4 Lifestyle Changes Improve Heart Health, Sexual Health, and Alzheimer’s Risk
Dean Ornish, M.D., is one of medicine’s great pioneers of the last 40 years. His work has shown that a plant-based diet and healthy lifestyle can not only reverse heart disease but also actually lengthen telomeres, perhaps slowing the aging process. Dean and his wife Anne Ornish have written a breakthrough, evidence-based book that provides a clear guide for living a longer, better life. From the team who proved that diet can reverse heart disease, they now open the aperture to show us not only the right foods to feel our best, they also reveal how social connectedness and even love are the next blockbuster drugs. Everyone from Nobel Prize-winning scientists to Beyonce endorses it. We do too.
Dan Buettner: Why will people want to read Undo It! With Ornish?
Dean Ornish, MD: The book puts forth an important new and unifying theory. We tend to think of chronic diseases as being fundamentally different from each other. Heart disease is different than diabetes or prostate cancer or Alzheimer’s. But they’re really the same disease manifesting in different forms because they all share the same underlying biological mechanisms, things like chronic inflammation, oxidative stress, changes in the microbiome, telomeres, gene expression and so on. In turn, each one of these mechanisms is directly influenced by what we eat, how we respond to stress, how much exercise we get, and how much love and support we have. That’s what you found in the blue zones as well.
This book is the culmination of 40 years of work we’ve done showing what a powerful difference diet and lifestyle can make. Blue Zones shows what a powerful difference diet and lifestyle makes in preventing disease. The field of Lifestyle Medicine, which I helped create, actually treats and even reverses chronic disease with diet and lifestyle changes.
D Buettner: You’re investigating this new theory in your research?
D Ornish: This theory provides a more scientific basis for understanding disease and helps explain why blue zones regions and some Asian countries have had low rates of all these different chronic diseases. Yet you see that when they start to live and eat like us, the rate of these chronic diseases goes up very quickly because they’re activating those same mechanisms that we are in this country.
The radical underlying theory is that for the vast majority of chronic diseases in our 40 years of research, we didn’t find that it was one set of lifestyle changes for reversing heart disease and a different diet and lifestyle program for diabetes or prostate cancer. It was the same lifestyle changes for all of them.
That’s what you find in the blue zones, that these same lifestyles in different areas of the world are linked to improved health outcomes in a variety of different measures.
Now we’re doing the first randomized trial to see if we can reverse early-stage Alzheimer’s Disease with these same lifestyle changes.
D Buettner: Besides diet, exercise, and stress, Love More is an essential part of your program. Tell us about that.
Anne Ornish: Love More is one of the four pillars of the program, along with Eat Well, Move More, and Stress Less. Love is not something you hear about often in mainstream medicine, and that’s the part that our participants are most apprehensive about, even though it’s probably the most valuable. In a week or two, they find that love is the most sustainable driver to whatever lifestyle choices they make.
Four Pillars of Ornish Lifestyle Medicine: Eat Well, Move More, Stress Less, Love More
The first question we ask people when they get started on the program is: What is your motivation? They can only answer in the most personal way. As researchers, we know what’s most effective and can give advice. A spouse or loved one can say: This is what you need to do. But it’s powerful when you step back and ask yourself, What is my motivation? Each one of us has to have a reason for lifestyle changes to be sustainable.
People reflect on the peak moments they’ve had in their lives, the last time they’ve had one, what their dreams are, and with whom they want to share their dreams. What or who makes us feel the most enlivened is the reason, or the why, that we make the healthier choice.
D Ornish: Of all the four, Love More may be the most important. You found in the blue zones that cultures with strong communities live longer. There is a direct primal need that we have as humans for connections and community. That’s how we’ve survived as a species all these years, by taking care of each other.
Study after study have shown that people that are lonely and isolated, which I believe is the real epidemic now, are 3 to 10 times more likely to die from all causes compared to those that have a sense of love and connection and community.
I don’t know anything in medicine that has that powerful impact, including smoking. But even behaviors like smoking, overeating, opioid addiction, or working too hard, or often direct extensions of that loneliness and depression.
I asked the people in our studies, after we’ve gotten to know each other, why they do these unhealthy things. And they always say it helps them get through the day, and through their loneliness and depression. Smoking, overeating, video games, or working fills that void and numbs the pain. Information is important, but it’s not sufficient enough to motivate people to make lasting changes. Everyone knows smoking is bad for you. It’s on every package of cigarettes.
We need to work on a deeper level. When we teach people the importance of love and intimacy, and that’s where your Blue Zones work has been important, awareness is the first step in healing. Most people think that the time we spend with friends and family is a luxury after we do the important stuff, but what science teaches us is that it is the most important stuff. The time we spend with loved ones is the single most important determinant in how long and how well we live.
The Curse of Loneliness, a Modern Epidemic
D Buettner: About 20% of Americans meet the technical definition of loneliness. If I’m a middle-aged lonely person without love, what can I do to reverse the loneliness and get healthier?
D Ornish: We can only be intimate to each other to the degree that we are emotionally vulnerable to each other. In our program, we’ve designed groups that help people experience what it’s like to really connect on a deep level. So much of our culture now is not based on authentic connections, like Facebook. I cite a study in our new book that says the more time you spend on Facebook, the more depressed you are. Even though there are a billion and a half members, it’s not genuine intimacy because it looks like everybody has this perfect life except for you. In the blue zones regions that you study, there are communities with two or three generations of people living together, there are neighborhoods that people have lived in for many years, there are church and synagogue services that people attend regularly, and there are jobs that people have been going to for decades.
What happens in all of those circumstances and in our support groups is that people really know you. They don’t just know your good side or your Facebook profile. They know your mistakes or your dark side and where you messed up, and there’s just something primally healing about that. Many people, unfortunately, have no one that they feel like they can open their hearts to and really be their authentic self.
The support group is part of our program that people often have the most puzzlement or even apprehension about. But it’s the most meaningful because the whole approach of the support group is to create an environment that feels safe enough for people to let down their emotional defenses and just be open and authentic with each other. Somebody might say, Hey, you know I look like the perfect father, but my kid is on drugs. Or someone else might say, It may look like I’m really successful, but I have a lot of anxiety or maybe I’m not as successful as I thought. And that’s without someone rejecting them or condemning them or giving them glib advice on how to fix it. Just to be able to have people to tell that to and to focus on their feelings really connects people. That feels so good that they then have the courage and the experience to go out in the world to do that with other people. Anne talks very eloquently and often about how these approaches bring a sense of pleasure and meaning into our lives. And that’s ultimately what makes the lifestyle change sustainable.
D Buettner: We’re convinced that getting more love in our life and better social connectivity is going to help our health. But I’m wondering for our readers that now know love will help their health and cardiovascular vitality. What do they do? Short of joining one of your support groups, what can they do to get more love in their lives?
A Ornish: I think it’s really important to distinguish and make the point that this kind of love and support is not limited to romantic love. We must first start by loving ourselves. If we can create self-care practices that allow us to have a more intimate, authentic, and compassionate relationship with ourselves, then we are opening up for other people to meet us there.
1. If you can, find a class in your local community center or a yoga studio and then regularly attend that class.
Making friends from a shared experience is something that we can all go out in our communities and do—especially if it’s a healthy type of shared experience.
2. Also, reach out to the people that you already know and feel a sense of gratitude for what you do have.
It’s like when talking about diet—it’s more important to emphasize what you include versus what you exclude. In the sense of Love More, it’s more important to be grateful for what you do have and who you have in your life and start there. Build on those existing friendships and your family or origin. If there needs to be some forgiveness, then go through a thoughtful empathy exploration of what it’s like to be in the shoes of someone that you’ve felt isolated from or separated from. To have those types of mindfulness exercises and daily practices for ourselves makes it that much easier to go out and connect with other people. So those are a couple of things people can do.
D Buettner: That’s very helpful. You guys are in a loving relationship and it’s one of the best relationships I know. But when you have the added pressure of co-authoring a book together, I wonder how that process works and did it strengthen your relationship with each other or did it strain it?
D Ornish: Good question. Anne and I have been working together for 20 years. She created the learning management system that we use in hospitals and clinics around the country. So it was really great for her to co-author the book so people could really understand how brilliant she is and what she brings to this. And so, for me, it was a real joy. There’s something that’s really meaningful about working on something that’s been our life’s work and having something that’s tangible that will help millions of people.
A Ornish: It’s funny because so many people have asked that over the years even before we started writing the book. Since we worked together for eight years before we became a couple, that’s all we know. We’re just so passionate about being on this mission together. Are there tough days? Yes, it can be very stressful trying to do this. We’re disrupting mainstream medicine on some level, so of course, we’re going to ruffle some feathers and have some trolls out there.
This book was a labor of love and I think it personally replenished my love for this work. Because I built the learning management system and started working with Dean 20 years ago at WebMD, I have been massaging this content for 20 years. Sometimes I have to kind of step back and step away from it. But diving into the deep end of writing this book really kind of reincarnated our love for the work that we do. It’s like never stepping into the same river twice. It actually became very exciting for us to find new ways to discuss the discoveries that Dean started talking about 40 years ago, and that I started talking about 20 years ago. The beauty of the work is that it keeps evolving.
D Buettner: Having done this blue zones research, I completely understand and believe that things like love and social connectivity can lessen the chance of Alzheimer’s disease and cardiovascular disease. But Dean, you play in the gladiator ring of hard science as a physician. What kind of criticisms are you getting from the medical industry about taking a loving approach to health?
D Ornish: You know love is one of those four letter words that cardiologists are trained not to use even though the heart is a symbol of love. A few years ago, when Kim Williams was the president of the American College of Cardiology, he found that his own cholesterol level was high. He didn’t want to be on statins for the rest of his life, so he did a literature review and came across our work. He went on our program and his LDL came down 50%. So he organized the first seminar on lifestyle medicine, which is using lifestyle changes to actually treat and reverse chronic diseases. It was a six-hour special seminar at the American College of Cardiology annual scientific sessions in Chicago, with over 1,000 cardiologists in attendance. I gave a talk on love, and it may be the first time that anyone actually spoke about love at a cardiology meeting like that. It was extremely well received because these are profoundly human issues.
Most doctors wouldn’t recommend medicine as a career for their kids, because they’re so burned out. If you have to see a new patient every 10 minutes, then you don’t really have time to talk about love, diet, exercise, or smoking. You just go to the problem list and write a prescription, which is profoundly unsatisfying for many doctors and patients. So, we’re really creating a new paradigm here that enables us to use our research to build on that and to explain how important these issues are. Medicare is now covering our program at hospitals and clinics around the country, and most of the other insurance companies are now doing so as well.
People come for four hours twice a week for nine weeks, and they exercise, meditate, and take part in support groups, where, as Anne puts it, they learn to love themselves and to love other people. To me, science is a way of raising awareness, and there are so many scientific studies that I cite that provide the basis for understanding what a powerful difference love makes in our lives. We’ve really reached a tipping point here where there’s a receptivity to this work—much more than I’ve ever seen in the past 40 years of doing it.
D Buettner: What’s the best way for people to start changing their lifestyle? The blue zones approach is changing the environment. What’s the Ornish approach to changing your lifestyle?
D Ornish: Well, I think changing the environment is important as you show. Changing what you do internally in your own life, regardless of your environment, is also important.
The overarching issue that we’ve found over the many years of doing this is that what enables people to make sustainable changes is not fear of dying, it’s joy of living.
If it’s pleasurable, it’s sustainable; if it’s meaningful, it’s sustainable. Because these underlying biological mechanisms are so dynamic, when you make big changes in your lifestyle, you generally feel so much better so quickly. That reframes the reason for making the changes from fear of something bad happening to joy and pleasure and feeling good.
There’s a wonderful movie called Game Changers that will be out soon by James Cameron and Louie Psihoyo. Cameron became a vegan eight years ago and felt so much better and had so much energy that he’s able to film and create Avatars 2, 3, and 4 all at the same time.
There’s a scene in the movie which I cover in the book, where they gave a meat-based meal to a group of three elite athletes in their mid-20s and then measured the frequency and duration of the erections they had at night. This was high quality grass-fed beef and organic chicken. They did the same thing with the same athletes with a plant-based meal and found that the group had 3-500% more frequent erections that were 10-50% harder than after the meat-based meal. The film crew apparently became vegan after shooting that scene.
So it’s clear how dynamic these mechanisms are and how quickly you can get better and how quickly you can get worse. Most people feel so much better so quickly, that it reframes the reason for making these changes—from preventing something bad from happening years down the road to a better life now.
Everything gets more blood flow, not just your sexual organs and your heart. Your brain, so you think more clearly. Your entire body, so you have more energy. Your skin, so you look younger.
A Ornish: It goes back to that question I talked about at the beginning, which is what is your motivation? In moments of temptation, take a deep nourishing breath to refocus and re-align yourself with the very personal answer to the question of why you want to live longer and better. It doesn’t have to happen all at once, especially if you’re not trying to reverse a disease. But the more you make healthier choices, the better you feel, so it becomes self-reinforcing and self-fulfilling. It just becomes easier and easier to continue to do so.
Dr. Dean and Anne Ornish
D Buettner: Now, I have just a few short questions. You guys have been in a relationship for a long time—what is the single most important ingredient to a successful long-term relationship?
D Ornish: The key is trust because you can only be intimate to the degree you can be vulnerable, and you can only be vulnerable to the degree you trust the other person. The more intimate it is, the more erotic and pleasurable it becomes.
D Buettner: What one person do you admire the most?
D Ornish: The person I admire the most is my wife and lover and partner Anne. We’ve been together for 20 years and we’ve seen each other through so many things. I’ve never met anyone who has it all in one person. She is brilliant, beautiful, sexy, creative, talented, and loving. Every day I wake up and think: Oh my goodness, she’s still here! I thank my lucky stars.
A Ornish: It sounds so campy, but I do feel the same way. We have certainly been through some battles and wars together and it’s just made me respect and love Dean more than I possibly could have at the outset.
D Buettner: What do you consider your greatest achievement?
D Ornish: I think being a good parent is probably up there. I think our life’s work of being able to empower millions of people with new health and new choices is incredibly meaningful for us.
A Ornish: I would say it’s somewhere between our work and all the people that have transformed their lives through the program. I also feel like our children are the most rewarding experience. I guess the love that we share is our greatest accomplishment—whether it ripples out into the work we do in the world or to our family.
D Buettner: Do either of you have a personal mantra?
Eat well, move more, stress less, love more.
Dean Ornish, MD
Anne Ornish
Choose what you love with those you love. Live the life you love with those you love.
Ornish Lifestyle Medicine is the first and only program that is scientifically proven to reverse the progression of heart disease and other chronic diseases. Today, the program is reimbursed by Medicare and many other commercial payers, offered in more than 30 states, and delivered with a turnkey process that is optimized by decades of operating knowledge.
This interview has been edited for brevity and clarity.