Dean Ornish Interview
A Conversation with Dr. Dean Ornish
Dr. Dean Ornish is one of the leading voices in the medical community promoting a balanced, holistic approach to health, and proving that it works. As the founder, president, and director of the Preventive Medicine Research Institute, Dr. Ornish directed clinical research demonstrating, for the first time, that comprehensive lifestyle changes, including diet and exercise, can reverse even severe coronary heart disease, prostate cancer, and other chronic illnesses.
Dr. Ornish is also the author of six best-selling books, including New York Times' bestsellers Dr. Dean Ornish's Program for Reversing Heart Disease; Eat More, Weigh Less; Love & Survival; and his most recent book, The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health.
This August Dr. Ornish will be the keynote speaker at the Chopra Center’s Journey into Healing: Grow Younger, Live Longer, a powerful four-day workshop led by Deepak Chopra, the Chopra Center’s physicians and master educators, and other guest experts.
In a recent conversation, Dr. Ornish talked to us about his groundbreaking work, the newest research in mind-body medicine, and the keys to creating a lifestyle that will not only help us live longer, but more important, live well.
Chopra Center: Could you tell us about your current research focus?
Dr. Ornish: For the past thirty-five years I’ve directed a series of scientific research studies showing that these simple, low-tech, low cost, often ancient interventions can have such powerful outcomes and how quickly they can occur. We’re used to thinking of advances in medicine as being a new drug, a new laser . . . something really high-tech and expensive. Many people have a hard time believing that the simple choices that we make in our lives each day – like what we eat, how we respond to stress, how much exercise we get, whether or not we smoke, and perhaps most important, how much love and intimacy and emotional support we have in our lives – can have such powerful outcomes, but they often do.
We’ve been able to show for the first time that even severe heart disease can be reversed in most cases by making these lifestyle changes. Our research has shown that within a month, blood flow to the heart improved and the heart pumped blood more normally. We found that within a year, even severely blocked arteries became measurably less clogged – and there was even more improvement after five years than after one year. In later research, we discovered that early-stage prostate cancer could be slowed, stopped or even reversed. This was the first and only randomized trial to show this. We did this study in collaboration with Dr. William Fair, who at the time was the Chair of Neurology at Memorial Sloan- Kettering Cancer Center in New York; and Dr. Peter Carrell who is the Chair of Neurology at U.C. San Francisco’s medical center.
We also found that these same lifestyle changes could reverse type 2 diabetes and gene expression – in effect turning on hundreds of good genes within just three months while turning off the bad genes that promote disease – particularly the those genes that promote prostate cancer, breast cancer, and colon cancer, as well as down-regulating the genes that promote inflammation and oxidative stress that often lead to heart disease. We also found that after three months, telomerase increased significantly. [Telomerase is an enzyme that repairs and slows the degradation of telomeres – the protective endings on our cell’s chromosomes. Research has found that people with longer telomeres are healthier, age more slowly, and are less likely to get chronic diseases associated with aging, such as cancer, heart disease, and diabetes.]
We did this study in collaboration with Dr. Elizabeth Blackburn of Harvard, who received the 2009 Nobel Prize of Medicine for her role in leading the research team that discovered telomerase.
I’ve seen what a powerful difference these lifestyle changes can make in people’s lives, I’d been in a dialogue with the people at Medicare [the U.S. government program designed to guarantee access to health insurance for citizens ages sixty-five and older as well as younger people with disabilities and certain illnesses]. In January of 2011, Medicare began to cover “Dr. Ornish’s Program for Reversing Heart Disease,” which is the first time that Medicare has ever covered an integrative medicine program.
I used to think that good science was enough to change medical practice, but I was wrong. What I learned is if it’s not reimbursable, it’s not sustainable. And if you could change medical reimbursement you could change medical practice and medical education. It was the scientific evidence that convinced Medicare to cover this, after sixteen years of internal and external review. And because Medicare is covering it, most other insurance companies are covering it as well. We’ve been contacted by thousands of healthcare professionals who want us to train them in our program, and we’ve begun doing that.
We’ve trained about fifty hospitals and clinics and practitioners so far, including most recently the Cleveland Clinic, which has the largest cardiac program on the planet. We are ramping up to train many more, so if anyone is interested in learning about becoming a trained and certified provider, they should go to our website at http://www.ornishspectrum.com.
What is your perspective on the role of genes in health and disease?
Dr. Ornish: So often I hear people say things like, “I just have bad genes, what can I do?” This perspective is what I call “genetic nihilism.” What we’ve learned is that our genes are our predispositions but our genes are not our fate. I say this not to blame but to empower, because if it’s all in our genes, then we’re helpless and there’s nothing we can do about it. I’ve been impressed by how dynamic these biological systems in our body are, how quickly they can get better or worse, and how lifestyle has such a powerful impact on our gene expression.
One of the interesting findings in all of our studies was that the more people changed their lifestyles, the more they improved in ways we could measure and the better they felt. And the better they felt, the more they wanted to keep making these changes. The more people changed their lifestyle, the more their genes expressed and the longer their telomeres got – at any age. I find that a very empowering message to give people, again not to blame but to empower . . . to say that while we don’t have complete control over our genes, we can influence our health and wellbeing much more to a much larger degree than we once realized, and much more quickly than we once realized. And we’re now beginning to understand some of the genetic mechanisms by which these changes and improvements occur.
Do you think genetic testing is useful and in what situations would you recommend it?
Dr. Ornish: I think that genetic testing can be helpful to the degree that it can motivate you to change your lifestyle. But it’s not like there’s one lifestyle program for reversing heart disease, and another one for reversing diabetes, and another for improving your gene expression and for making your telomeres longer. It’s the same lifestyle for all of these.
You could argue that if you’re already leading a healthy lifestyle, there’s not a lot of added benefit for getting genetic testing. But for most people, if they find out that they’re genetically predisposed to heart disease or prostate cancer or something like that, a genetic test could be a powerful motivator to make bigger changes in lifestyle than they’re currently making. But what we’re finding in general is that it takes a lot more lifestyle change to reverse disease than it does to prevent it. As the old saying goes, an ounce of prevention is worth a pound of cure. So what matters most for most people is their overall way of eating and living. You know, if you go on a diet, you’re going to inevitably go off of it. If you go on an exercise program, you’re going to go off it.
I’ve learned that a much more compassionate, lifestyle-based approach is the most effective. And that is what we’ve created with the Spectrum program, which is based on the research findings of all of our studies, which show that the more people change, the more they improve, both in how they feel and in ways that we can measure. When they make these changes, most people find that they feel so much better so quickly that it reframes their reason for making these changes – from fear-based approaches such as fear of dying or fear of a heart attack or fear of something painful, which is not sustainable, to joy-based approaches that are sustainable. Your brain gets more blood, you can think more clearly, you have more energy, you need less sleep, your skin gets more blood flow so you don’t age as quickly, your heart gets more blood flow, your sexual organs get more blood flow, which is the same way Viagra works.
For many people these are choices worth making, not to live longer but to live better. And you can’t fail, because if you indulge yourself one day, it doesn’t mean you’ve cheated or you’re bad. You just eat better the next day. If you don’t have time to exercise one day, do a little more the next. If you don’t have time to meditate for an hour, do it for a minute . . . you get the idea. It’s a sustainable way of living and eating.
What do you believe are the most promising areas of medical research in terms of growing younger and living longer?
Dr. Ornish: Some of the kinds of things we’ve just been discussing . . . the studies showing that you can change your gene expression and you can lengthen your telomeres. As your telomeres get shorter, your life gets shorter, and the Spectrum program is the only lifestyle intervention that’s been proven to lengthen telomeres and increase telomerase. We’re also finding improvements in angiogenesis. When tumors grow, they secrete substances to cause blood vessels to grow and feed them, and we found that these same lifestyle changes can inhibit that process. So the more we look, the more we find that these biological mechanisms improving in ways that enhance our health and wellbeing, help slow the aging process, and sometimes reverse it.
Could you tell us about your perspective on the spiritual dimensions of health and healing?
Dr. Ornish: Sure, you know the ancient swamis and rabbis and priests and monks and nuns didn’t practice meditation or yoga to unclog their arteries, lower their cholesterol or change their gene expression, even though it can do all these things. They are really powerful tools for transforming our lives. They can help us quiet down our body and mind enough to experience an inner sense of peace and joy and wellbeing. This innate wellbeing is our natural state.
I had the good fortune and blessing to study with Sri Swami Satchidananda. We talked at least once a week for more than forty years. He was a powerful ecumenical teacher and when people would ask him, “Are you a Hindu?” he would say, “No, I’m an un-do.” He built a temple on the James River about forty-five minutes outside of Charlottesville, Virginia. He named it the Lotus temple, which is an acronym for “Light of Truth Universal Shrine.” There’s a column of light that goes up the middle of the temple and a beam splitter that divides the light so that it illuminates the altars of all the different world religions – the idea being that truth is one, paths are many.
So much of our modern Western culture teaches us that our health and our peace of mind are something that we have to get from outsides of ourselves. If only we had more money or more power or more accomplishment or more whatever, we’d be happy. But really, the goal of all spiritual teachings, which I learned from Swami Satchidananda, is that once you get past the rituals and other things that often divide us in the name of religion, we realize that we have already have everything inside of us.
Peace of mind isn’t something that you get but something that you have, until you disturb it. It’s one of the great ironies of life that we often run after so many things that we think will bring us peace, and we disturb what we have already in the process of trying to get these things because we’re not mindful of that. And so, when you meditate, practice yoga, pray, or do any spiritual practice, it doesn’t bring you a sense of peace from outside of yourself. What it does, at least temporarily, is to help quiet down your mind and body so that you can experience what’s already there. Learning this had a powerful impact on my life because stress comes not from what you do but from how you react to what you do, and if you think that you need to get all these things to bring you peace and happiness, then the stress levels go way up.
The paradox is that to the degree that you’re more inwardly defined, you can often go out in the world and accomplish even more, without getting stressed and sick in the process, because your intention behind what you’re doing is very different. It’s not to get something you think you lack, but rather because it’s just something you’re doing.
In many ways this is the conspiracy of love. I wrote a book called Love and Survival about fourteen years ago, based on the research available at that time. There were thousands of studies showing that people who were lonely, depressed or isolated were three to ten times more likely to get sick and die prematurely than those who had love and connection and community in their lives.
The time we spend with our friends, family, and loved ones, the time that we spend on our spiritual practices to transcend that sense of separateness, is powerfully healing. In fact, I don’t know anything in medicine that has such a powerful impact. And so, when most people think about my work, they often think it’s about diet. And to me, diet is important, but it’s the least interesting part of it, because we’re all going to die, it’s just a question of when. What’s much more important is how well we live, not just how long we live. The more inwardly defined we can become, the more intimate and loving our relationships are, the more we can create a heaven instead of a hell. It’s a conspiracy of love.
Depression has become a worldwide epidemic, with the World Health Organization ranking it as one of the world’s most debilitating disease. In previous talks, you’ve shared that you personally suffered such a severe depression that you considered ending your life. Can you tell us about your perspective on what depression is and how it can best be treated?
Dr. Ornish: I was profoundly depressed when I was in college, to the point of being actively suicidal. It’s a long story but that’s how I ended up meeting Swami Satchidananda and getting interested in these approaches. So depression was my doorway to these spiritual practices that have transformed my life. For someone else, the catalyst for change could be a heart attack or a diagnosis of cancer. I’ve often heard patients say that getting diagnosed with a life-threatening condition was a blessing because it got their attention led them to begin looking deeply at what really brings meaning into our lives. In my case, I was depressed for two reasons. One is I felt I was stupid and somehow had managed to fool people into thinking I was smart. I thought that now that I was in a school with really smart people, it was just a matter of time before they realized what a mistake they’d made in letting me in. The second reason why I was depressed was because I had a spiritual vision at that time that showed me that nothing could bring lasting happiness.
The combination of feeling like I never was going to amount to anything because I was stupid, and even if I did, it didn’t matter anyway, was profoundly depressing. It was a feeling of “Why bother?” What I learned later was that for many people, depression is caused by a lack of meaning in their lives. It certainly was for me. There’s a difference between being profoundly depressed versus feeling a little blue. When you’re blue, you may say to yourself, “I’m a little sad but I’ll feel better later.” When you’re really depressed, you feel like you’re seeing the world clearly for the first time. You think that things are bad, they will always be bad, and they have always been bad – and anytime that you felt otherwise you were just kidding yourself or deluding yourself. And that’s where the hopelessness and helplessness that are the hallmarks of depression come from.
What I’ve learned is that we can take meaning out of anything, and we can put meaning into anything. By finding ways of making our lives more sacred through spiritual practices and religious rituals, by saying “I’m totally and monogamously committed to the person I’m married to or in a relationship with and I’m not going to have sex with anyone else,” and by saying “I’m will only eat these kinds of foods and not these others” . . . when we consciously choose not to do something that we otherwise could be doing, it makes it sacred – not in the dry, dusty, moldy sense but sacred in the sense of the most special, the most meaningful, the most joyful. All religions have dietary restrictions, but the types of foods that are prescribed are often different. One religion will say you can eat this food, but not that food, while another says that you can eat anything after midnight, but not before midnight, at different times of the year . . .
What all these traditions have in common is the “rules” they have make eating sacred or special.
So rather than coming from a place of deprivation or scarcity, saying “I can’t eat certain foods that I want to” or “I can’t have sex with everyone I want to” or I can’t do whatever,” we can reframe it to say, “I am creating meaning in my life by choosing not to do certain things or actions, because that makes them special or meaningful. And I can create a heaven in my life instead of a hell in my life.” You can’t really say yes to something until you can say no to something.
Again, these spiritual practices are powerful because so often people are depressed because they think they’re not getting what they need – as opposed to realizing that they have everything already. The ultimate paradox and irony is that we often run after these things that we think are going to make us happy and peaceful, and in the process of running after them, we disturb what’s already there. If we’d simply stop running and pushing and struggling, we could experience that. And so at the end of a meditation or at the end of a yoga class or at the end of a prayer or whatever allows you to experience peace, remind yourself that the peace you feel is your natural state.
The next question is about exercise, which is an important part of the Spectrum program you developed. The Olympics are unfolding as we speak, and in the past week we’ve an opportunity to watch athletes who have devoted their lives to getting into incredible mind-body shape. We’re also seeing the growing popularity of endurance sports events such as marathons, triathlons and even ultra marathons, where people run distances of 100 miles or more. Based on your research, how much exercise is beneficial? Are endurance sports good for the body or do they wear it out in the long run?
Dr. Ornish: Well, the latest research is showing that you don’t really need that much exercise to benefit from it. There’s a difference between fitness and health. Just walking fifteen to twenty minutes a day, and not even all that fast or all at once, can reduce premature mortality by up to 50 percent.
The more you exercise the more fit you become, but not necessarily the more healthy you become. Even five or ten-minute exercise sessions can make a difference in people’s lives. I find, and many people find, that if you can incorporate exercise into your daily life, you’re more likely to do it. We all lead such busy lives, and if you have to get into a car and drive to the gym, then it’s easy to say, “I’ll do that tomorrow,” and tomorrow never comes. So I find that simple things we can do throughout the day can make a big difference For example, getting a cordless phone and walking around in my office or home when I’m on the phone, as opposed to sitting in a chair, can burn a lot of. You can use the stairs rather than the elevator. Instead of getting stressed out because you can’t find a parking place close to where you’re going, deliberately park far away, which will not only reduce your stress but give you a little more exercise. And then if you can go for a walk with a friend, you get the emotional support as well, so you get a twofer.
What do you believe are the five most important things we can do to reverse disease and the aging process?
Dr. Ornish: The elements we include in the Spectrum program: Eat healthier, love more, manage stress, stop smoking, and get moderate exercise.
Can you give us a preview of the ideas you’ll be discussing at Journey into Healing in August?
Dr. Ornish: I’ll be talking about the themes we’ve been discussing today in greater detail, showing both the science behind them and the spiritual lessons I’ve learned along the way.
Thank you very much for speaking with us today. I there anything else you’d like to share that we haven’t talked about yet?
Dr. Ornish: Thank you. I just want to say that I have deep gratitude every day for the love and relationships in my life and the opportunity to do this work. I hope it’s useful.