>>Dean Ornish: I don't know about you, but
I feel so inspired to be here. And very grateful
to Eric and to Gary Bowles and everyone else
who was kind enough to included me in this.
You know, I want to talk about some themes
that the previous distinguished speakers have
also discussed. You know, we tend to think
of advances in medicine as being a new drug,
a new laser, something really high tech and
expensive. And we often have a hard time believing
that the simple choices that we make in our
lives each day, like what we eat, how we respond
to stress, how much exercise we get, and perhaps
most important, how much love and intimacy
that we have in our lives, that these simple
choices can make such a powerful difference.
But they do.
And what we find is that if we can address
the underlying cause of the problem, if we
can turn off the faucet around the sink that's
overflowing and not just simply mop up the
floor, that our bodies have a remarkable capacity
to begin healing themselves much more quickly
than we once realized. And in this sense,
lifestyle cannot only be preventing diseases,
but actually treating them, sometimes with
drugs, sometimes in place of drugs, sometimes
more effectively than drugs. And everything
that I'm going to talk with you about this
morning was thought impossible just a few
years ago.
And so we are able to show, for example, that
even severe heart disease can actually begin
to be reversed simply by making changes in
diet and lifestyle. When we look at the upper
left is a narrowing in one of the arteries
in the heart. A year later it is less clogged.
Usually goes in the other direction.
And the PET scan shown in the bottom left,
before the blue and black, is no blood flow.
A year later, orange and white is maximal.
Shows kinds of improvements in how dramatic
it is.
We found when we looked at all the arteries
in all patients in a randomized control trial,
that the arteries got more and more clogged.
From beginning to one year to five years in
the group that made more conventional changes
in lifestyle, that they got less and less
clogged. I think these findings are giving
many people new hope and new choices we didn't
have before.
I want to show you what this looks like in
a real patient.
>>> I am no longer using a cane or a wheelchair.
In November 2001 was using a cane to walk
with, and I had to have the humiliating experience
of riding a wheelchair around Walmart. Now,
I didn't like that. I wasn't going to settle
for that. I knew there must be a better way.
Thank God I found a better way. I no longer
have to take my diabetes medication. In fact,
my total medication has been reduced by 75%.
I had trouble getting to my mailbox without
having chest pain, but now I am walking at
least two miles a day. I ride my stationary
bike anywhere from eight to ten miles a day.
>>Dean Ornish: This is not a best case. This
is representative of what happens when people
change their lifestyle. It is why I am so
passionate about doing this work because I
have worked with thousands and thousands of
people like this, and they don't know how
much better they can get.
So then we did a study to see whether or not
we could affect the progression of early stage
prostate cancer which we did in collaboration
with the chair of urology at UCSF and the
chair of urology and Memorial Sloan-Kettering
Cancer Center.
What we found was that the PSA levels, which
is a marker for prostate cancer, went down
in the group that made these, went up in the
group that didn't in direct proportion to
the degree of change, just like we found in
the cardiac studies. The more people changed,
the more they improved.
We found the tumor growth was inhibited by
70% in vitro in the experimental group compared
to the control group was only 9%. Also, the
more people change their lifestyle, the more
directly inhibited the tumor growth.
Then we did MR spectroscopy scans, which are
shown here, and the tumor activity is shown
in red, which after just a year begins to
diminish. So we wondered: How is it that people
can get better so quickly? And so we looked
at their gene expression. You know, so often
people say, "It is all in my genes, what can
I do?" It turns out you can actually do a
lot. We found after just three months of making
these lifestyle changes over 500 genes were
beneficially affected. In effect, turning
on the good genes that prevent disease and
turning off the genes that promote disease,
particularly the oncogenes that promote breast,
prostate and colon cancer which are shown
here in what's called a heat map. Red is turned
on. You can see it is mostly red at the beginning.
Each one of those down here, these are all
different genes that promote cancer. They
get turned off in just three months.
So this idea that our genes are our destiny
is really not true. Our genes are not our
fate, and we can change them. When you change
the expression of your genes, it actually
gets transmitted to your kids as well, what's
called epigenetics.
We then did a study with Dr. Liz Blackburn
who got the Nobel prize last year for discovering
telomerase which is an enzyme that repairs
and lengthens damaged telomers which are the
ends of our chromosomes that control how long
we live.
She did a study and found that women who are
taking care of kids with autism or parents
with Alzheimer's who are under chronic stress,
the more stress they felt and the longer they
felt stress, the shorter -- the lower their
telomerase and the shorter their telomers.
It was the first study showing on a genetic
level that chronic stress can actually shorten
your lifespan.
So we were presenting at a conference. I said,
If bad things make your telemers shorter,
maybe good things make them longer. We found
after just three months that the telomerase
increased by almost 30%.
We just got some data which we are about to
publish showing that the telomer lengths increased
as well. Even pharma hasn't yet been shown
yet to do this.
What have we learned about what enables to
make sustainable changes? It is not what I
thought when I first started doing this work
35 years ago. It is not fear of dying. It
is joy of living. And if we go back -- Can
we go backwards a few slides? There we go.
Right there.
This goes back to the first dietary intervention
when God said don't eat the apple. That didn't
work very well, and that was God talking.
I have learned that even more than being healthy,
people want to feel free and in control. And
as soon as I tell somebody don't eat this
and do that, they immediately want to do the
opposite.
And if you tell kids, for example, that smoking
is bad for them, that just makes it cool,
like James Dean on a Harley. We have to take
a different approach. Part of what we learned
is that just telling people they are going
to live longer doesn't really make a difference.
The fortune teller says, I give smokers a
discount because there is not as much to tell.
That's the fear-based approach that doesn't
work.
And if you go on a diet, sooner or later you
are going to go off a diet because diets don't
work. They are all about what you can't have
and what you must do.
So what we have learned is that we can take
a spectrum approach, that the more you change,
the more you improve. It is not all or nothing.
It is how you can personalize a way of eating
and living. The more you change, the better
you feel. The better you feel, the more you
want to keep doing it. And the more you keep
wanting to do it, the more you improve. You
get a virtuous cycle going.
You decide how much you want to change, how
many things, how quickly. We support that
degree of change. If that's enough, great.
If not, you can do more. It is radically simple.
Here is a clip we put together that talks
about this.
(Music).
>>Dean Ornish: So it is not all or nothing.
If you go on a diet, you are going to go off
a diet. Fear and failure are built into it.
This way do what you can. It is a much more
compassionate approach.
What we have learned is that what's sustainable
is feeling good, is feeling pleasure and joy.
When you make these changes, your brain gets
so much more blood flow. You begin to think
more clearly. You have more energy. You need
less sleep. Your skin gets more blood so you
don't age as quickly. Your heart gets more
blood. You can reverse heart disease. And
you can actually grow so many new brain cells
that your brain can get measurably bigger
in just a couple of months.
It is not what you exclude from your diet
that's harmful. It is also what you include
that's beneficial. There are literally hundreds
of thousands of substances, predominantly
in fruits and vegetables and whole grains
and so on, that have anti-cancer, anti-heart
disease, even anti-aging properties.
Some of my substances actually promote neurogenesis.
For example, chocolate and tea and blueberries
can increase neurogenesis. Whereas, what's
bad for your heart is bad for your brain,
things like saturated fats, sugar and nicotine.
And a recent study came out just a couple
of months ago that found that frequent sex
actually increases neurogenesis, as do things
like stress management, moderate exercise
and, believe it or not, even cannabinoids
increase neurogenesis. I'm just the messenger.
[ Laughter ]
What were we talking about? Nevermind.
Let me show you one study that was done in
rats where they actually compared rats who
are forced to have -- allowed to have sex,
I should say, and those that were not and
found that just in a very short time, in about
14 days, they had significantly more neurogenesis
-- what happened here. We ended up going forward
two. There it is -- showing the extra brain
cells that can grow, how dynamic these are,
and how quickly that can occur.
Now, it turns out that there are a lot of
health policy implications from this as well,
that 75% of the $2.5 trillion in health care
costs, sometimes more like sick care costs,
are from chronic diseases that can be largely
prevented or even reversed simply by making
changes in diet and lifestyle.
Now, it turns out that, you know, we have
a big debate going on about, you know, the
Democrats who want to raise taxes or let the
deficit go up, Republicans who want to dismantle
Medicare. It is at a loggerhead because neither
choice is really very good.
When we realize 3/4 of the cost of this $2.5
trillion are from things that our lifestyle
changes can prevent or even reverse simply
by making these changes, we have a third alternative.
We can make true health care available at
a fraction of the cost, and the only side
effects are good ones.
Nowhere is that easier to see that in cardiovascular
disease, which kills more than everything
else combined, not only in this country but
now worldwide because we have this globalization
of chronic diseases going on.
Now, many people are surprised to learn that
95% of heart disease could be prevented today
and even reversed knowing what we know now.
We don't need a new drug. We don't need a
new laser. We don't need a new breakthrough.
We simply we need to put into practice what
we already know.
Many people are also surprised to find that
the randomized trials show that bypass surgery,
angiography and stents really don't prolong
life or even prevent heart attacks for the
vast majority of people who get them unless
you are in the middle of having one, which
95% of people who get them are not.
We spent $100 billion last year on these operations
that are dangerous, invasive, expensive and
largely ineffective. If we can focus on the
lifestyle choices and realize they work not
only as well as drugs and surgery but often
even better at a fraction of the costs and
only the side effects are good ones.
Now, we found, for example, that we did a
demonstration project with Mutual Omaha. They
found that most people could avoid surgery.
They saved $30,000 per patient in the first
year.
We did a second demonstration project with
Highmark Blue Cross/Blue Shield where they
found they cut their costs in half in the
first year and by an additional 20 to 30%
in years two and three.
We also -- Sorry. There we go.
We did a study with -- Oh, sorry. I wanted
to show you, this is one of my favorite anti-smoking
ads that, you know, if you tell somebody smoking
causes lung cancer, heart attacks, it is just
too horrible to hear about. People don't want
to think about it. Fear is not sustainable.
It turns out nicotine constricts the arteries
in your body. So in your face, it makes you
age faster. In your heart, it can cause a
heart attack. In your brain, it can cause
a stroke.
But half of guys who smoke are impotent. So
when you tell people that the advertising
says that smoking makes you beautiful and
sexy, it really makes you ugly and impotent,
it puts it much more into the present tense
and is much more effective in getting kids
not to smoke than telling them that something
bad will happen to them 30 years down the
road, which they don't want to think about.
Now, it turns out that because these costs
are so high and because they're modifiable,
that we can make these changes. And we can
give a third alternative to what we have been
doing before. What's good for you is good
for the planet. There is a sense of feeling
overwhelmed at these crises that we're facing.
But when we realize that lifestyle consumption
causes more global warming than all forms
of transportation combined, what we choose
to eat each day makes a difference not only
in our own lives but in the lives of our planet
as well.
And as other countries are beginning to eat
like us and live like us and die like us,
these are global phenomena that we can do
something about as well.
Now, we finally -- after -- By the way, if
you are interested in this stuff, we have
a lot of free meditations and information
on our Web site, at ornish.com.
What I am most interested is in not simply
saving money. We were finally able to get
Medicare to cover our program after 17 years
of going back and forth, that what -- I used
to think that science was the primary determinative
medical practice. And I've learned that science
is important but reimbursement is a much more
powerful driver. And so if we can change reimbursement,
we can change not only medical practice but
also medical education.
And that we need to work at a deeper level.
I asked people: Why do you smoke? Why do you
overeat? Why do you drink too much? Why do
you work too hard? These behaviors seem so
maladaptive to me. They say, You don't get
it, Dean. These behaviors are very adaptive
because they help us get through the day.
They say things like, I have got 20 friends
in this package of cigarettes and they are
always there for me and nobody else is. Are
you going to take away my 20 friends? What
are you going to give me?
Or they say that food fills the void or alcohol
numbs the pain or working all the time numbs
the pain or video games numb the pain or spending
too much time surfing the Web numbs the pain.
We have lots of ways of numbing, killing,
bypassing, distracting ourselves from pain.
But, you know, pain isn't the problem. Pain
is the motivator. Pain gets our attention.
It says, Hey, listen up. Pay attention. You
are not doing something that's in your best
interest. If we just literally or figuratively
bypass the problem without also treating the
underlying cause, the problem comes back again
or we get a new set of problems or we have
painful choices.
And so what we are learning is that at the
root of so many of these behaviors is the
sense of loneliness and isolation. The real
epidemic isn't just heart disease or cancer.
It is loneliness, depression, isolation with
a breakdown of the social networks that used
to give us a sense of connection, the community.
I wrote a book called "Love and Survival"
about 12 years ago where I reviewed hundreds
of studies that showed that people who feel
lonely and depressed are three to ten times
likely to get sick and die prematurely than
those who have a sense of love and connection
and community, in part because you are likely
to abuse yourself and part through other mechanisms
we don't fully understand.
One study showed, for example, people with
heart disease who were depressed six months
after a heart attack were five times more
likely to be dead than those who weren't.
And when you are depressed, your immune system
is depressed. H.I.V. positive men and women
in San Francisco who were depressed had more
than double the likelihood of dying from AIDS
than those who weren't.
But they've also shown that we could do something
about that. David Spiegel did a classic study
of women with metastatic breast cancer. And
he found when he brought them together in
a support group once a week for just an hour
and half in a supportive, safe environment
to talk about what was really going on in
their lives and just did that for a year -- once
a week for a year, five years later those
women lived twice as long.
Now, a skeptic might say, Come on, give me
a break. You mean talking about my feelings
in a group of women who have got cancer is
going to help me live longer? Please. That's
what the studies show because we are creatures
of community. The need for connection and
community is really the unmet human need.
And if you can meet that even badly, you can
create a multibillion-dollar business like
the lounges s in Starbucks or the chatrooms
in AOL or Facebook. But if you can do it more
intentionally, we can really create a real
sense of community.
And to me, the ancient spiritual teachings,
we're all about anything that brings us together
is really healing. The word "healing" comes
from the root to make whole. The word "yoga"
comes from sanskrit, to yog, to unite, to
bring together.
And Aldous Huxley talked about the perennial
philosophy of altruism, compassion, love and
forgiveness because these are things that
connect us, that keep us from our own suffering.
It is the false choice that Professor Reich
was talking about: Am I going to be for me
or am I going to be other people?
As Nelson Mandela said when he was released
from jail, Do you still hate your jailers?
He said, Well, if I did, then I'm still in
prison. When I can have that sense of forgiveness,
it frees me. It doesn't condone what they
have done, but it frees me from the suffering.
And so ultimately the ancient swamis and rabbis
and priests and monks and nuns didn't develop
these techniques to unclog their arteries
or lower their blood pressure or do all these
things, they can do that but we are all going
to die. The mortality rate is still 100%.
It is one per person. So to me the more interesting
question is not how long we live but how well
we live and we can use the experience of suffering
as a doorway for transforming our lives, that
anything that takes us from the "i" of isolated
separate to the "we" -- if we can go back
one slide -- to the -- sorry, go forward one
slide then -- can really give a sense of community
and connection which is ultimately what frees
us from our own suffering.
And in that sense, as Mayor Booker said, it
is a conspiracy of love. If I went to Medicare
and said, I want to create these oases of
safety where people can get together and open
their hearts and let down their emotional
defenses and rediscover inner sources of peace
and joy, they would say, You are out of here,
buddy.
If we can show them the quantitative arteriograms
and the cardiac PET scans and for every dollar
they spend, they save three more, even then
it took us 17 years but we were able to get
it done.
To me that's what really makes this matter,
is that we can -- Change is hard. But if we
are in enough pain and we can help people
guide them at a time when they are suffering,
suddenly the idea of change becomes more interesting.
And they often say things like, Having a heart
attack was the best thing that ever happened
to me. What are you nuts? They say, No, that's
what it took to get my attention to begin
making these changes that have transformed
my life in ways that go beyond just living
longer to living better. Thank you so much.
[ Applause ]
