Other large observational studies have found that diets high in fat and protein are not associated with disease and may even protect against it. They concluded, A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates. Another major research article studied 43,396 Swedish women over 15 years. Ornish D, Pettengill E, Merritt-Worden T. Marked improvements in biomedical and psychosocial cardiac risk factors from a community-based lifestyle program. A person is likely to lose more weight by reducing intake of both simple carbohydrates and fat than from simple carbohydrates alone. WebNo two doctors represent opposite sides of THE DIET WAR spectrum better than Dr.s Atkins and Ornish. So theres little evidence to suggest that we need to avoid protein and fat. To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables. Comparison of the Atkins, Ornish, Weight Watchers, and JAMA. The Diet Fight: Atkins Vs. Ornish - RetailWire (PDF) Terminologija/Terminology 27 - Academia.edu 4) Dr. Below is my letter to the editor of The New England Journal of Medicine that they published about this study: Protein, too, doesnt look so evil when one considers the 2010 trial published in The New England Journal of Medicine that found individuals who had recently lost weight were more likely to keep it off if they ate more protein, along with the 2005 OmniHeart trial that reported individuals who substituted either protein or monounsaturated fat for some of their carbohydrates reduced their cardiovascular risk factors compared with individuals who did not. This study was widely reported and caused many to say, See, another study showing that the Atkins diet is good for your heart. It sounds good, but it is not true. CLAIMS THAT AN ATKINS DIET IS BETTER THAN A LOW-FAT DIET. She wrote about the reasons that autoimmune diseases overwhelmingly affect women in the September 2021 issue. Solved 7. Dr. Dean Ornish and Dr. T. Colin Campbell have - Chegg Even better would be to reduce the intake of simple carbohydrates and most fats, which results in losing even more weight while enhancing health rather than potentially harming it. Ornish represented the other viewpoint with his fruits, veggies, and sharp criticisms of Atkins. Its possible that quitting smoking, exercising and stress management, without the dieting, would have had the same effectbut we dont know; its also possible that his diet alone would not reverse heart disease symptoms. Atkins Nutritionals, Inc. For example, an important article, published in The New England Journal of Medicine, reviewed data showing that high-protein, low-carbohydrate diets promote coronary artery disease independent of their effects on traditional risk factors such as blood pressure and cholesterol levels. 2003;348:2082-2090. USDA data also show (pdf) that between 1970 and 2005 U.S. consumption of saturated fatrich butter and lard as well as hydrogenated shortening decreased 17 percent. 2001;291:2536-2545. Atkins R, Ornish D. Cardiology Crossfire. American College of Cardiology 50th Annual Scientific Sessions, Orlando, FL, March 20, 2001. Liu S, Stampfer MJ, Hu FB, et al. You can lose weight without feeling hungry or deprived. Am J Clin Nutr. When people dutifully cut down on fat in the 1980s and 1990s, they replaced much of it with high-sugar and high-calorie processed foods (think: Snackwells). The Framingham risk score is calculated from age, sex, total cholesterol, HDL, smoking, and systolic blood pressure (46). MAIN OUTCOME MEASURES: The USDA tracks changes in consumption of the entire food supply. This reduction in LDL-C is much greater than on an Atkins diet and is comparable with the effects of statin drugs. A related study by this group looked at 85,168 women and 44,548 men without heart disease, cancer or diabetes from the Nurses Health Study and the Health Professionals Follow-Up Study. The level of LDL-C is regulated by the LDL receptor, a cell surface glycoprotein that removes LDL from plasma by receptor-mediated endocytosis (27). SUBSTITUTE SIMPLE WITH COMPLEX CARBOHYDRATES. Over and over, Ive seen patients with coronary heart disease so severe that they cant walk across the street or work or play with their kids or make love or do much of anything without getting severe chest pain become pain-free after only a few weeks of making these diet and lifestyle changes. Fourth, the Gardner study did not really test very much of anything, other than its hard for many people to change their dietsany dietfrom just reading a book. Weight loss at 12 months was the primary outcome. The case for a low-fat, highcarbohydrate diet. Ornish begins his piece with a misleading statistic. RAISING AND LOWERING HDLBENEFICIAL OR HARMFUL? Am J Cardiol. 2001;4:171-177. Dean Ornish, MD, is founder and president of the non-profit Preventive Medicine Research Institute and is Clinical Professor of Medicine at the University of California, San Francisco. She completely misrepresents my recommendations: carbohydratesone of the nutrient groups Ornish says we should eat more ofincreased. Ive always recommended that people limit their consumption of sugar and other refined carbohydrates. However, reducing dietary fat and cholesterol may cause a decrease in HDL-C because there is less need for it. 2002;40:265-274. Moyers article only adds to that confusion. If his diet worksand again, we dont know for sure that it doesis that because it reduces protein or fat or refined carbohydrates? How might a mans reproductive health concerns change at different periods of his life? Other studies have documented that an AHA/NCEP diet is not very effective in lowering LDL-C (21). An example of the half-truth of saying that anything that raises HDL-C is beneficial whereas anything that lowers it is harmful came at the November 11, 2003 annual scientific session of the American Heart Association. Stefanick ML, Mackey S, Sheehan M, Ellsworth N, Haskell WL, Wood PD. Atkins Is Better Than Ornish, Stanford Study Says. Third, shes confusing the USDA data (which I cited in my oped) and the National Health and Nutrition Examination Survey (NHANES) data (which looked at the percentage of calories). Mean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), and Ornish, -2.2 kg (-3.6 to -0.8 kg). Dean Ornish, MD
After 1 year, there was a 52% decrease in LDL-C on the 10% fat diet compared with a 6% increase in LDL-C on the Atkins diet (33). The New York Times Sunday Magazine, July 7, 2002. Am J Clin Nutr. Taubes G. The soft science of dietary fat. 2002;76:535-540. Explore our digital archive back to 1845, including articles by more than 150 Nobel Prize winners. Let us know if you have suggestions to improve this article (requires login). Based on his experience caring for patients, Atkins thought that the things that were relegated to the narrow point of the food pyramidmeat, eggs, cream, and cheesewere the healthiest. Dean Ornish, MD, is founder and president of the non-profit Preventive Medicine Research Institute and is Clinical Professor of Medicine at the The diet I recommend is low in refined carbohydrates and low in harmful fats (including trans fats, hydrogenated fats and some saturated fats) and low in animal protein (particularly red meat) but includes beneficial fats (including omega-3 fatty acids), good carbs (including fruits, vegetables, whole grains, legumes and soy in their natural, unrefined forms) and good proteins (predominantly plant-based). So when Ornish wrote in his oped that for reversing disease, a whole-foods, plant-based diet seems to be necessary, he is incorrect. Plus, discouraging the intake of entire macronutrient groups can backfire. Westman EC, Yancy WS, Edman JS, et al. Available at: http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof . WebIn this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more Diet was assessed by validated food frequency questionnaires and updated every four years. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. All consumption estimates are imperfect, of course, including the U.S. Department of Agriculture (USDA) data he cites. That year Ornish also founded the nonprofit Preventive Medicine Research Institute (PMRI) in nearby Sausalito. Dietary cholesterol and saturated fats increase plasma LDL-C in part by down-regulating LDL receptors in the liver (28). JAMA. The corresponding HRs (95 percent CIs) were 1.18 (1.131.23) and 1.21 (1.131.31) for CVD mortality and 1.10 (1.061.14) and 1.16 (1.091.23) for cancer mortality. In our randomized controlled Lifestyle Heart Trial, HDL cholesterol did not increase but patients showed regression of coronary atherosclerosis after one year, even more improvement after five years, and a 300 percent improvement in myocardial perfusion (blood flow to the heart) as measured by cardiac PET scans. Goldstein JL, Brown MS. Cholesterol and cardiovascular disease. I believe the low-fat message promoted the obesity epidemic, says Lyn Steffen, a nutritional epidemiologist at the University of Minnesota School of Public Health. HDL-C decreased 9% from 40.0 to 36.3 mg/dL after 1 year, yet these patients showed clear improvement in coronary atherosclerosis, myocardial perfusion, and cardiac events. 1968;2:702-703. The diet limited fats to 10 percent of total caloric intake and cholesterol to only 5 mg a day, mainly through eliminating animal products and processed foods. Only total cholesterol and HDL changed in this study, so these were the only factors in determining the risk score. However, CHD patients who followed a 10% fat, whole foods diet demonstrated significant regression of coronary atherosclerosis after 1 year as measured by quantitative coronary arteriography (37) and even more regression after 5 years (the amount of exercise was not significantly different between groups, but the experimental group was also practicing yoga and meditation) (32). We documented significant improvements in the hearts function after only 24 days compared with a randomized control group. For instance, he wrote that animal proteins have been associated with higher disease and mortality risks in observational studies. This article was most recently revised and updated by, https://www.britannica.com/biography/Dean-Ornish, American Entertainment International Speakers Bureau - Biography of Dean Ornish, Ornish, Dean - Student Encyclopedia (Ages 11 and up). The mechanism of the effects on HDL-C levels of changing from a high- to low-fat diet differs substantially from the mechanism explaining the differences in HDL-C levels between individuals who are eating a high-fat diet. Bazzano and her associates concluded that going on a low-carb diet is better than a low-fat one for those wishing to lose weight. In summary, decreases in HDL-C due to a low-fat diet have a very different prognostic significance than someone who cannot raise HDL-C as much on a high-fat diet. Ornish D. Dr. Dean Ornishs Program for Reversing Heart Disease. Not exactly. Blind Taste Test: Atkins vs Quest Protein Chips Nacho Cheese A randomized trial of a low-carbohydrate diet for obesity. National Institutes of Health. This optimal diet is based predominantly on fruits, vegetables, grains, and legumes in their natural, unrefined forms. Comparison of the Atkins, Zone, Ornish, and LEARN Diets Fleming R, Boyd LB. 1993;328:1213-1219. Fourth, the patients in our randomized controlled trial (JAMA. Only one person in the experimental group of the Lifestyle Heart Trial was smoking at baseline, so its unlikely that made a significant difference. OBJECTIVE: Also, C-reactive protein and creatinine clearance were significantly lowered only on the Ornish and Weight Watchers diets. Boston: W.B. But fact that the participants were making all of these lifestyle changes means that we cannot make any inferences about the effect of the diet alone. Peyreigne C, Bouix D, Aissa Benhaddad A, et al. Dr Atkins advocated substituting simple carbohydrates with high-fat, high-animal protein foods such as bacon, sausage, butter, steak, pork rinds, and brie. This is why I use the USDA data (which tracks consumption of the entire food supply, not just a tiny sample). Another meta-analysis of 21 studies found no association between saturated fat intake and heart disease. WebDean Ornish and Dr. T. Colin Campbell have conducted research and published books that suggest a "Whole Food Plant-Based" (WFPB) diet is best for achieving optimal health. 1998) showed an average reduction of 24 pounds in the first year. (In contrast, the recommendations of the American Heart Association allowed up to 30 percent of total calories from fat and 300 mg of cholesterol daily.) Therefore, diet-induced changes in HDL-C levels correlate with and may result from changes in apo A-I transport rate. By planning to improv Science. Despite being told to eat less fat, he says, Americans have been doing the opposite: They have actually consumed 67 percent more added fat, 39 percent more sugar and 41 percent more meat in 2000 than they had in 1950 and 24.5 percent more calories than they had in 1970. Yes, Americans have been eating more fat, sugar and meat, but we have also been eating more vegetables and fruitsbecause we have been eating more of everything. (Also: the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does.) Total fat and animal fat intake were higher and carbohydrate intake was lower in those with recently diagnosed diabetes or previously undiagnosed diabetes in the multinational, multicenter study of the Mediterranean Group for the Study of Diabetes (17). The participants all had trouble adhering to their regimens, but all lost about the same statistically significant amounts of weight, and when compared head to head, the Atkins dieters saw greater improvements in blood pressure and HDL cholesterol than the Ornish dieters did. Hemorheologic effects of a short-term ketogenic diet. His famous 1990 Lifestyle Heart trial involved a total of 48 patients with heart disease. History tells us its not going to be spinach. But his claims about the dangers of saturated fat and red meat go beyond the science and in some cases contradict it. The other problem with Ornishs antiprotein stance is that he lumps all animal proteins together. Pereira MA, Jacobs DR Jr, Pins JJ, et al. As all dietetics professionals know, there is no mystery in how to lose weight: burn more calories and/or eat fewer calories. In contrast, the NHANES data is from surveying only a small sample of people nationwide, so its less reliable. N Engl J Med. Armstrong ML, Warner ED, Connor WE. All three diets reduced blood pressure, total and low-density lipoprotein cholesterol levels, and estimated coronary heart disease risk. And the 10 percent reduction in carbohydrate in the higher protein diet and the higher unsaturated fat diet was achieved by replacing some fruits with vegetables, reducing sweets and using smaller portions of refined grain products. Popular diets, particularly those low in carbohydrates, have challenged current recommendations advising a low-fat, high-carbohydrate diet for weight loss. And it is worth noting that among people in the study over 65, heavy consumption of animal protein actually protected against cancer and mortality. (An adult who consumes two tablespoons of olive oil in, say, a portion of salad dressing has already exceeded getting 10 percent of his days calories from fat if hes eating 2,000 calories daily.). The abstract clearly states, Respondents aged 5065 reporting high protein intake had a 75 percent increase in overall mortality and a fourfold increase in cancer death risk during the following 18 years. Guidelines on diet, nutrition, and cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity. WebIn contrast to these studies, and most others, on the lack of influence of calcium intake on fracture risk, the authors of this study conclude calcium is the problem and this is based on findings in only 74 people with fractures following a vegan diet. For 37 years he has been touting the benefits of very low-fat, high-carbohydrate, vegetarian diets for preventing and reversing heart disease. 1988;81:300-309. 1990;336:129-133. Bill Clinton from 1993 to 2000 and served on the White House Commission on Complementary and Alternative Medicine Policy in 200102. The fact that not all studies have shown this risk does not mean that it is not true. One-year effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in decreasing body weight and heart disease risk. 2003;348:2057. Atkins Thus, by eating less fat, you reduce calories by reducing energy density without having to reduce volume. Corrections? BACKGROUND: Both eating plans recommend avoiding saturated fat from animal proteins and full-fat dairy. I feel passionately about doing this work because it helps transform peoples lives for the better. If you know or suspect that you have a health problem, consult a health professional. The percentage of calories from fat has decreased, but the amount of fat consumed has increased (6). Whats more relevant to the discussion is this fact: During the time in which the prevalence of obesity in the U.S. nearly tripled, the percentage of calories Americans consumed from protein and fat actually dropped whereas the percentage of calories Americans ingested from carbohydratesone of the nutrient groups Ornish says we should eat more ofincreased. The Atkins Diet plan and the Dean Ornish diet are both established and popular diet plans. DISTINGUISHING BETWEEN RISK FACTORS AND ACTUAL MEASURES OF DISEASE. Knight EL, Stampfer MJ, Hankinson SE, et al. As Moyer indicates here, the 2014 meta-analysis showed higher mortality risks associated with both processed meat and unprocessed meats. Dietary fat intake as risk factor for the development of diabetes: Multinational, multicenter study of the Mediterranean Group for the Study of Diabetes (MGSD). The point here is not that Ornishs dieta low-fat, whole food, plant-based approachis necessarily bad. A critique of the diet guru's views on high-protein diets, followed by a response from Ornish and a reply from the author. Ornish studied the effects of a similar regimen on prostate cancer patients and in 2008 concluded that adherence to the lifestyle changes recommended by the program slowed progression of the cancer. All evidence is to the contrary. The Lifestyle Heart Trial. Ornish D. The case for low fat. An AHA/NCEP 30% fat diet reduces LDL-C by only about 5% to 7% in most patients (22-24). In our debates, Dr Atkins often claimed that his diet can reverse coronary heart disease (CHD) but never published any peer-reviewed data to support this assertion, nor has anyone else, including advocates of similar diets such as the Zone and the South Beach diets (34). CA Cancer J Clin. Prev Cardiol. They lost 24 pounds during the first year and kept off more than half of that weight 5 years later and had 2.5 times fewer cardiac events than the control group. For those simply trying to lose weight or lower their risk factors moderately, less extensive changes may be required. Omissions? Thanopoulou AC, Karamanos BG, Angelico FV, et al. The decrease in the percentage of calories from fat during the period 1971 to 1991 is attributed to an increase in total calories consumed; absolute fat intake in grams actually increased. In another study, 100 people were randomly assigned to one of four diets for 1 year: an Atkins diet; a 30% fat diet; a 15% fat, calorie-controlled diet; or a 10% fat, whole foods diet with an emphasis on complex carbohydrates. For someone trying to reverse heart disease, for example, the diet needs to be rather strict to accomplish this. Join the hundreds of thousands in my email community for the latest news, insight, and more, Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, Kraemer HC, King AC. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. These surges may cause a reactive hypoglycemia, increasing hunger and a desire to eat more simple carbohydrates in a vicious cycle, sometimes called carbohydrate cravings. In addition, excessive insulin enhances the growth and proliferation of arterial smooth muscle cells, promoting atherosclerosis (9). 1994;1:283-286. WebDean Ornish, in full Dean Michael Ornish, (born July 16, 1953, Dallas, Texas, U.S.), American physician and author whose approach to treating heart disease through radical Some colleagues claimed that the admonitions of his program were entirely unrealistic and that patients not under supervision would in all likelihood return to their previous, unhealthy habits. N Engl J Med. Ornish wrote several popular books, including Stress, Diet, and Your Heart (1982), Dr. Dean Ornishs Program for Reversing Heart Disease: The Only System Scientifically Proven to Reverse Heart Disease Without Drugs or Surgery (1990), The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health (2007), and Undo It! Was Dr. Atkins Right? Science. Am J Clin Nutr. Available at: http://www.americaonthemove.org/. After multivariate adjustment for major lifestyle and dietary risk factors, the pooled hazard ratio (HR) (95 percent CI) of total mortality for a one-serving-per-day increase was 1.13 (1.071.20) for unprocessed red meat and 1.20 (1.151.24) for processed red meat. Urinary excretions of calcium and acids are correlated positively with intakes of animal and nondairy animal protein but are correlated negatively with plant-protein intake (53). As stated earlier, a low-fat, whole foods diet has been proven to reverse heart disease using actual measures of coronary atherosclerosis and myocardial perfusion, whereas none of the other three diets has been shown to do so. Web3) Dr. Ornish focuses on the fact that eating eating vegetable diet can reduce weight loss. Presented at the American Heart Association Annual Scientific Sessions, Orlando, FL, 2003. 2001;73:1010-1018. Diabetes mellitus, hypoglycemia, and other endocrine disorders. Hu JF, Zhao XH, Parpia B. Dietary intakes and urinary excretion of calcium and acids: A cross-sectional study of women in China. Updates? Ornish D. A diet rich in partial truths. WHAT IS THE EVIDENCE THAT COMPLEX CARBOHYDRATES ARE BENEFICIAL? Stout RW. In a larger study of almost 3,000 patients who went through my lifestyle program in 24 hospitals and clinics, BMI (body mass index) decreased by 6.6 percent. WebMean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), Foster GD, Wyatt HR, Hill JO, et al. He received an M.D. 1993;58:398-406. It is all about energy balance. Your body excretes toxic substances through your bowels, breath, and perspiration, so this is not surprising. Regulation of low-density lipoprotein receptors: Implications for pathogenesis and therapy of hypercholesterolemia and atherosclerosis. In my numerous debates with Dr Atkins, we agreed that many Americans eat excessive amounts of processed foods high in simple carbohydrates, including sugar, high-fructose corn syrup, white flour, white rice, and alcohol. The results of the trial, published in 1990, revealed that at least some effects of coronary atherosclerosis had been reversed in many patients. Yet as I read this article, I cant help but to find amusement in . David Perlmutter, MD, FACN is a board-certified neurologist, Fellow of the American College of Nutrition, and five-time New York Times bestselling author. Nutrition is complex but there is little evidence our countrys worsening metabolic ills are the fault of protein or fat. (This lack of association is notable because this analysis probably overestimates risks associated with red meat consumption; all but two of the studies it assessed lumped processed meats into the red meat category.)
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