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Monday, October 02, 2006

Ornish: Extra Calories From Fat Makes You Fat


Dr. Ornish wants low-carb supporters to know what he really believes

When you talk about the subject of diet, health and nutrition in the United States, one man embodies what has become a cultural phenomenon that has quite literally enveloped our government, medical community and the very citizens of this country for the past three decades. His name is Dr. Dean Ornish.

Widely considered "that low-fat diet doctor," Ornish told me in my exclusive interview with him that he really doesn't like that title since a very low-fat diet is merely one minor blip among the spectrum of dietary choices he recommends for people to lose weight, get healthy, and, based on his studies, reverse heart disease.

Some may question why someone like Jimmy Moore, arguably the biggest supporter of the low-carb lifestyle on the Internet today, would even want to interview someone holding such a diametrically opposite belief about diet and health as Dr. Dean Ornish, but the answer is a simple one in my eyes. I wanted to learn more about what he REALLY believes straight from the horse's mouth rather than simply relying on what I've heard and read about him before.

People who support livin' la vida low-carb often lament how the late great Dr. Robert C. Atkins was unfairly maligned by his opponents who twisted and perverted what he really believed. And they did and still do. So why should we do the same when it comes to Dr. Dean Ornish? At least you will have the chance to hear him out in his own words and decide for yourself what you agree with and disagree with about his philosophy. This interview should shatter any misconceptions that may exist in your mind about him.

Don't get me wrong, though, you'll still be able to see for yourself the gigantic philosophical differences that this man ascribes to compared to those of us who support low-carb living. I quite literally had to bite my tongue in some parts of the interview because I vehemently disagreed with what he was saying. But I was merely listening and learning. At the same time, don't be surprised to find yourself actually agreeing with "the enemy" himself on several pertinent points during my interview as well.

Dr. Ornish hopes by sharing what he believes that people who support livin' la vida low-carb can stop just long enough to listen to what he has to say with an open mind and only base their opinions on what he says, not on what others have said about him. It's sad that the same professional courtesy cannot be given to Dr. Atkins now, but that's a topic for another day.

I'm sure there will be many of my readers who wished I had hammered Dr. Ornish more on certain subjects or challenged him on statements he made during the interview. Sorry to disappoint you, but that wasn't the point of my interview with him. I truly wanted to ask my questions and listen to what he had to say for my own enlightenment about what he believes and why he believes it. No pretenses, no agenda, no needless fanfare--just his honest responses to a low-carb supporter's concerns.

I have previously blogged about my disdain for Ornish's beliefs, so it was time to see what he really had to say for himself. This interview has been months in the making and I'm so glad to finally be able to bring it to you beginning today.

Much of what you will discover about Dr. Dean Ornish may be stuff you already knew about him, but I won't be surprised to hear that you found out something brand new that you never knew before. That's why I did this interview and I'm thankful that Dr. Ornish was willing to go into "enemy territory" by sharing his thoughts on the "Livin' La Vida Low-Carb" blog.

The length of my interview was such that I decided to publish this as a four-part series on successive days this week.

Part 1 out of 4 of my interview reveals what Dr. Ornish believes about nutrition, the differences between his plan and low-carb, calories and fat as they pertain to weight, the impact of sugar on health, and dietary recommendations in America.

JIMMY MOORE: Thank you for agreeing to do this interview with me today, Dr. Ornish. Share a little bit about your basic philosophy for healthy living from a nutritional standpoint and explain why you believe that to be the best way to attain optimum health.

DEAN ORNISH: For the last 30 years I've directed a series of randomized controlled clinical trials and demonstration projects to assess the effectiveness of a comprehensive intervention for reversing the progression of coronary heart disease. This includes a very low-fat, whole foods diet, stress management techniques, various stretching, breathing, meditation and relaxation techniques, moderate exercise, smoking cessation, and support groups.

In our studies, which have been published in the leading peer-reviewed journals such as The Journal of the American Medical Association (JAMA), The Lancet, The American Journal of Cardiology and so on, we used high-tech, state-of-the-art measures to prove the power of this very low-fat diet. We saw that the blood flow to the heart improved and patients not only felt better, but in most cases they were better in ways we could measure.

The was some measurable reversal of coronary artery blockages on the very low-fat after one year compared to the control group that made more moderate changes recommended by the American Heart Association-approved 30 percent fat diet which showed a worsening of coronary blockage, we received funding to extend the study for four additional years and after a total of five years, we found there was even more reversal after five years than there was after one year, whereas there was an even greater worsening after five years among the control group.

We found fewer and fewer cardiac events and we found that the LDL cholesterol levels on average decreased by 40 percent in the first year and none of those patients were taking cholesterol-lowering drugs.


JIMMY MOORE: Describe why there seems to be such a rigorous and sometimes heated debate between low-fat and low-carb diets.

DEAN ORNISH: I think that a lot of the confusion is around the issue of is it low-fat or is it low-carb and I think that's really the wrong question to ask.

JIMMY MOORE: I agree with that.

DEAN ORNISH: The diet that we're recommending is a low-fat, whole foods diet that is low in the bad carbs, low in sugar, white flour, white rice--that's something that Dr. Atkins and I agreed on. But high in fruits, vegetables, whole grains, legumes, soy products, which have a double benefit--they're rich in fiber and rich in at least a thousand other substances that are protective.

As you know, it's not just what you exclude from your diet that's harmful but what you include that's beneficial. Where do you find these protective substances? With few exceptions, you find them in the fruits, vegetables, whole grains, legumes and soy products. We also for the past 20 years have been supplementing with 3 grams a day of fish oil or flax seed oil for vegetarians to get the omega-3 fatty acids, something Dr. Atkins recommended as well.


JIMMY MOORE: Why do people eat too many calories and get overweight? Why do you believe fat make you fat?

DEAN ORNISH: The reason that people get overweight and consume too many calories in their diet is that they are eating generally foods that are too rich in fat and too high in simple carbs. Fat makes you fat because fat is extra calories--fat has 9 calories per gram whereas protein and carbohydrates have only 4. So, when you eat less fat you're eating fewer calories without having to eat less food. You can eat when you are hungry, you can eat until you are full, and you can lose weight and keep it off.

There's no mystery about how you lose weight--you burn more calories or you eat fewer calories. You burn more calories by exercise and you can eat less calories either by eating less food which why on any diet when you restrict the amount of food you eat from entire food groups you can lose weight. But sooner or later people get tired of feeling hungry or deprived, they get off the diet and they gain the weight back. Or you can change the type of food (i.e. eating less fat) for reasons we just talked about.

The other reason people eat too many calories is they eat too many bad carbs, simple carbs, refined carbs--sugar, white flour, white rice and alcohol. As you know, those give you a double whammy because you remove the fiber which is what generally fills you up before you get too many calories. So you can only eat so many apples or whole wheat bread because you're gonna get full before you eat too many calories.


JIMMY MOORE: What about your thoughts about sugar? Do you agree with Dr. Atkins that it harmful for people to consume for both the weight and health problems it causes?

DEAN ORNISH: A person could consume virtually unlimited amounts of sugar and refined carbs without getting full. One can of soft drink has 12-14 teaspoons of sugar, for example. When you get all these calories that don't fill you up and because you remove the fiber they get absorbed quickly so your blood glucose spikes with insulin surges which lower your blood sugar, that also accelerates the conversion of those calories into stored fat. They also cause a reactive hypoglycemia which creates sugar cravings, so it's a vicious cycle.

You know, Dr. Atkins and I agreed about that, it's just where you go from there where we differ. And I'd love to be able to say that bacon, butter, and hamburger are health foods, but they're not. If you eat less fat and fewer simple carbs and more of the whole foods, then you really get the best of both worlds.


JIMMY MOORE: Do you think people have misunderstood your dietary recommendations based on what they have heard about the Ornish diet plan through the media?

DEAN ORNISH: Yes, they have because the only diet that I recommend that's a very strict low-fat diet is for reversing heart disease. In all five of my books since the very first one I wrote back in 1982, I've categorized foods into a spectrum of choices. If you're trying to reverse heart disease or as we found more recently in a randomized controlled trial the prevention of prostate cancer and by extension breast cancer in women, then a very low-fat diet is good for that.

So, it's the ounce of prevention or pound of cure. If you are trying to reverse the progression of an existing disease, then moderate changes just don't go far enough. But for most people you have a spectrum of choices. It's not even a diet, it's just a way of eating and a way of living, so if you indulge yourself one day it doesn't mean that you cheated on your diet.

Too often that brings on the shame and guilt that so often come with diets. If you just get back on the diet and lifestyle changes the next day, then your overall way of living is what makes the difference.

Unfortunately, people often think of the only diet I recommend is a much stricter diet because a lot of the publicity has come around the research that we've published and that is a stricter diet for the reversal of heart disease.


JIMMY MOORE: Let's get into that a little more. I recently an e-mail from Donna Platt from your Preventative Medicine Research Institute and she wrote to me in that e-mail that "not everything works for absolutely everybody" when it comes to diet. So you've already said that you agree there are many different ways. What are they?

DEAN ORNISH: I mean, nothing works all the time for everybody. But what's remarkable in our research is how consistently people did show improvements. The more closely the people followed the diet in our trials, the better they got independent of their age or progression of their disease. In fact, the oldest patient who was 82 at the time and is now 90 showed the most reversal. And we found the same pattern in five years as I previously stated.

Yes, it's true that there are individual variations, but what's so remarkable about all of our studies is how consistently people do show improvements to the degree that they make these changes. But not everybody needs to make changes so big. If you're not overweight and have no major health issues, then you don't need to be on such a strict diet like a 10 percent fat diet, for example.

But to the degree that you do, you're gonna look better, feel better, lose weight and gain health. It's not all or nothing, there is a full spectrum of choices. But if you are trying to reverse disease then it takes a lot more than if you are just trying to maintain your health and prevent it. If someone wants to lower their cholesterol levels, then they could begin by making moderate changes sufficient to lower their cholesterol. If that doesn't work, then they can make bigger ones so they can achieve those goals.


Be sure to come back for Part 2, Part 3, and Part 4 the rest of this week.

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20 Comments:

Blogger Newbirth said...

First he says, "This includes a very low-fat, whole foods diet, stress management techniques, various stretching, breathing, meditation and relaxation techniques, moderate exercise, smoking cessation, and support groups."

Ok, so a multi-pronged approach. Fine.

But then he says, "In our studies...we used high-tech, state-of-the-art measures to prove the power of this very low-fat diet."

So which is it - all the factors, or just the low-fat factor? Seriously, that's some serious doublespeak going on there. Very sad.

10/03/2006 12:32 AM  
Blogger Newbirth said...

He says, "You burn more calories by exercise and you can eat less calories either by eating less food which why on any diet when you restrict the amount of food you eat from entire food groups you can lose weight. But sooner or later people get tired of feeling hungry or deprived, they get off the diet and they gain the weight back. Or you can change the type of food (i.e. eating less fat) for reasons we just talked about."

Um....I though fat was a macronutrient (just as carbohydrates are), and one that his diet radically restricts. So on his diet do people "get tired of feeling hungry or deprived, they get off the diet and they gain the weight back"?

I'm going to stop. This is so full of contradiction that it would be funny if he weren't serious.

Someone tell me I'm not the only one who sees the problems in his interview.

10/03/2006 12:37 AM  
Blogger David said...

Great Interview Jimmy! I can't wait for me.

*whisper* There are a couple of typos in your preface!

10/03/2006 2:54 AM  
Blogger Invisible Blogger said...

was he reeking of sulfur, jimmy?

if you can, ask him to defend this quote:

Even a single meal high in fat and cholesterol makes your arteries constrict and your blood clot faster, and also it can use sexual dysfunction. Viagra was the most popular drug of all time last year because it's a big problem in this country. A number of studies have shown that when we eat a high-fat, high-animal protein diet, it's not just your heart that gets less blood flow.

10/03/2006 7:22 AM  
Blogger Jimmy Moore said...

Hey Newbirth, keep in mind that I'm not defending what he said, but Dr. Ornish kept repeating over and over again in his interview that the only part of his spectrum of dietary choices that is very low-fat is the one that reverses heart disease. In an upcoming segment of the interview I asked him about how much fat consumption is the limit and you can read his answer then. You MUST read his surprising answer.

THANKS for catching my typos, David. I was doing that around midnight and very sleepy. :) Fixed!

IB, the interview is done, but he was quite forthcoming about his beliefs on fat, cholesterol, and more. While I didn't ask him that specific question, I think you'll enjoy reading what he did say.

THANKS for your comments! Keep 'em coming!

10/03/2006 8:21 AM  
Blogger K. Dill said...

I think you guys are nit-picking to discredit Ornish because you disagree with his approach. Like him or not, he does get results and thats the bottom line. I wouldn't want to eat his very low fat diet, but If I were to have a heart attack, or diagnosed with advanced CVD, and I thought it would save my life, I'd damn sure give it try. "The Rules" for people in those situations may be very different, and a LC diet may not be best. Also, the diet most helpful to prevent/treat heart disease may be very different then whats best to treat/prevent T2 diabetes.

10/03/2006 9:12 AM  
Blogger Invisible Blogger said...

I dont know about people with heart disease, but I do know that after 4 years of eating very high fat and low carb, and despite my very high LDL (201! oh my!), and despite my atrocious diet before lc, a CT angiogram (done about a month ago) revealed that I have zero calcium, which translates to Zero plague. Also have low trig., high HDL, naturally...

btw, I am ashamed to admit, I tried Onrish's plan about 15 years ago. I did lose weight, but I was one miserable bastard. Smells of grilled fatty foods were everywhere (I live and work in NYC), driving me crazy. Sheer willpower kept me in the game for 6 months, but that was all I could take, and I ended up back on my eat anything I see diet. Luckiliy I found lc, and have been on it 4 plus years, and I see no end in sight.

In my opinion, lc is by far the superior approach, because 1) I can stick to it, 2) evolution! 3) it's good for the heart!

10/03/2006 9:59 AM  
Blogger Jimmy Moore said...

Hey IB,

You'll never believe what Dr. Ornish says about HDL and triglycerides. The word analogy he implores will make most low-carbers gag. Just thought I'd warn you ahead of time.

10/03/2006 10:23 AM  
Blogger Invisible Blogger said...

I know, I know... but I wont spoil the suspense. If it's the analogy I'm thinking of, Dr. Eades made fun of it a while back. btw, I came across the same nonsense on Dr. "disease-proof" Furhman's site.

10/03/2006 10:55 AM  
Blogger LCforevah said...

*Sigh* Good carbs, bad carbs. Granted that veggies have a better nutrional profile than bread and pasta, but in the end, they all turn to glucose. For those of us fighting prediabetes and full on diabetes, a vlc or zc WOE is the best, fastest way of aleviating the situation.

10/03/2006 2:02 PM  
Blogger Jimmy Moore said...

Yeah, I wasn't buying the whole "good carbs" argument he made. I'll be blogging about a related subject on that thought soon.

10/03/2006 2:57 PM  
Blogger Anne said...

Very cool interview Jimmy! I may not agree with Dr. Ornish but I'm glad to be able to hear the man himself out as opposed to getting second and third hand information.

I especially like this quote:

The diet that we're recommending is a low-fat, whole foods diet that is low in the bad carbs, low in sugar, white flour, white rice--that's something that Dr. Atkins and I agreed on. But high in fruits, vegetables, whole grains, legumes, soy products, which have a double benefit--they're rich in fiber and rich in at least a thousand other substances that are protective.

I'd love to see that become the take home message from every expert regardless of what side of the debate they're on. Hopefully it would cut through some of the confusion. Get rid of all the junk and eat as many whole foods as possible. After you do that then start investigating what approach works best for you.

10/03/2006 5:09 PM  
Blogger AnOldHouse said...

Jimmy,

I'm curious about how you conduct your interviews for your blog.

Is it on the phone or through a series of emails or both?

-David

10/03/2006 5:11 PM  
Blogger Jimmy Moore said...

Great question, David. Most of my interviews are done via e-mail because that's most convenient for people. Dr. Ornish has been the lone exception because of the constraints on his time due to his busy schedule. I gladly took the time to set up the time to do it, conduct the 45-minute interview and tape it, transcribe the entire 45 minutes which took me about 7 hours and then edit it for posting on my blog. I think it will be worth it when you see the whole thing. THANKS for reading, David!

10/03/2006 5:50 PM  
Blogger LCforevah said...

Aaaaak ! I forgot the soy! Nobody should be eating soy--not even livestock--it causes problems for every kind of livestock it has been fed to, and I don't have the links right now. I think the westonprice site has some info.

Also for the guys--that stuff is estrogenic--not good if you already have hormonal problems from obesity and diabetes--and why would you want to instigate problems if you don't have any?

10/03/2006 6:22 PM  
Blogger helenmas said...

Ditto to what icforevah said a great site for all things related to soy is
www.soyonlineservice.co.nz

Soy, Trans-fats & sugar are probably the 3 biggest poisons masquerading as food in the entire world.

10/03/2006 7:49 PM  
Blogger Newbirth said...

IB,

I think I know the HDL analogy, too, if it's the same one on Eades' site. And Dr. Eades' gave a good rebuttal. :)

Hey, Ornish has to say these things because his approach LOWERS HDL!

10/03/2006 9:49 PM  
Blogger Rob said...

Evah is correct. Soy is the worst stuff. It's an allergen for many people, and the protein is practically useless.

People like Ornish are living examples of the Big Lie technique. Lie enough and eventually people will believe it.

10/04/2006 5:27 PM  
Blogger George Mead said...

How does Dr.O reconcile "Whole foods" and "soy products"? Promoting "soy products" as health foods is just as dishonest as doing the same for tobacco, alcohol & HFCS.

10/06/2006 3:42 AM  
Blogger Lonely Street Cafe said...

Dr. Ornish makes some very interesting points in his books - one of the things I like best about his philosophy is that he makes the mind-body connection and places a great deal of importance on stress reduction. If we "ate clean", although not necessarily "lean and clean", moved our bodies and spent time refueling our mental batteries, we'd all be better off IMHO.

10/22/2007 7:32 PM  

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