breakthrough is that just a few weeks ago medicare agreed to cover our program when offered through zoom at the same rate as when it's done in the bricks and mortar world so now we can reach people who don't live within driving distance of a hospital or clinic that they can be in rural areas we can help reduce health disparities and health inequities and so on anyway so we went on from there to do um if we found that you know high blood pressure high cholesterol type 2 diabetes because so many of these people have the same conditions and i'll come back to this but that's really the idea of the unifying theory but let me just make myself a note to come back to that anyway and then we did a study with the chair of urology at memorial sunken cancer center bill fair at the time and peter carroll the chair at ucsf at the time to see if these same lifestyle changes could affect the progression of men with early stage prostate cancer and we found that they did you know it was a randomized controlled trial and we were able to stop reverse the progression of early stage prostate cancer in the people who made these changes same changes whereas they got worse in the control group and then we did a study with craig venter to try to get us some sense of what are some of the mechanisms to help explain these findings and we craig was the first to decode the human genome as you know and we found that over 500 genes were changed in just three months turning on the good genes turning off the bad genes um in fact when bill clinton's bypass is clogged up 14 years ago um his cardiologist held a press conference and said oh it was all in his genes his dying lifestyle had nothing to do with it and having worked with him for so many years i knew it had everything to do with it so i i sent him a note and i said you know the friends i value the most are the ones who tell me what i need to hear not what i want to hear and you need to know it's not all in your genes in fact we've shown you can actually change the expression of your genes and and if it were all in your genes you'd be a victim and you're not a victim you're the most powerful guys on the planet so he began doing this he's now been doing it for 14 years i think he talked to your dad too which is great and um you know he's talked about this publicly is his heart because he's getting better and i think whatever your politics when a former president who is known for you know running to mcdonald's makes these changes it really can inspire lots and lots of other people anyway so we did a study showing that when you change your lifestyle it changes your genes we did a study with um elizabeth let me let me just go back for a second i just want to know like so you know you you've done all these studies research showing that you can reverse heart disease and then what was the impetus for you to try and show that you could do something with prostate cancer well it's a good question um i began to realize that the same biological mechanisms that affect heart disease affect so many other conditions and let me just digress a moment and talk about this unifying theory that i wrote about in the undo it book which which just now came out in paperback and that is over these four decades of studies i'm thinking like it wasn't like there was one set of diet and lifestyle changes for reversing heart disease or different or diabetes or prostate cancer or changing your telomeres or your gene expression and perhaps even alzheimer's disease it was the same for all these and i thought why is that and then it became like kind of a blinding flash for the obvious like i was trained like all doctors to view all these as being different diseases different diagnoses and different treatments but i became clear to me that they're really not so different they have a lot more in common they're in many ways the same disease manifesting and masquerading in different forms because they all share the same underlying biological mechanisms chronic inflammation oxidative stress changes in the microbiome and telomeres and gene expression and angiogenesis and overstimulation of the sympathetic nervous system and immune function and so on and each of these in turn is directly influenced by what we eat how we respond to stress how much we exercise and how much love and support we have and the more diseases we study the more evidence we find of that so prostate cancer again is is affected by these same mechanisms in fact when we found that we could affect over 500 genes we found that we were downrelogening what are called the ras oncogenes that promote prostate cancer breast cancer and colon cancer were just switched off so i thought okay and prostate cancer is a really interesting disease to study for a number of reasons one of which is that a certain number of men choose to do what's called watchful waiting or now called active surveillance where they they know they have cancer but they're not having it treated so we we only recruited people who were doing that so then we could randomly divide them into two groups and have one group who we knew had prostate cancer but wasn't being treated with chemo or surgery or radiation so we could then compare them and see what are the effects of lifestyle changes alone without being confounded with the other usual kinds of interventions but what's great for prostate cancer would likely be true for breast cancer as well and so we found that we could actually stop or reverse its progression which was exciting and you know right now what happens is most guys if you get long if you live long enough are going to get prostate cancer much more likely to die with it than from it and yet most guys get scared to death you know they have a biopsy oh you got to get it out now before it spreads and and they do and most of the time it turns out they're now two large-scale studies 10-year studies in the new england journal medicine that only about 1 out of 49 or 50 men actually lives longer because they have surgery or radiation or chemo the other 49 often get maimed in the most personal ways they're often either impotent they can't have sex or incontinent they're wearing a diaper for no real benefit at huge economic and huge personal cost but if the only choice you have is between doing nothing and doing something most guys you know like we want to do something you know and now we have the third alternative which is to um go to your doctor and make sure you don't have the most aggressive form of prostate cancer and if you don't then ask your doctor to go go on this lifestyle program and then monitor yourself you know every few months with ultrasounds and other things and repeat biopsies every few years or so and and uh and see if you can avoid having those interventions which is you know a different more a an aggressive non-surgical intervention if you want to put it through yeah we're actually able to show because i know you're able to show bringing down the psa level were you able to show a decrease in the potential size of the cancer we didn't measure the size of the cancer but we measure the tumor activity using a test called uh um that what was the guy's name did it anyway it's it's a um it's a it's a it's a special test that enables us to look at the activity of the tumor and we found that and also none of the experimental group patients needed surgery or radiation or chemo in the first year but six of the control group patients did and when we added the serum the blood of these patients to a standard line of prostate tumor cells growing in tissue culture in bill erinson's lab at ucla 70 of the tumor was inhibited versus only nine percent of the control group but think about that these are people who went on a plant-based diet and made these other changes grew their blood added it to a tissue culture of prostate tumor cells growing and it inhibited the growth seventy percent versus only nine percent in the uh control group and so uh taken as a whole it's for the first and as far as i know so the only randomized trial showing that these lifestyle changes can slow stop and often even reverse its progression which is really exciting incredible then we did a study with elizabeth blackburn who got the nobel prize for discovering telomeres which as you know are the ends of our chromosomes that regulate uh aging cellular aging they're like the plastic tips on the end of a shoelace to keep your shoelace from unraveling they keep our dna from unraveling and as the dna replicates over time the telomeres get shorter and as telomeres get shorter our lives get shorter and the risk of premature death from all these different conditions goes up proportional and so um she had done studies with alyssa apple showing that you know women under chronic stress had shorter telomeres or people who smoked it or even people who ate junk food or sedentary so i said you know most things in biology go both directions if bad things make your telomeres shorter maybe good things make them longer we try to found sure enough they got 10 percent longer this was the first studies from that any intervention could actually lengthen telomeres and we would publish this in the lancet the lancet editors called it the first study showing that lifestyle changes may reverse aging at a cellular level which i thought was really exciting wow so the unifying theory is to say look um you don't need one set of diet and lifestyle programs for this and for that you know personalized medicine is fine but you see the same lifestyle changes that can affect so many different chronic diseases because they all share the same mechanisms which in turn are directly influenced by the lifestyle choices that we make each day and it helps explain why you know colin campbell found that you know in the china study that they had such low rates of all these chronic diseases until they started to eat like us and live like us and all too often die like us or while we find what we call comorbidities i'm sure when you work with people with heart disease they often have type 2 diabetes or high blood pressure high cholesterol or obesity because it's the same disease just kind of manifesting in different ways and why when you put them on the same lifestyle changes all these different conditions often get better and people who are told that you know these are drugs you have to take for the rest of your life to lower your cholesterol blood pressure blood sugar that under their doctor's supervision they can often reduce them or get off them all together wow so dean that was quite a litany right there so between between between you know showing reversing heart disease prostate cancer changing gene expression uh you know lengthening the telomeres what has you excited right now well spending more time with my friends and family it's been really great not having to travel so much during covet has been wonderful but um what i'm most excited about professionally is we're in the midst of doing the first randomized trial to see if we can uh stop reverse the progression of men and women who have early alzheimer's disease and i have a personal interest because my mom and all of her siblings died of alzheimer's she was totally brilliant and just watching her beautiful mind decay was so tragic um and i think we're at a place with and i have one of the apoe4 genes for it but i think we're to place with alzheimer's very reminiscent rip of where we were with heart disease 40 some odd years ago in other words the same biological what's good for your heart is good for your brain and vice versa what's bad for your heart is bad for your brain the same biological mechanisms that affect heart disease affect alzheimer's and the less intensive interventions of alzheimer's the what's called the finger study the mind study can slow the rate at which they get worse because they progress into dementia just like back then the less intensive like american heart association diet slowed the rate at which your arteries got clogged but wasn't enough to stop or reverse it an ounce of prevention pound of cure if you will my hypothesis is that a more intensive intervention might stop or reverse it and unlike heart disease where there are there's still other treatments that have some benefit you know drugs and surgery and so on nothing really can stop the progression of early stage alzheimer's yeah you know there was a drug that was approved this year called education it was the first drug in 20 years that has been approved for treating alzheimer's they've spent billions and billions of dollars on these drugs and they've all failed this drug should never have been approved in fact three of the fda commissioners resigned in protests because it's 56 000 per dose only it only slows the rate at getting worse a little bit and a third of people get bleeding into their brain and brain swelling and have to stop taking it but it just shows you how desperate people are for some sense of hope because right now if you get diagnosed they say they'd say rip i'm sorry you've got alzheimer's the best we can do is slow it down a little bit get your affairs in order and by the way we're going to take away your driver's license so your your world starts to shrink even more and it's just this unfathomable dark place you know which i'm very familiar with having been so suicidally depressed uh years ago of uh like of hopelessness you know and the worst thing about really being depressed like i was when i was 19 uh the hallmark of real depression is the sense of helplessness and hopelessness that comes when you take someone's hope away and um and you're told that nothing it's only going to get worse and that can be self-fulfilling in in a way because it's like your brains just starts to shut down almost as an adaptive response to such horrible news so i thought you know if and it's still a big if but if we could show that we could stop or reverse its progression that would be monumental because then we could you know empower people and give people a sense of hope which can also be self-fulfilling in a good way which is again why i spend so much of my time doing these studies which are really hard so i'm cautiously optimistic that we might be able to show that and if anyone is listening to this we're still recruiting people we provide 21 meals a week for you and your spouse for caregiver for 40 weeks we do all the testing it's just cognitive function testing and so on and we had to start doing it so just go to ornish.commyname.com and there's information on there how to enroll in the study and now we can reach people and have them in the study pretty much wherever they live because you know we were meeting with people in person as we had with the medicare heart disease patients but then when coveted hit we had to stop doing that because um you know there vote such a vulnerable population so i would never have done this i had thought incorrectly as it turned out that this was such a high touch intervention it just wouldn't work as well if you did it by zoom but i was wrong it turned out it worked just as well or almost as well so now we're collaborating with the heads of neurology at harvard with rudy tanzi and steven arnold and jonathan rosen and dorian rentz as well as at um university of california san diego and jonathan arts and others at renown and probably the people in cleveland clinic uh uh neurology to see where we're we're recruiting patients they provide and test the patients locally like in boston but we'll do the intervention from here via zoom and we drop ship the food to them so we can now reach people wherever they live with and i think it's going to be the latest example of how these you know to radically simplify you know the the undo it book starts with one of my favorite quotes from albert einstein which is that if you if you can't make it simple if you can't explain it simply you don't understand it well enough and to try to reduce all this complexity down to you know eat well move more stress less love more you know that's it and even with covet you know with the new omicron variant that's just coming out everybody's so justifiably concerned about because you know the vaccinations only protect you about 40 even get a booster it's only about 78 so people are looking for new ways of trying to strengthen their immune system even if they everybody should get vaccinated and wear mass and so on but even if you do that you're not you know there's only going to be a lot of breakthrough cases and there was a study that came out about a month ago in the british medical journal where they looked at frontline coven 19 health care workers in six countries who are exposed to covet every day and they found those on a plant-based diet were 73 percent less likely to get moderate to severe coven those on a pescetarian diet were 59 percent less likely those on an atkins paleo keto diet were actually 400 percent more likely you know so it just goes to and then walter whether that harvard looked at 600 000 doctors and nurses and found that they were 42 less likely to get moderate to severe covet if they were on a plant-based diet so again the more we look the more evidence we have of how these simple changes can make such a powerful difference as you well know well so that that leads me to my next question is it the latest data that i have dean is that annually we're now spending like 3.6 trillion dollars on healthcare um and that's like ten almost eleven thousand dollars per person in america um and that less than three percent of that budget or or that that cost is prevention i'm surprised it's that high actually eighty-six percent of that it's actually up to three point eight trillion now uh adds up uh 86 of that is for treating chronic diseases which as you know are largely preventable and even often reversible through changing lifestyle my approach just like yours is to treat the cause and when we can treat the cause which are to a much larger degree than we had once realized these lifestyle choices we make each day that our bodies often have this remarkable capacity to begin healing and much more quickly than we had once thought but it's not only medically effective it's cost effective as i mentioned you know we did a study with highmark blue cross blue shield where there was not only covering but also providing our program in west virginia nebraska and pennsylvania it's 26 different sites there three of the more challenging parts of the country and uh they cut their costs in half in the first year and by fourfold when they looked at the people they'd spend at least 25 thousand dollars on in the prior year so if we really want to reduce costs and these are really not healthcare costs are mostly sick care costs and we want to reduce costs and make better care available to more people at lower costs you know the more democratic agenda or empowering the individual and freedom of speech and freedom of choice and and personal responsibility more the republican side really kind of comes together we have to work with people on the real basic cause which are these lifestyle choices and one of the reasons why i spent 16 years of my life to work to try to ultimately get medicare to cover this which they did is that if you change reimbursement you change medical practice and even medical education you know i'm on the uh nutrition working group of the american college of cardiology we published a paper last year in the leading peer-reviewed cardiology journal journal american college of cardiology that the average doctor gets four hours of nutrition training a year the average cardiology fellow in four years of training it's none you know but now that we're changing reimbursement that's slowly beginning to change and and your work and your dad's work and other people are really helping to lead the way in doing that [Music] well so over your last 40 years i want to know what would you say and it sounds like maybe medicare but i what's your biggest victory and what's your biggest frustration um i think getting medicare i don't know they're all kind of important if we continue you know medicare was probably the the will have the most impact just because for all the reasons we've been talking about and now that medicare is paying for it most of the other insurance companies are and then we can make it like you having seen what a powerful difference these changes can make i didn't want this just to be concierge medicine i wanted to be available to as many people as possible now it is which is great uh if we can show and it's still an if but it's not as big enough as it was when we started that we can stop reverse the progression of early stage alzheimer's that'll be probably the biggest accomplishment because nothing else works and when you lose your memories you lose everything so um and i think it will and again if we can reverse it then we can prevent it and or at least help prevent it and a lot of there's some new tests coming out the biomarkers that can like measure amyloid in your blood you know 20 years before it becomes clinically apparent but a lot of people say why would i want to know if i'm at risk for getting such a horrible disease if i can't do it to get anything do anything about it it's just going to make me crazy but if we can show you can do something about it then it'll probably require less intensive changes to help prevent it than it does to stop or reverse it after the fact yeah so have you um communicated at all with uh dean and aisha cher's eye at all and their work at loma linda yeah i think they're doing really good work uh they're not doing the kind of research that we're doing but they're they're wonderful people anybody named dean has to be a cool guy for one time i love it what about what about um sanjay gupta because didn't he just come out with a book all about uh i think alzheimer's and stuff yeah i wrote him a quote for that book he actually came and filmed our study so when it's finished you may do something on that and louis hoyos who as you know did the game changers have been filming the alzheimer's patients all the way through so we'll be able to um have more than just a journal article we can actually share people and show the struggles they go through and you know how they can overcome them and actually seeing them to the year that they're getting better what's your what's your time frame on this study i don't know it just depends on how now that we're recruiting from all these different sites we're hoping that we can get the rest of the patients a lot more quickly than it's taken up us until now and and so we're cautiously optimistic yeah yeah well deservedly so um i was talking to my parents last night they told me to give you a big hello yeah and we also um my mom wanted me to let you know that she can't wait to get your christmas card this year if you're if you're actually doing one because she said you you guys send out the most fantastic original christmas cards ever and she said i think maybe last year or the year before everybody you had a big like boa constrictor oh that was that that was earlier this is the one let me see if i can anyway and so from uh last year we were in london so you know my daughter's a big oh abby road love it so what i want to know is dean what do i got to do to get on your christmas card list well give me your home address that would be great i will i will as soon as as soon text it to me or email it to me i i absolutely will hey so tell me i know that um the um the u.s news and world report is coming out with their you know number one uh diets pretty soon did you guys make it again for the 11th straight year they uh they've been rating down since 2011 and they uh it's they just announced that uh for 2022 the number one heart healthy diet is is our diet which is graded from a panel of experts there for the 11th year since 2011 so we appreciate that that's fantastic tell me how many ornish certified locations are there do you have any idea i really don't we partnered with sharecare and they're they've been training hospitals and clinics and physician groups but now that we can do it virtually we can reach anyone anywhere and that'll just you know exponentially expand the number of people we can help and that's really that's you know just like you having seen what a powerful difference these changes can make and now have the reimbursement to make it sustainable uh it's it's it's you know it's an exciting time yeah well for everybody that's out there i highly encourage you to go to ornish.com it's a beautiful gorgeous website it is so well done by the way my wife ann who's collaborated with me for 20 some odd years um is brilliant and has a one of her superpowers is making everything around her beautiful and she's completely designed the website and empower our learning management system she doesn't get nearly enough credit um but that's all really her well it it is really it's uh i am very envious it's beautiful tell me this dean you know what did you have for breakfast and lunch have you had lunch yet and please let us know what you ate i'm actually having lunch with uh louis cyhoious in a few minutes um so we're gonna go down to a restaurant that's uh called avatar no pun intended uh since james cameron who did avatar did the game changers um but for breakfast i had a bowl of uh whole grain cereal and some blueberries and some sugar-free soy milk and that was it yeah did you hear uh that uh avatar two's coming out in december of 2022 so in a year yep and then three is coming out two years after that then four and then five and avatar two is like almost all underwater and these actors and actresses had to learn to hold their breath for like minutes at a time yeah well i i know that because uh as you know jim cameron went on a vegan diet because he's an explorer as well as a filmmaker and when he learned that more global warming is caused by livestock consumption than all forms of transportation combined he uh he went on this for environmental reasons and he has so much energy he's in his 60s like i am you know he's actually making avatars two three and four at the same time in new zealand they'll be released a year apart but they're actually doing them all at the same time it just goes to show you how you know how much energy doing something like this can do and by the way my younger my son who's 21 is a as an accomplished musician and one of his favorite indie bands is called wolfpack v-u-l-f-p-e-c-k and they gave a concert a couple years ago at the greek theater at university california berkeley where i you know i lived and they had 15 000 you know mostly kids in their 20s and the front man of the man is vegan and he said you know we went backstage to say hi to him he said you know in the middle of my concerts i usually talk about why i'm on a vegan diet but and i talk about your work and other people's work but since you're here why don't you come out in the middle of the concert i said what i said okay so for like 15 minutes i was actually cool to my son it didn't last much longer than that but when i went out there i didn't talk about you know reversing heart disease and diabetes and prostate cancer and alzheimer's these are kids in their 20s i said you know it's so easy to feel overwhelmed by what's happening in the world like what can i do as one person about global warming about you know feeding the hungry about the deforestation in the amazon about you know all these animals that are you know kept in such horrible conditions what can i do well you know something that's primal is what you put in your mouth every day can affect all those things you know more global warming is caused by livestock consumption and all forms of transportation it takes 14 times more resources to make a pound of meat based protein than plant-based protein if enough people ate a plant-based diet no one needs to go hungry you know one out of five kids in the bay area goes to bed hungry every night it's pitiful the deforestation the amazon is largely to clear cut to make room to graze cattle for for me you know and so on there's seven to 11 billion animals that get uh held under the most horrible conditions and killed just to provide food that we don't really need to do you know it was like this roar of the crowd i said oh this is why people like to be rock stars you know it's amazing energy like that but again i think that anytime we can imbue the choices that we make with meaning when i was so depressed when i was 19 i could take all the meaning out of life you know and and that's why i got so depressed but i later learned that just choosing not to do certain things like not to eat certain foods so that it frees up resources to do all these wonderful things to help what's good for you is good for the planet you know it's personally sustainable is globally sustainable it can imbue those choices with meaning and therefore that itself also helps to make them sustainable that's why i think that all religions and spiritual paths have dietary guidelines even though they're often in conflict with each other just whatever the intrinsic benefit is just the act of choosing i'm not going to eat certain foods imbues those choices with meaning and i think meaning is something that we're all looking for more of wow dean beautiful thank you i just got to say that you are you are there and i hope you don't mind me using this term but you're the godfather of lifestyle medicine treatment treatment prevention reversal and this is the direction that we got to get this country moving in and you have done such an amazing job being that just guiding light for so many people including myself my father and uh you know colin campbell john mcdougall you know we're all indebted to your to your ferocious um ambitious research and you are all over the map it is the most beautiful thing way to go oh you've made my day my dear friend thank you and right back at you and um i look forward to the next time we can be together in person hopefully we don't have to wait for another film to get made thank you so much for listening today for a list of the resources on today's episode visit the episode page at planstrongpodcast.com and we'll be sure to link to dr ornish's new book undo it as well as information on his latest research studies at pmri thanks again for following and sharing and subscribing and man plants are the best thank you the plantstrom podcast team includes carrie barrett laurie kordowicz amy mackey patrick gavin and wade clark this season is dedicated to all of those courageous truth seekers who weren't afraid to look through the lens with clear vision and hold firm to a higher truth most notably my parents dr colbert esselstyn jr and ann kryl esselstyn thanks for listening you

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Length: 64min 32sec (3872 seconds)

Published: Thu Jan 13 2022