Doctor returned heart disease. Now he’s looking at Alzheimer’s

“I think our unique 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 interventions can be,” said Ornish, a researcher. professor of medicine at the University of California, San Francisco.

“What’s good for your heart is good for your brain and vice versa,” Ornish said. “Previous studies have shown that moderate lifestyle changes can slow the progression of dementia and Alzheimer’s disease. So my hypothesis is that more intense lifestyle changes can halt or even reverse the decline.”

The original heart disease study was small – 28 people were in the Ornish experimental group and then followed for five years. Some skeptics criticized the program for its small sample size, saying there was no way people could stay on the program’s strict plant-based diet without supervision.
In the Ornish meal plan, no more than 10% of a person’s daily calories can come from fat. To achieve that, all animal products except protein and one cup of skimmed milk or yogurt per day are banned. (This doesn’t apply to Alzheimer’s research.) Whole grains, fruits, vegetables, and legumes make up the foundation of the diet, along with a few nuts and seeds. Refined carbohydrates, oils and excessive caffeine are avoided, but a maximum of two cups of green tea per day is allowed.

“It’s low-fat, but that’s only a small part of the overall diet,” Ornish said. “It’s essentially a vegan diet, low in fat and sugar, eating foods that are as close to nature as possible.”

Ornish's program includes walking or other aerobic exercise.

The program also includes one hour a day of yoga-based stress management using stretching, breathing, meditation and relaxation techniques. Strength training and walking or other aerobic exercise are required for 30 minutes a day or an hour three times a week. Smoking is not allowed.

“There are also support groups,” Ornish told CNN, “not just to help people stay on the diet, but to create a safe environment where people can lower their emotional defenses and talk openly and authentically about what’s going on.” is really going on in their lives, warts and all.

“That was the part that surprised me the most — these support groups are really intimate,” he added. “Sharing things like ‘I may look like the perfect dad, but my kids are on heroin’ or whatever. Even with Zoom, they reach the same level of intimacy within one or two sessions because there’s such a hunger for it. .”

Ornish calls that part of his program ‘Love More’. He answers skeptics who wonder why intimacy is such an integral part of a plan to reverse disease by pointing out studies on people who are lonely, depressed or isolated.

Those people are “three to 10 times more likely to get sick and die prematurely from just about anything” compared to people who say they have a sense of love, belonging and community, Ornish claimed.

“Why? Partly because you’re more likely to smoke, overeat, quit exercising and other unhealthy things when you’re feeling lonely and depressed,” Ornish said.

Impact on other chronic diseases

In 1993, insurance giant Mutual of Omaha began reimbursing policyholders for the costs of Ornish’s program, making it the first alternative therapy besides chiropractic to win insurance reimbursement. Medicare began lifestyle interventions for heart disease in 2006.

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“And in October 2021, Medicare agreed to cover my heart disease reversal program when it’s done through Zoom, which is really a game changer,” Ornish said. “Now we can reach people at home, in rural areas and food deserts wherever they live, which will help reduce health inequalities and health inequalities.”

Over the past two decades, Ornish’s research has shown that the same four-part program can lower blood sugar and cardiovascular disease risk for patients with diabetes, reduce prostate cancer cell growth, improve depression within 12 weeks, reduce the “bad cholesterol.” ” can decrease by an average of 40% and more.

“With all this interest in personalized medicine, how come the same lifestyle changes stop and often reverse the progression of such a broad spectrum of the most common and costly chronic diseases?” Ornis asked.

“Because they all share the same underlying biological mechanisms: chronic inflammation, oxidative stress, changes in the microbiome, changes in gene expression, overstimulation of the sympathetic nervous system, changes in immune function, and so on,” he said.

“And in turn, each of these is directly affected by what we eat, how we respond to stress, how much exercise we get, and how much love and support we have,” Ornish said.

Those lifestyle improvements likely change the body on a cellular level, he said. A 2008 study found that the Ornish program affected some 500 genes in the body through epigenetics, chemical reactions that can activate or dismantle the expression of a gene.

“After just three months on the Ornish life program, the research found a number of genes that regulate or prevent disease, and genes that drive many of the mechanisms that cause all of these different conditions, have been turned off,” Ornish said.

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“You don’t technically change your genes, but you change the expression of those genes with chemical switches, turning them on or off,” he said. “So that means it’s no longer all in our genes, making us victims of our genetic fate. We’re not victims. There’s a lot we can do.”

Ornish lifestyle interventions have also been shown to lengthen telomeres, the ends of chromosomes that control lifespan, and shorten as we age. Ornish conducted a pilot study in 2013 with UC San Francisco biochemist Elizabeth Blackburn, who won the 2009 Nobel Prize in Physiology or Medicine for her work on telomeres.

“We found that telomerase, the enzyme that repairs and lengthens telomeres, increased by 30% after just three months on the program,” Ornish said. “Then we found that people who had been on the program for five years had telomeres that were about 10% longer, a sign that aging is being reversed at the cellular level.”

Will the same lifestyle interventions be enough to slow or even reverse cognitive decline in Alzheimer’s disease and other dementias? Time will tell. Ornish’s investigation is still ongoing and all data must be collected, analyzed and peer reviewed before a result can be reported.

“But I believe it’s not one diet and lifestyle intervention for heart disease, another for diabetes or prostate cancer, and yet another for Alzheimer’s disease. It’s really the same for all these different conditions,” Ornish told CNN.

“To reverse the disease, you have to follow the interventions almost 100%. If you just try to prevent disease, the more you change, the more you improve. But the most important thing is your overall way of eating, living and loving, so that we can all die young and as old as possible.”

This story has been updated.

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