- Solid nutritionally
- Your heart will love you
- Staying the course could be tough if you're aiming to reverse heart disease
- Not exactly cheap
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What is Ornish Diet?
The Ornish diet was created in 1977 by Dr. Dean Ornish – a clinical professor of medicine at the University of California, San Francisco, and founder of the nonprofit Preventive Medicine Research Institute in nearby Sausalito – to help people “feel better, live longer, lose weight and gain health.”
The diet is low in fat, refined carbohydrates and animal protein, which Ornish says makes it the ideal diet. But it’s not just a diet: It also emphasizes exercise, stress management, and relationships. On nutrition, for instance, Ornish categorizes food into five groups from most (group one) to least (group five) 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.
The Ornish diet is one of the four key components of Ornish Lifestyle Medicine by Sharecare, an evidence-based clinical program to reverse the progression of heart disease. In addition to the whole-food, plant-based Ornish diet, other program pillars are stress management, fitness, love, and social support.
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 sometime 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.
While followers can cater the plan to their goals – whether that’s losing weight, lowering blood pressure, or preventing cancer – the program to reverse heart disease is the one for which Ornish is best known since, as he says, it’s the only scientifically proven program to do so in randomized controlled trials without drugs or surgery.
If that’s your aim, only 10% 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, though the plan includes some seeds and nuts.
Fiber and lots of complex carbohydrates are emphasized. Up to 2 ounces of alcohol a day are permitted. 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.
U.S. News experts rank the diet high in most categories – especially heart health – due in part to its solid evidence base. The whole foods, plant-based diet is made up predominantly of fruits, vegetables, whole grains, and legumes, minimally processed and low in fat, sugar, and refined carbohydrates. But it’s not just a diet: It also emphasizes exercise, stress management, and relationships.
How does Ornish Diet work?
You can ease into the Ornish diet if your goal is a general health boost or modest weight loss, but if you want to reverse heart disease, you’ll have to get more serious. Either way, these tips apply:
- Trade refined carbohydrates like white bread and pasta for whole-grain options like whole-grain bread or quinoa spaghetti.
- Avoid saturated fat by limiting many animal products and processed foods.
- Stock up on fruits and vegetables.
- Trade full-fat dairy for low-fat or nonfat versions.
- Add meditation or another stress-management technique to your morning routine.
- Plan to spend time with friends and family.
For more guidance, turn to any number of Ornish’s books, including the original 2007 book “The Spectrum,” in which Ornish 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.
“Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases,” co-authored with his wife, Anne Ornish, delves into decades of research to detail how making dietary and other lifestyle adjustments can help to combat conditions ranging from cancer to diabetes to heart disease.
How does the Ornish Diet Support You?
If you’re looking to start the Ornish diet or have already begun your dieting journey, it’s helpful to know the different ways you can receive support throughout the process. Below are a few examples of how the Ornish diet can support you:
- Refer to the Ornish website for all things to do with the Ornish lifestyle.
- The community resources section offers a patient portal with articles, recipes, fitness videos, and more.
- There are a number of Ornish diet cookbooks, such as “Everyday Cooking with Dr. Dean Ornish.” Or turn to any number of Ornish’s books, including the original 2007 book “The Spectrum.”
How much does Ornish Diet cost?
If you’re at the most healthful end of the spectrum, following the Ornish diet may be pricey – whole foods and whole grains tend to be more expensive than processed foods. Still, you can be smart with your purchases, buying whole grains in bulk and focusing on fruits and vegetables over expensive cuts of meat.
“The Spectrum” and “UnDo It,” essential guides, are available in paperback, hardcover, audio, and e-book formats.
Medicare covers the Ornish program as part of its coverage of intensive cardiac rehab programs, which extends to 18 four-hour sessions (twice weekly over nine weeks) to reverse heart disease. Virtual participation is now covered, as well, as a result of a May 2020 rule from the Department of Health and Human Services in response to the COVID-19 pandemic.
Most private insurers also cover the Ornish diet and lifestyle program for this. Ornish notes that some insurers are also covering the diet and lifestyle program for Type 2 diabetes, or even for those who have two or more risk factors for chronic disease.
Will Ornish Diet help you lose weight?
You may or may not lose weight on the Ornish diet, since there is no one 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 above 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, by almost 8%, from 32 (people with obesity) to 29 1/2 (overweight) after a year. No control group was used.
- A 2007 study in the Journal of the American Medical Association divided roughly 300 women who were overweight or had obesity into groups and assigned them to one of four types of diets: an Ornish approach emphasizing no more than 10% 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 4/5 pounds, the Atkins group had lost 10 3/10 pounds, the LEARN group had lost 5 7/10 pounds and the Zone group had lost 3 1/2 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% of calories from fat – hardly close to the recommended 10%.
- 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% of their calories from fat had lost about the same as those put on a diet that was 40% based on fat.
- Still, a 2015 study in the journal Cell Metabolism found that calorie for calorie, reducing fat led to a 67% greater weight loss than reducing carbohydrates among adults with obesity. While the study was carefully controlled, it only included 19 people and lasted six days.
How easy is Ornish Diet to follow?
The Ornish diet can be a piece of cake or very tough to follow – it depends on which program you choose.
If you’re taking the spectrum approach, which allows you to make decisions based on your priorities, tastes, and level of commitment, it’s pretty easy.
If you’re aiming to reverse heart disease, the program is more restrictive and therefore can be tougher to follow. Ornish contends, however, that it’s easier in the long-term than taking, say, a statin since the program boosts your quality of life enough to make you want to continue. For example, he notes that most patients report substantial reductions in chest pain, or what’s called angina, within the first few weeks of following the program.
In fact, close to 80% of the nearly 3,000 participants in the 2011 American Journal of Health Promotion study were still following the program after one year. In contrast, less than 50% of people are taking statins after one year, one study found.
Still, research shows most dieters have a hard time sticking to a plan that restricts fat to 10% of daily calories. Our take? If your health doesn’t depend on it (i.e., you don’t have heart disease), working with a slightly higher fat intake or trying the spectrum approach may help you keep a firm hold on the wagon. Ornish, too, supports making more moderate changes that fit with your lifestyle before making bigger ones as you see the benefits.
The Ornish diet is convenient. Recipes are abundant, and eating out is OK if the chef can improvise. Alcohol is allowed in moderation.
Ornish diet recipes are easy to find. “The Spectrum” and “UnDo It” 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 is manageable on the Ornish diet. Just 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 is allowed in moderation on the Ornish diet. 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 1 1/2 ounces of liquor.
You’ll have to figure out your own ways to save time on the Ornish diet. Some prepackaged foods and meal kits could be considered Ornish-diet compliant; appendix A of “UnDo It” lists two weeks’ worth of prepackaged foods by various manufacturers that meet the program’s guidelines. Otherwise, your only timesaver would be hiring somebody to plan your meals, shop for them and prepare them.
You can find ample Ornish diet resources online and in bookstores. Ornish’s books offer extras like 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. You can find more at ornish.com.
You’re unlikely to go hungry on the Ornish diet. Nutrition experts emphasize the importance of satiety, the satisfied feeling that you’ve had enough. On Ornish, a large amount of fiber you’ll get from whole grains, fruits, and veggies should keep you feeling full.
The Ornish diet can taste great – or not. You’re making everything, so if something doesn’t taste good, you know who to blame.
The bottom line: is the Ornish diet worth a try?
The Ornish Diet is a low-fat, lacto-ovo-vegetarian diet that claims to offer substantial health benefits.
In addition to being flexible and easy to follow, some studies suggest that the Ornish Diet may help increase weight loss and protect against chronic disease.
However, it’s also very low in healthy fats and may lack certain vitamins and minerals, which can increase your risk of nutritional deficiencies.
Thus, if you want to give the Ornish Diet a try, be sure to plan it carefully to avoid negative health effects.