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===== Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases =====

//Ornish, Dean; Ornish, Anne//

**Chapter 1: It Works!**

For lifestyle changes to be sustainable , they have to be pleasurable and meaningful , fun and joyful , loving and feeling good , as well as effective — and freely chosen . What you gain has to be much more than what you give up — and quickly ! With our lifestyle medicine program , it is . Life is to be enjoyed and savored .\\

But for many people , an even more motivating example than increasing blood flow to your brain and your heart can be found in The Game Changers , a powerful new documentary film produced by legendary filmmaker James Cameron with James Wilks and Joseph Pace and directed by Academy Award winner Louie Psihoyos . This movie addresses the most common misconceptions about eating a whole - foods plant - based diet — that meat is necessary for protein , strength , and optimal health . It tells powerful stories about world - class elite athletes who dramatically improved their performance after changing to a whole - foods plant - based diet .\\

**Chapter 2: Why It Works**

One of the most surprising findings in our research was that the same lifestyle medicine program described in this book has such far - reaching impacts on undoing such a wide range of diverse chronic illnesses . This flies in the face of the latest trends in personalized medicine . Many books , new lines of food , and healthcare companies are promising to tailor a diet and lifestyle program based on your genome , blood test results , and clinical status .\\

But this is largely a myth . In our research , there wasn’t one set of lifestyle recommendations for reversing heart disease and different ones for reversing prostate cancer , diabetes , and other chronic illnesses . It was the same lifestyle medicine program for reversing all of these .
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Although this may seem like a radical theory , on further reflection it’s not really that surprising . We know , for example , that regular exercise will help prevent and improve a wide variety of conditions — it’s not disease - specific — whereas a sedentary lifestyle significantly increases the risk of many chronic diseases — also not disease - specific .\\

Those with four healthy lifestyle factors — moderate exercise of at least 30 minutes per day ; not smoking ; normal weight ; and a high intake of fruits , vegetables , and whole grains and low meat consumption — had a 78 percent lower risk of developing any chronic disease , including a 93 percent lower risk of getting type 2 diabetes , an 81 percent reduced risk of a heart attack , a 50 percent lower risk of a stroke , and a 36 percent reduction in all forms of cancer !\\

The guiding principle of our lifestyle medicine program has always been based on addressing the underlying causes of illnesses on many levels simultaneously . By analogy , if you have a rock in your shoe , don’t blame the stone , use painkillers or surgery to cut the affected nerves , or wear thicker socks — just take out the rock !\\

A sedentary lifestyle increases inflammation , whereas exercise decreases it . Only twenty minutes of walking significantly reduces markers of inflammation .\\

The American Heart Association diet includes fish , chicken , and beef in moderate amounts . While it’s a step in the right direction , a recent study provided more evidence to explain why this diet doesn’t go far enough to reverse heart disease in most people . In this study , 100 patients with coronary heart disease were placed on a whole - foods vegan diet or an American Heart Association – recommended diet . After only eight weeks , inflammation was significantly lower in the vegan group compared with those on the American Heart Association recommended diet , as measured by highly sensitive C - reactive protein assays , even though weight loss was the same in both groups .
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Fiber and bran fill you up before you get too many calories . Also , they slow the rate of absorption from your gut into your blood , so your blood sugar rises slowly and not too high . When fiber and bran are removed , your food gets rapidly absorbed , causing your blood sugar to spike to high levels , which in turn causes your pancreas to secrete insulin to bring your blood sugar back down . After a while , it’s as if these repeated surges of insulin cause your insulin receptors to say , “ Oh , no , not more insulin ! ” so they downregulate and become less sensitive . Because of this , your body needs to make more and more insulin to lower your blood sugar an equivalent amount . This is called insulin resistance .
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Insulin resistance also causes inflammation by increasing secretion of what are called cytokines from immune function cells . A vicious cycle results in which more insulin causes more inflammation , which causes more insulin resistance , often leading to metabolic syndrome and type 2 diabetes .
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Glycation is a natural process in which the sugar in your bloodstream attaches to proteins or fats , forming new , harmful , highly oxidant molecules called advanced glycation end products ( AGEs ) . Poetically , “ AGE ” makes you age .
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Both the type of food and the way it’s cooked affect the amount of AGE . Animal - derived foods that are high in fat and protein are generally AGE - rich and prone to new AGE formation during cooking . In contrast , carbohydrate - rich whole foods such as vegetables , fruits , and whole grains in their natural forms contain relatively few AGEs , even after cooking . ( Is this pattern starting to sound familiar ? ) For example , a soy burger cooked in a microwave has only 20 AGE units . Cooking it in a pan with a little vegetable oil spray increases it to only 30 AGE units . Adding 1 teaspoon olive oil to the pan increases it to 131 AGE units . In contrast , a turkey burger cooked in a pan with a little vegetable oil spray has 7,171 AGE units . One serving of beefsteak , cooked in a pan with olive oil , has 9,052 AGE units . Two strips of bacon fried for five minutes with no added oil have 11,905 AGE units . One roasted chicken thigh with skin has 10,034 AGE units . Barbecuing the chicken thigh increases that to 16,668 AGE units — almost three orders of magnitude higher than the microwaved soy burger !
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In the meantime , it’s clear that changing your diet in the ways outlined in this book will reduce AGEs and increase sirtuins , providing yet another mechanism to explain why a whole - foods plant - based way of eating is so beneficial .
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In anti - aging research , caloric restriction has been shown to slow the aging process in animals , in part by reducing AGE . It also increases what is called autophagy , in which your body detoxifies and cleans out damaged cells , especially those involving your brain , and reduces chronic inflammation .
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Also , sugar causes your body to produce more insulin , which then blocks leptin , a hormone that reduces appetite and induces fat burning — so when you eat a lot of sugar , it actually increases your appetite rather than making you feel satiated .
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Investigators were puzzled that prostate cancer didn’t spread even when they intentionally turned off both of these genes in mice . They had a moment of insight at a scientific meeting when they realized that the mice had been fed a low - fat vegetarian diet , which might have protected them . They wondered if putting these mice on a high - fat , meat - based Western diet would cause the cancer to spread . It did — the Western diet caused them to quickly develop tumors that grew rapidly and spread . The point is this : even when there is a known genetic predisposition to developing metastatic ( lethal ) cancer and other chronic diseases , the lifestyle medicine program outlined in this book may help prevent this from happening .
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In our Lifestyle Heart Trial , there was an average weight loss of 24 pounds in the first year . The primary determinant of the amount of weight lost was the degree of adherence to our lifestyle medicine program , not age or genetics . The
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So often , I hear people say , “ Oh , it’s all in my genes , and I’ve got bad genes , so there’s nothing I can do about it . ” Fortunately , there is .
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I have had the privilege of being one of President Bill Clinton’s consulting physicians since 1993 , when Hillary Clinton asked me to advise the chefs who cooked for them at the White House , at Camp David , and on Air Force One to make healthier meals . The president initially did well and lost 26 pounds , but later , with the stresses of what he was going through politically , he understandably paid less attention to his diet and lifestyle choices at the time . In 2004 , he underwent bypass surgery on four of his clogged coronary arteries . In February 2010 , he learned that one of his four bypass surgery grafts had clogged up since his operation almost six years earlier , and he had two stents placed to open it up . At a press conference then , one of his doctors said , “ This was not a result of either his lifestyle or his diet , ” implying that it was because of his genes . After watching this press conference , I sent an email to President Clinton saying , in effect , that it wasn’t all in his genes — and if he would be willing to make bigger changes in his diet and lifestyle , there was a good chance that he could reverse his coronary heart disease . “ Our genes are a predisposition , but our genes are not our fate , ” I wrote to him . “ If they were , then you’d be a victim , but you’re not — you’re one of the most powerful people on the planet . You’re genetically predisposed to having heart disease because it runs in your family , but this just means that you need to make bigger changes to prevent or reverse it than someone else might . Our DNA is not our destiny . ” We met together soon after , and he began following the lifestyle medicine program described in this book . He’s remained on it since then and has talked publicly about how he continues to follow this program and is doing very well .
Chapter 4: Eat Well
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Myth # 2 : A Low - Carb , High - Protein Diet Is Good for You I’m a veteran of so many nutritional debates and diet wars , but I thought I was done . So I wasn’t planning to address this issue here . After so many studies were published showing that people on low - carb , high - fat , high - protein diets were mortgaging their health to lose weight , I was hoping that it would no longer be necessary . But never underestimate the power of telling people what they want to hear . This diet keeps resurfacing under various names — Atkins diet , Paleo diet , ketogenic diet , and so on . What makes this diet so seductive is that it’s based on a half - truth .
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It’s not just low - fat versus low - carb — that’s a false choice . And it’s not just about food . An optimal way of eating is low in fat and low in refined carbohydrates , as well as low as in animal protein . The half - truth on which we all agree is that Americans do eat too many refined ( “ bad ” ) carbohydrates , such as sugar , white flour , and white rice , as I described in Chapter 2 . Because of this , if you reduce your consumption of refined carbohydrates , you’ll lose weight .
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Here’s the bottom line : the only diet that has been scientifically proven to reverse heart disease , to slow , stop , or reverse early - stage prostate cancer , and to reverse aging by lengthening telomeres ( among other benefits ) is a whole - foods plant - based diet low in both fat and refined carbohydrates .
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In fact , meat actually increases insulin levels in your blood , both by raising insulin secretion and by causing insulin resistance . So does fat . Because of this , diabetes increases as the frequency of meat consumption increases . In contrast , insulin levels are lower in those following the whole - foods plant - based diet described in this book . A study of 37,000 men from the Harvard Health Professionals Follow - Up Study and more than 83,000 women from the Harvard Nurses ’ Health Study who were followed up for almost 3 million person - years found that a daily serving of red meat no larger than a deck of cards increased the risk of type 2 diabetes by 19 percent . Processed red meat proved even worse : a daily serving half that size — one hot dog or two slices of bacon , for example — was associated with a 51 percent increase in risk of diabetes . This study also found that consumption of both processed and unprocessed red meat is associated with an increased risk of premature mortality from all causes as well as from cardiovascular disease and cancer .
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Myth # 3 : Carb Calories Are Bad for You , and Fat Doesn’t Matter — It’s All About Sugar A myth that has been repeated so often it’s become a meme is that calories from carbohydrates are more likely to cause you to gain weight than an equivalent number of calories from fat . To address this issue , Dr . Kevin Hall placed overweight people in a metabolic ward at the National Institutes of Health to determine what actually happens on different diets . They lived there for four weeks , so the researchers knew exactly what and how much they were eating . Dr . Hall and his colleagues found that , indeed , all calories are not alike — but the opposite of what was predicted ! The title of the journal article reporting their findings says it all : “ Calorie for Calorie , Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity . ” Restricting dietary fat intake led to body fat loss at a rate 68 percent higher than cutting the same number of carbohydrate calories when adults with obesity ate strictly controlled diets .
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Let me reiterate yet again : it’s not low - carb versus low - fat . An optimal way of eating is low in total fat and especially low in “ bad fats , ” including trans fats and saturated fats ; low in “ bad carbs , ” such as refined carbohydrates and sugar ; and low in animal protein , especially red meat . It includes predominantly “ good carbs , ” whole foods such as fruits , vegetables , whole grains , legumes , and soy in their natural , unrefined forms ; includes 3 – 4 grams per day of “ good fats , ” to provide at least 1 gram per day of omega - 3 fatty acids ( DHA + EPA ) ; and is plant - based . Another related myth that’s been repeated so often that many people believe it’s true is this : “ Americans have been told to eat less fat ; we’re eating less fat but we’re fatter than ever , so low - fat is dead ; it’s all due to sugar and refined carbohydrates . ” It’s true that we’ve been told to eat less fat — but are we ?
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Myth # 4 : The Mediterranean Diet Is Optimal for Reversing Heart Disease The Mediterranean diet is a better diet than what most people consume , especially with its emphasis on fruits and vegetables and less red meat . But it doesn’t go far enough to reverse heart disease .
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However , when examined separately , there was no reduction in heart attacks , death from cardiovascular disease , or death from any cause — only in stroke rates . Because of methodological irregularities and errors , this study was retracted and republished in 2018 . To repeat : a Mediterranean diet is better than what most people are consuming , but it doesn’t go far enough to reverse heart disease . Even better is a whole - foods plant - based diet low in fat , especially saturated / trans fats , low in refined carbohydrates , and with sufficient omega - 3 fatty acids .
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Eat Real Foods One of the goals of this book is to keep it simple . Dean described the parameters of the diet we’ve proven can reverse — undo ! — the progression of so many chronic diseases . This includes abundantly enjoying a variety of plant - based foods that are low in fat and sugar , such as fruits , vegetables , whole grains , legumes , and soy products as close as possible to the way they come in nature , with minimal processing — in other words , what are known as real foods or whole foods .
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Just Plants ( “ Good Carbs ” ) As we’ve been describing , our way of eating includes a delicious abundance of foods you can enjoy . These include a wide variety of fruits , vegetables , whole grains , legumes ( beans , lentils , and dried peas such as chickpeas and black - eyed peas ) , and soy products .
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Not Too Much Sugar ( “ Bad Carbs ” ) “ Bad carbs ” include concentrated sweeteners such as sugar , high - fructose corn syrup , honey , maple syrup , and so on . They also include the “ whites ” — that is , white flour and white rice . When you go from whole - wheat flour to white flour , or from brown rice to white rice , you turn a good carb into a bad carb because you’ve removed the fiber and bran that keep you healthy .
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Alcohol causes your body to burn calories more slowly , so limit your consumption of alcohol to no more than one glass of wine , one can of beer , or one shot of hard liquor per day . Your liver’s priority is to detoxify alcohol before processing anything else , so drinking slows down the burning of fat , which leads to weight gain . Drinking alcohol can also cause low blood sugar because nutrients are not transformed into energy . And it’s worth noting that even one glass of wine per day increases the risk of breast cancer .
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Our results show that the safest level of drinking is none . This level is in conflict with most health guidelines , which espouse health benefits associated with consuming up to two drinks per day . Alcohol use contributes to health loss from many causes and exacts its toll across the lifespan . We found that the risk of all - cause mortality , and of cancers specifically , rises with increasing levels of consumption , and the level of consumption that minimizes health loss is zero .
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Not Too Much Fat The way of eating that we found can reverse most chronic diseases is much lower in fat than what most people eat — closer to 10 – 15 percent fat than to the 40 percent in a typical American diet . This is the percentage of fat found ( until recently ) in the diet in countries such as China , where the prevalence of heart disease and other chronic diseases was quite low . In practical terms , there’s no need to track the amount of fat you’re consuming if you only eat plant - based foods as they come in nature ( other than very high - fat foods such as oils , avocados , seeds , and nuts ) . If you’re eating commercially processed foods , try to limit your overall fat consumption to 10 – 15 percent of your total calories .
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Invest in some nonstick cookware , which makes it easier to cook without adding oil and butter . ( But avoid Teflon , which may be harmful . ) The recipe section of this book gives lots of examples of how to make foods taste delicious without adding extra fat and butter .
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if you’re trying to reverse a life - threatening illness such as heart disease , it’s actually easier to make the changes all at once , even though this may be hard to believe . Why ? Because when you make big changes all at once , and because these underlying biological mechanisms we’ve been discussing are so dynamic , you’re likely to feel so much better , so quickly , that the choices and benefits become clearer and worth making .
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if you immerse yourself in our lifestyle medicine reversal program , you’re likely to feel so much better , so quickly , it makes these changes sustainable — not just to live longer ( and you probably will ) but also to feel better . Your palate adapts to enjoying healthier foods . After all , who wants to live longer unless you’re enjoying life ? Ah , Nuts !
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One low - fat serving ( around 3 grams of fat ) equals any of these : 5 almonds 9 pistachios 1 whole walnut 3 pecan halves 2 cashews 6 peanuts 5 teaspoons of ground flaxseed 2 teaspoons chia seeds or shelled sunflower seeds 5 teaspoons pumpkin seeds
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… And More Fiber The USDA’s recommendation is at least 14 grams of fiber per 1,000 calories per day , which for an average intake of 2,000 calories per day is equivalent to about 25 – 30 grams daily . On food labels , the Daily Value ( DV ) shows this percentage based on 2,000 calories per day . This is a good way to use labels to check if a product is a good source of fiber . A food labeled as a “ good source of fiber ” provides between 10 and 19 percent of the DV of fiber per serving ; a “ high - fiber ” food offers over 20 percent . Products low in fiber are under 10 percent of the DV .
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Where Do I Eat ?
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When people eat in front of a TV , studies show , they eat 40 percent more , yet enjoy the food less .
Chapter 7: Love More
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Only close , authentic , loving relationships can support and meet your primal need to be seen , to be heard , to love , and to be loved .
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The word “ intimacy ” comes from the Latin intimatus , which means “ to make known . ” “ Health ” comes from a root that means “ to make whole . ” The word “ yoga ” derives from the Sanskrit word that means “ to yoke , ” “ to bring together , ” “ union . ” These are old ideas whose power we are rediscovering . The point is that you can make your feelings known to yourself by intimately recognizing them , and then you can make them known to others by intimately sharing them . This process helps to decrease the emotional symptoms most commonly correlated with chronic diseases , such as isolation , anxiety , hostility , stress , depression , and anger .
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Being social is how we’ve evolved , and it is still your network of close relationships that reinforces who you are today . Humans are highly social beings . The ever - rising wave of social networks and their exponential adoption rate demonstrate humans ’ primal need for social belonging , support , and interpersonal meaning .
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There’s an African proverb : “ If you want to go fast , go alone ; but if you want to go far , go together . ”
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Your life blooms by cultivating love for yourself and others , from the inside out . Life’s sweetest , most meaningful moments are savored together , when deeply connecting with others and by loving beyond yourself . “ Loving More ” is about developing a deeper , true connection — to yourself , to your support circle , to your family and friends .
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Our feelings connect us , whereas our thoughts often are perceived as judgments that isolate us . Feelings include joy , anger , peacefulness , anxiety , worry , love , and so on . Therefore , differentiate your thoughts from your feelings . Pay attention to your feelings . Express your authentic feelings . Listen with empathy and compassion . Avoid judging , criticizing , or offering advice . Respond with your feelings . Keep it confidential .
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The essence of emotional well - being is being able to identify and express your true feelings in ways that foster empathy , compassion , intimacy , and support . One basic principle of good communication is that our feelings help to connect us , whereas thoughts — especially judgments — tend to isolate us . It’s being able to express your feelings that connects you with others , not your thoughts .
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Bring your attention to rest at your heart , and simply notice the emotions that are present . Remaining gently at the helm of your heart , tune in and genuinely ask it , “ Heart , how are you feeling ? ” Simply listen .
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Give yourself full permission to attend to whatever you’re honestly feeling in this moment . Sense a “ feeling tone ” word that is palpable to you , that resonates like a bell of truth within you — good , bad , or ugly . Simply hold a safe space for it inside and name it . Some feeling words include “ frustrated , ” “ depressed , ” “ discouraged , ” “ sad , ” “ afraid , ” “ worried , ” “ anxious , ” “ lonely , ” “ happy , ” “ loving , ” “ energized , ” “ calm , ” “ confident , ” “ hopeful , ” “ grateful . ” Remember that all feelings are okay and intrinsically valid and valuable .
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“ Putting our feelings into words helps us . If a friend is sad and we get them to talk about it , they will feel better . ”
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Expressing your true feelings is a learned skill that you don’t develop unless you practice . You can learn how to hone your emotional compass and enlarge your vocabulary by practicing communication skills in your daily interactions with others .
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By remaining focused on sharing your feelings , you’re not just telling a story , you’re telling how that story is affecting you . As you do that , it reveals more about who you really are , and it allows others to get to know you and to connect with you on a deeper level .
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Few of us were taught how to listen to others in order to connect deeply with them . The good news is that this is a skill that can be learned . Learning how to connect deeply with others through empathic listening increases emotional intimacy and decreases isolation and loneliness . This has been shown to have a protective effect against heart disease , cancer , depression , and other conditions .
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Simply put , the goal of listening with empathy is to listen nonjudgmentally . You try to see from another’s perspective in order to try to understand and validate their experiences and feelings . When you are speaking , the words you use can either elicit empathy from the listener , leading to a sense of understanding and connection , or cause the listener to become defensive and resistant to what you are saying , leading to a sense of frustration and disconnection .
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A famous line from the novel To Kill a Mockingbird explains it this way : “ You never really understand another person until you consider things from his point of view — until you climb into his skin and walk around in it . ”
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To give an example , let’s say someone is telling you that her dog recently got hit by a car . An empathetic response could be , “ Oh no ! Your dear dog got run over — I’m so sorry to hear that ! You must be feeling heartbroken … how can I be of support ? ” A non - empathetic response would be detached and lacking in emotional connection , such as : “ Your dog got run over ? No way ! Where ? What kind of car was it ? ”
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Avoid Judging , Criticizing , or Offering Advice and Reassurance In our increasingly polarized and divided world , we need empathy more than ever before . Too often we are talking at each other , unable to listen without our judgments and opinions thwarting what would otherwise be opportunities to connect with one another .
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Many of us don’t know how to respond in a helpful way to someone who is feeling discouraged . You may feel an urge to rush in and “ fix ” their “ problem , ” or to ask questions , or to tell stories of your own . While often well - intended and motivated by the desire to be supportive , giving advice and talking too much can actually create more separation and concealment . It’s far more effective when you can learn to resist such urges and instead practice listening in ways that keep the other person talking , sharing , and connecting with you .
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Smile and laugh freely . Smiling and laughing are simple yet powerful ways to lead your life with a friendly tone , to boost your mood while enhancing the mood of others . Express gratitude daily . The ability and willingness to feel and express your gratitude on a regular basis sparks joy while significantly enhancing your relationships . Let forgiveness free you . When you forgive someone else , it doesn’t mean you have to forget , condone , or excuse what they’ve done . The far more significant opportunity is to free yourself from carrying that blame and misery any further , and from spreading your suffering out to others . Support and serve others . Lending your support and serving others boosts your mood and increases your overall well - being — because you feel like what you’re doing really matters .
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Health experts now have proof that laughter is good medicine — especially for the heart . A good belly laugh can send 20 percent more blood flowing through your entire body . One study found that when people watched a funny movie , their blood flow increased . When you laugh , the lining of your blood vessel walls relaxes and expands .
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When you smile , you’re extending your warmth and goodwill . Smiling is a gesture of kindness that transcends language barriers , so it can be easily received and understood .
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Laughter also bolsters your well - being while arousing good - spirited relations with others . Therefore , consider it another part of your lifestyle prescription : allow your laughter to rise up more freely and be generously shared .
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Express Gratitude Daily The practice of expressing gratitude is another powerful antidote to the modern - day stresses of overwhelm , irritation , impatience , and plain old exhaustion . To the extent that we can take regular moments to shift our awareness to gratitude , we can effectively reframe challenging moments and persevere .
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Dr . Glen Affleck and his colleagues at the University of Connecticut found that gratitude can have a protective effect against heart attacks . Researchers also found that those patients who saw benefits and gains from their heart attack , such as becoming more appreciative of life , experienced a lower risk of having another heart attack .
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Gratitude can actually boost your mood and improve your physical health , as shown in a study by Paul J . Mills , Ph.D . , and colleagues . The authors state : “ We found that more gratitude in these patients was associated with better mood , better sleep , less fatigue and lower levels of inflammatory biomarkers related to cardiac health . ”
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Before falling asleep at night , try reflecting on your day and naming at least one new thing you’re grateful for each day . Let this practice be how you check in with yourself , sum up your day , and support a more peaceful sleep . You may enjoy keeping a gratitude journal or jar — whenever you’re feeling gratitude flow , write down the experiences and people that make you happy , give you strength , and provide personal meaning . Fill up your life with more gratitude !
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When at the end of your life you look back , what matters most isn’t what you’ve done , what you’ve accomplished , but how meaningfully you’re able to answer the question “ Have I grown in love and wisdom ? ”
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If you have time and energy left after helping friends and family , it’s also rewarding to do volunteer work in your community . Think of an organization or a cause that touches you . Who could benefit from your kind support , your helping hands ? It’s a wonderfully symbiotic relationship , as serving and supporting others in need can measurably enhance your own health , happiness , and longevity .
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As you think about why you want to live longer , consider a passage from Dr . Rachel Remen’s extraordinary book Kitchen Table Wisdom , in which she shares a parable from Roberto Assagioli of three stonecutters who were building a cathedral in the fourteenth century . The first one says , bitterly , “ Can’t you see what I’m doing ? I’m cutting stones into blocks and I will be doing this until the day I die ! ” The second one says , warmly , “ I’m earning a living so I can support my beloved family . I can provide clothing and food in our home filled with love . ” The third one says , joyfully , “ I have the privilege to help build a great cathedral so magnificent it will inspire people and lift their spirits for a thousand years . ” Same work , but each brings very different meaning to it . We often have more choices than we realize .

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