Is your doctor telling you to “meditate, eat veggies, walk, quit smoking?” If not, why not?

by Carolyn Thomas  ♥ @HeartSisters

Newsweek once called his advice “the state of the art in psycho-cardiology” – a lifestyle regimen best known for the stringency of its ultra-low-fat diet, but with equal emphasis on exercise and stress reduction. And in The Atlantic, the famous preventive medicine guru Dr. Dean Ornish has written an essay called Why Health Care Works Better than Disease Care. Dr. O is founder and president of the non-profit Preventive Medicine Research Institute.

And his research studies were the first to claim that lifestyle changes can reverse cardiovascular disease without drugs.

He’s a rare duck: a man with the letters M.D. after his name who shuns the prescription pad and Big Pharma’s domination of what’s been called “marketing-based medicine”. Instead, he has long advocated preventing – and even reversing – heart disease without drugs or surgery through changing your lifestyle. He actually recommends two different diets:  the prevention diet and the reversal diet. The reversal diet is a very strict low-fat diet designed for people who have diagnosed heart disease.

Alas, so far I have yet to meet any heart patient who has been successful in sticking to this extremely restrictive diet for any significant length of time.

And, despite a considerable amount of scientific and media attention over the years, Dr. O’s heart-smart recommendations for a very low-fat diet, smoking cessation, aerobic exercise, stress management training and psychological support continue to create controversy in the mainstream medical community.

For example, consider the significantly higher fat content of dietary recommendations from the American Heart Association, and the popularity of fad diets (like high-fat, low-carb Atkins diet).

But here’s what Dr. O told Atlantic readers:

“In 2006, 1.3 million coronary angioplasty procedures were performed in the U.S. at an average cost of $48,399 each, or more than $60 billion. Over 448,000 coronary bypass operations were performed at a cost of $99,743 each, or more than $44 billion.  This means more than $100 billion for these two operations.

“Many people are surprised to learn that randomized controlled trials published in The New England Journal of Medicine and elsewhere showed that angioplasties and stents – common surgical procedures used to treat heart disease – do not prolong life or even prevent heart attacks in stable patients (i.e., at least 95% of those who receive them).

“And coronary bypass surgery prolongs life in less than 2% of patients who receive it. 

“If we were truly practicing evidence-based medicine, our practice patterns would have shifted away from these expensive and relatively ineffective surgical treatments once these randomized controlled trials were published.

“Yet to many people, these approaches are still considered conservative or conventional medicine, while teaching people to walk, meditate, eat vegetables, and quit smoking  – which has been shown to be more effective –  is often called ‘alternative medicine’.

“Studies have shown that changing lifestyle could prevent up to 80% of all heart disease, and likely even more. Thus, the disease that accounts for more premature deaths and costs us more than any other illness is almost completely preventable, and even reversible, simply by changing lifestyle.”

It’s not an easy road that Dr. O is on, despite medical research that supports these lifestyle improvement theories. He’s up against formidable obstacles, including some erected by allies like the American Heart Association. You’d think they’d all be on the same page! But as Dr. O recently explained in this interview with the San Francisco Medical Society:

“My problem with the American Heart Association is that their position on dietary recommendations for heart health has been that people won’t make big changes. So we shouldn’t tell them and get too far ahead of the parade or we’ll lose our credibility.

“And that to me is a very paternalistic view of people. So heart patients get put on a 30% fat diet (his own recommendation is for an ultra-low 10% fat limit). Then, in most cases, their lipids (cholesterol numbers) do not respond very well and they are told that they have ‘failed diet’, and what they now need is a lifetime of statin medications.

“What I would do instead is walk the patient through the risks, the benefits, the costs, and side effects of drugs, angioplasty, bypass surgery and lifestyle changes. And then they can make an informed choice.”

Learn more about Dr. Dean Ornish and several bestselling books he has written, including Dr. Dean Ornish’s Program for Reversing Heart Disease; Stress, Diet & Your Heart; Eat More, Weigh Less; Everyday Cooking with Dr. Dean Ornish; and Love & Survival, 8 Pathways to Intimacy and Health.


 See also: You Can Lead A Cardiologist to Water, But Apparently You Cannot Make Him Drink at my other site, The Ethical Nag: Marketing Ethics for the Easily Swayed.



20 thoughts on “Is your doctor telling you to “meditate, eat veggies, walk, quit smoking?” If not, why not?

  1. A year and a half ago, I was diagnosed with pericarditis and had to have a large amount of fluid surgically drained from around my heart.

    It struck me out of nowhere. I had always eaten healthy and exercised. I had no idea that the condition was going to be a chronic thing that I would still be dealing with almost 2 years later. The doctors all told me that I had no restrictions and could return to normal activities as I felt ready. They left me with the impression that the chance of recurrence was slim to nil.

    As it turns out, the recurrence rate for pericarditis is around 30%. I have since had 4 recurrences, the last one lasted for most of June.

    I have dramatically changed my diet to follow an anti-inflammation diet which involves cutting out things like dairy, wheat, processed foods, sugar, to name a few. I couldn’t change my diet so drastically if my husband wasn’t fully on board.

    I knew I needed a new approach since the medications that I have been taking do not seem to work as well anymore. I have been amazed at how great I feel since starting the new diet about a month ago. I have more energy now than I have in a long time. I didn’t think that was possible given all of the medications that I take.

    Feeling this good has been a great motivator to stick with the new diet. I don’t plan on going back. I think maybe if more people could just stick with a diet change like this long enough to feel tangible results, they would be more likely to stick with it. I am always amazed that most people seem to just give up in the face of a health crisis.

    I suppose that it helps that I have a toddler son who needs me. I want to watch him grow up, and I will do anything in my power to make that happen.

    Thank you for all of your writing. I find it all extremely helpful in dealing with my own chronic health condition. For a long time, I could not accept my change in health. Lately, I have decided to stop living like a sick person. When I feel good, I do things that I want to do. When I don’t feel good, I rest. My recurrences seem to have no rhyme or reason at this point, so I’ve stopped trying to prevent them, and have started to live instead.

    Liked by 1 person

    1. Wow! That’s an amazingly inspiring story, Jamie. Thanks so much for sharing it here. “Stop living like a sick person” is a simple yet profound motto. Brilliant…. 🙂


  2. Exercise is one of the best ways to fight heart disease. If you can’t exercise vigorously that is O.K. you don’t have to. Walking 30 minutes a day will do or even better yet, try some light Yoga which helps in reducing stress and the waist line as well.

    Liked by 1 person

  3. Seems like Carolyn Thomas ought to know better. Especially since she won an award for gardening! She might like to know even food pantries are distributing more fresh fruits and vegetables because it’s healthier! Good health is better for everybody.


      1. Flowers make a lovely centerpiece on a table filled with fresh fruits and yummy vegetable dishes. 😉

        (Check out Rip Esselstyn’s book, ‘The E2Diet’ for great recipes – and stories – from the newly-vegan firemen of the Austin, Texas fire department)

        [[Not that I don’t love Dr. O, of course, but y’know….]]


          1. Thanks so much. That was really fun to read! I think most of the nutritionists’ concerns are addressed in the book. The death stats certainly give me pause. Tho heart disease runs in my family, it is not currently my primary concern. But MS is.


  4. I find it rather surprising that telling a patient to stop smoking and to perform more exercise is often considered “alternative medicine.”

    It’s always important to maintain a healthy heart and these are two very important steps in the process. Big changes are sometimes needed to stop the worst results from happening.

    Liked by 1 person

    1. I agree, Jessica. These are not “alternative” suggestions – they are just basic common sense for HEALTH care, not DISEASE care.
      Thanks for your comment here,


  5. The argument that’s not really living is just a rationale. It’s actually quite amazing how much pain a human will endure to live, and how much they value life after the disaster has occurred that changed it.

    In that, I am saying there is a small amount of leeway here and there, but 30% is a huge amount of fat. There is an excellent book out now on why sex, fat, alcohol and other addictions ARE so compelling to the brain, but it CAN be overcome (title forthcoming…)

    As in everything, why do we humans have to learn EVERYTHING the hard way ~ by losing our health, our vitality and capacity before truly grasping the message. That is the billion dollar question.


    1. Hi Mary,
      As crazy as it sounds, not every heart patient seems to “value life after the disaster has occurred”. About half of heart attack survivors who are smokers, for example, leave the hospital still smoking, even though researchers show consistently that this decision doubles the chances of suffering a repeat heart attack. And over half of survivors stop taking their cardiac medications within three years post-MI, according to results from a 2007 Mayo Clinic study.

      Maybe that’s why so few heart patients can stick longterm with yet another difficult lifestyle change – like Dr. O’s diet restrictions?

      Let us know when you remember that book title, okay?


      1. ‘Breaking the Food Seduction’ by Dr. Neal Barnard is one. Dr. Barnard also has a very tasty collection of recipes in the ’21-Day Weight-Loss Kickstart’. And, of course, Dr. Ornish himself is famous for his several cookbooks. Mainstream medicine is – thankfully – undergoing a much needed paradigm shift to PREVENTATIVE care over sick care. (See the movie, “Forks Over Knives” if you get the chance)


  6. Although what Dr. O advocates is sound medically and certainly sound for other areas of our lives as in mentally and spiritually, our ‘techie’ world wants a quicker, easier fix available with so much less effort! After all, going to the drugstore to fill a prescription is a ‘quick-fix’ compared to spending time on grocery purchases, cooking, exercise, and meditation! However, there are no side effects to making healthy choices!

    I’ve been following Dr. O for 20-30 years (long before most people even knew who he was) because of my Mother’s early death from undiagnosed familial heart disease. Even before the ease of purchasing low or zero fat products like today! And it’s a tough recipe he gives us. After all, taking time to meditate when we could be “doing” something productive! (who ever would have thought?)

    Dr. Esselstyn from Cleveland Clinic advocates a plant based diet….and proves that the inside of our arteries shows positive changes from even 1-2 months of that type of eating. He and Dr. O have hearty agreement on the causes and cures for heart disease. But they are bucking powerful lobbies and organizations! (AHA and meat and dairy producers)

    I have to balance that thinking with the knowledge that my Mother died at the age of 55 from a sudden MI while I’m still alive at 67 with tons of pharmacology, a few stents, a cardiac by-pass, and an insufficient amount of Dr. O’s prescriptions! I can preach about it, but it’s really really REALLY hard to live it!


    Liked by 1 person

    1. Amen to that, Lynn. I’ve also heard heart attack survivors say that if they actually had to live for the rest of their lives the way Dr. O recommends in his extreme ultra-low fat diet, it’s not really “living” at all. Surely, however, there must be a happy medium where we can all eat a whole lot healthier and get a whole lot more exercise than we’re willing to do right now.



      1. The movie, “Forks Over Knives” might inspire you further. You might think you’re really ‘living’ on a hi-fat diet, but in truth, it’s your doctor who’s benefiting. In any case, it’s not a religion. Do the best you can. Any change in the right direction is a good change.

        Liked by 1 person

        1. I am so on the fence regarding a Dr Ornish regimine vs the Paleo/ wheat belly one. My body seems to get better results by eating grass fed lean animal protein but no wheat, gluten, sugar, and very little dairy…. I ration fruit a bit, still watch calories, but due to illness, not enough exercise. I was vegan and Ornish for a couple of months and felt sluggish, gained a few pounds. Can both lifestyle extremes (Ornish Vs Paleo, Lo carb) both be right for the right person?


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