Dr. Dean Ornish, President of the Preventive Medicine Research Institute

Dr Dean Ornish

Mark Masselli: This is Conversations on Healthcare , I’m Mark Masselli.

Margaret Flinter: And I’m Margaret Flinter.

Mark Masselli: Well Margaret we are getting more deta ils about the pathology of the
Z ika virus which is still fraught with many unknowns, Global Health Officials are still
trying to connect the dots between women being infected during pregnancy and the
likely result of birth effects in their offspring and whether there maybe other causal
factors at play.

Margaret Flinter: Well Mark at this phase where there are still so many unknowns but a
lot of fear, experts are emphatically warning women of child bearing age and certainly
women who are pregnant already to simply avoid the hardest hit areas South and
Central America as well as the Caribbea n for now.

Mark Masselli: Now there is an added threat health officials have recently determined
that the virus can be sexually transmitted based on a recent case they examined in
Texas.

Margaret Flinter: Well another pathway to transmission now to be very concerned
about Mark , and as we have seen with other epidemiologic studies the recent Ebola
outbreak is a great example. We have just got to get far more data on the pathology of
the virus , all transmiss ion roots, potential risk assessments and of course prevention.
All around just another new major global worry.

Mark Masselli: You are absolutely right. And as health providers it's important that we
all know the facts and members of Congress are also c oncerned about getting the facts .
HHS Secretary, Sylvia Mathews Burwell updated members of Congress on the latest
details about the virus and what Federal or the State precautions are being put in place.

Margaret Flinter: Meanwhile epidemiologists are co nverging on ground zero , t he region
in Brazil with the highest number of cases as well as babies born with the signature birth
defects in order to get to work on a vaccine . Officials caution it could take years to
produce a viable one but to protect popul ation health that’s the goal at the moment.

Mark Masselli: Another threat to population health Margaret is the obesity epidemic , t he
USDA just released new federal nutritional guidelines to help educate the public about
ways to achieve optimal health and weight, something our guest today is a renowned
expert on.

Margaret Flinter: Dr. Dean Ornish the Founder of The Preventive Medicine Research
Institute which has been dedicated for decades to producing sound empirical evidence
on the link between good nutr ition and good health. And he is going to bring some

Dr Dean Ornish

unique insights into solutions to the obesity epidemic which also underlines so much of
the chronic disease burden in our country.

Mark Masselli: We will also hear from Lori Robertson, Managing Editor of
FactCheck.org , she is always on the hunt for misstatements spoken about health policy
in the public domain but no matter what the topic , you can hear all of our shows by
going to chcradio.com.

Margaret Flinter : And as always if you have comments , email us at
[email protected] or find us on Facebook or Twitter because we love hearing from
you. Now we will get t o our interview with Dr. Dean Ornish in just a moment.

Mark Masselli: But first here is our producer Marianne O'Hare with this week's headline
news.

(Music)

Marianne O'Hare: I'm Marianne O'Hare with these healthcare headlines. President
Obama’s final budget proposal includes request for a number of health issues that have
taken center of stage in his last year in office. The president’s budget proposal includes
more than $700 million for cancer research to support his moon shot for cancer initia tive
being led by Vice President Joe Biden . President is also asked $1.1 billion to help
combat the opioid addiction problem in this country, roughly 30,000 overdose deaths
occurred on opioids in 2014 both with prescription opioids as well as heroin . Hal f the
money will go towards creating treatment facilities to meet the rising tide of addicts in
need of treatment . The other half of the money will go to programs intended to prevent
prescription drug overdoses crackdown on a legal sales and improve acces s to
naloxone a drug that can rescue those who have overdose.

US experts will travel to Brazil next week to start work on the development of a vaccine
against the mosquito borne zika virus, ministers from across South America met to
discuss the public heal th emergency and how the region can coordinate its fight against
the virus . Zika has been linked to a birth defect known as microcephaly , most babies
are born with ab normally small head s and underdeveloped brains and is also spreading
rapidly through the Americas. The World Health Organization has declared an
emergency.

Meanwhile the recent revelation that zika virus can be sexually transmitted between
partners, adds a new level of concern and warning to those planning to travel to the
region and certainl y those of child bearing years living in South and Central America as
well as the Caribbean . And the growing concerns of burnout among medical residents
a recent study shows calling on young medical trainees to work longer hours maybe
exhausting for the r esidents but the study shows no real harm done to patients.

Dr Dean Ornish

The New England Journal of Medicine Study looked at a recent effort to cap the number
of hours medical residents were expected to work to protect not only their health but the
health of their patients. A study conducted a direct experiment tracking patient
outcome s after loosening rules for doctors in 58 surgical residency prog rams, found
their patients did not die or suffer complications anymore than a 59 residency programs
that didn’t waive from the current rules. I am Marianne O'Hare with these healthcare
headlines.

(Music)

Mark Masselli: We are speaking today with Dr. Dean Ornish, Founder and President of
the nonprofit Preventive Medicine Research Institute and a Clinical Professor of
Medicine at UC San Francisco. Dr. Ornish has served both the O bama and Clinton
administrations advising on nutritional guidelines for optima l health, a prolific writer and
author Dr. Ornish serves as the Medical Editor of the Huffington Post and has written
several New York Times bestsellers including Dr. Dean Ornish’s Program for Reversing
Heart Disease, Eat More, Weigh Less and the most rece nt The Spectrum. Dr. Ornish
has earned numerous awards for his work including the National Public Hero Award
from UC Berkeley. He earned his medical degree from Baylor University School of
Medicine and was a Clinical Fellow at Harvard Medical School. Dr . Ornish welcome to
Conversations on Healthcare.

Dr. Dean Ornish: Thank you , glad to be here.

Mark Masselli: Yeah. And you have been on the leading edge for a long time now
conducting longitudinal studies on the science and nutrition, its impact on heal th and
wellness. And your studies point to the potential of proper nutrition in not only
preventing illness but reversing illness as well and I wonder if you could describe for our
listeners the relationship between nutrition health and wellness and how y our work has
evolved over the past few decades?

Dr. Dean Ornish: Well 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 what we have
done for the last, almost 40 years now is t o use the latest technology that high - tech,
state - of - the - art scientific measures to prove how powerful and how dynamic these
underlying lifestyle changes can be, and everything we have done was thought
impossible at the time we were able to show for the fi rst time that even severe heart
disease can often be reversed by making lifestyle changes that Type II diabetes can be
reversed, that early stage prostate cancer maybe slowed , stopped or even reversed .
When you change your lifestyle in these ways it changes your genes turning on the
good genes that protect us and turning off the genes that cause oxidative stress and
inflammation which is you know are often at the root of so many chronic diseases, as

Dr Dean Ornish

well as d ownregulating or turning off what are called oncogenes that promote prostate,
breast and colon cancer over 500 genes in just three months.

And we have found in our latest work that the same lifestyle changes can actually begin
to reverse aging at a cellula r level by lengthening telomeres the ends of our
chromosomes that actually control how long we live it's really the only control study
showing that any intervention including drugs can actually lengthen telomeres. And so
the more we study , the more mechan isms we find to explain why these simple changes
in dieting lifestyle were so powerful , and how dynamic they are, how quickly you can
feel better. And so that in turn reframes the reason for making these changes from fear
or for preventing something bad f rom happening to joy and pleasure. When you make
these changes most people find that they feel so much better so quickly it reframes the
reason for making them from preventing something bad or fear of something bad
happening to joy and pleasure and ultimately it's joy and pleasure that make these
changes so sustainable.

Margaret Flinter: Well Dr. Ornish certainly one of the biggest challenges when it comes
to health of the American public is the throws of the obesity epidemic that we find
ourselves in with a third of the nation’s population obese or overweight , and the USDA
recently upgraded their nutritional guidelines for healthy eating and I understand that
you have supported them. So tell us about these recent changes and why you think
there are step in the right direction and what else would you like to see in terms of those
recommendations and guidelines?

Dr. Dean Ornish: What I like about them is that for example they call the plant - based
health y eating something that they would recommend. Unfortunately between the initial
recommendations , the draft recommendations and the final ones , they got a lot of
pressure from Congress to take out parts about the fact that what's good for you is good
for t he planet because it turns out that one of the leading causes of global warming is
lifestyle consumption , a nd so you know more global warming is caused by eating meat
than all forms of transportation combined. So for all those reasons I think that there i s
the convergence of forces that after doing this work for almost 40 years is finally making
of the right idea at the right time.

Mark Masselli: You know I was interested when you were talking about telomeres and
obviously in your book The Spectrum you, I think a way ahead of you know the human
gene almost only being mapped around then and I always wonder what the resistance
is for people to believe this and do you think the mapping of the genome and the work
that’s going on there is advancing your cause y ou know what's the tipping point in
getting people to sort of connect the dots as you so eloquently you have done ?

Dr Dean Ornish

Dr. Dean Ornish: Well I think that we have reached a tipping point in part because the
limitations of high - tech medicine are becoming increa singly clear the randomized trials
have shown for example that angioplasties and stents really don’t work in people who
have stable heart disease that while they can be life saving in people who are in the
middle of having a heart attack let's say, they do n’t really work for people who are stable
and that most of the people who get angioplasties and stents were stable . Bypass
surgery if it's effective at all is only in a fairly small group of people who have left main
disease or equivalent and left ventric ular dysfunction , it's about 2% or 3% of the people
who get operated on, getting your blood sugar down with drugs then the ACCORD
study, the NAVIGATOR study and others that were in New England Journal of Medicine
didn’ t really reduce the horrible complications of the diabetes you know the blindness
and amputations , and kidney failure , and impotence , and heart attacks and strokes and
so on. But there is evidence of getting your blood sugar down with lifestyle works even
better than getting it down with drugs. Maybe 1 out of 49 men with early stage prostate
cancer benefits from surgery or radiation or chemo , the others get maimed in a most
personal ways because they are often either wearing diapers because of incontinent or
they can't have sex because they are impotent. And so at the same time the limitations
are becoming clear for the most common chronic diseases the power of these lifestyle
changes that not only prevent but actually reverse these conditions we are show ing is
becoming more well - documented.

And now that Medicare is covering my program the last couple of years , 3 or 4 years ,
most of the other insurance companies are doing that, so we are really creating a new
paradigm with healthcare that’s sustainable bec ause it is reimbursable than a
sustainable and if we change reimbursing we change even medical practice and even
medical education.

The skepticism among a lot of doctors has been, oh you know my patients will take their
Statin s , their Lipitor but there is no way they are going to change their lifestyle, it's too
hard or why would I want to do that you know am I going to live longer or just going to
seem longer if I even just have this idea that, this is what, what’s really a false choice
you know is it good for me or is it fun for me. But it turns out that , first of all , the
adherence to stand drug is really terrible , half to two - thirds of people who are prescribed
them are not taking them after just 4 to 6 months . And although we don’ t usually think
of it this way they are fear based, take this pill , the doctor tells the patient, it's not going
to make you feel better, hopefully it won't make you feel worse to prevent something
really awful like a heart attack or stroke from happening years down the road that you
don’t want to think about.

So when we are getting 85% to 90% adherence to our program in all of the various sites
we trained around the country even though it's a lot harder to change your lifestyle than
to take a pill, and the reason is is that there is not point of giving up something that you

Dr Dean Ornish

enjoy unless you get something back that’s better and quickly. And when people make
these lifestyle changes because these underlying biological mechanisms that we have
been talking abou t are more dynamic than we have once realized, most people find that
they feel so much better so quickly, it reframes the reason for making these changes
from fear of dying or fear of something bad happening which is not sustainable , to joy
and pleasure an d freedom and love which are .

Most people we found that 96% reduction in the frequency and severity of chest pain in
the first few weeks for someone who can't work or walk across the street before the life
changes or play with their kids without getting pa in and within a few weeks they are
essentially pain free, they say, oh I like eating cheeseburgers but not that much
because I like some of these other things even more. And as you put it they connect
the dots as what they do and how they feel, it's like , oh when I eat these foods, when I
don’t do these things, I don’t feel so good, when I do this, I feel really good so then they
get into a virtual site where they start to make changes they feel better which makes
them want to do even more which makes them feel even better. And what we have
learned in all of our studies is that the more you change the more you improve at any
age both in how you feel and in the underlying matrix that we look at.

Margaret Flinter: Well Dr. Ornish I think it's also safe to s ay that both providers and just
people have a little bit of fatigue maybe from the constant input about nutritional diets or
changes that they should follow from fat free to sugar free to the low carb, Atkins, Paleo ,
what is the most effective way to help patients make these changes , can a provider
one - on - one with a patient communicate this effectively? Do they need to enroll in some
kind of a program , what's your experience around the best way to help people make the
changes?

Dr. Dean Ornish: That’s why I spent 16 years to work with Medicare to get Medicare
coverage of our program because I realized that you know we don’t learn about these
things in medical school as physicians. And we don’t really have much time to teach
our patients I mean if you h ave to see a new patient every 8 or 10 minutes like most
doctors do, so we are really trying to create , and we are creating a new paradigm of
healthcare , rather than sick care that now Medicare will pay for 72 hours of training . So
in our approach for doc tor is the quarterback but there is also a nurse, a yoga teacher,
and exercise physiologist, the dietician and the psychologist all of them work together,
people come for four hours at a time , not for 10 minutes and they get an hour of
supervised exercise , an hour of stress management which includes yoga and
meditation and now our support group where people can really talk authentically and
openly with each other which is so powerful. But you know it's hard to create something
that’s never done before and yet it's incredibly meaningful , and so I feel very grateful to
be a part of that.

Dr Dean Ornish

Mark Masselli: We are speaking today with Dr. Dean Ornish, Founder and President of
the nonprofit Preventive Medicine Research Institute and a Clinical Professor of
Medicine at UC San Francisco a proponent of nutrition and integrative medicine you
know this whole concept of integrative care is so important, how did you get to that side
of the equation? What was the sort of pathway for yourself to come on over and look at
all of the other elements that are really key to successful rehabilitation for folks?

Dr. Dean Ornish: I got interested in doing has had my own pain when I was a freshman
in college back in 1972 and was suicidally depressed and this approach has really
helpe d bring me out of that . And later when I was in medical school and I was learning
how to do bypass surgery with Michael DeBakey , a pioneering heart surgeon we cut
people open, we bypass or clogged out and usually tell them they were cured and more
often t han not, they got home and do all the things that have caused the problem in the
first place and their bypasses will often clog up, we would cut them open again and that
for me became metaphor of an incomplete approach that we were literally bypassing
the problem rather than treating the underlying cause .

And so we are trying to create a greater sense of awareness and empower people with
the information that the se simple choices that we make in our lives each day can make
such a powerful difference in not only how long we live but also how well we live.

Margaret Flinter: When we think about this large scale change whether it's Medicare
taking 16 years, we wonder what's your vision for how this really goes mainstream,
large - scale in a way that really changes health outcomes in the future, what's your
grand plan for how we do this on a very large - scale?

Dr. Dean Ornish: Well it's what we are doing now. I mean the fact that Medicare is
paying for this they are paying for it at a r ate of reimbursement that is sustainable and
we are now finding that you know the big question was, oh you know you live in
California it's an altered state they will do anything [Inaudible 00:17:24] that we are
getting the same outcomes from you know Jack son , Mississippi or California, UCLA .
So if you actually look at the data of what people are actually eating, not what they say
they are eating but what they are actually eating and what I learned is that, every
decades since 1950 we are eating more fat, more sugar, more calories and more meat
so not surprisingly we are fatter not because we are eating too little fat but because we
are eating too much of everything. An optimal diet is low in fat but it has enough of the
good fats C Omega 3 fatty acids for example that you find in fish oil or the flaxseed oil or
plan k t on - based Omega 3 s .

And the other thing is that weight is not really the whole issue. We need to also look at
what enhances our health as well as helps us to lose weight. You can lose weight on
lots of things that are not very good for your health. Smoking cigarettes is a good way

Dr Dean Ornish

to lose weight, chemotherapy you know taking amphetamines those kind s of help you
lose weight but you mortgage your health. And there was an article by Steven Smit h in
the New England Journal of Medicine, what happens in arteries on different diets and
they found that on whole food plant - based diet like I recommend, the arteries were
healthy and clean, on a standard American diet they were partially clogged and on a
high protein low carb , Atkins , Paleo whatever type diet they were severely clogged even
though the weight and blood pressure and cholesterol levels weren’t necessarily all that
different from each other.

And so the bottom line is really what’ s happening in your arteries . And we have shown
in randomized trials that the arteries become less clogged , no other diet has been
shown to do that in randomized trials. So if you have a life threatening condition you
are trying to reverse it, that’s wha t it takes sets a pound of cure that’s why we were the
first to approve that is because people didn’t go far enough. But if you are just trying to
stay healthy , lose a few pounds, it's not all or nothing, the more you change, the more
you improve . So you decide how much you want to change, how quickly, how many
things. Now I was encouraged that US News and World Report which has been rating
diets since 2011, last six years, every year since then has rated our diet number one for
heart health including 20 16.

Mark Masselli: We have been speaking today with Dr. Dean Ornish, Founder and
Director of the nonprofit Preventive Medicine Research Institute and a Clinical Professor
of Medicine at UC San Francisco School of Medicine. You can learn more about his
wo rk by going to his website ornish.com. Dr. Ornish, thank you for joining us on
Conversations on Healthcare today.

Dr. Dean Ornish: Great pleasure thanks for having me on the show.

Margaret Flinter: Thank you great.

(Music)

Mark Masselli: At Conversatio ns on Healthcare , we want our audience to be truly in the
know when it comes to the facts about healthcare reform and policy. Lori Robertson is
an award - winning journalist and managing editor of FactCheck.org , a nonpartisan,
nonprofit consumer advocate fo r voters that aim to reduce the level of deception in US
politics. Lori what have you got for us this week?

Lori Robertson: Senator Ted Cruz is in the last GOP debate before wining the Iowa
caucus claims that the Affordable Care Act had forced millions into unemployment and
part time work. He repeated the old claim that the law was the “biggest job killer in this
country”. We have noted several times over the years that the fact s show otherwise.
And the latest jobs statistics make it more clear that Cruz’ s claims is a partisan

Dr Dean Ornish

falsehood . The economy has added millions of jobs since the A CA and fewer people
are being forced to work part time , not more.

It is true that independent nonpartisan expe rts projected some negative effect on
employment with some small employers potentially resisting hiring new workers or
cutting back the hours of current employees to keep their total payroll under 50 full time
equivalent s , that’s the point at which the law would require employers to provide
insurance or pay a penalty . But those projections were that the effect would be small or
a minimal, the employer mandate for businesses with a 100 or more employees , went
into effect on January 1, 2015 . Since then the economy has added more than 2.4
million new jobs. As for part time workers the Bureau o f Labor Statistics measures the
number of people working part time for economic reasons either because an employer
had cut hours or full time work wasn’t available. Th at number has gone down by
762,000, and that’s my fact check for this week, I am Lori Robertson , Managing Editor
of FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factual accuracy from the country's
major political players and is a project of the Annenberg Public Policy Center at the
University of Pennsylvania. If you have a fact, that you would like checked, email us at
www.chcradio.com . We will have FactCheck.org's Lori Robertson check it out for you
here on Conversations on Healthcare.

(Music)

Mark Masselli: Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Falling is a common experience
among the elderly and that is not good news.

Drew Lakatos: Hip fractures in the elder ly are an enormous devastating expensive,
death sentence of an injury. If you are over 65 and you have fallen and broken your hip,
25% of them will die within 12 months , a nother 25% will never be able to live
independently and a full 75% will never regain full mobility.

Mark Masselli: That statistics got former a irbag executive Drew Lakatos thinking , what
if you could apply the technology used in airbags to create wearable devices that
protect a person from the impact of falling ?

Drew Lakatos: So similar to the auto industry our government has spent billions in
about two decades on fall prevention programs for the elderly. What I am suggesting is
we make that same strategic shift that the auto industry did and we begin focusing on
intelligent protection of our elderly.

Dr Dean Ornish

Mark Masselli: So they did their research and found a combination of accelerometers
and other sensors on the band worn around the waist could deploy within 6 milliseconds
of sensing an imminent fall, and protective bags unfurl around the hip joints, before
impact with the floor, significantly reducing the blow to the joint.

Drew Lakatos: Physics has taught us that bodies in motions stay in motion un til they
meet in an im movable object , right . In this case the immovable object is the living room
floor . With the right technology we can ensure that these people that meet that
inevitable immovable object which is the floor can not only survive that acc ident , they
can walk away.

Mark Masselli: He founded ActiveProte ctive Technologies and while his initial focus
was providing the significant barrier to devastating injury in adults he has additional
potential markets as well.

Drew Lakatos: With this type of technology we can protect against concussions; we can
now protect Coumadin patients. We can protect postal workers when it's icy hot. We
can protect our military soldiers from IEDs.

Mark Masselli: A simple retooling of airbag technology in a wearable device that could
greatly reduce the devastation of hip fractures , leading to better health outcomes, lower
health cost, and better quality of life , now that’s a bright idea.

(Music)

Margaret Flinter: This is Conversations on Healthcare, I a m Margaret Flinter.

Mark Masselli: And I am Mark Masselli, peace and health.

Conversations on Healthcare, broadcast from the campus of WESU at Wesleyan
University, streaming live at www.wesufm.org and brought to you by the Community
Health Center.