Reversing Chronic Diseases With Lifestyle Medicine

Introduction to Dr. Ornish and Lifestyle Medicine 0:00

All right. Welcome, everybody, to our, plant based Cancer Solutions summit. And today, we're so excited to be here with Doctor Ornish, one of the obviously recognized as the father of lifestyle medicine and been doing research in this field for more than 40 years. Let me tell you a little bit about him. And to get some really critical information for you today that you can put into action in your lives. And Doctor Ornish has been recognized by, you know, life magazine. Time magazine. Life magazine is one of the 50 most influential members of the of this generation is by Forbes, is one of the seven most powerful teachers in the world.

I mean, he's the founder of the nonprofit Preventive Medicine Research Institute and clinical professor of medicine at UCSF, and author of seven books, all bestsellers, including Undo It How Simple Lifestyle Change Can Reverse Most Chronic Diseases, coauthored with his wife and and he was appointed by President Clinton and Obama to White House, to a white House advisory committee before the end. For 44 years, he's directed randomized clinical trials, proving and proving for the first time that comprehensive lifestyle change can reverse the progression of heart disease and other chronic diseases, change gene expression and reverse aging by lengthening telomeres.

So a lot of work has been done in this field and has been and doctor Ornish has been at the forefront of the science generating the data for lifestyle medicine physicians and the Ornish diet, of course, because of its documented success in research, has been rated the number one diet by heart health by a panel of experts at U.S. News and World Report for 11 years in a row, and he was the first lifestyle medicine program to be covered by Medicare and now is even reimbursed for people can get it all over the country for people, doing it on zoom through through his through the website mri.org and and of course more information, of course.

Hornets.com. But here we're going to talk about we're going to talk with Doctor Ornish. Yes, about cancer, about his work with prostate cancer, but also the biologic unifying mechanisms of all disease and the link between heart disease, cancer, dementia and on

A Unifying Theory Behind Chronic Disease 2:25

and how the cell works and how Doctor Ornish has really put together this idea of lifestyle medicine in a holistic sense, because he's not only focused on diet, but also goes to all the other things that can help the body the cells heal, including emotional love, loneliness, exercise. He really has put together the whole or all the different pieces of the puzzle that we need to consider. So welcome. Welcome to the pleasure. Thank you. That's that's really one of the nicest introductions I've ever had.

But I'm not a former Olympic skater like yourself, so, my hat's off to you as well. Besides all of your other many accomplishments. Thank you. All right, so let's start with this idea of. Now, I know you've just completed some major work on showing early stage prostate cancer can be halted, in many cases reversed. And how does that so talk a little bit about that. And how you decided to go from heart disease to dementia to prostate cancer. We actually went from heart disease to prostate cancer to dementia.

The dimension is the most the most current word. Oh, okay. But it might be helpful to talk about a little more about what you introduce. This idea of a unifying theory. So, as you say, I've been doing studies in this field for since I was a second year medical student in 1977. So for 46 years, I guess a long time. It's hard to believe. And, And why is it that these same lifestyle changes can affect so many of the most common and costly chronic diseases, because we found that it wasn't like, here's your diabetes lifestyle program and diet, and here's the one for heart disease, and here's the one for prostate cancer and Alzheimer's and so on.

It was really the same for all of them. And in this era where there's so much interest in personalization, wisely, these same lifestyle changes have such far reaching impact. And the reason is that they're not these diseases are not. I mean, when you and I were in medical schools, are we different, different diseases, different diagnoses, different treatments. Right. But they all share the same many of the same underlying biological mechanism. They're not as different as we once thought. And you mentioned several of the chronic inflammation, oxidative stress, changes in the microbiome and telomeres and gene expression and gene genesis overstimulation of the sympathetic nervous system during times of stress.

And all of these, changes in immune function. All of these mechanisms are directly influenced, for better and for worse, by what we eat, how we respond to stress, how much exercise we get, how much love and support we have, how much sleep we have, and so on. And they're very dynamic. You can show improvements very quickly and get worse very quickly. And when you change a lot of things at the same time, paradoxically, you get bigger outcomes even. And so it paradoxically becomes easier for people in some cases to make big changes and a lot of things at the same time, because you feel so much better so quickly in ways that matter.

For example, when people have heart disease and they get angina where they, can't walk across the street without getting chest pain or make love with their spouse, or play with their kids, or go back to work, and within a few weeks, more often than not, they can do all those things. Then it's reframes the reason for change from from fear of dying to joy of living. It's like, okay, I like eating cheeseburgers, but boy, I sure like not having chest pain. And that's a that's a choice worth making. Not to live longer, but to feel better. So we started by doing studies with heart disease.

And as you mentioned, we found for the first time that back then, people viewed heart disease the way they view Alzheimer's today, that once you had it the best, you could hope to do was to slow down the rate at which you got worse. You get worse, but maybe a little more slowly. We showed that if we make bigger changes and a lot of things at the same time, instead of getting worse over worse and worse, you can often get better and better and much more quickly. We found that in just three weeks, we could measure blood flow improvement to the heart.

After a year, there was reversal reduction of the blockages in the arteries overall, and even more improvement after five years and after one year. Whereas the randomized control groups and all these studies got worse and worse over time, we found that there was a dose response correlation between the degree of lifestyle change and the degree of improvement. The more you change, the more you improved. I thought incorrectly that the younger people would get better than the older ones, but it wasn't how older sick they were.

It was mainly a function of the degree of lifestyle change, which is really a very, you know, empowering realization as you found in your work. We then found that these same lifestyle changes could often reverse type two diabetes, high blood pressure, high cholesterol. You know, when people get put on these medications, they're often told they have to take them the rest of their lives.

Prostate Cancer Study and Active Surveillance 6:54

We found that under their supervision, if they make big enough lifestyle changes, they can often reduce or in some cases get off these medications altogether. We found that we did a study with men who had early stage prostate cancer that you mentioned, and we did that in collaboration with the chair of urology at, University of California, San Francisco, where I'm a full professor and with the chair of urology at the time, Bill Ferrer, at Memorial Sloan-Kettering Cancer Center, the two of the leading urologists in the world.

And we took men who had early stage prostate cancer, but who had decided, for reasons unrelated to our study, not to be treated conventionally, what used to be called watchful waiting. And now it's called active surveillance. You might say, well, why would somebody who knows they have cancer not want to just cut it out right away? And the answer is because the treatments, first of all, often main guys in the most personal way is they often leave men either impotent where they can't have sex, or incontinence where they're wearing literally wearing a diaper or both, where it's not really clear that there's a real benefit.

90% of men who have prostate cancer have what's called a Gleason score of three plus three or or six, which means that their their if they are monitored carefully in most cases, depending on, a few other factors, they can do what's called watchful waiting or active surveillance for doctor tests and periodically. But they don't necessarily have to have treatment. And so those are the people that we, that we enroll now. I want to make sure that your audience understands that there are, with both prostate cancer and breast cancer, which act very similarly.

There are hormonal different dependent cancers, that there are aggressive subtypes that really do need surgery or chemo or radiation or something like that. Right. Most of them don't have that, but some people do. If you're, you know, bracket positive and or two negative and so on. Or if you have a Gleason score of 8 or 9, you need the lifestyle change in addition to those can help reduce the risk of recurrence. But you probably don't need conventional treatment. But 90% of guys have a Gleason score of six.

Pardon me. And for them, they can, if their doctor monitors them carefully and determines that they're in the right subgroup, they can do that. So from an experimental design standpoint, it was great because we could then take men who had biopsy proven prostate cancer, who had decided not to have conventional treatment, randomly divide them into two groups and have one group change their lifestyle and the other group to their whatever they were doing before. So now we could actually have a nonintervention control group so we can look at the effects of lifestyle changes alone.

In most cases, most people with cancer get treatment, so then you can't really figure out how much of it is due to the treatment and how much is due to the lifestyle. And in this case we could. So what we found was that after a year, none of the people in the intervention group needed surgery or radiation or chemo, but six of the patients did. This is out of a sample size of 93. The PSA levels, which is a marker for prostate cancer, went down or got better in the intervention group, went up or got worse in the control group.

The differences were highly statistically significant, and they occurred in direct proportion to the degree of lifestyle change. In other words, the more people change, the more their these, biomarkers improve. But PSA is not a perfect measure. And so we added some of their serum, their blood to a standard line of prostate tumor cells growing in tissue culture at Baylor Instance Lab at UCLA. And found that the tumor growth was inhibited 70%. And the group that made these lifestyle changes when we added their blood, but only 9% in the control group.

And what was really mind blowing to me was that based on an apriori formula, there was a dose response correlation not only between the degree of lifestyle change and the degree of change in their biomarkers like PSA, but between the degree of lifestyle change and the actual effect on tumor growth and tissue culture. So to make that clear, if you can imagine a prostate tissue, prostate cancer growing in a, excuse me, and I've been lecturing all day in a, in a laboratory in a petri dish, if you will, and they take the blood of someone has changed their lifestyle and they add it to that, that it inhibits the growth of that tumor by 70% through mechanisms we don't fully understand compared to the control group, when they added their blood only 9%, and probably because they were changing, but just not as much.

So it really shows us that our, there's a lot we can do. There's no guarantees whether or not you have conventional treatment or not. Certainly the lifestyle changes can help make that treatment work even better. And in certain cases, in the case of men with early stage prostate cancer under their doctor supervision, it may prevent them from needing conventional treatment. Right. It's really it's nicely with prostate cancer is so such a great disease to monitor of nutritional interventions and lifestyle interventions because we have the PSA to monitor which is not invasive with breast cancer, it's hard to monitor the whole thing of the progression because there's no a blood test is easiest to collect for a PSA with breast cancer, which there is something there.

But what's true for prostate cancer will likely be true for breast cancer as well. Yeah, similar diseases, but we just can't market as well. But that's right. And it's the same thing with you have some aggressive cases but you have the garden variety breast cancer postmenopausal estrogen positive still react still responds very well to halting of growth and slow and preventing of recurrence in the testes longer lifespan. So it's very much related. So that's why it's really good to have this data.

Yeah. And one study came out recently that if you have really early stage breast cancer, what's called ductal carcinoma in situ, that, you know, watchful waiting could be, an option for women for, for many women, in which case that instead of just watchful waiting, they can feel like they're actually taking charge of their life and making these lifestyle changes, which can only, you know, the only side effects are really good ones.

Psychology, Meaning, and Social Connection 12:28

Do you think that the people who are encouraged to make these changes, it has an effect to help their psychology, their positive emotions, because they have more hope and they feel like they're actively participating in their own bodies, in their own wellness. Does it make it easier for you to give them more emotional counseling and reduce stress from them when they're actually actively changing their life? Absolutely. You know, we found that in the data we have on 15,000 people who've gone through our program, that we've collected data on, that the depression scores are reduced almost 50%, even though we're not targeting depression, per se.

But when you eat better, when you have a sense of control over your life, when you can find meaning in it, when you have social connections with other people, it really affects our mood as well. I actually got interested in doing this work as my life's work when I was suicidal, depressed, when I was a, second year sophomore in college at Rice University in Houston, and came about as close to committing suicide as a person can without actually doing it. If I hadn't gotten so sick with mononucleosis and didn't have the energy to do it, I probably would have done that.

But I learned that I could take all the meaning out of life. You know? Who cares? So what? Big deal, nothing matters, etc. but I also learned that I could imbue my. What saved me was I learned that I could I had a spiritual teacher, the name Swami Ananda, that I found that helped me realize that I could, just as I could, take all the meaning out of my life, I could put it back in. I could imbue my life with meaning. And for me, it was by doing acts of service, I decided to become a doctor so I could help people.

But it was the most selfless thing I could do. I'm sure you you. I imagine you have a lot of the same motivation that when you help somebody else, it really helps you. Vivek Murthy came out with the report, the surgeon general, about one of the best ways to heal that sense of isolation is to, find somebody who can do something for it. Really is the best antidepressant, if you will. That's really amazing. And so I noticed that you have tremendous compassion for others. I, I've always noticed that.

And I'm thinking now this idea of social isolation and loneliness, does have how do you deal with the fact that when people switch to they become like a health nut or a health advocate, or start to take really good care of their health, they sometimes get ostracized or feel that they're not getting the support of their community, leading to less social connections. How do you counter that with what you're dealing with? What your advice, what kind of advice could you help us in that field? Well thank you. Yeah.

What I mean, when you go through a lot of suffering, survive it. It does make you more compassionate. So that's the good side. That's where the the beneficial part. But it's worth mentioning that, you know, study after study have shown that people who are lonely and depressed and isolated are 3 to 10 times more likely to get sick and die prematurely. It pretty much all causes when compared to those who have a sense of love and connection and community. I don't know anything that both directly and indirectly, because it affects our behaviors as well.

People often say things like, you know, I, I'm really lonely. I smoke because I've got 20 friends in this pack of cigarets, and they're always there for me. And nobody else is, you know, or food fills that void, or alcohol numbs the pain, or fentanyl numb the pain or fat cuts my nerves and numbs the pain. Or video games distract me from my pain or working all the time or, you know, whatever alcohol or other dogs do. And so I've learned then, that it's not enough to give people information. Sometimes that's enough.

But, you know, if that were true, nobody would smoke. It's not like people don't know it's bad for them. Right? But the problem is, is how the information is conveyed. So much of, in the name of trying to help people, we the, the whole language of behavioral change has this kind of fascist, judgmental shaming, Nurse Ratchet wagging their finger. I'm sure you have more than one occasion where you go out to dinner and people start to apologize for what they're eating or comment while you're eating.

You know, I'm just having the all the time like it does for me. And I just, you know, I say, you know, you are forgiven, you know, to kind of make fun of that. But, you know, once you're quite the language of behavioral change, like once you call food's good or bad, it's a small step to say I'm a bad person because I a bad food. And at that point, you know, I might as well just, you know, finish the burger because you're a bad person or, you know, I cheated on my diet, you know, and I even more than being healthy, people want to feel free and in control.

And as soon as you I tell somebody, you know, eat this and don't do that and do this and don't do that, they immediately want to do the opposite, you know, and it goes back to the first dietary intervention, you know, which didn't go so well when God said, don't eat the apple. And you know, that was got to talking. So I think one of the problems when people kind of change their lifestyle, whether it's a doctor or are just up here and they try to get other people, you they with the best of intentions, they want to bring people in, but they can like how, you know, put down that burger, like, how can you eat that junk, you know, and nobody wants to feel shamed or judged or whatever.

And so, it can be counterproductive. I wrote a book years ago called The Spectrum that was designed for preventing disease, and part of what I did was to say, look, instead of saying, these are good foods and these are bad foods, I categorize foods from the most healthy group, one which are the same foods that can cause reversal of disease, the whole foods, plant based foods, essentially vegan foods to group five the least healthy foods. The usual suspects, you know, cheeseburgers or fried cheesecake or whatever and say, look, if you want a reverse disease, that's more prescriptive, this is what it takes to do it.

That's why we were the first to show it. And all these different, illnesses in a, in randomized trials is because people did usually didn't go far enough. But if you're just trying to lose a few pounds, get your LDL or blood pressure, a once a year or whatever down. It's not all or nothing. You know, one of the things we learned in all of our studies is the more you change, the better you get at any age. So if you if a patient came to me and said, hey, I'm here, I want to I want to live longer. First of all, I'd say, why do you want to live longer?

And they go, doesn't everybody want to live longer? I said, well, no, like I almost killed myself was 19. You know, a lot of people are depressed or just trying to get through the day. You know, that's a big accomplishment. So that was I get them this sense. Well, I want to gosh, why do I look like I want to watch my kids grow up? I want to dance at their wedding. I want to write whatever it is that provides them, that sense of meaning. If they can find meaning in it, then they're much more likely.

First of all, it has great benefit that they're more likely to make these changes, and then they'll say, well, okay, what else do you want it? Why else are you here? Well, I want to get my LDL down 50 points. Okay. Great. What are you eating now? And so I show them the spectrum from the most healthy to the least helpful, the most healthy group one, the least healthy group. Five. While I'm eating, mostly group five a little bit. For how much are you willing to change? Wow. No one's ever asked me that before.

They're always telling me what to do. That's great, you know, because, again, even more than being healthy, people want to feel free. So I go, okay, I don't know, I'll eat less four and five and more one and three, but isolates some four and five. I said, great. You know, if you indulge yourself one day, eat healthier the next, you know, they're if you don't have time to exercise one day, do a little more the next. You can't fail in that context. How much exercise you you're getting not enough. How much you willing to do.

Gosh, no one's ever asked me that either. They're always telling me how much I should be exercising. I don't know, I'll. I'll walk, 20 minutes a day. Great. How much meditation and yoga are you doing? Zero. How much are you willing to do? I know I'll meditate five minutes a day. Great. How much time you're spending with your friends and family and loved ones? Not enough. I'll spend more. Great. So we'll support it. We'll track it a month later, they come back. Their LDL is down 30 points. I say, how wonderful.

Look at this. Look what you've done. And now, if you're willing to go eat a little healthier, do a little more exercise, a little more meditation, a little more time with your friends and family, that'll probably do it.

Practical Lifestyle Change and Patient Empowerment 19:40

So again, it takes it out of the realm of all or nothing. It takes it out of the realm, you know, on the bus or off the bus. It's saying you can't fail. Instead of saying, oh, I cheated on my diet, say, you know, I indulge myself, but I will do a little better the next day. You know, I didn't have time to exercise today. I'll do it the next time. Exercise, meditate for an hour, but try to have time to do it for a minute. So it just makes it much more sustainable, right? Well, so people can adjust this when they go back to their their real life.

But I think what you're saying too, is that when people feel they're in control of their own decisions, they're not being forced to do it. They're making the decision to do it. It's like I used to, and I used to always do. The patients. Well, you know how much what kind of where are your goals? What do you want to accomplish? What do you want to do to accomplish that? Right. So it's like it's just like we're doing here is that we're giving people the ability to take back control over their own life and based what they're doing, willing to do.

But also, I think that when you teach people about how to make healthy food tastes great and the feel that they're the idea that they're missing the enjoyment and pleasure of eating is mostly a myth, I think. And they can see that over time because they actually can learn the recipes, improve their taste, muscle. And as they're going in the program, they're more desirous of being of getting more into it, you know, in a bigger degree. Yeah. That's why in our program that Medicare's paying for now for heart patients, we actually take that out of what Medicare pays us, and we give them their first two weeks of meals for free, three meals a day and two snacks a day while they make that transition first of all, in a couple of weeks, as you know better than anybody, your palate begins to shift so you actually begin to earn healthier foods.

Second, you start to feel so much better that you want to learn how to cook and shopping it out. And this and you can say, oh, this food actually tastes pretty good. You know, they'll, you know, tired cliche, am I going to live longer or is it just going to seem that way? You know, you say, wait a minute, I actually like the food. And by the way, my chest pain is gone and my my sexual function is improved and I can think more clearly. And I have more energy and I feel better. And yeah, I like eating junk food, but not that much.

You know, I like feeling this way even better. And so it reframes the whole reason for making these lifestyle changes from fear, which is not sustainable, to joy and pleasure and love and feeling good, which really are. Yeah, that's phenomenal. And I think that you're right about this idea that when people could verbalize and think about their mission and purpose in life and their effect to have a good effect on others, they could be more likely to use their own improvement in health to connect more with people, rather than connect less with people.

Exactly. You know, Viktor Frankl wrote a book called Man's Search for meaning years ago that looked at concentration camp survivors in World War Two, and he found the ones that survive weren't the healthiest for the strongest. They were the ones that had the strongest sense of meaning and purpose. I have to survive so that I can, whatever, fill in the blank, be it with my loved ones or bear witness or whatever it was. So, as you were saying so eloquently earlier, if you can help someone find like nobody looks for suffering, but sometimes there it is, because say, okay, what what what can we make out of this?

That's good. You know how I mean, for one thing, you know, change is hard. But if you're in enough pain, the idea of change becomes more interesting. It's like, wow, I'm hurting so bad. But boy, that stuff seems so weird. But boy, I'm so hurting. So let me try this weird stuff. And that's part of the reason why I've spent so much of my life doing these research studies. Because it's saying, look, if you're willing to make these changes, this is the benefit you're likely to get. And so we can help people use that moment of crisis as an opportunity for change as opposed to just literally or figuratively, bypassing it.

And, you know, because the, the I can't I'm sure you've had patients who've said, you know, having a heart attack was the best thing that ever happened to me, you know, like, what, are you crazy? And they say, no, that's what it took to get my attention that I began making these changes that I never would have made. Just like, for me, it was getting suicide, depressed. That made my life so much more joyful and meaningful that I'm rediscovering inner sources of peace and joy and well-being. I mean, having more intimate relationships with my family and loved ones.

I'm, having more energy. I feel better, I look better, I smell or taste better or whatever. You know, these are things that, I would never have done had I not, done that. So as doctors and and caring people, if we can reach people when they're suffering not to be glib and say, oh, how wonderful you have this heart attack, but to say, look how horrible you had this heart attack. But how can we use that experience in a constructive way can really be transformative, right? So your your work and the work on and lifestyle medicine has somewhat infiltrated into conventional cardiovascular care, mostly for the advanced people with serious illnesses.

You know, it's got a it's just a small you know, it's got to be be more it should be all over the place even when people not so not seriously they should be every person should be getting this information. But when I what about in in the oncology field. Are you seeing any growth that oncologists are utilizing this the science here that's been emerging over the last few decades that they could start to get better outcomes? Well, it's more so in cardiology. And that's why I spent so many years to try to get Medicare to cover our program.

I realized that when I first started publishing these papers, I thought, if you just said good science, that'll change medical practice. And that was a little naive. It's important, but not usually sufficient. But if you have good science and you change reimbursement, then

Cancer Care, Reimbursement, and Closing Remarks 24:58

you know, that's a more powerful driver of of real transformation. And again, it's not the doctors are only interested in money. But if you're trying to use drugs in surgery only and you're paid to use drugs in surgery only, then that's what you do. It's like, you know, it remembers that if you want to heal, you have as a hammer. You see, everything is a nail. Now, in college and in prostate cancer, for example, Medicare is not covering that. We haven't really tried to get that, but we'd love to one day because again, for the same reasons.

But, so there's no real economic incentive. I'm on the nutrition working group of the American College of Cardiology. We published a paper a few years ago that the average doctor gets four hours of nutrition training a year. The average cardiology fellow gets 0 in 4 years of training. So there's a lot of work to be done and a lot of room for improvement. But so some of the best urologists, like Peter Carroll, who's the chair of urology at UCSF, where I'm a professor, have have pioneered to say, you know, if, if, like if somebody needed surgery, he's the guy to go to.

But he has the largest cohort of men doing watchful waiting or active surveillance of anybody on the planet, because he's so gifted and smart that he can really see that. Oh, you know, for 90% of people who have Gleason scores of six or less, they probably don't need to have surgery or treatment right away. There's no evidence those people are going to live longer than those who don't. But for the subtype of people who have Gleason 8 or 9, they really do. And so I think that that because of pioneers like him and the work that we're doing together, I think that is changing, but more slowly than in the cardiology world.

Right. So you think this it will change in the future as a result of this work. And then Laura is from and is also at UCSF. She's a close friend. She's the head of the breast cancer center there. And she also has done pioneering work showing that, again, women with with localized breast cancer and who have, you know, don't have the risk factors that make it more aggressive, can often be treated, in a watchful waiting way as well. And it is encouraging them to make if you're going to do watchful waiting to make these lifestyle changes as well, or even if you're going to have breast cancer treatment to make these lifestyle changes as well, to reduce the risk of recurrence.

Yeah for sure. And and people don't even realize that even if you're in an aggressive category where you require required chemotherapy, you to improve your health, you overall makes you respond better to treatment, prevent recurrence, as you said, but also prevent the chance of getting a secondary cancer. That could be or any damage from the chemo itself. So it's just like we've even more reason to embrace healthy living. Yeah, I know there's nothing that's a guaranteed for sure. I mean, chef AJ talked recently about having lung cancer even though she's never been a smoker.

Yes you can chef. So these things are not guaranteed. There's a certain element of humility we have to have around all this. You know there's a bit of mystery, but overall these things clearly make a difference in reducing risk and of both recurrence and of getting cancer in the first place. Well, thank you so much for joining us and for being part of this summit. Really appreciate that. And of course, wishing everybody great health and much happiness and the motivation, the passion, the compassion and the, you know, and then the ability to move forward and make improvements in your life.

Well, Joe, I just want to end by saying, what a difference you've made in the lives of so many people. That awareness is the first step in healing. And I salute you for raising awareness in the lives of so many people and empowering them. And thank you for the chance to be with you today. Appreciate so much. Appreciate that. Again. Thank you everybody. Bye bye.