We’ve heard it many times…what’s good for your heart is good for your brain. Dr. Dean Ornish, developed the #1 ranked heart health diet, according to US News and World Report. Now he wants to determine if lifestyle changes can reverse early stage Alzheimer’s the way they have for heart disease. Here he shares with the WAM Weekly why he believes there is a chance lifestyle holds promise when it comes to Alzheimer’s and lays out what some of the most important lifestyle changes are.
WAM: Your cardiac intervention program is consistently recognized as the number one approach to healing, preventing and reversing heart disease. A panel of experts at U.S. News & World Report recently rated “The Ornish Diet as #1 for Heart Health” for the 10th year since 2011 when they began rating diets. Now you want to take many of the principles of the program and apply them to Alzheimer’s. What makes you believe that what heals the heart may heal the brain?
Ornish: I was trained, like all doctors, to view heart disease, type 2 diabetes, hypertension, obesity, early-stage prostate cancer, and many other chronic diseases as having different diagnoses, different causes, and different treatments. But in 43 years of conducting research, my colleagues and I found that the same lifestyle changes could often reverse the progression of all of these conditions.
In UnDo It, the book I co-authored with Anne Ornish, I present a new unifying theory: the reason that these same lifestyle changes can reverse so many different chronic diseases is that these diseases are really not so different from each other. They all share many of the same underlying biological mechanisms. These include chronic inflammation, oxidative stress, overstimulation of the sympathetic nervous system, angiogenesis, apoptosis, and changes in immune function. These mechanisms, in turn, are directly linked to the lifestyle choices we make each day: what we eat, how we respond to stress, how much exercise we get, and how much love and support we have.
I think we’re at a place now with respect to Alzheimer’s disease very reminiscent of where we were four decades ago when I began conducting research on coronary heart disease. In other words, at that time it was thought that it was impossible to reverse the progression of heart disease, it could only get worse. At best, you could slow down the rate at which it got worse, but that was it.
In our research, we use high-tech, state-of-the-art scientific measures to prove the power of these low-cost, low-tech interventions. In a series of randomized controlled trials, published in the Journal of the American Medical Association, The Lancet, and other leading peer-reviewed journals, we showed that while moderate changes could slow the rate of worsening of heart disease, more intensive lifestyle changes could often reverse its progression—the pound of cure instead of the ounce of prevention.
It takes very intensive lifestyle changes to reverse a chronic disease. These include a whole foods plant-based diet (essentially a vegan diet) low in fat and refined carbohydrates; moderate exercise (30 minutes/day); stress management techniques including meditation (one hour/day); and social support, including support groups and spending more time with friends and family.
In short: eat well, move more, stress less, love more.
Alzheimer’s disease shares many of these same underlying biological mechanisms. There are many studies that show what’s good for your heart is also good for your brain. The FINGER and MIND studies showed that less-intensive lifestyle changes slow the rate of dementia. Our hypothesis is that a more intensive intervention may stop or even reverse the progression of early-stage Alzheimer’s disease.
WAM: You are doing the first randomized controlled trial to test whether your program of lifestyle interventions for heart disease can be applied to Alzheimer’s. What are you asking of participants? How are they having to change their behaviors? Are you targeting those diagnosed with Alzheimer’s or those at risk for it?
Ornish: We are recruiting a total of 100 patients who have documented early-stage Alzheimer’s disease and randomly assigning them to receive 20 weeks of these intensive lifestyle changes—the same ones described in the UnDo It book and that were used in our earlier studies—or to a usual-care control group. We test both groups at baseline and after 20 weeks, including standard measures of cognitive function such as the ADAS-Cog test as well as a variety of biomarkers for inflammation and amyloid, telomere length, gene expression, proteomics, and microbioime. The experimental group receives the lifestyle program for 40 weeks and are tested at baseline, 20 weeks, and 40 weeks. The control group is asked not to make any new lifestyle changes for 20 weeks and are tested; then, they receive the lifestyle program for a total of 40 weeks, and both groups are tested again and compared.
We are still recruiting patients for this study. We were forced to virtualize the intervention using Zoom in February when Covid-19 hit, so we learned that the intervention works very well when offered this way. If anyone reading this is interested in learning more about enrolling in this study—or in helping to fund it—please send an email to Colleen Kemp RN MSN at firstname.lastname@example.org or go to www.pmri.org
WAM: Do you have some initial results that indicate lifestyle changes may delay, prevent or reverse Alzheimer’s—and what are they?
Ornish: We are still conducting our study, so it would be premature to share any of our interim findings. I remain as cautiously optimistic now as when we first began this research. Whatever we show will be of great interest—if we find it’s not beneficial, then people will need to know that. If this study is successful, it will redefine what is possible, empowering many people with new hope and new choices since no drugs have been shown to stop or reverse the progression of Alzheimer’s disease.
WAM: We are at the beginning of a new year when many of us set new health goals. From your experience, what’s a technique someone could use to help adopt healthier habits? Is there a way to help get the right “mindset” for change?
Ornish: Because these biological mechanisms I mentioned are so dynamic, when you make big changes in diet and lifestyle, you are likely to feel so much better, so quickly, it reframes the reason for changing lifestyle from fear of dying (which is not sustainable) to joy of living (which is). What you gain is so much more than what you give up.
Ask yourself, “Why do I want to live healthier and longer?” To watch your kids grow up? Do meaningful work? If it’s meaningful, then it’s sustainable.
WAM: Can you give us simple things everyday people can do starting today that will help them on their way to a healthier brain?
Ornish: What’s good for your heart is also good for your brain. One study showed that eating five or more fruits and vegetables a day was associated with a 47% reduction in cognitive impairment. Walking for only 30 minutes/day caused so many new brain neurons to grow (neurogenesis) it increased the size of the hippocampus, the part of your brain that controls memory. Consuming omega-3 fatty acids once/week reduced the risk of Alzheimer’s disease by 60%. Saturated fats and trans fats double the risk of both heart disease and Alzheimer’s disease as significantly associated with a 47% decreased prevalence of cognitive impairment.