Pros & Cons
- Solid nutritionally
- Your heart will love you
- Staying the course could be tough
- Not exactly cheap
Do's & Don'ts
|Weight Loss Short-term|
|Weight Loss Long-term|
|Easy to Follow|
|For Heart Health|
Scores are based on experts' reviews
Resembles these U.S. News-rated diets:
Variable. Can be tailored to losing weight, preventing or reversing diabetes and heart disease, lowering blood pressure and cholesterol, and preventing and treating prostate or breast cancer.
It’s scientifically proven to make you “feel better, live longer, lose weight, and gain health.”
The more you change your diet, the more health benefits you reap. If you’re only looking to lose a few pounds, a couple of this-for-thats might do the trick. But if you want to reverse heart disease—which research shows may be possible at the rigorous end of this diet’s spectrum of choices—you’re looking at big changes. For most programs, though, you have plenty of room between all and nothing. If you indulged yesterday, make more healthful choices today; if you didn’t have time for a run yesterday, make it a must-do today. What matters most is your overall approach—if it’s doable and pleasurable over the long haul, you’ll stick with it for life.
How does the Ornish Diet work?
Through his 2007 book The Spectrum, Dean Ornish—a professor of medicine at the University of California, San Francisco, and founder of the Preventive Medicine Research Institute in nearby Sausalito—lays out your nutrition, exercise, stress management, and emotional support options as a guide toward achieving any goal, from weight loss to preventing or reversing chronic diseases.
On nutrition, Ornish categorizes food into five groups from most (group 1) to least (group 5) healthful. It’s the difference, for example, between whole-grain bread and biscuits, between soy hot dogs and pork or beef ones. Ask yourself what groups tend to fill up your grocery cart, and decide how you want to fill it up. As for exercise, Ornish stresses aerobic activities, resistance training, and flexibility; you decide what you do and when. To manage stress (long a core element of his program), you can call on deep breathing, meditation, and yoga. Find a combination that works for you and set aside some time each day to practice. Finally, Ornish says that spending time with those you love and respect, and leaning on them for support, can powerfully affect your health in good ways.
Ornish applies these “spectrums” to a host of common health problems, dedicating chapters to losing weight, lowering cholesterol and blood pressure, preventing and reversing type 2 diabetes and heart disease, and preventing and treating prostate and breast cancers.
The program to reverse heart disease is the one for which Ornish is best known. Given the ambitious goal, it’s unsurprising that doing it right, at the most healthful end of the spectrum, doesn’t give you much wiggle room. Only 10 percent of calories can come from fat, very little of it saturated. Most foods with any cholesterol or refined carbohydrates, oils, excessive caffeine, and nearly all animal products besides egg whites and one cup per day of nonfat milk or yogurt are banned. Fiber and lots of complex carbohydrates are emphasized. Up to 2 ounces of alcohol a day are permitted, but guardedly. This regimen, combined with stress-management techniques, exercise, social support, and smoking cessation, formed the basis of Ornish’s landmark heart disease-reversal trial in the 1990s. He explains it in more detail in Dr. Dean Ornish’s Program for Reversing Heart Disease (1991).
Will you lose weight?
Perhaps, perhaps not. There are varying degrees of an Ornish diet. But if you’re exercising regularly and have adopted a menu filled with foods from the healthiest three nutrition groups—which emphasize produce, whole grains, and fish—it’s likely.
Here’s a look at some studies analyzing the potential for weight loss on an Ornish diet:
- In the extension study to Ornish’s landmark heart disease-reversal trial, published in the Journal of the American Medical Association in 1998, researchers reported that a small group of Ornish dieters who followed the plan described in the previous section had lost an average of 24 pounds after a year. At five years, they still maintained a loss of 13 pounds from their original weight. At one- and five-year check-ins, control-group dieters were on average 3 pounds heavier than when they started.
- In an analysis published in the American Journal of Health Promotion in 2010, about 1,300 participants on the Ornish plan to reverse heart disease decreased their body mass index, a measure of body fat, from 32 (obese) to 29.5 (overweight) after a year. No control group was used.
- A 2007 study in the Journal of the American Medical Association divided roughly 300 overweight or obese women into groups and assigned them to one of four types of diets: an Ornish approach emphasizing no more than 10 percent of daily calories from fat; low-carb (Atkins); low saturated-fat/moderate-carb (LEARN); and roughly equal parts protein, fat, and carbs (Zone). After 12 months, Ornish dieters had lost an average of 4.8 pounds, the Atkins group had lost 10.3 pounds, the LEARN group had lost 5.7 pounds, and the Zone group had lost 3½ pounds. Drawing firm conclusions from this study is risky, however. The differences in weight loss among Ornish, LEARN, and Zone participants weren’t statistically reliable. And many participants didn’t follow their assigned diet. The Ornish group, for example, took in up to 30 percent of calories from fat—hardly close to the recommended 10 percent.
- In another JAMA study, published in 2005, researchers assigned 160 overweight or obese participants to one of four diets: Atkins, Weight Watchers, Zone, and a version of Ornish emphasizing a vegetarian approach with 10 percent of calories from fat. After a year, the Ornish group had lost an average of 7 pounds, which was similar to the range of weight loss (4½ to 7 pounds) in the other groups.
- Weight loss may not be tied to lower fat intake specifically, however. Many experts maintain that the number of calories you take in—not whether you get them from fat, carbs, or protein—drives weight loss, especially in the long run. In one study, published in 2009 in the New England Journal of Medicine, researchers assigned 811 overweight adults to diets of differing nutrient amounts. At two years, the groups assigned to get 20 percent of their calories from fat had lost about the same as those put on a diet that was 40 percent based on fat.
Does it have cardiovascular benefits?
Without question. Ornish and a team of researchers were the first to show that heart disease, beyond being stoppable, can also be reversed, without drugs or surgery, through changes in diet and lifestyle. In a randomized trial of 48 heart-disease patients published in 1990 in The Lancet, the Ornish program to reverse heart disease reversed artery blockages after one year—and continued to do so after five years. The changes were highly meaningful when compared to a control group, whose condition worsened at both points. The diet has also been shown to lower blood pressure and decrease both total and “bad” LDL cholesterol.
Can it prevent or control diabetes?
Prevention: Being overweight is one of the biggest risk factors for type 2 diabetes. If you need to lose weight and keep it off, and an Ornish diet helps you do it, you’ll almost certainly tilt the odds in your favor.
Control: Because you develop your own plan on the Ornish diet, you can ensure that what you’re eating doesn’t conflict with your doctor’s advice. Ornish’s basic principles of emphasizing whole grains and produce and shunning saturated fat and cholesterol are right in line with American Diabetes Association guidelines.
In the American Journal of Health Promotion analysis cited in the weight-loss section, 329 Ornish dieters decreased their hemoglobin A1C levels—a measure of blood sugar control—by 0.4 percentage points after a year. That was considered meaningful.
Are there health risks?
No. It’s not off-limits to anyone, either. Still, experts advise checking with your doctor before making changes to your diet.
How well does it conform to accepted dietary guidelines?
Fat. Ornish diet plans are likely to be below, perhaps far below, the government’s recommended 20 to 35 percent of daily calories from fat.
Protein. In line with the 10 to 35 percent of daily calories the government recommends.
Carbohydrates. Most Ornish plans should fall within the government’s 45 to 65 percent recommendation; Ornish’s plan to reverse heart disease slightly exceeds it.
Salt. The majority of Americans eat too much salt. The recommended daily maximum is 2,300 milligrams, but if you’re 51 or older, African-American, or have hypertension, diabetes, or chronic kidney disease, that limit is 1,500 mg. Two sample Ornish plans were below the 2,300 mg. cap; with a little finagling, you shouldn’t have trouble staying under the more restrictive target.
Other key nutrients. The 2010 Dietary Guidelines call these “nutrients of concern” because many Americans get too little of one or more of them:
- Fiber. Getting the recommended daily amount of 22 to 34 grams for adults helps you feel full and promotes good digestion. It should be a breeze meeting that goal on Ornish.
- Potassium. A sufficient amount of this important nutrient, according to the 2010 Dietary Guidelines, counters salt’s capacity to raise blood pressure, decreases bone loss, and reduces the risk of developing kidney stones. It’s not that easy to get the recommended daily 4,700 mg. from food. (Bananas are high in potassium, yet you’d have to eat 11 a day.) The majority of Americans take in far too little. The sample Ornish plans are two of very few that manage to attain and even surpass the recommendation.
- Calcium. It’s essential not only to build and maintain bones but to make blood vessels and muscles function properly. Many Americans don’t get enough. Women and anyone older than 50 should try especially hard to meet the government’s recommendation of 1,000 to 1,300 mg. You should clock in somewhere around your goal.
- Vitamin B-12. Adults should shoot for 2.4 micrograms of this nutrient, which is critical for proper cell metabolism. You’ll meet or exceed this recommendation on Ornish.
- Vitamin D. Adults who don’t get enough sunlight need to meet the government’s 15 microgram recommendation with food or a supplement to lower the risk of bone fractures. Sample Ornish plans came in just under the target.
Supplement recommended? Yes. Omega-3, and a multivitamin as insurance (in case you’re not as virtuous as you should be).
How easy is it to follow?
Well, how much fat will you include? Research shows most dieters have a hard time sticking to a plan that restricts fat to 10 percent of daily calories. If your health doesn’t depend on it (i.e., you don’t have heart disease), working with a slightly higher fat intake may help you keep a firm hold on the wagon.
Recipes are abundant, and eating out is OK, if the chef can improvise. Alcohol is allowed in moderation.
Recipes. The Spectrum serves up quite a few. While many fall into the most-healthful category, variations are suggested if you prefer the middle of the spectrum. There’s also an Ornish-approved cookbook on the market. Once you get the hang of your program, though, any cookbook or Internet search will turn up recipes that align.
Eating out. Fine, but try to find restaurants that will cater to special requests. And eat slowly—you’ll know when you’ve had enough, and you’ll enjoy your food more.
Alcohol. If you choose to drink, savor it in moderation. That’s generally considered no more than one drink a day for women, two a day for men. (A drink is considered 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.)
Timesavers. None, unless you hire somebody to plan your meals, shop for them, and prepare them.
Extras. Ornish offers a table that details the health benefits of various foods; tips to get through the holidays; the omega-3 content of selected fish; tables showing where various foods fall on the nutrition spectrum; and some cooking lessons.
Nutrition experts emphasize the importance of satiety, the satisfied feeling that you’ve had enough. On Ornish, the large amount of fiber you’ll get from whole grains, fruits, and veggies should keep you feeling full.
You’re making everything, so if something doesn’t taste good, you know who to blame.
How much does it cost?
If you’re at the most healthful end of the spectrum, it’ll likely be pricey—produce, whole grains, and fish are expensive.
The Spectrum, an essential guide, is $27.
Does the diet allow for restrictions and preferences?
Anyone can follow this approach—choose your preference for more information.
You can easily make vegetarian- or vegan-friendly choices in any area of the nutrition spectrum.
Yes, you can choose products that are certified gluten-free.
Doable, but it’ll be up to you to read the labels and hide the saltshaker.
Yes, you have the freedom to use only kosher ingredients.
Yes, but it’s up to you to ensure your food conforms.
What is the role of exercise?
It’s strongly encouraged.
You’ll use the exercise spectrum to develop a routine that aligns with your goal—weight loss, controlling diabetes, or reversing heart disease—and includes a mix of aerobic, strength, and flexibility activities. Do what you enjoy, and do it often.
Last updated by Kurtis Hiatt | January 02, 2013
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