compare and contrast dr ornish and dr atkins

Both are written by doctors and have many successful followers but RAISING AND LOWERING HDLBENEFICIAL OR HARMFUL? Am J Clin Nutr. The rivalry between Atkins and Ornish was related to food intake. And although Ornish is right that I lack clinical experience, when analyzing evidence, distance can be useful. Risk assessment tool for estimating 10-year risk of developing hard CHD (myocardial infarction and coronary death). Copyright [c] 2004 by the American Dietetic Association. Fourth, the Gardner study did not really test very much of anything, other than its hard for many people to change their dietsany dietfrom just reading a book. 1998;280:2001-2007. Insulin may also raise the secretion of lipoprotein lipase, increasing the uptake of fat into cells, leading to weight gain (10). (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.). It's the type of protein, fat and carbohydrates that matters. 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. The New York Times, op-ed page, July 13, 2002. 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 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). 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. N Engl J Med. 2003;138:460-467. 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. 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. Clinical professor of medicine, University of California, San Francisco After 1 year, there was a 52% decrease in LDL-C on the 10% fat diet compared with a 6% increase in LDL-C on the Atkins diet (33). Ornish begins his piece with a misleading statistic. This site is using cookies under cookie policy . The primary drive was volume not calories (7). Mean apo A-II levels did not change. Web3) Dr. Ornish focuses on the fact that eating eating vegetable diet can reduce weight loss. But his claims about the dangers of saturated fat and red meat go beyond the science and in some cases contradict it. 1996;46:325-341. Moyers article only adds to that confusion. In August 1993 the insurance company Mutual of Omaha announced that it would reimburse policyholders for the cost of participation in Ornishs program, marking the first time a major insurer had agreed to cover an alternative treatment for heart disease. 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. J Am Coll Nutr. (This lack of association is notable because this analysis probably overestimates risks associated with red meat consumption; all but two of the studies it assessed lumped processed meats into the red meat category.) 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. 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. Available at: http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof . 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 fruitsbecause we have been eating more of everything. The results of the trial, published in 1990, revealed that at least some effects of coronary atherosclerosis had been reversed in many patients. While every effort has been made to follow citation style rules, there may be some discrepancies. 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), Dietary fat intake as risk factor for the development of diabetes: Multinational, multicenter study of the Mediterranean Group for the Study of Diabetes (MGSD). Again, meta-analyses of observational studies are certainly not perfect, but because they analyze all relevant data, they circumvent the problem of cherry-picking. The New York Times Sunday Magazine, July 7, 2002. If moderate changes are not sufficient to achieve the desired goals, then the patient can be encouraged to make more intensive ones. One-year effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in decreasing body weight and heart disease risk. Anitschkow N. Experimental arteriosclerosis in animals. David Perlmutter, MD, FACN is a board-certified neurologist, Fellow of the American College of Nutrition, and five-time New York Times bestselling author. Angiology. : How Simple Lifestyle Changes Can Reverse Most Chronic Diseases (2019; written with his wife, Anne Ornish). This case report is not proof, but it is worrisome, especially in that these disorders of electrolytes and free fatty acids that increase the risk of sudden cardiac death may be seen in high-protein diets. The information on this website is intended to supplement, not replace, the advice of a trained health professional. Dietschy JM, Brown MS. Effect of alterations of the specific activity of the intracellular acetyl CoA pool on apparent rates of hepatic cholesterogenesis. We also published an analysis showing that improvements in dietary fat intake, exercise and stress management were individually, additively and interactively related to coronary risk. Popular diets, particularly those low in carbohydrates, have challenged current recommendations advising a low-fat, high-carbohydrate diet for weight loss. HDL returns cholesterol to the liver for metabolism, a pathway known as reverse cholesterol transport. In other words, when you change the type of food, you dont have to be as concerned about the amount of food. 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. Its not just 48 patients. WHY PEOPLE LOSE WEIGHT ON LOW-CARBOHYDRATE/HIGH-FAT DIETS. Ornish D. A diet rich in partial truths. 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. Ann Intern Med. Ornish moved to San Francisco in July 1984 after accepting a teaching position at the University of California School of Medicine. Weight loss was 1 lb/week on the 10% fat diet and 0.6 lb/week on the Atkins diet. Chanmugam P, Guthrie JF, Cecilio S, Morton JF, Basiotis PP, Anand R. Did fat intake in the United States really decline between 1989-1991 and 1994-1996? These associations were either abolished or attenuated if the proteins were plant derived.. 1997;337:562-563. Also, C-reactive protein and creatinine clearance were significantly lowered only on the Ornish and Weight Watchers diets. J Lipid Res. And it is worth noting that among people in the study over 65, heavy consumption of animal protein actually protected against cancer and mortality. 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. Ornish D. The case for low fat. Diet, obesity, and cardiovascular risk. In: Seman FJ, ed. In contrast, the NHANES data is from surveying only a small sample of people nationwide, so its less reliable. These types of studieswhich might report that people who eat a lot of animal protein tend to develop higher rates of diseaseonly look at association, not causation, explains Christopher Gardner, a nutrition scientist at the Stanford Prevention Research Center. For example, the message of many recent articles has been Americans have been told to eat less fat; the percentage of calories from fat is lower, yet Americans are more overweight than ever. This is the premise of organizations such as America on the Move (63). Am J Cardiol. Zeman FJ, Hansen RJ. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. Am J Clin Nutr. Available at: http://www.americaonthemove.org/. Guidelines on diet, nutrition, and cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity. Whole-grain intake and the risk of type 2 diabetes: a prospective study in men. 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. 75 percent increase in premature deaths from all causes, rated the Ornish Diet as the number-one diet for heart health, a recent National Institutes of Health study, In a study from Harvard School of Public Health, reverse the progression of early-stage prostate cancer, Four Laws That Could Stem the Rising Threat of Mass Shootings, Long-Haul COVID Cases Could Spike after Latest Wave. Prev Cardiol. If they stop eating bagels, they may also stop eating the cream cheese. (Also: the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does.) 1995;19:811-816. Westman EC, Yancy WS, Edman JS, et al. Effect of 6-month adherence to a very low carbohydrate diet program. 2000;19(suppl 3):326S-330S. WebDr. 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. DESIGN, SETTING, AND PARTICIPANTS: Discover world-changing science. WHAT EVIDENCE SUPPORTS THAT HIGH-PROTEIN DIETS MAY BE HARMFUL? Whole foodssuch as whole grain products and fruits and veggiesare healthy, but I think that dairy products, fish and lean cuts of meat or poultry can also be part of a healthy diet, Steffen says. Resolving the coronary artery disease epidemic through plant-based nutrition. Three recent studies suggested that an Atkins diet is superior to a low-fat diet with respect to short-term changes in weight, triglycerides, and HDL cholesterol (HDL-C) (18-20). But what about the claims Ornish makes about the success of his own dietdo they hold up to scrutiny? 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). J Am Diet Assoc. WebIn this video, we are comparing the new Atkins Protein Chips to the Quest Protein Chips. 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. Dean Ornish, MD, is founder and president of the non-profit Preventive Medicine Research Institute and is Clinical Professor of Medicine at the If they stop eating pasta, they are often avoiding sauces that are high in oil or cream (olive oil is 100% fat and only 1 tablespoon has 14 g fat). Regression of coronary atheromatosis in rhesus monkeys. But fact that the participants were making all of these lifestyle changes means that we cannot make any inferences about the effect of the diet alone. As all dietetics professionals know, there is no mystery in how to lose weight: burn more calories and/or eat fewer calories. Effect of 6-month adherence to a very low carbohydrate diet program. Ornish was a physician consultant to U.S. Pres. The people in the control group were told to do none of these things. Flavors include Nacho Cheese and Ranch. Am J Clin Nutr. Telephone: (415) 332-2525 x222. WebDr, Atkins vs. Dean Ornish and John McDougall - USDA Debate from 2000. 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). These studies need to be replicated, although similar findings were found by others (39,40). These studies have been conducted with well-respected collaborators, published in the leading peer-reviewed journals, and presented at the most credible scientific meetings. Wing RR, Vazquez JA, Ryan CM. A more healthful and evidence-based choice is to substitute simple carbohydrates with complex (unrefined) carbohydrates including whole foods such as fruits, vegetables, legumes (including soy products), and whole grains (such as brown rice and whole wheat flour). JAMA. Its hard to move the science forward when there are so many stakeholders who say this is the right diet and no other one could possibly be right, Bazzano says. 1993;328:1213-1219. For example, someone may indulge himself or herself one day and eat more healthfully the next. 1998;339:12-20. (All groups consumed about the same amount of protein.). 1995;274:894-901. He should know better. 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. Dr. Atkins believed that cutting off carbohydrates and sugar will also do the same. 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. 1968;2:702-703. They write new content and verify and edit content received from contributors. 2003;103:867-872. Stevens A, Robinson DP, Turpin J, et al. Lancet. 2001;73:1010-1018. In other words, the diet I recommend causes weight loss, not weight gain. This is not true, as I wrote about years ago in my Newsweek column. Although Dr Atkins and I agreed on the diagnosisthat many Americans eat too many simple carbohydrateswe disagreed about the prescription. 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! Ornish D, Brown SE, Scherwitz LW, et al. 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. We found that almost 80 percent were able to avoid surgery by making these comprehensive lifestyle changes. N Engl J Med. Telling people what they want to believe is part of the reason that the Atkins diet has become so popular. As I wrote about in my oped, according to the U.S. Department of Agriculture (pdf), every decade since 1950 Americans actually have been eating more fat, more sweeteners, more meat and more calories. He is recognized internationally as a leader in the field of nutritional influences in neurological disorders. Pereira MA, Jacobs DR Jr, Pins JJ, et al. 2002;75:848-855. A receptor-mediate pathway for cholesterol homeostasis. Increased whole grain intake was associated with decreased risk of CHD in 75,521 women followed for 10 years (13). Dr. David Perlmutter is on the cutting edge of innovative medicine that looks at all lifestyle influences on health and illness. 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. INTERVENTION: On one side was Atkins, who had two strips of bacon and three eggs for breakfast. 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. CONCLUSIONS: Most Americans consume a diet high in saturated fat and cholesterol, so those who are able to increase HDL-C in response to this diet are at lower risk than those who cannot, since they will be more efficient at metabolizing excessive dietary fat and cholesterol. If anything, our attempts to eat less fat in recent decades have made things worse. National Institutes of Health. Accessed March 5, 2004. Ornishs diet would probably be an improvement on the current American dietif people could actually follow it long-term. 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. Articles from Britannica Encyclopedias for elementary and high school students. She wrote about the reasons that autoimmune diseases overwhelmingly affect women in the September 2021 issue. But Ornish is conflating hot dogs and pepperoni with fresh, unprocessed meats, says Lydia Bazzano, professor of nutrition and epidemiology at Tulane University School of Public Health and Tropical Medicine, and theres a big difference between them. A 2010 systematic review and meta-analysis of 20 studies found consumption of processed meat was associated with an increased risk of diabetes and heart disease but eating unprocessed red meat was not. Ninety-nine percent of experimental group patients were also able to stop or reverse the progression of CHD as measured by cardiac positron emission tomography (PET) scans (38). Bell EA, Rolls BJ. When people go on a high-protein diet, they may lose weight and lower triglycerides if, like most Americans, they had been eating a diet high in simple carbohydrates. These foods are low in cholesterol, saturated fat, oxidants, and other disease-promoting substancesa double benefit (12). In rural China, for example, the average LDL is less than 95 mg/dL. After one year those following his diet were more likely to see a regression in their atherosclerosis. Kern PA, Ong JM, Saffari B, Carty J. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. Bill Clinton is one of the more public examples of this, having lost and kept off more than 20 pounds since following the whole foods, plant-based diet I recommended for him five years ago (including salmon once a week). 2001;291:2536-2545. This is some-what akin to the story of Dr Johnsons dog walking on its hind legs: it does not do it very well, but it is amazing that it can do it at all. 1993;58:398-406. Cognitive effects of ketogenic weight-reducing diets. In another study, 100 people were randomly assigned to one of four diets for 1 year: an Atkins diet; a 30% fat diet; a 15% fat, calorie-controlled diet; or a 10% fat, whole foods diet with an emphasis on complex carbohydrates. But Ornish is conflating hot dogs and pepperoni with fresh, unprocessed meats, says Lydia Bazzano, professor of nutrition and epidemiology at Tulane University School of Public Health and Tropical Medicine, and theres a big difference between them. A 2010 systematic review and meta-analysis of 20 studies found consumption of processed meat was associated with an increased risk of diabetes and heart disease but eating unprocessed red meat was not. HDL is important only to the extent that it affects atherosclerosis and myocardial perfusion, it is not a disease. Diabetes Care. 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 Nutrition is complex but there is little evidence our countrys worsening metabolic ills are the fault of protein or fat. Science. Outcomes were assessed at months 0, 2, 6, and 12. Insulin-stimulated lipogenesis in arterial tissue in relation to diabetes and atheroma. Dean Ornish, MD 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. Ornish studied the effects of a similar regimen on prostate cancer patients and in 2008 concluded that adherence to the lifestyle changes recommended by the program slowed progression of the cancer. In locations such as Asia, where a low-fat diet has been the norm, HDL-C levels are low, yet the incidence of CVD is among the lowest in the world (43). However, HDL increased more on the other diets, so the differences in the Framingham risk score were due primarily to changes in HDL. 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. 1961;16:407-415. Campbell TC, Parpia B, Chen J. 2003;348:2074-2081. But the research he cites to back up his oped claims is tenuous at best. What is missing in Moyers article is the clinical experience that comes from helping people change their diet and lifestyle. In practice, someone trying to lose weight may begin by moderately reducing their intake of simple carbohydrates and fat and moderately increasing their level of exercise. Ornish said that the Atkins diet contributed to his impotence and poor breath. In simple terms, those with higher HDL-C levels have more garbage trucks (HDL) to get rid of the garbage (excessive fat and cholesterol). The decrease in HDL-C and apo A-I levels correlated with the decrease in apo A-I transport rate but not with the increase in apo A-I FCR. The reduction in HDL-C that may occur on a low-fat diet is another example of a half-truth that is confusing to many people. Only one person in the experimental group of the Lifestyle Heart Trial was smoking at baseline, so its unlikely that made a significant difference. His dietary regimen was mostly an inverted version of the USDA pyramid that was high in fat and low in carbohydrates. Diet was assessed by validated food frequency questionnaires and updated every four years. 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). Hu JF, Zhao XH, Parpia B. Dietary intakes and urinary excretion of calcium and acids: A cross-sectional study of women in China. The fact that not all studies have shown this risk does not mean that it is not true. 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. At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups. 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. Dansinger ML, Gleason JL, Griffith JL, Li W, Selker HP, Schaefer EJ. ", The recent multicenter PREDIMED trial also supports the notion that fat can be good rather than bad. Insulin stimulates 3-hydroxy-3-meth-ylglutaryl coenzyme A reductase (which statin drugs inhibit), increasing lipid production, which may help to explain why high-protein diets do not always exacerbate hypercholesterolemia (26). Peyreigne C, Bouix D, Aissa Benhaddad A, et al. Ornish told Reuters, There has been a bit of a backlash against not only just low-fat eating, but healthy living in general.

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