natural treatment for diseases worming

if you've been following the evolutionmedicine and the functional form for awhile you know that would be mainlyencouraging you to build what we call a micro practice a low overhead practicethat doesn't take insurance really because insurance and preventivemedicine don't make a lot of sense going together and there are new modelsavailable through doing things like direct primary care and packages thatmake a lot more sense for chronic disease however you know the majority ofmedicine is on insurance that's how the majority of peopleintegrative medicine and when an

opportunity to meet dr. ornish last weektold me about how his program is now available on medicare some of the otherinsurance providers so for particularly those doctors who are new to theevolution of medicine and are still practicing an insurance practice i believe this is a way that we canreally move the needle on insurance and move the needle on the delivery ofintegrating functional medicine into the general population through the ornishprotocol so we're going to go and speak to dr. ornish find out some more thingsabout this program ask some interesting questions hopefully about his work andyou know some of the the critics of it

and some of his supporters and then we'll see how it goes so doc just first for all of ourcommunity just a big thank you for the persistence that it took to not only youknow prove that your diet works and your plan works but also to get this coveredby medicare i think it's a huge huge thing for people who are not completelyfamiliar with the diet and the program can you sort of give us an overview ofthe last that he is one closer to 40 now actually i began doing this work in 1977when i was a second-year medical student and learning how to do a bypass surgerywith michael debakey the pioneering

heart surgeon and we cut people open webypass your clogged arteries he'd tell them they were cured and more often thannot their bypasses would clog up again because they went back and did all thesame things that cause a problem the first place and so that became for meand metaphor of an incomplete approach that we really literally bypassing theproblem without also treating the cause and so the guiding principle for me foralmost 40 years now has been what is the cause and how can we addressthat and i often show a cartoon of doctors busily and mopping up the flooraround the sink that's overflowing but nobody is reaching over to turn off thefaucet and the faucet is to a large

degree the lifestyle choices that wemake each day what we eat how we respond to stress howmuch exercise we get and how much love and support we have you know when peopleget put on blood pressure medications or blood i statins like lipitor to lower theircholesterol or drugs to lower their blood sugar and the patient says howlong do i have to take these the doctor usually says forever it's kind of like how long do i have tomop up the floor is like forever well why don't we just turn off the faucetand what we've learned using these very

high-tech expensive state-of-the-artscientific measures to prove how powerful is very simple and low tech andlow-cost interventions can be is that our bodies often have a remarkablecapacity to begin healing and much more quickly than we had once thoughtpossible if we treat the underlying cause andbecause these underlying biological mechanisms are so much more dynamic thanwe had once thought when people make big changes in lifestyle that we recommendthey usually feel so much better so quickly it reframed the reason formaking these changes from fear or prevention to just joy and pleasurewhich is ultimately what makes them so

sustainable and so in a series ofrandomized trials were able to show for the first time that even severe heartdisease often can begin to reverse by making these changes the blood flowcould improve within just a few weeks the engine went down by over ninetypercent in the first few weeks after a year there were significant regressionof even severely clogged coronary arteries and there's even moreimprovement after five years whereas the control group got worse and worse andthere was a three hundred percent improvement in myocardial perfusion orblood flow to the heart is measured by cardiac pet scans and we found thatthere was two and a half times your

cardiac events bypasses angioplastystands heart attacks strokes and so on we then did a study a randomized trialsshowing for the first time that the same lifestyle changes that could reverseheart disease could also slow stop and even reverse the progression of men withearly-stage prostate cancer and probably by seven extension women with breastcancer as well and we did that in collaboration with the chair ofneurology at ucsf dr. peter carol and the man who was then the chair ofurology at memorial sloan-kettering cancer center dr bill fair we always tryto work with the leading authorities in the field because when you're trying todo something disruptive

it's nice to work with people who havethat kind of credibility we then found wondering why these patients wereimproving so quickly we wondered what some of the underlyingmechanisms might be and so we looked at their changes in gene expression and wedid this with craig venter who pioneered decoding the genome and we found thatover 500 genes were changed in only three months with the same lifestyleintervention in the end in every direction in every gene in a gooddirection and it's that sense up-regulating or turning on the genesthat keep us healthy down regulating the genes that cause oxidative stresschronic inflammation and particularly

the wrath of oncogenes that promoteprostate breast and colon cancer would just shut down within just three monthsits again part of how dynamic these mechanisms are and then we did a studywith dr. elizabeth blackburn who was ordered the nobel prize in medicine about five years ago for her pioneeringwork with telomeres which as you know where the ends of our chromosomes andcontrol aging and as their there's sometimes like into the plastic tips onthe end of shoelaces that keep your shoe laces from unraveling they keep your dnafrom unraveling and as we get older they tend to get shorter and as our telomeresget shorter our lives get shorter and

our risk of premature death from prettymuch everything goes up proportionate to that so she had done astudy showing that women who are under cronic emotional stress had shortertelomeres and that when you compare the high stress and love trans women therewas a nine to 17 years shortening of their life span from thestress although what i found most interesting about that study was notjust the stress shorten your telomeres but that it wasn't an objective measureof stress it was the women's perception of thedetermine whether or not it made a difference

so you can have two women in the samekind of life situation taken care of parents of alzheimer's the kids withautism for example but if some of them were coping with it better they weremeditating they were eating better they were exercising they had more love andsupport all the things that we do in our program it could mitigate and blunt theeffects of that so that it didn't shorten their telomeres to the samedegree so i met with dr. black red and i said you know if that thing's make yourtelomeres shorter maybe the things make them longer and we found sure enoughthat we actually could increase the enzyme telomerase by just thirty percentof three months which were published in

the lancet oncology and over a five-yearperiod we found that the telomere is actually got ten percent longer whereas they got shorter than thecontrol group it's still the only control study showed that anyintervention including drugs can actually like them your telomeres andwhat's so interesting about all these things is that although we tend to thinkof advances in medicine as being a new drug a new laser something really hightech and expensive we're using these very high-techexpensive state-of-the-art scientific measures to prove how powerful is verylow-tech and low cost and low end of the

low low low tech interventions can beand you know if a new drug came out that could do any of these things even if itjust shows that it can lengthen your telomeres would be a multi-billiondollar drug and yet these are simple lifestyle changes and that with all thisinterest in personalized medicine i i think that in some ways personalizedmedicine can be really helpful if you're gluten sensitive that's good to know ifyou have pancreatic cancer and you can target and immunotherapy to a particulartype of tumor cells that's a good thing but in our studiesit was the same lifestyle intervention for all of these

it wasn't like we had a different onefor prostate cancer then from heart disease or diabetes or you know your jeans are your telomeresit's almost as though if you give your patient the right raw ingredients theycan extract or personalized what they need in order to begin to heal and as anemerging field of what's now called lifestyle medicine which is lifestyle totreat disease and even reverse it either in combination with drugs and surgery oroften as an alternative and there is a convergence of forces that i thinkfinally make this the right idea at the right time and the one hand thelimitations of high-tech medicine drugs

and surgery becoming clearer for examplethe randomized trials have shown that angioplasties and stents and the couragestudy and seven other randomized trials don't prolong life don't prevent heartattacks don't even reduce angela in people with stable heart disease whichis usually the people who get them and then with early-stage prostate canceronly one out of 49 men actually benefits from chemo or radiation or surgery andthe other 48 often get named in the most personal ways because now they'reimpotent and they can't have sex they are incontinent they are wearing diapersfor no benefit at huge economic and whose personal cost

getting your blood sugar down with drugsin the navigator in the accord studies in the new england journal of medicinedidn't prevent the horrible complications of diabetes or thepremature death getting it down with diet and lifestyle does and so at thesame time that the limitations of drugs and surgery becoming clear for so manychronic diseases the power of lifestyle changes lifestyle medicine is alsobecoming clearer and now that with the advent of obamacare whatever peoplethink about it it's really turning all the incentives on their ear you know in the past and if you forservice environment the more operations

you do the more hospitalizations andmore drugs you prescribe more money is generated now it's more here is x amount ofdollars to take care of someone you the doctor the hospital or clinic gets tokeep what's left over so keeping people out of the hospital actually now as is amuch healthier in a much more economically beneficial thing to do now the other thing that's happened isthat after 16 years of review medicare is now covering our program asa dr dean ornish program it's the first time they've covered a lifestylemedicine intervention like that and as a

sign of the times just yesterday i waspart of a day-long seminar at the american college of cardiology is annualscientific sessions in chicago that was organized by dr. kim williams who is the president of the acc and a year and ahalf ago he was written about this in in medpage and medscape he was he foundthat is ldl cholesterol was too high he knew all too well the side effects ofstatins and look to see if there was a different approach that he could takethat involve lifestyle and came across our work and has now been on our dietfor many years he talked about this at the meeting yesterday and we did aday-long symposium where which i was

part of but so we're a number of otherpeople and it was really a first i think it was a real sea change a tipping pointin cardiology with it that the president of the organization can have a day-longseminar on lifestyle medicine it was thrilling in the bog ironically it wasin the same room at ten years ago i debated dr. atkins during the accmeeting so just felt like a marker that things have really changed so dr. you spent so much time provingthat this diet works why is this just so important to you well first it's not just to die thereare four components the diet exercise

the stress management clean yoga andmeditation and love and support or eat well move more stress less and love moreit's really simple in that way and i thought you know before that if we justdid good signs that would change medical practice and to some degree did but notas much as i'd hoped and so one of the questions was well youknow before it's like heart disease can be reversed in and there's no way .lifestyle could do it in such a short time anyway and so we show that it couldand then they said well you live in california it's an altered state youknow they'll this will never play in peoria

so through our nonprofit preventivemedicine research institute beginning in 1993 we train hospitals and clinics aroundthe country over 50 of them prestigious hospitals like harvard and that there isno medical center new york and scripts and ucsf but also community hospitals inomaha des moines columbia south carolina where they told me grave is a beveragethis will be a big change in our lifestyle and so on and we got biggerchanges in lifestyle better clinical outcomes and even larger cost savingsand anyone's ever shown but it was ultimately disheartening in every senseof the word because the number of the

sites closed down and they said this isthe best program we've ever had but we can't afford it because it's notreimbursable and so the painful lesson for me wasthat either if it's not reimbursable it's notsustainable unless you have other way we realm of concierge medicine or you knowprivate practice we charge people a lot of money for lab tests and things likethat which i i didn't want this having seen what a powerful differencethese changes can make i didn't just want it to be for wealthy people iwanted to be for everyone so that set me on a 16 year journey to get medicare tocover the program because i figured if

medicare-covered it most of the other insurance companieswhat is well and we had the support of bill clinton because i've beenconsulting with him since 1993 but also newt gingrich when he wasspeaker the house 20 members of the senate 30 members of the house acrossthe political spectrum heads of the aarp and most of the major organizations andit still took a 16 years in fact i was talking with some of the governmentrecently they said only 16 years you know when you're trying to do somethingthat's really disruptive it's it can be threatening but i'm grateful to cms forfor covering the program and now that

medicare is paying forward and the mostof the blue cross blue shield organizations and others are alsocovering it and so now it's financially sustainablefor doctors and so on to cover this and one of the other good things that thatthey did is that they're not only covering it in hospitals but they'realso covering it in private physician offices at the same level that they doin hospital as opposed to regular cardiac rehab where it's only paid afraction in a physician practices it is in the hospital based practice and theycreated a new benefit category called intensive cardiac rehabilitation whichis 72 hours of reimbursement now

most doctors are not really happypracticing medicine these days the survey show that most doctors wouldn'trecommend medicine is required for their kids they're getting bought out byhospitals are leaving the the practice because if you have to see a new patientevery eight to ten minutes you don't have time to talk about what'smost important you basically have time to listen to the heart and lungs you know rather progress no write aprescription you're off to the next patient it's profoundly unsatisfying for aboutdoctors and patients it's one of the

reasons why more money has been spent ona pocket for the last 30 years for so-called alternative medicine thantraditional medicine because they spend time with you and they talk with you so we've created a new paradigm of realhealth care rather than six care where medicare and now most insurancecompanies will pay for 72 hours of training and so we divide that into 18for our sessions and we have a team of people the physician is quarterback but he or she works with a dietitian anurse a yoga teacher and exercise physiologist a psychologist and then ithink that's it in six people and they

all work together under the physiciansdirection but the physician isn't spending most of his or her time doingthat they just have to be in the office or inthe building when the program is being offered by taking even be seeing otherpatients or dictate charts for things like that and by dividing this in 18 forour sessions over a 12-week period i it makes it feasible for everyone soif they work to come from five to nine p.m. if they don't work they can comeduring the day and they get an hour of supervised exercise but they also get anhour of yoga and meditation i mean who would have thought ten years ago thatmedicare will be paying for yoga

meditation they get an hour of a group meal with alecture and what we call an hour of a support group but it's really more thanit's not just helping support the other parts of the program it's not just youknow exchanging recipes and 10 types of running shoes and things like that it's really creating a safe environmentin which people can be authentic with each other who can let down theiremotional defenses and feel safe and talk openly and authentically aboutwhat's really going on in their lives without fear they're going to be judgedor criticized or rejected or giving good

advice and then we sound so you knowtouchy feely and i used to get defensive when people would say all this programis so touchy feely and i say no now look at our pet scans and our quantitativearteria grams and our radionuclide ventricular grams and all this stuff andthen finally i said one day it is actually feeling that's what makes itwork so well yeah we are touchy feely creatures werecreatures of community and so that's why we're getting 85 to 90 percent here instar program after a year you know many doctors think oh i can get my patientsto take their statins they'll take their lipitor there's no way they're going tochange your lifestyle and yet when you

actually look at the data from thepharma companies own results half to two-thirds of people prescribed any ofthe statins lipitor zocor mevacor you name it are not taking them after just four tosix months even if someone else pays for them and even if they don't have sideeffects and and statins are approving value and people with heart disease andthe answer is why not and part of what we've learned over theyears is what enables people to make sustainable changes and it's not fearits joy and pleasure and freedom and love and when you givesomeone a statin you so you're basically

saying take this pill it's not going tomake you feel better hopefully it will make you feel worse toprevent something really awful from happening maybe years down the road likea heart attack or stroke that you don't want to think about and so they don'tthink about it i mean for a month or two after someone's had a heart attack or aner visit though they're pretty much anything that their doctor inner sensebut then they stopped doing it because it's fear base and fear is not asustainable motivator but joy and pleasure and love are and because theseunderlying biological mechanisms are so dynamic when people make these changesmost people find that they feel so much

better so quickly it completely reframedthe reason for making these changes from fear or prevention of something bad fromhappening years down the road to feeling better know your brain gets more bloodyou think more clearly you have more energy you need less sleep your skingets more blood you don't age is quickly your heart gets more blood even yoursexual organs get more blood flow in the same with viagra works we found a 90 over ninety percentreduction of the frequency of angina in the first few weeks for someone whocan't work or make love with her there there there partner or play withtheir kids or you know walk across the

street before the light changes withoutgetting chest pain and you know within a few weeks they're essentially pain free they say oh when i do this i feel goodwhen i do that i don't feel so good it comes out of their own experience i camejust a few days ago from one of the hospitals we trained in south bendindiana of all places you know it's like if as frank sinatra said if i can makehimself in indiana can make it anywhere one of the guys there was on theheart-transplant list and after just nine weeks he improved so much in hisejection fraction response and so on with an ischemic cardiomyopathy that heno longer needs a heart transplant we

have several patients like that it'skind of like what's the more radical intervention here you know cutting yourchest open having a heart transplant or bypass for putting a centon or you knowit well move more stress less and love more youknow one of the things that we've had a lot of content on join the functionalform and through the evolution of medicine has been on this new emergingfield of human social genome mix in the interaction between peopleand relationships and how patients interact with each other and how tocreate good social interactions and how that affects health

how have you sought to deliver that inyour program or how important has that being in the overall dynamics of yourprogram what we found that all four componentsare important we found that overall adherence was correlated directly themore people change their lifestyle the better they follow the program the longer their telomeres god the lessquad their arteries became the smaller their their prostate tumors became thelower their psa levels came to lower their blood sugar's when etcetera the more you change the more you improveat any age which is a really powerful

message to give people in fact i thoughtthe younger people with less severe disease would do better but i was wrongit wasn't how old or how sick they were it was mainly a function of the more youchange the more you improve but i think the people that most doctors have themost skepticism about the love and support they say i get the diet you havegot to eat it's just a question of what and exercise you know you're reallydoing something meditation i don't know but there's alot of evidence now about that the love and support sorry i gave most of mylecture yesterday at the american college of cardiology annual meeting toa thousand cardiologist yesterday about

love which is kind of funny because wheni look back of the abstracts over the last 20 years and i put in love when youexclude the names of people who happen to be named love there's almost nothing in their onlineeven though the heart is the symbol of love it's like if it's like we focus onwhat we can measure but what we can measure isn't often what's mostmeaningful or even though what's most important albert einstein once said that noteverything that counts can be counted you know not everything's meaningful isis is measurable and when you look at

the studies its its powerful to me thatstudy after study has shown that people who are lonely and depressed andisolated are three to ten times more likely to get sick and die prematurelycompared to those who have a sense of love and connection community in partbecause you're more likely to abuse yourself in part through mechanisms wedon't fully understand you know information is important but ifinformation were enough you know for one thing nobody wouldsmoke and so it's on every pack of cigarettes it's not like a televisionhey i want you to quit smoking is bad for you go

i didn't know that i'll quit today youknow it's like everybody knows it's bad for you and we're drowning ininformation with google but information is not the same as as wisdom and whatpeople in and what's important is that we not just give people information notjust focus on the behaviour the work at a deeper level you know so i'd ask people in ourstudies you know teach me something why do you smoke why do you overeat why doyou drink so much why do you abuse substances why do you spend too muchtime playing video games these behaviors seen maladaptive to meand that kind of smile and look at me

like you know with pity know they sayyou just don't get it you don't have a clue these behaviorsare maladaptive they say they're very adaptive because they help us deal withour paint you know the real epidemic isn't justheart disease or diabetes or cancer its is loneliness and depression andisolation you know the leading prescription drugsafter statins are antidepressants and telling somebody who is lonely anddepressed that they're going to live longer if they just change your dietlifestyle or quit smoking is is is not that motivated you know they're justthey say things to me like i'm just

trying to get through the day or they'llsay i've got one patient told me i've got 20 friends in this pack ofcigarettes and they're always there for me and nobody else is you're going totake away my 20 friends what are you going to give me or food fills that voidor one patient said fat coats my nerves and numbs the pain or alcohol or otherdrugs and i'm the pain or video games then the pain or you know working allthe time we have lots of ways of distracting ourselves from our pain butin our program that pain is the messenger is saying hey listen up pay attention you're not doing somethingthat's in your best interest and so when

people begin making these changes inlifestyle and again because the underlying biological mechanisms are sodynamic they generally the pain goes away andthey feel so much better they they often even say things likehaving a heart attack was a good thing or the best thing that ever happened tome about what do you not simply say no that's what it took to get my attentionto begin making these changes that have made the quality of my life so muchbetter and they will continue to meet together these groups are so powerfulbecause many people don't have any place that feels safe enough to to reallyconnect on a deeper authentic level with

a breakdown of the social networks youknow like a you know 50 years ago people had two or three generations of peoplein a neighborhood that had a job that they've been out for 20years they had a treasure synagogue or mosque they went to they had a extendedfamily they saw a regularly and many people don't have any of those thingsand when you put them in an environment and create a sense of safety it's really powerful . one of the thingsthat we talked about at the evolution of medicine is the potential forintegrative and functional medicine senses to become real census of healthcreation in the local communities

how can these practitioners tap into thegood weather you've been doing and actually do this on insurance well when medicare agreed to cover ourprogram in 2011 we were they lose with literally thousands of requests fromhealthcare professionals who wanted to train and certify them in our programand i and we're just a small non-profit so we spent a year looking for the yearand a half looking for the right partner the business partner and we settled witha group called healthways based in tennessee so that we could focus on the clinicalaspects and the model is is that they've

been marketing this primarily to helpsystems and hospitals and so on i said let's market in to the physiciangroups that that's who really needs it the most and also the incentives arecompletely aligned because if a physician refers to a patient to ourprogram in the hospital there's no economic incentive a benefitfor doing that but if they offer themselves as part of a physician groupthen all the revenue goes directly to them so it's a way and a time when manyphysicians are typically cardiologists are finding their income is being cutback as they say they're not doing as many senses they were there cutting backon non invasive testing and so on

here's a chance to a practice the kindof medicine that's really fun you know if all we are is a collection ofalgorithms we're going to get replaced by an iphoneapp you know the computers do that better but i know i wanted to medicine iimagine most of the people watching this one in the medicine to be healers notjust technicians and so it gives us an opportunity to create a new paradigmwhere we spent 72 hours with patients and yet the position is in spending mostof that time it's really fun practicing medicine whenyou see empower your patients with information that transform those withtheir lives and makes them get better

and better and win them off medicationsin most cases again under their supervision that the physician controlsall therapeutic decisions related to the patient but it gives them the tools andthe time and the effort that they don't normally have and the reimbursement tomake this a viable so in our model we trained agroup of people ideally it should be a physician group of 10 or morecardiologist or they can be primary care doctors are internists orendocrinologist the cardiologist especially because they have the largestnumber of people with heart disease which is what medicare is painful rightnow and medicare will pay for 72 hours

of training and they keep raising therates of reimbursement it's now on average about a hundred and sevendollars an hour x 72 hours is around seventy six hundreddollars a patient which is a lot and the patients come for four hours at a timeso they get an hour of supervised exercise and our of a support group anhour of yoga and meditation and our group me with the lectures we weretalking about earlier this can be done in their office it caneven be done from after hours when you've already paid for the space and soon so this is just an incremental cost and because we do this in groups of 15people at a time it's really 15 people

times a hundred and seven dollars anhour or over fifteen hundred dollars an hour and of course you don't pay yogateacher or a dietician and exercise physiologist that much i really helps to if you'redoing this is part of an integrated medicine practice it helps to defray thecost of other interventions that are not yet covered by medicare or by otherinsurance companies but it provides an opportunity to provide these kinds ofservices that are that patients really want that are incredibly emotionallygratifying for us as healthcare providers to offer our patients in a waythat can actually double or triple your

income and therefore make this much moresustainable in a way that i can last and and can really be to everyone'sadvantage and then because we're collecting data on all the people who gothrough it allows us to do large rescale research at a fraction of the cost so that one question i have is how longdoes it take to get up and running on the program force a group ofcardiologists that decide they want to run this how long does it take for them to decidethey want to do it until they're running these kind of sessions on a tuesdaynight

well our training model is that wetrained a team of six people and we bring them to san francisco and they gothrough an immersion program for three and a half day so they travel on amonday they usually get in monday night we spent all day tuesday wednesdaythursday and then it's a lunch on friday and it's a combination of didactic andexperiential so you go through the program like a patient would becausewe've learned the best way to teach it is to really experience it and then evenif you otherwise you're healthy people still feel so much better they reallyunderstand the nuances of what makes this work is as effectively as it doesand they also get lectures from me and

others and breakout sessions and that itactic information as well and then you go back and you start to implement thiswe work with you with your players we work with you on sight we have rigorousquality assurance and quality control and ongoing education and support it's a really fun way to do this and wemake this is turn pieces as it possibly can be you know i'd be fascinated to know whatare some of the characteristics of the clinics that really make a go of thisand are successful with the program straight away while the clinics to dowell are are are the ones that believe

this is worth doing you know it's good to have an internalchampion that says yeah this is something that's really important thisis how i want to practice medicine this is the medicine of the future and it'sit is it's incredibly gratifying as a way of doing that healthways takes a small percentage ofthe revenue that you otherwise wouldn't be getting to provide the training andthe ongoing support and data collection and pay our support and so on and soit's something that really works well for everyone

doctor is one of the words used earlierwas convergence and i think that's a really interesting word obviously herein san francisco you got singularity university down the road where they'retalking about p4 medicine and that they're coming to that from thetechnology angle you've got integrative medicine and your work becoming more andmore clear you've got the functional medicine revolution happening at thecleveland clinic in all these areas what do you see what's causing thisconvergence and how do you feel about this convergence in lifestyle integratedand functional medicine well i'm grateful to be part of it letme also mention i forgot the commercial

insurance companies like anthem which isblue cross blue shield in 14 states including new york in california arereimbursing this at about a hundred and thirty percent ofwhat medicare is paying so it's more like a hundred and thirty dollars in ourx 72 is more like ninety-five hundred dollars per patient so that makes iteven more financially viable this is really what's happening and i'vespoken many times at the singularity university there exponential medicineconferences daniel craft is a good friend whoorganizes them and i'm usually that you know i mean there's a there's a lot ofemphasis on on technology and quantified

self and things like that and i thinkthose are interesting but again information is usually not enough tomotivate people to change it was a great way to bring awareness and awareness isthe first step in healing to that extent it can be useful and certainly as aresearch tool that can be incredibly useful but it's not enough for mostpeople just to be given the numbers and say here's what's happening we have togive them the tools to be able to transform what's happening and that'swhat we do functional medicine i i also have a lotof respect for i guess what's different is that they they spend so manythousands of dollars in doing testing

for people that usually isn't covered byinsurance and again i wanted this to be more for everyone and i really thinkthat you know to me that fact that we can give people the same interventionwhich you know by the time you get done with all of your functional medicinetesting you know there's some fine tuning withru gluten sensitive or not and so on but the most common recommendation that youget in a functional medicine practice is the whole food plant-based diet which isreally what we're doing anyway so i think there's there's information fromthat likelihood is doing some really interesting work as well but you know iwas on craig venters board of directors

of his nonprofit 44 45 years so i'mreally pretty up on what's happening in the genomics field and this idea and ichaired google health with marissa meyer from 2007-2009 and we were trying tocome up with these very complex algorithms for personalizing a lifestyleintervention for people and one day i said you know we're making this socomplicated for so i think at some point as we learn more we'll be able to personalize things inmore and more detail but i don't think we're there yet and i to me i said let'smake it radically simple and so for reversing disease this is i think whatit takes that's what were the first to

prove that in scientific studies because mostpeople didn't go far enough but if you're just trying to stayhealthy you know you don't have to make such big changes and what i learned isthat you know even more than being healthy people to feel free and controland as soon as i tell somebody you know eat this and don't have that and do thisand don't do that they often immediately want to do the opposite you know it goesback to the first dietary intervention when god said don't eat the apple andthat wasn't and so that didn't go so well that was god talking and apples aregood for you

so i said look instead of me telling thepatient here's here's your diet or here's yourlifestyle intervention which is automatically pushed back i said let's let's do a different listturn it on its here let's say you tell me what you want to do and the wholelanguage of behavioral change often has this very judgmental moralistic kind ofshaming quality and even the language we use i cheated on my diet you know wherethese are good foods and these are bad foods and as soon as you call foods goodor bad it's a very small step to say i'm a bad person has a bad food at thatpoint you might as well just finish the

cheeseburger and a pint of ice cream asyou're a bad person so i wrote a book a few years ago called the spectrum thatwas based on the finding that we saw in all of our studies that i mentionedearlier surprise me that the more you change the more you improve at any age so i said okay let's just call foods andsetting these are good and bad lets i categorize food for what i call the mosthelpful group 12 the least helpful group 5 and so what matters most is youroverall way of eating and live it so if you indulge yourself one day itdoesn't mean you cheated or you failed or your bad just eat healthier the next

you don't have time to exercise one dayto a little more than x you don't time to meditate for now or do it for aminute whatever you do there's a corresponding benefit and thenyou can't fail it's a much more compassionate approach because if you goon a diet generally sooner or later you're goingto go off and then you have all those toxic emotions of you no shame and guiltand anger and hostility and humiliation which really are bad for you so you canfail so then i'd ask a patient instead of me saying okay here's your program tosay why are you here what do you want to accomplish oh idon't know what you're asking that

i'd like to lose 10 pounds lower my ldlcholesterol 50 points lower my hemoglobin a1c you know get my bloodpressure down 10 points whatever happens to be is a great what are you doing now oh i'm eatingmostly unhealthy group 4 and 5 foods and how much exercise you get it well not somuch and not too much yoga and not spend that much time with my friends andfamily loved ones that say so instead of saying here's your prescription to sayhow much are you willing to change oh no one's ever asked me that well i'mnot ready to be a vegetarian but i less of the unhealthy group for and fives thefoods that are you know red meat and

sugar and things like that and and moreof the healthier group 1 you know wholefoods plant-based foodslike that how much yoga meditation join 0 how much you're willing to do i'm i'llmeditate 15 minutes a day how much exercise you doing well not toomuch how much are you willing to do well i walk 20 minutes a day ok how muchlove and support you have not enough but all spend more time with my friends andfamily is a great will support it will track it and after like four to sixweeks will measure it against a ok look you've lost five pounds you wantedto lose ten your cholesterol come down

thirty points you want to come down 50and so on just go a little farther and you can getthe rest of the way there doesn't mean you have to eat this way all the timebut to the move degree move in that direction you know you're going to look betterfeel better lose weight and gain health so dr. we asked our community no so tocome up with some questions that they would like to ask you and one of themajor things that comes up in the most controversial area of your work in thatis is the diet out of the the four parts of it and the nutrition what do you eatand what would you say to some

detractors of your work that would saythat the nutrition is just one part but the actual health effects are comingfrom the other three parts the meditation exercise and the love andsupport and they're causing the majority of the effect and the diet is stillstuck in the eighties methodology of low carbs well first of all we've actually doneanalysis where we correlated not only the appearance of the overall programwhich changes in the arteries with the appearance of the diet and changes inthe art and we found that both one year and atfive years there was a highly

significant i statistically significant correlationbetween adherence to the diet and changes in their arteries across bothgroups so we know it's not just one it's the diet is very important there's a whole literature on everythingfrom animal studies epidemiological studies in randomized trials have shownthat there was a wonderful article by stephen smith in the new england journalof medicine a few years ago that showed what happens to your arteries ondifferent nights not just to your risk factors like cholesterol blood pressureand weight and so on

it's worth pointing out that we stillhave the only randomized controlled trial data is showing that any dietaryintervention can reverse heart disease now if other people want to show that apaleo diet or other things like that an atkins diet can reverse heart diseasei i will be the first to welcome them but no one has shown that and what thisarticle in england journal of medicine showed that on a wholefoods plant-basedi that's also low and refined carbs i the arteries are essentially clean ona standard american diet they're partially clogged and on an atkins typaleo type high protein low carb diet a high-fat diet they're severely clogged

what was most interesting is that it'snot often it's not always reflected in the usual risk factors like cholesteroland blood pressure i mean people have done studiescomparing atkins diet and orange dye and they'll say well you lose weight on bothdiet so pick the . you want but or they'll say well the hdl goes up more onthe atkins diet the ldl goes more down and order side so it doesn't matter tellyour page and see what they like but what happens in your arteries is verydifferent we've shown through valium scans the blood flow to the heartimproves in just a few weeks that with cardiac pet scans there's a threehundred percent improvement of blood

flow using quantitative arteriographythese are the state of the art measures there's some reversal after one year andeven more versatile after five years you know like and two and a half times fewercardiac events if anyone else has a better diet and they can do inrandomized trials that it shows reversal of heart disease i would be all yours to hear that but noone has done that the only diet that's been shown to dothat in our work and other people's work as well has been a wholefoodsplant-based diet now you know there's a you know i i likei said it's never just a low-fat diet i

i as i mentioned earlier i debated dr.atkins and people like in many times in the past and he was the low carb guys soi got pegged as a low fat guy it's never been about just fat is just one of manyconstituents in it that will relate to our diet it slow and the bad carbs thebad fats in the bad proteins and high in the good carbs the good fats in the goodproteins so i've been adding fish oil to our diet since 1984 1983 because mymentor when i was doing my training at harvard medical school and themassachusetts general hospital was alexander leaf who was the chair ofmedicine there he then they became their first chair ofpreventive medicine at harvard and he

did a lot of the pioneering work withfish oil so i've been recommending omega-3 fatty acids longer than most ofthe other people and in functional medicine and others but but not a lot offat just you only need about 4 grams a day more than that doesn't give you anyextra benefit there was a and and there's it's not just fat versus carbsthe diet that i recommend is a wholefoods plant-based diet becausethere are literally hundreds of thousands of protective substances andfruits and vegetables and whole grains and legumes and soy products fromphytochemicals by flavonoids crowd noise retinols isoflavones genesee likeopinion that have any cancer and heart

disease in any aging properties and theyare naturally low in fat and naturally low in refined carbs this has alwaysbeen the diet that that i've recommended now more recently we've added nuts andseeds to the even the reversal diet because there's enough evidence outthere that i was impressed by that and i think that it's not in booksbecause of the fat but i think there's just the germinal quality of nuts andseeds the you know it may sound a little unscientific but the the regenerativeyou know seeds and that's all about creating the life force if you will thechi the shakti the you know whatever name you want to give to that i thinkit's powerful and there's certainly

enough enough scientific studies showingthat they're beneficial that we've added them or not this is not a sermon on themount when i had one studies come out that show that they work we include thembut on the other hand when you look at the things like the mediterranean diet there was an article in the the presentstudy that came out a couple of years ago in the new england journal ofmedicine have on was you know mediterranean die better than low fatdiet at preventing heart disease well if you actually look at that studycarefully the the control group was on a that what they call the low-fat dietwhen from thirty-nine percent fat to

thirty-seven percent that hardly anyreduction at all they replace that with sugar which isnever a good idea and if you actually look at the outcomedata they didn't show a significant difference in cardiovascular events theyshowed a reduction and stroke because the omega threes help to prevent bloodclots from forming which are that promise is usually what causes strokesbut it was only when they pull the stroke data in the cardiovascular datedthat they showed a reduction when they only look at the cardiovascular data inisolation there was there was no significant difference so themediterranean diet is a better diet but

it doesn't go far enough to actuallyreverse disease in the same way that what we're doing does now doc i knowthat you've been completely focused through your career on the hot as theorgan of specialty if you had being focused on diabetes andtype 2 diabetes do you think the recommendations in your program wouldhave been different well it's not what we feel you knowwe've done we published a paper in the american journal of health promotion andalmost 3,000 patients who went through our our program in 24 sites in westvirginia nebraskan pennsylvania three of the more challenging parts of thecountry and which has significant

reductions and in every metric you knownot just ldl but also and hemoglobin a1c and then and in blood sugars and so on andtriglycerides and such you know one of the the things that'sbeen repeated so often it's almost become a meme even though it's not true is thatamericans have been told me less fat they're fatter than ever low fat is dead we should eat more fat well it's true that americans have beentold a less fat but i went to the us

department of agriculture database tosay what are we actually eating not one of you been told you but weactually eating they track the entire united states food supply every decadesince 1950 so what they know exactly what the country as a whole has beeneating and what i learned is that we've actually been every decade since 1950we've been eating more fat more sugar more calories and more meat sixty-seven percent more more more oncalories for example so not surprisingly successful more more more calories sonot surprisingly where were fat or not because we're eating too little fat weactually more fat than ever but was

ready too much of everything and so ithink it's really important for people to understand that it's not thisreductionistic thinking of you know it's all low fat is all low carb or whateverit's not first of all it's not just fat versus carbs an optimal diet is low inboth because that has nine calories per gram protein and carbs have four so whenyou eat less fat or put another way if you lower fat you can get the samevolume of food but you're getting a lot fewer calories because the food is lessdense in calories also there was an important article thatcame out a couple of years ago in cell metabolism and others have shown that aswell

that is not just fat versus carbs ananimal protein itself is harmful they found that people who have a lot ofanimal protein that there was a seventy-five percent higher risk ofpremature death from all causes a four hundred percent increase risk from fromtype 2 diabetes and a five hundred percent increase risk from all cancersso independent of the whole fat versus walter willett and his group of theharvard school of public health and published a meta-analysis of hundreds ofthousands of people and found that people ate a lot of red meat had higherrates of cardiovascular disease stroke the most common forms of cancer prostatebreast and colon cancer and type 2

diabetes i wrote the editorial that acompany that it was called think holy cow or something like that sothere's a lot of evidence out there there are people out there who reallyobfuscating this most of whom our doctors you know occasionally some whoare who should know better that's a great way to sell books bytelling people what they want to hear but you know red meat you know this lolis grass-fed beef is is good for your regular beef is not there's not a shredof evidence to show that it sounds good it may be true but no one has ever shownthat people eating grass feet grass-fed beat get less heart disease orother conditions

the only thing they have shown is it's alittle bit higher in the omega-3 fatty acids but there are a whole lot betterways of getting omega threes and eating a slab of beef so i'd love to be able to tell peoplethat you know red meat is good for you but it's not you know it's just the wayit is now should you never eat it i'm not saying that either if you if youdon't have heart disease or otherwise healthy and you have been on occasion oruse it as a condiment probably not a big deal but if you're trying to reverse alife-threatening condition the pound of cure rather than the ounce of prevention

what we found is that the more youchange the more you improve and if you want to get reversal it takes a lot of change but the goodnews is that we're getting 85 to 90 percent adherence to our lifestyleintervention after a year in all of the many sites that we've trained even though the training program is only12 weeks long dr. one of our goals here the evolution of medicine is to movemore doctors across to move doctors from traditional medicine into integratedfunctional lifestyle medicine what would you say to those doctors who arecurrently on the fence you haven't made

it across to encourage them to make iton this journey well it's a very powerful way ofpracticing in a very emotionally gratifying way of practicing medicinefor both the providers and for the patients and this integrates very wellinto functional medicine practice there's nothing here that is at oddswith functional medicine rather it's a it's a synergy of the two integrativemedicine it is integrative medicine you know on president clinton appointedto this white house advisory commission on complementary alternative medicinepolicy president obama . to this white house advisory commission on integrativemedicine and public health and

prevention it is an integrative medicine it ispreventive in public health medicine but the nice thing about is what'sdifference from these other things is that is reimbursable at a very highlevel and so that provides a sustainability that enables you to offersay integrative medicine approaches and aren't yet reimbursable by medicareby insurance to make your practice more financially viable and sustainable andthat's the painful lesson that i learned many years ago that if it's notreimbursable it's not sustainable now it is and so this is my life's workthis is what i want to be our life's

work you know this is our mission where wecan work together to create a whole new paradigm of health care that brings in no one has a monopoly on truth includingme especially me but we can all work together and find ways of of continuingto advance the field and involve it you've all the recommendations do highquality research so we can really be a best service to our patients which isreally what it's all about anyway so dr. just one last question this isreally for me this is not necessarily for our community but i would justwanted to know you know i see more and

more countries around the world and bigorganizations and countries that are looking to cut costs and are looking todeal more effectively with non communicable diseases you know what there are there theseother countries that aren't as far along with integrated functional medicine intheir communities what would be your recommendation togovernments people high up making decisions about how to really reducehealth care costs from non-communicable diseases well uh those are important questionsand i've given a lot of thought to them

and i was in dalian china last fall forthe world economic forum lecturing at their annual meeting and what's so sadis that i we were in china the the rate of these chronic diseases in china was afraction 50 years ago as it is now but unfortunately so many countries arestarting to eat like us and live like us and now all too often die like us andit's all completely preventable it's all happened in the last generation or two and so you know and and the irony in allof this is that the diet they were eating before they copy the americandiet and lifestyle was the one that we found that can reverse to prevent allthese conditions it's essentially a

third-world diet and so i've beenworking with leaders around the world to to help them understand that i metseveral times with prince charles in the uk and the ministries of health carebecause you know they're at a point now for the national health service that ifthey start cutting any their schedule go bankrupt in a few years and if theysimply just do more of what they're doing then the only options are going nervous to ration and and that'spolitically unfeasible that here we found in our studies that mutual ofomaha did a very carefully controlled

study and found they say it's almostthirty thousand dollars per patient in the first year highmark blue cross blue shield foundthey cut their overall health care costs in half in the first year and by fourhundred percent in that sub group of people that they spend at least 25thousand dollars on the in the previous year so these are normally magicallyeffective but very cost effective interventions and if you take an evenbroader perspective you know so often people say what can i do is one personabout these major issues of global

warming or you know health care costs orenergy use for things like that and it it turns out that one of the mostpowerful contributors to global warming is livestock consumption more globalwarming is caused by livestock consumption more greenhouse gases areadmitted that all forms of transportation combined that's why al gore became a vegan eventhough his family's cattle rancher because he realized you can't just talkabout you know light bulbs and and smaller cars could have if the majorissue is what we eat and part of what i've learned is that if it's meaningfulthan its sustainable and if you

understand that something is as primalas what you eat every day is not only good for you but good for the planet it makes it abuse those choices with meand it's meaningful than its sustainable you know it doesn't mean you have to bea vegan but even if you have a meatless monday to whatever degree you you cut back on on animal proteinparticularly read me it's not only helping you but it'shelping the planet as well and it takes ten times more resources to eat me basedon a plant-based diet there's enough food to feed all thehungry people in the world today if more

people ate a plant-based i so again ithink that there are the people who say we should be eating more red meat andgrass-fed beef and things like that in addition to the fact that is not truefrom a health standpoint it's definitely not true from a planetary standpoint andwhen people understand that these choices that we make each day for betterand for worse are imbued with meaning it makes those choices good choices muchmore sustainable dr. just a warm thank you from ourcommunity thank you so much for all the pioneering efforts that you've done in order to be able to make thisscientifically credible to get lifestyle

medicine to be available on healthinsurance both medicare and all these other insurances i think it's a massivestep forward i was in texas recently where i grew upand somebody said oh this is pioneering like you're saying and somebody said youknow you know how we tell pioneers in texas by the arrows in their backs isaid you have had a few yeah but thank you for making thisavailable to people i'm really grateful thank you so much from our community andyou know if there's anything else if you ever want to speak to the functionalintegrated medicine community in the future we'd love to have you on the showand share some of your work so thank you

so much if anybody's interested in learning moreabout our work just go to our website orange dot com everything on there isfree but there's also a section on there if you're interested in learning moreabout this will be happy to contact you and i look forward to that thank you so that was a lot of fun hopeyou enjoyed it thanks so much for tuning in you know we'd love to get our feedbackfrom our community as to what you thought of the interview what you thinkof dr. ornish we tried running dr.

ornish protocol are you interested in running it youknow the thing that i'm struck with every time that i go and meet thesehealthcare luminaries people who have been pushing forward medicine fordecades i'm just always struck by the the quality of character the heart thatthey show their love for what they do you know i think they just interested intaking medicine and humanity forward and it's always refreshing and inspiring tospend time with them and that makes me very thankful for our community and whati think we're capable of doing you know they start at the beginning youknow this is available on medicare

this is a access point for doctors whoare just wanted to come in to integrate in functional medicine for the firsttime and this is an access point where you can still bill insurance you can getpaid the same as if you're working in a group system hospital system think it'sa very exciting opportunity and you know really glad to be able to document it thanks so much for watching and we'llsee you next time