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The Power of Personalized Lifestyle Changes

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Physical Effects of Lifestyle Dr. Ornish decided to investigate the impact of lifestyle changes on heart disease. With a series of studies he was able to show that even severely blocked arteries can become less clogged, simply by changing diet and lifestyle. He tracked patients who were making significant changes, as well as a control group that was making moderate changes, for five years. The study group showed some improvement after just a year and significant improvement after five years—while the disease continued to progress in the control group. Logic might dictate that younger patients with less severe disease would be more likely to show improvements; however, the age or general

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ost of us typically think of advances in medicine as something like a new drug or a laser—high-tech and expensive. Would you believe how we eat, how we respond to stress, how much exercise we get and how much love and intimacy we have in our lives profoundly affects our overall health? These things, to which we often give little consideration, actually have a powerful impact on how long and how well we live. Dr. Dean Ornish is the founder of Preventative Medicine Research Institute, a nonprofit organization in Sausalito, California. He has been a clinical researcher for the past 33 years and has authored numerous books, four of which have been on the New York Times best-seller list. We were lucky to have him deliver a keynote presentation at our 2012 Symposium in Laguna Niguel, California. Early in his career, while learning how to perform heart bypass surgery, Dr. Ornish noticed that following this surgery, heart patients often continued unhealthy habits like sitting on the couch, eating junk food and smoking. Before too long, they would end up back in the operating room and he was bypassing the previous bypass, sometimes multiple times. This procedure became a metaphor to Dr. Ornish for all the things the medical profession is doing wrong. Technology can be life-saving in a crisis, but we also need to get to the root cause of the problem. When we treat the cause, the body often has a remarkable capacity to quickly heal itself.

health of the patients didn’t seem to matter. Dr. Ornish realized that the more people changed their diet and lifestyle, the more they improved. This was true after one year and after five years. Seeing such significant effects on heart disease, Dr. Ornish decided to research the impact of diet and lifestyle changes on prostate cancer. He collaborated with two other physicians to study men who, for reasons unrelated to the study, had decided against treatment. This led to the obvious question—why would someone with cancer decide against treatment? Dr. Ornish shared some frightening statistics on prostate cancer. Only 1 in 50 men who undergo surgery, radiation or chemotherapy for prostate cancer actually benefits from the treatment they receive. The other 49 become impotent, incontinent or both, with no measurable benefit. Dr. Ornish and his colleagues followed two non-treatment groups—one made up of patients who followed the lifestyle changes Dr. Ornish suggested and the other with men who made no changes. After one year, the group following Dr. Ornish’s program had PSA (prostate-specific antigen) levels lower than when they started. The group without changes showed higher PSA levels. They found, again, the more people had changed their diet and lifestyle, the more they lowered their PSA levels. Dr. Ornish and his colleagues also looked into the tumor growth and found it to be inhibited by 70% in the group with lifestyle changes. They looked at the genetics of the patients in this study and found gene expression in over 500 genes to be beneficially affected. Genes that prevent disease were upregulated and genes that produce cancer were down-regulated. These changes were apparent after only three months. Dr. Ornish shared the results of a study done at Harvard on the effect of meditation on genes. Similar to the study of men with prostate cancer, researchers noted genes promoting health were up-regulated and the ones promoting disease were down-regulated after just eight weeks of regular meditation. Many people often think because they have “bad genes” they are destined for disease, but Dr. Ornish pointed out that science now shows our genes are not our fate. It is easy to succumb to feelings of stress and anger. Most of us don’t realize the negative effect this has on our bodies. Regular meditation

SYMPOSIUM SYNOPSIS

Symposium 2012: Dr. Dean Ornish




can quiet the mind and body to create a sense of inner peace that helps us focus and enables us to perform better in whatever we do. Elite athletes often use meditation and visualization techniques to gain the mental edge against other world-class competitors. Dr. Elizabeth Blackwell is a researcher who won the Nobel Prize for her work discovering the enzyme telomerase. This enzyme lengthens and repairs our telomeres, which are the ends of our chromosomes that control aging. As telomeres shorten, life also gets shorter. Blackwell found that women who were under chronic emotional stress had lower levels of telomerase and shorter telomeres. Her study was the first to show that chronic stress can actually shorten your life, even on a genetic level. The more stress someone feels, the greater the effect. Dr. Ornish met Dr. Blackwell at a conference and they decided to research the effect of lifestyle changes on telomerase. They found after only three months of lifestyle changes, telomerase increased by 30%. Even more remarkable, they are about to publish data showing that after five years of lifestyle changes the telomeres themselves were actually longer when compared to the control group. Our genes are not our fate. They are a predisposition, but we can override that when we make positive choices in our lives.

Sustainability



Most people decide to change their diet and lifestyle either after some major health issue, like a heart attack, or out of fear of something horrible, like cancer, happening in the future. One of the reasons diets typically don’t work is because fear is really not a sustainable motivator. People who go off of a diet often feel like a failure. Shame, guilt, anger and humiliation are the most toxic emotions. Most people who make the changes Dr. Ornish suggests find themselves quickly feeling so much better that the reasons for making the changes shift from risk-factor reduction or fear of dying to joy of living. Dr. Ornish doesn’t label foods as good or bad. He has categorized them into five groups—group five contains the unhealthiest foods and group one contains the healthiest foods. To the degree that we can move in a healthy direction we are going to look better, feel better, lose weight and gain health. Followers of his system can personalize their own way of eating based on individual needs, genes and preferences.

Nutrition Advice Dr. Ornish shared the following overview of his program: s s s

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#ONSUMEMOSTLYPLANTSˆVEGETABLES fruits, whole grains, legumes and soy products in their natural forms. 5SEMEATONLYASAmAVORINGORSPECIAL occasion food. #ONSUMEFOURGRAMSPERDAYOFlSH oil. This can reduce your risk of sudden cardiac death by up to 80%. It reduces the risk of colon cancer, prostate cancer in men and breast cancer in women. #ALORIESCOUNT /RGANICISBETTERˆINTASTEANDHEALTH #HOOSEQUALITYOVERQUANTITY 7HATYOUINCLUDEISASIMPORTANTASWHAT you exclude. 2EDUCEINTAKEOFTOTALFATSˆSATURATED hydrogenated and trans. 2EDUCEINTAKEOFSUGARANDRElNEDCARBOhydrates in their various forms.

Refined carbohydrates cause insulin spikes. It’s better to eat vegetables, fruits and whole grains that are rich in fiber. These foods will fill you up faster so you don’t need to eat as much and they don’t cause drastic swings in insulin. Chronic insulin spikes cause an acceleration of the conversion of calories into body fat, promote chronic inflammation and lead to insulin resistance and metabolic syndrome by raising triglycerides and lowering HDL. Insulin resistance also promotes heart disease and cancers of the breast, prostate and colon.

Diet and World Issues Our food choices affect more than just our health—they also contribute to the energy crisis. Twenty percent of the fossil fuels burned in the US are used in the production of processed foods. It takes ten times more energy to produce animal-based proteins than plant-based proteins. Our diet also contributes to global warming. Livestock accounts for 18% of the world’s total greenhouse gas emissions. The entire global transportation system accounts for only 13% of global greenhouse gas emissions. What we eat also has a profound effect on our health crisis. In the United States we spend $2.5 trillion annually on healthcare. Chronic disease care accounts for 75% of that figure and much


of this could be prevented or even reversed by changing diet and lifestyle. The CEO of Safeway approached Dr. Ornish in 2005 because Safeway was spending 120% of its net revenue on healthcare for employees. Dr. Ornish implemented many of his principles at Safeway work sites and, in the first year, healthcare costs went down by 11% and have remained flat since then. Highmark Blue Cross Blue Shield began covering the program as well as providing it to their own employees at 24 different sites and found their costs cut in half in the first year. In 1994, Dr. Ornish began a dialogue with Medicare about the benefits of his program. They initiated a review process that finally, on January 1, 2011, resulted in Medicare covering the Ornish program of comprehensive lifestyle changes for reversing heart disease. This is the first time Medicare has covered lifestyle changes as treatment and many other insurance companies are following their lead. Dr. Ornish is working to create a new paradigm of medical care that is more caring and compassionate.

Support Sadly, the number one prescription drug for the last 10 years has been anti-depressants. Depression is more than simply feeling sad or blue. People who are depressed truly believe they are seeing things clearly for the first time and that things are bad, they’ve always been bad and anytime they may have thought things were good they were only fooling themselves. Dr. Ornish shared the story of his own experience with depression when he was a freshman in college struggling with his medical prerequisites. Knowing he had to pass his classes to become a doctor, he began to worry. The more he worried, the harder it was to study and he found himself caught in a vicious cycle. He believed he was never going to amount to anything because he was stupid and even if he did manage to be successful, nothing would bring lasting happiness, so the situation was hopeless and he was going to kill himself. While contemplating methods to carry out his plan, he became so run down from lack of sleep that he wound up with mononucleosis and had to go to his parents’ home to recover. Dr. Ornish’s sister had been studying yoga and while he was home his parents hosted a gathering for the Swami who had been teaching her this discipline. The Swami gave a short lecture for the

people in attendance. He opened by saying that nothing can bring you lasting happiness. This statement resonated deeply with Dr. Ornish at the time. The Swami had validated his belief that he would never be happy. But the Swami then said that happiness is something we all have already. Our nature is to be happy and peaceful. We wind up running around looking for these things and disturbing the happiness we already have. All of these spiritual practices, whether they are religious, secular, yoga-based or whatever, don’t bring you happiness. They quiet and focus your mind and body so you can experience what is already there. Dr. Ornish decided to begin studying with the Swami—he could always go back to Plan B and kill himself later. The practice helped him. He went back to school and wound up graduating first in his class. Studies have shown depression not only affects the quality of your life, but also how long you live. Depression, loneliness and isolation increase mortality between three and seven times. Dr. Ornish shared a study published in The Journal of the AMA of patients who had experienced a heart attack. Of the heart patients who said they were depressed, 18% were dead six months later. Of the group who were not depressed only 3% had died after six months. That is a six-fold increase in mortality six months after a heart attack—independent of their diet, cholesterol, whether or not they smoked or any other normal risk factors. The only variable was depression. Often, doctors don’t even ask their patients if they are depressed and are missing this information that has a tremendous effect on recovery. The need for love and intimacy is fundamental. Intimacy and understanding brings healing. All religions and spiritual traditions have altruism, forgiveness, compassion and love in common. Creating connection and community in our lives brings with it powerful healing. Dr. Ornish left us with one last piece of advice. Dentistry is already ahead of the medical profession in its focus on prevention. However, as healthcare professionals, we have a unique opportunity to make a real difference in the lives of our patients that goes well beyond their oral health. He suggested taking a few extra minutes with patients to ask about what’s happening in their lives. Making people feel valued, understood and accepted can have a profound impact on their mental and physical health.




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