compare and contrast dr ornish and dr atkins
Whole grain consumption improves insulin sensitivity in overweight and obese adults (15). Am J Clin Nutr. One-year effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in decreasing body weight and heart disease risk. This article was most recently revised and updated by, https://www.britannica.com/biography/Dean-Ornish, American Entertainment International Speakers Bureau - Biography of Dean Ornish, Ornish, Dean - Student Encyclopedia (Ages 11 and up). A paper was presented from Tufts University titled One Year Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in Decreasing Body Weight and Heart Disease Risk. The researchers concluded All diets resulted in significant weight loss from baseline and all but the Ornish diet resulted in significant reductions in the Framingham risk score (45). Journal of the American Medical Association 104(2004):537. Some people are able to handle more simple carbohydrates and/or more cholesterol and saturated fat in their diet than others. Join the hundreds of thousands in my email community for the latest news, insight, and more, Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, Kraemer HC, King AC. He received an M.D. If his diet worksand again, we dont know for sure that it doesis that because it reduces protein or fat or refined carbohydrates? Dietary cholesterol and the pathogenesis of atherosclerosis. To address this issue, a recent National Institutes of Health study that I cited in my oped put people in a metabolic ward where they could actually control what people were eating and then measured the effects. How might a mans reproductive health concerns change at different periods of his life? Reductions in total cholesterol, LDL-C, triglycerides, and total-to-HDL cholesterol ratios were significant only in patients who were following either a 10% fat diet or a 15% fat, calorie-controlled diet. The New York Times Sunday Magazine, July 7, 2002. The March 2014 study that Ornish cites as finding a 75 percent increase in premature deaths from all causes and a 400 percent increase in deaths from cancer and type 2 diabetes among heavy consumers of animal protein under the age of 65, also did not distinguish between types of animal protein. But Ornishs arguments against protein and fat are weak, simplistic and, in a way, irrelevant. Stefanick ML, Mackey S, Sheehan M, et al. New York: MacMillan; 1933:271-322. All evidence is to the contrary. This does not confer the same risk of atherosclerosis as in Americans with low HDL levels who are consuming a high-fat diet (41). This is especially incongruous when, as mentioned earlier, the only study to examine blood flow on the Atkins diet found that it actually worsened (35). He began the Lifestyle Heart Trial, a controlled study of the effects of a low-fat diet and stress-management regime on a small group of heart disease patients, implementing a unique approach to treating heart disease that he developed in the late 1970s while he was still a student. Im not cherry-picking data; Im looking at the preponderance of evidence from many studies by leading investigators such as those at Harvard School of Public Health. Westman EC, Yancy WS, Edman JS, et al. Leaf A, Weber PC. Second, another big fat lie that has been repeated so often its becoming a meme is that there is not enough good science to inform us about an optimal way of eating. Interaction of dietary cholesterol and triglycerides in the regulation of hepatic low-density lipoprotein transport in the hamster. We documented significant improvements in the hearts function after only 24 days compared with a randomized control group. Even better would be to reduce the intake of simple carbohydrates and most fats, which results in losing even more weight while enhancing health rather than potentially harming it. A receptor-mediate pathway for cholesterol homeostasis. Weight loss was 1 lb/week on the 10% fat diet and 0.6 lb/week on the Atkins diet. Other studies have documented that an AHA/NCEP diet is not very effective in lowering LDL-C (21). Dean Ornish, MD, is founder and president of the non-profit Preventive Medicine Research Institute and is Clinical Professor of Medicine at the University of California, San Francisco. Other nonscientist, nonphysician writers have also been saying that Americans have been told to eat less fatWere eating less fat, were fatter than ever, so weve been given bad advice. You can eat fewer calories by consuming less food. Ornish D, Pettengill E, Merritt-Worden T. Marked improvements in biomedical and psychosocial cardiac risk factors from a community-based lifestyle program. His dietary regimen was mostly an inverted version of the USDA pyramid that was high in fat and low in carbohydrates. CONCLUSIONS: There are no data showing that the physiologic reduction of HDL-C levels with a low-fat diet is detrimental, especially in that LDL-C usually decreases more than HDL-C (42). The purpose of this article is to find common ground among seemingly contradictory information about different diets, present an evidence-based rationale for optimal nutrition, and describe many of the half-truths and distortions of the Atkins diet and other similar diets. In contrast, within each diet, the HDL-C and apo A-I levels were inversely correlated with apo A-I FCR both on the high-and low-fat diets but not with apo A-I transport rate (44). Dietary cholesterol and saturated fats increase plasma LDL-C in part by down-regulating LDL receptors in the liver (28). As I wrote: I agree that replacing fat with sugar is not healthful, as Ive written about for decades. Armstrong ML, Warner ED, Connor WE. 1990;336:129-133. Dean Ornish, MD The fact that not all studies have shown this risk does not mean that it is not true. Cardiovascular effects of n-3 fatty acids. WebDr, Atkins vs. Dean Ornish and John McDougall - USDA Debate from 2000. This reduction in LDL-C is much greater than on an Atkins diet and is comparable with the effects of statin drugs. Ornish D. The case for low fat. The American Cancer Society 1996 Advisory Committee on Diet, Nutrition, and Cancer Prevention. To some, the fact that an Atkins diet does not significantly raise LDL-C is surprising given the amount of saturated fat and cholesterol in the diet. In contrast, differences in HDL-C levels between people on a given diet correlate with and may result from differences in apo A-I FCR. 1999;70:412-419. WebIn this article, an example of translation of the English term learning outcome into the Lithuanian system of educational terms is used to discuss semantic peculiarities of translating professional terms. 2002;75:848-855. In his lengthy reply to my article Dean Ornish says I distort his beliefs, cite questionable studies and dont have the clinical experience to assess nutritional evidence. Intensive risk factor modification. She wrote about the reasons that autoimmune diseases overwhelmingly affect women in the September 2021 issue. First, shes again perpetuating the myth that when we cut out fat, we began eating foods that were worse for us. As the USDA data show, were eating more fat, not less. N Engl J Med. (Also: the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does.) N Engl J Med. When you eat less fat, you consume fewer calories without having to eat less food, thereby increasing satiety without adding calories. However, even in those with reduced numbers of LDL receptors who are not very efficient in metabolizing dietary saturated fat and cholesterol, decreasing the intake of these to a greater degree has a much bigger impact. When people dutifully cut down on fat in the 1980s and 1990s, they replaced much of it with high-sugar and high-calorie processed foods (think: Snackwells). However, CHD patients who followed a 10% fat, whole foods diet demonstrated significant regression of coronary atherosclerosis after 1 year as measured by quantitative coronary arteriography (37) and even more regression after 5 years (the amount of exercise was not significantly different between groups, but the experimental group was also practicing yoga and meditation) (32). I'm not aware of a single study showing that a diet high in red meat can reverse the progression of coronary heart disease. Ornish represented the other viewpoint with his fruits, veggies, and sharp criticisms of Atkins. Weight loss at 12 months was the primary outcome. WHAT EVIDENCE SUPPORTS THAT HIGH-PROTEIN DIETS MAY BE HARMFUL? Earlier this year a panel of experts from U.S. News & World Report rated the Ornish Diet as the number-one diet for heart health for the fifth year in a row (that is, all five years they have been doing rankings). This is not true, as I wrote about years ago in my Newsweek column. Participants were randomly assigned to follow the Atkins (n = 77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up. The March 2014 study that Ornish cites as finding a 75 percent increase in premature deaths from all causes and a 400 percent increase in deaths from cancer and type 2 diabetes among heavy consumers of animal protein under the age of 65, also did not distinguish between types of animal protein. While every effort has been made to follow citation style rules, there may be some discrepancies. Moyers article only adds to that confusion. Melinda Wenner Moyer, a contributing editor at Scientific American, is author of How to Raise Kids Who Arent Assholes: Science-Based Strategies for Better Parentingfrom Tots to Teens (G. P. Putnams Sons, 2021). In another study, 70% of patients on an Atkins diet for 6 months were constipated, 65% had halitosis, 54% reported headaches, and 10% had hair loss (59). Over and over, Ive seen patients with coronary heart disease so severe that they cant walk across the street or work or play with their kids or make love or do much of anything without getting severe chest pain become pain-free after only a few weeks of making these diet and lifestyle changes. Although Dr Atkins and I agreed on the diagnosisthat many Americans eat too many simple carbohydrateswe disagreed about the prescription. Since the U.S. population last year was 322 million people, this represents only 0.000044% of the population, and different people are surveyed each year. JAMA. That only supports my thesis, because I recommend that people eat less harmful fats and fewer refined carbohydrates. WebWas Dr. Atkins Right? 1993;58:398-406. The diet I recommend is low in refined carbohydrates and low in harmful fats (including trans fats, hydrogenated fats and some saturated fats) and low in animal protein (particularly red meat) but includes beneficial fats (including omega-3 fatty acids), good carbs (including fruits, vegetables, whole grains, legumes and soy in their natural, unrefined forms) and good proteins (predominantly plant-based). Well, thats the pointwere not fat because were eating too little fat; were fat because were eating too much of everything. WHAT IS THE EVIDENCE THAT COMPLEX CARBOHYDRATES ARE BENEFICIAL? In one of these studies, low-density lipoprotein cholesterol (LDL-C) increased from 118 to 121 mg/dL on an AHA/NCEP low-fat diet and increased from 114 to 118 mg/dL on a high-protein/low-carbohydrate diet (19). I have no horse in this race. These studies have been conducted with well-respected collaborators, published in the leading peer-reviewed journals, and presented at the most credible scientific meetings. In other words, when you change the type of food, you dont have to be as concerned about the amount of food. WebMean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), The goal is to lose weight in ways that enhance health rather than in ways that may harm it. 2007 Jul 11;298(2):178).This says something important about the quality of that research. Circulation. Knowledge awaits. Explore our digital archive back to 1845, including articles by more than 150 Nobel Prize winners. The impact of protein intake on renal function decline in women with normal renal function or mild renal insufficiency. Stefanick ML, Mackey S, Sheehan M, Ellsworth N, Haskell WL, Wood PD. J Am Diet Assoc. 1998) showed an average reduction of 24 pounds in the first year. A critique of the diet guru's views on high-protein diets, followed by a response from Ornish and a reply from the author. Circ Res. Mean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), and Ornish, -2.2 kg (-3.6 to -0.8 kg). There has been a recent resurgence of interest in low-carbohydrate/high-fat diets such as the Atkins diet (1-3). In a survey of food consumption data from the United States Department of Agricultures National Food Consumption Surveys (NFCS) and the Continuing Survey of Food Intakes by Individuals (CSFII), Individuals of all ages who consume a diet with fewer than 30% of calories from fat consistently have lower energy intakes. Oliver MF, Yates PA. A wide body of scientific evidence links the consumption of animal protein, saturated fat, and cholesterol with CVD, cancer, and other chronic illnesses (47-51). Brown MS, Goldstein JL. . These are rich in fiber, which enhances satiety without adding significant calories. 2003;26:302-307. Presented at the American Heart Association Annual Scientific Sessions, Orlando, FL, 2003. Cambridge, MA: Harvard University Press; 1980. 1974;15:508-516. As stated earlier, a low-fat, whole foods diet has been proven to reverse heart disease using actual measures of coronary atherosclerosis and myocardial perfusion, whereas none of the other three diets has been shown to do so. I would love to be able to tell you that these are health foods, but they are not. Changes in myocardial perfusion abnormalities by positron emission tomography after long-term, intense risk factor modification. Eating a high glycemic index food along with mostly low glycemic index foods may reduce the overall glycemic load of the meal. Hu JF, Zhao XH, Parpia B. Dietary intakes and urinary excretion of calcium and acids: A cross-sectional study of women in China. 2002;76:535-540. It is all about energy balance. Her article begins with a gross distortion of what I believe. One reason that people often lose weight when they reduce their intake of carbohydrates is that they are usually reducing their intake of fats as well. The level of LDL-C is regulated by the LDL receptor, a cell surface glycoprotein that removes LDL from plasma by receptor-mediated endocytosis (27). The decrease in the percentage of calories from fat during the period 1971 to 1991 is attributed to an increase in total calories consumed; absolute fat intake in grams actually increased. N Engl J Med. But replacing animal protein with well-balanced plant proteins is beneficial, and this is in the mainstream of what most scientists who do nutrition research believe. The USDA tracks changes in consumption of the entire food supply. Ketone bodies formed on a high-protein diet undergo urinary excretion with a cation to maintain electrical neutrality, resulting in the loss of cations such as calcium, magnesium, and potassium (55,56). In a 2007 clinical trial led by Gardner researchers randomly assigned 311 individuals to four groups: One group was assigned the high-fat, high-protein and low-carbohydrate Atkins diet; the second was assigned Ornishs very low-fat vegetarian diet, which requires consuming fewer than 10 percent of calories from fat; the third was assigned the Zone diet, which aims for a 40/30/30 percent distribution of carbohydrate, protein and fat; and the fourth was assigned the high-carbohydrate, lowsaturated fat LEARN (for: lifestyle, exercise, attitudes, relationships, nutrition) diet. Am J Clin Nutr. Reddy ST, Wang CY, Sakhaee K, et al. Therefore, diet-induced changes in HDL-C levels correlate with and may result from changes in apo A-I transport rate. Brody J. Fleming R, Boyd LB. 1995;274:894-901. Total fat and animal fat intake were higher and carbohydrate intake was lower in those with recently diagnosed diabetes or previously undiagnosed diabetes in the multinational, multicenter study of the Mediterranean Group for the Study of Diabetes (17). Thanks for reading Scientific American. Ornish moved to San Francisco in July 1984 after accepting a teaching position at the University of California School of Medicine. By planning to improv 1968;2:702-703. But what about the claims Ornish makes about the success of his own dietdo they hold up to scrutiny? Copyright [c] 2004 by the American Dietetic Association. But even if the NHANES data are accurate, they show Americans are eating more fat than ever and even more refined carbohydrates than ever. Its almost certainly healthier than the highly processed, refined-carbohydrate-rich diet most Americans consume today. Kern PA, Ong JM, Saffari B, Carty J. As you approach your weight loss goals, you start to Losing weight is important, but the history of medicine is replete with examples of weight-loss approaches that were harmful to health (eg, amphetamines, fen-phen). BACKGROUND: Taubes G. The soft science of dietary fat. 1990;85:144-151. Dr. David Perlmutter is on the cutting edge of innovative medicine that looks at all lifestyle influences on health and illness. 1998;318:549-557. New York: Random House; 1990. Am J Physiol. An easier way to consume fewer calories is to eat less fat because fat (whether saturated, monosaturated, or unsaturated) has 9 kcal/g, whereas protein and carbohydrates have only 4 kcal/g. For 37 years he has been touting the benefits of very low-fat, high-carbohydrate, vegetarian diets for preventing and reversing heart disease. Ornish then moved to the Boston area for a clinical fellowship at Harvard Medical School and an internship and residency in internal medicine at Massachusetts General Hospital, which he completed in 1984. Editor's Note: Our April 22 article elicited a lengthy response from Dean Ornish, which we publish here, along with a rebuttal from Melinda Wenner Moyer. In addition to promoting weight loss, Atkins claimed that this diet may help people prevent heart disease, diabetes, and possibly other chronic illnesses. And although no one likes to be falsely accused that almost everything they say is wrong, the bigger concern I have is that people who otherwise might have been motivated to make these highly beneficial diet and lifestyle changes may be discouraged from doing so by reading this essay by Ms. Moyer in which, unfortunately, almost everything she writes about my work is wrong. In simple terms, those with higher HDL-C levels have more garbage trucks (HDL) to get rid of the garbage (excessive fat and cholesterol). Samaha FF, Iqbal N, Seshadri P. A low-carbohydrate diet as compared with a low-fat diet in severe obesity. The effect of high-, moderate-, and low-fat diets on weight loss and cardiovascular disease risk factors. 1988;81:300-309. Spady DK, Dietschy JM. Founder and president, Preventive Medicine Research Institute 2003;103:867-872. Weight loss was not statistically different among the Zone, LEARN, and Ornish groups. Indicate whether you agree with one or both researchers or have a different To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables. J Am Coll Nutr. Lancet. Foster GD, Wyatt HR, Hill JO, et al. Ornish D. Dr. Dean Ornishs Program for Reversing Heart Disease. Articles from Britannica Encyclopedias for elementary and high school students. Clinical professor of medicine, University of California, San Francisco Hemorheologic effects of a short-term ketogenic diet. They should not be used to make claims about cause and effect; doing so is considered by nutrition scientists to be inappropriate and misleading. The reason: People who eat a lot of animal protein often make other lifestyle choices that increase their disease risk, and although researchers try to make statistical adjustments to control for these confounding variables, as theyre called, its a very imperfect science. Nutrition is complex but there is little evidence our countrys worsening metabolic ills are the fault of protein or fat. You used to find a lot more people interested in Ornish eventually received a bachelors degree in humanities (1975) from the University of Texas at Austin, graduating first in his class. All three diets reduced blood pressure, total and low-density lipoprotein cholesterol levels, and estimated coronary heart disease risk. 2003;348:2082-2090. 2002;40:265-274. The arterial damage was caused by animal-protein induced elevations in free fatty acids and insulin levels and decreased production of endothelial progenitor cells (which help keep arteries clean). (All groups consumed about the same amount of protein.). Meat has virtually no dietary fiber. DISTINGUISHING BETWEEN RISK FACTORS AND ACTUAL MEASURES OF DISEASE. Ornish wrote several popular books, including Stress, Diet, and Your Heart (1982), Dr. Dean Ornishs Program for Reversing Heart Disease: The Only System Scientifically Proven to Reverse Heart Disease Without Drugs or Surgery (1990), The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health (2007), and Undo It! 1998;82:18T-21T. What happens to changes in blood pressure, cholesterol and weight are important only to the extent that they affect the underlying disease process (for example, degree of atherosclerosis, blood flow to the heart, cardiac events, changes in prostate cancer), which is what we documented. Ornish also dismisses the randomized controlled trials I cited in large part because the subjects in these trials did not adhere to the diets and reduce their fat intake enough. Sample sizes ranged from 1,730 men and 2,003 women in NHANES 1999 to 2000 to 6,630 men and 7,537 women in NHANES III. And it is worth noting that among people in the study over 65, heavy consumption of animal protein actually protected against cancer and mortality. In: Cowdry EV, ed. National Institutes of Health. The Lifestyle Heart Trial. Accessed March 5, 2004. Atkins R, Ornish D. Cardiology Crossfire. American College of Cardiology 50th Annual Scientific Sessions, Orlando, FL, March 20, 2001.
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