With all the focus in recent years on high-protein/low-carb diets (such as Atkins, South Beach, and Dukan)—and now on “good” fats (as in the Mediterranean diet)—what ever happened to the Ornish diet, which promotes very-low-fat, high-fiber, high-carb foods? Is it still considered a healthful way to eat today as it was in the 1990s, when it was all the rage for heart health?
The short answer is yes. And as researchers have been discovering, the diet may have benefits beyond the heart as well.
More than a diet
The “Ornish diet” is actually a lifestyle program that has four components. It was developed by Dr. Dean Ornish, who is the president of the nonprofit Preventive Medicine Research Institute, a clinical professor of medicine at UC San Francisco, and a well-known author and lecturer. The nutrition part is a plant-based diet that consists of fruits, vegetables, whole grains, and legumes (soy in particular), with an emphasis on whole unprocessed foods. In its strictest form, animal protein is limited to egg whites and nonfat dairy foods, and there are no added oils. Less than 10 percent of calories come from fat.
The other three key elements are moderate exercise (such as brisk walking, at least three hours a week), stress management (such as yoga and meditation, one hour a day), and social support (connecting with others helps keep us well).
Since its earlier days, the program (now referred to as the Ornish Spectrum) has undergone a modest facelift: Depending on your goals, you can now select from a “spectrum” of food categories, ranking from most to least healthful. Some people, for example, may choose to include fish, vegetable oils, or even some pasta, white rice, and sweets on occasion.
Not surprisingly, like other plant-based diets, Ornish is rich in vitamins, minerals, antioxidants, and fiber, and low in saturated fats and cholesterol—especially compared to high-protein/low-carb diets. One study found that men following an Ornish-like diet (very low-fat and vegan) consumed 59 grams of fiber a day, on average (compared to 16 grams in the typical American diet) and lowered their saturated fat intake from 20 to 5 grams a day. But the diet also tends to be lower in other nutrients that are predominantly found in animal foods, like vitamin B12 and zinc—which is why the Ornish Spectrum recommends a multivitamin.
Dr. Ornish’s research in the 1990s showed that his integrative lifestyle approach not only treats coronary artery disease, it can, like statin drugs, also promote regression of plaque in arteries. Some people who followed it for a year reversed arterial blockage by 10 percent, which should result in a significant reduction in heart attacks and strokes.
Research over the last few years supports the earlier findings. For example, in a study in the American Journal of Cardiology in 2011, people with heart disease, diabetes, or cardiac risk factors who followed the Ornish program for three months had significant improvements in blood cholesterol, blood sugar, blood pressure, quality of life measures, and even cognition. And a 2008 study in the same journal found that most people with heart disease who followed the program became angina-free.
As with other low-fat vegetarian diets, HDL (“good”) cholesterol drops along with LDL (“bad”) cholesterol on the Ornish diet, though this doesn’t adversely affect cardiovascular health, according to a 2009 review.
Since 2011, Medicare has covered the Ornish program for people who have had a heart attack within the previous year or have other cardiac conditions or risk factors. This intensive cardiac rehab program, provided by certified health care professionals, is offered in several states, with plans to expand. Some private insurers also cover it.
Still, the diet part of the Ornish program has not been compared to other diets. It’s possible that the same benefits would occur with any healthy diet that is combined with exercise, stress reduction, and social support.
The challenge: sticking to it
Even if the Ornish diet hasn’t been the talk of the diet town of late, that doesn’t mean it has been off the radar. U.S. News & World Report rated it the #1 “Best Heart-Healthy Diet” out of 35 popular diets in its 2015 rankings. Unfortunately, it was also ranked #29 in “Easiest Diets to Follow.”
No diet is easy, but this one presents even more challenges, since, in its original form at least, it is so rigid and extreme—and the lack of fat and lower protein intake may make it less satisfying and thus harder to stick to. And of course, much of the benefit may come from the non-diet elements—the exercise, stress reduction, and social support— which require even more commitment and perhaps some one-on-one instruction.
If you have coronary artery disease, the closer you stick with the program, the better. If your goal, however, is to maintain general good health and maybe lose a few pounds (see inset), you can be more moderate in your approach and include more heart-healthy fats, such as those from fish, nuts, olive oil, and avocados. In essence, that would be more in line with a heart-healthy Mediterranean diet, which ranked #3 in “Easiest Diets to Follow.” For more information on Ornish, go to the Ornish Spectrum website.
Published January 06, 2015