compare and contrast dr ornish and dr atkins

Below is my letter to the editor of The New England Journal of Medicine that they published about this study: Protein, too, doesnt look so evil when one considers the 2010 trial published in The New England Journal of Medicine that found individuals who had recently lost weight were more likely to keep it off if they ate more protein, along with the 2005 OmniHeart trial that reported individuals who substituted either protein or monounsaturated fat for some of their carbohydrates reduced their cardiovascular risk factors compared with individuals who did not. The rivalry between Atkins and Ornish was related to food intake. These include JAMA The Journal of the American Medical Association, The Lancet, Proceedings of the National Academy of Sciences, The Lancet Oncology, The New England Journal of Medicine, The American Journal of Cardiology and others. Prev Cardiol. A randomized trial of a low-carbohydrate diet for obesity. 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). But Ornishs arguments against protein and fat are weak, simplistic and, in a way, irrelevant. Also, as I wrote in my oped in The New York Times, my colleagues and I have conducted randomized controlled trials that these same diet and lifestyle changes reverse the progression of other common chronic diseases. Stevens A, Robinson DP, Turpin J, et al. Wing RR, Vazquez JA, Ryan CM. (Also: the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does.) Regulation of low-density lipoprotein receptors: Implications for pathogenesis and therapy of hypercholesterolemia and atherosclerosis. History tells us its not going to be spinach. Judging the quality of a study by the number of patients is like judging the quality of a book by the number of pages. When you eat less fat, you consume fewer calories without having to eat less food, thereby increasing satiety without adding calories. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. Protein, too, doesnt look so evil when one considers the 2010 trial published in The New England Journal of Medicine that found individuals who had recently lost weight were more likely to keep it off if they ate more protein, along with the 2005 OmniHeart trial that reported individuals who substituted either protein or monounsaturated fat for some of their carbohydrates reduced their cardiovascular risk factors compared with individuals who did not. New York: Random House; 1990. 1990;336:129-133. Moyers article only adds to that confusion. Thus, dietary fat is not responsible for obesity. In fact, per capita consumption of fat has risen by 10 Ib/year since 1975, whereas per capita consumption of simple carbohydrates has increased even more, by 20 Ib/year (5). But heres the thing: The patients who followed his diet also quit smoking, started exercising and attended stress management training. Dietschy JM, Brown MS. Effect of alterations of the specific activity of the intracellular acetyl CoA pool on apparent rates of hepatic cholesterogenesis. 2000;51:817-826. Bell EA, Rolls BJ. Explain the scientific basis of each author's position. Get a Britannica Premium subscription and gain access to exclusive content. Web3) Dr. Ornish focuses on the fact that eating eating vegetable diet can reduce weight loss. Southern Med J. Diet, lifestyle, and the etiology of coronary artery disease: The Cornell China Study. Dietary cholesterol and the pathogenesis of atherosclerosis. This study was widely reported and caused many to say, See, another study showing that the Atkins diet is good for your heart. It sounds good, but it is not true. The Atkins diet caused the most coronary artery blockages whereas a diet low in fat and high in unrefined carbohydrates caused the least amount of blockages. 1998;339:12-20. Eat more meat, butter and eggs, theyre good for you (prominently pictured on the cover of their books), all those experts have been wrong. This has been repeated so often in the echo chamber of modern media that its become a meme. The impact of protein intake on renal function decline in women with normal renal function or mild renal insufficiency. 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. Westman EC, Yancy WS, Edman JS. Twenty-eight were assigned to his low-fat, plant-based diet and 20 were given usual cardiac care. Accessed March 5, 2004. (An adult who consumes two tablespoons of olive oil in, say, a portion of salad dressing has already exceeded getting 10 percent of his days calories from fat if hes eating 2,000 calories daily.). In: Cowdry EV, ed. Some scientists think so. Let us know if you have suggestions to improve this article (requires login). WebDean Ornish and Dr. T. Colin Campbell have conducted research and published books that suggest a "Whole Food Plant-Based" (WFPB) diet is best for achieving optimal health. Hu JF, Zhao XH, Parpia B. Dietary intakes and urinary excretion of calcium and acids: A cross-sectional study of women in China. Resolving the coronary artery disease epidemic through plant-based nutrition. WebComparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction: a Randomized Trial The following information is available Nutrition is complex but there is little evidence our countrys worsening metabolic ills are the fault of protein or fat. This is why I use the USDA data (which tracks consumption of the entire food supply, not just a tiny sample). Insulin may also raise the secretion of lipoprotein lipase, increasing the uptake of fat into cells, leading to weight gain (10). And although Ornish is right that I lack clinical experience, when analyzing evidence, distance can be useful. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. Am J Clin Nutr. : How Simple Lifestyle Changes Can Reverse Most Chronic Diseases (2019; written with his wife, Anne Ornish). 1987;76:504-507. The March 2014 study in Cell Metabolism did distinguish between animal protein and plant-based proteins. Could it be that our attempts to reduce fat have in fact been part of the problem? Despite being told to eat less fat, he says, Americans have been doing the opposite: They have actually consumed 67 percent more added fat, 39 percent more sugar and 41 percent more meat in 2000 than they had in 1950 and 24.5 percent more calories than they had in 1970. Yes, Americans have been eating more fat, sugar and meat, but we have also been eating more vegetables and fruits (pdf)because we have been eating more of everything. N Engl J Med. Potential benefits and risks have not been tested adequately. In our debates, Dr Atkins often claimed that his diet can reverse coronary heart disease (CHD) but never published any peer-reviewed data to support this assertion, nor has anyone else, including advocates of similar diets such as the Zone and the South Beach diets (34). When Moyer accuses me of having inadequate scientific evidence to support my statements, I must respectfully and strongly disagree. A 2014 meta-analysis similarly reported much higher mortality risks associated with processed meat compared with red meat consumption and found no problems associated with white meat. After multivariate adjustment for major lifestyle and dietary risk factors, the pooled hazard ratio (HR) (95 percent CI) of total mortality for a one-serving-per-day increase was 1.13 (1.071.20) for unprocessed red meat and 1.20 (1.151.24) for processed red meat. Dansinger ML, Gleason JL, Griffith JL, Li W, Selker HP, Schaefer EJ. My colleagues and I have been training and certifying teams of health care professionals at leading hospitals, clinics and health systems in this lifestyle program for reversing heart disease. WebDean Ornish, in full Dean Michael Ornish, (born July 16, 1953, Dallas, Texas, U.S.), American physician and author whose approach to treating heart disease through radical Dr. Atkins believed that cutting off carbohydrates and sugar will also do the same. Westman EC, Yancy WS, Edman JS, et al. WebDr. 2003;348:2057. Ornish D. Dietary treatment of hyperlipidemia. Sudden cardiac death of an adolescent during dieting. 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). They concluded, A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates. Another major research article studied 43,396 Swedish women over 15 years. 2001;73:1010-1018. In assessing the health effects of different diets its important to measure the disease process itself, not just risk factors such as blood pressure and cholesterol levels. The goal is to lose weight in ways that enhance health rather than in ways that may harm it. Samaha FF, Iqbal N, Seshadri P. A low-carbohydrate diet as compared with a low-fat diet in severe obesity. The editor of JAMA Internal Medicine invited me to write an accompanying editorial for this study. But looking more closely at the report (pdf) he discussesas others already haveone finds that it, too, shows that in the decades from 1970 to 2000, when obesity and chronic disease rates skyrocketed, U.S. consumption of red meat and eggs dropped 12 percent. 2000;19(suppl 3):326S-330S. OBJECTIVE: Fiber from whole grains, but not refined grains, is inversely associated with all-cause mortality in older women: The Iowa womens health study. Intensive lifestyle changes for reversal of coronary heart disease Five-year follow-up of the Lifestyle Heart Trial. Pereira MA, Jacobs DR Jr, Pins JJ, et al. They wrote: In any event, I wasnt wrong about this; in my oped I was clear that these benefits were seen in those under age 65. A person is likely to lose more weight by reducing intake of both simple carbohydrates and fat than from simple carbohydrates alone. If his diet worksand again, we dont know for sure that it doesis that because it reduces protein or fat or refined carbohydrates? Science. Foster GD, Wyatt HR, Hill JO, et al. Another meta-analysis of 21 studies found no association between saturated fat intake and heart disease. The Tukey studentized range test was used to adjust for multiple testing. The case for a low-fat, highcarbohydrate diet. In educating patients in an evidenced-based practice, it may be helpful to summarize an optimal diet as one that is high in good carbohydrates (complex carbohydrates), good fats (n-3 fatty acids) (62), and good protein (plant based) and low in ones that are less healthful. For example, an important article, published in The New England Journal of Medicine, reviewed data showing that high-protein, low-carbohydrate diets promote coronary artery disease independent of their effects on traditional risk factors such as blood pressure and cholesterol levels. Its possible that quitting smoking, exercising and stress management, without the dieting, would have had the same effectbut we dont know; its also possible that his diet alone would not reverse heart disease symptoms. Taubes G. What if its all been a big fat lie? HDL is important only to the extent that it affects atherosclerosis and myocardial perfusion, it is not a disease. Plus, discouraging the intake of entire macronutrient groups can backfire. In rural China, for example, the average LDL is less than 95 mg/dL. But what about the claims Ornish makes about the success of his own dietdo they hold up to scrutiny? 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. Spady DK, Dietschy JM. J Am Diet Assoc. After one year those following his diet were more likely to see a regression in their atherosclerosis. Ornish said that the Atkins diet contributed to his impotence and poor breath. The fact that not all studies have shown this risk does not mean that it is not true. The data suggest that reducing fat intake is one effective strategy for also reducing total energy consumption Given the increasing rates of obesity in the United States at an earlier age, dietary-fat reduction may be an effective part of an overall strategy to balance energy consumption with energy needs (8). 1990;85:144-151. J Am Coll Nutr. CA Cancer J Clin. For the past 37 years my colleagues and I at the nonprofit Preventive Medicine Research Institute, in collaboration with leading scientists and medical institutions, have published a series of randomized controlled trials and demonstration projects showing that comprehensive lifestyle changes may slow, stop and often reverse the progression of many chronic diseases. As evidence for these causal claims, he cites a handful of observational studies. Ornish D. Everyday Cooking with Dr. Dean Ornish. Fleming RM. 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. Peyreigne C, Bouix D, Aissa Benhaddad A, et al. His dietary regimen was mostly an inverted version of the USDA pyramid that was high in fat and low in carbohydrates. This becomes a way of eating rather than a diet with rigid eat this and dont eat that guidelines. Medicare followed suit in 2006. Ornish D. Concise Review: Intensive lifestyle changes in the management of coronary heart disease. 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. 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). N Engl J Med. CLAIMS THAT AN ATKINS DIET IS BETTER THAN A LOW-FAT DIET. Bazzano and her associates concluded that going on a low-carb diet is better than a low-fat one for those wishing to lose weight. The results of the trial, published in 1990, revealed that at least some effects of coronary atherosclerosis had been reversed in many patients. In addition to fiber, complex carbohydrates and whole foods are rich in phytochemicals, bioflavonoids, carotenoids, retinols, sulforaphanes, isoflavones, and polyphenols and other substances that may reduce the risk of many chronic diseases. Our editors will review what youve submitted and determine whether to revise the article. 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. The title is confusing and potentially harmful to many readers. Urinary excretions of calcium and acids are correlated positively with intakes of animal and nondairy animal protein but are correlated negatively with plant-protein intake (53). 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). MAIN OUTCOME MEASURES: 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). In addition, patients on an Atkins diet are counseled to take n-3 fatty acids in the form of fish oil (something else we agreed on), which is known to reduce triglycerides significantly. Brody J. JAMA. J Lipid Res. 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. RESULTS: Am J Cardiol. Many dietitians and other health professionals as well as people in the general public are often confused by the fact that many people are able to lose weight on these diets. First, in this study, JAMA published a retraction of one of the main conclusions of this study by led by Christopher Gardner, which initially claimed that people lost more weight on the Atkins diet than on the diet I recommend, which turned out to be false (JAMA. You used to find a lot more people interested in 1998;339:12-20. A frequently overlooked "waste product" of metabolism, uric acid actually threatens our health. 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. A diet high in whole grains was associated with a reduced risk of type 2 diabetes in 42,898 men followed for 12 years. The Lifestyle Heart Trial. Circ Res. Other high-protein diets such as the Zone and the South Beach diets are somewhat better but still emphasize consumption of meat, eggs, and butter. Again, we dont know because his studies have not been designed in a way that can tell us anything about the effect of his diet alone. You can hear some of their stories here. The recent multicenter PREDIMED trial also supports the notion that fat can be good rather than bad. Leaf A, Weber PC. Available at: http://www.americaonthemove.org/. You can specify conditions of storing and accessing cookies in your browser, Compare and contrast Dr. ornish and Dr Atkins, which virus is responsible for chickenpox?. 2003;348:2074-2081. He attended Rice University in Houston but dropped out after experiencing severe depression and mononucleosis. First, I cited several large-scale studies from many different investigators, all of which showed that a diet high in red meat increases the risk of premature death from virtually all causes, even when adjusting for confounding variables. As I wrote: I agree that replacing fat with sugar is not healthful, as Ive written about for decades. She wrote about the reasons that autoimmune diseases overwhelmingly affect women in the September 2021 issue. America on the Move. People have a spectrum of choices. WebIn this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more At Pennsylvania State University, researchers found that healthy women instinctively ate about 3 lb of food a day, whether high or low in calories. A critique of the diet guru's views on high-protein diets, followed by a response from Ornish and a reply from the author. Others expressed skepticism because his experimental methods did not attempt to account for the ways in which each component of his program affected the results. Available at: http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof . Its hardly surprising that quitting smoking, exercising, reducing stress and dietingwhen done togetherimproves heart health. If you know or suspect that you have a health problem, consult a health professional. You start by eating 40 grams of net carbs, 4 to 6-ounce servings of protein and 2 to 4 servings of fat per day. 1995;19:811-816. I have presented these research findings on several occasions at the annual scientific meetings of the American Heart Association, American College of Cardiology, American Dietetic Association (now the Academy of Nutrition and Dietetics), the Institute of Medicine of the National Academies and many others. Stefanick ML, Mackey S, Sheehan M, et al. Fiber from whole grains, but not refined grains, was inversely associated with all-cause mortality in 11,040 postmenopausal women followed for 11 years (16). Ornish was a physician consultant to U.S. Pres. Brinton EA, Eisenberg S, Breslow JL. Accessed March 5, 2004. All consumption estimates are imperfect, of course, including the U.S. Department of Agriculture (USDA) data he cites. 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). Ornish believed that the stress-management aspect of his program, designed to combat social isolation as well as daily pressures, was as essential to his patients recovery as diet and physical activity. 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! Armstrong ML, Warner ED, Connor WE. She completely misrepresents my recommendations: carbohydratesone of the nutrient groups Ornish says we should eat more ofincreased. Ive always recommended that people limit their consumption of sugar and other refined carbohydrates. Diabetes mellitus, hypoglycemia, and other endocrine disorders. Ornish D. A diet rich in partial truths. Some colleagues claimed that the admonitions of his program were entirely unrealistic and that patients not under supervision would in all likelihood return to their previous, unhealthy habits. J Am Diet Assoc. (Also: the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does.) In other words, the diet I recommend causes weight loss, not weight gain. New York: Macmillan Publishing Co; 1991:409-410. N Engl J Med. Thats in part because when we cut out fat, we began eating foods that were worse for us. The relative risk of developing type 2 diabetes was 58% lower when comparing the highest with the lowest quintile of whole grain intake (14). An Atkins diet often shows a greater reduction in triglycerides by comparison. 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. Anitschkow N. Experimental arteriosclerosis in animals. www.atkins.com, All Content Copyright 2014-2019 AtkinsFacts.org, Center for Science in the Public Interest, Low Carb Diets: Potential Short and Long-term Health Implications, Northwestern University School of Medicine, Physicians Comittee for Responsible Medicine, Sudden Cardiac Death of an Adolescent During [Atkins] Dieting, United States Department of Agriculture 1/2, United States Department of Agriculture 2/2, http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof. The fact is, individuals on his diet are supposed to consume (pdf) no more than 10 percent of calories from fat, and thats very, very low compared to the average Americans adults intake of 33 percent of calories from fat. WebDr. The concept of a dietary spectrum empowers people with information and freedom of choice rather than the feeling of constraint or restriction. the following link: In a larger study of almost 3,000 patients who went through my lifestyle program in 24 hospitals and clinics, BMI (body mass index) decreased by 6.6 percent. 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. On one side was Atkins, who had two strips of bacon and three eggs for breakfast. which types of nerves carries stimuli away from the brain?, In planning his fitness goals, Alonso wants to make sure that he improves his fitness without pushing himself too hard too fast. INTERVENTION: Whats more relevant to the discussion is this fact: During the time in which the prevalence of obesity in the U.S. nearly tripled, the percentage of calories Americans consumed from protein and fat actually dropped whereas the percentage of calories Americans ingested from carbohydratesone of the nutrient groups Ornish says we should eat more ofincreased. 1974;15:508-516. In doing large-scale studies in which people complete dietary surveys, there is often so much noiseespecially in combining data in meta-analysesthat a type 2 error often occurs (that is, the noise obscures the ability to detect statistically significant differences). The only peer-reviewed study that examined the underlying disease processes found that blood flow to the heart improved on a very low-fat, whole foods diet but worsened on an Atkins diet (35). New York: MacMillan; 1933:271-322. Upon changing from high to low intake of saturated fat and cholesterol, the mean HDL-C decreased 29%, whereas apo A-I levels fell 23%. 1999;277:F813-F819. 1988;81:300-309. The American Cancer Society 1996 Advisory Committee on Diet, Nutrition, and Cancer Prevention. It may be worth noting that my most recent book, The Spectrum, featured a piece of salmon on the cover. . Fourth, the patients in our randomized controlled trial (JAMA. Campbell TC, Parpia B, Chen J. HDL-C decreased 9% from 40.0 to 36.3 mg/dL after 1 year, yet these patients showed clear improvement in coronary atherosclerosis, myocardial perfusion, and cardiac events.

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