What is a Healthy Diet?
Dean Ornish and Caldwell Esselstyn

Dr Dean Ornish, founder of the Preventive Medicine Research Institute, and the University of California School of Medicine, has conducted research over 24 years to prove that diet (strictly applied) is a low cost alternative to extensive medical intervention and surgery, for many common "medical" problems. This raises a serious question for us all. Many of the common "medical problems" that we have, are clearly shown by the work of Dr Ornish, to be diet and lifestyle problems we have created for ourselves.

You can do your own research on Dr. Dean Ornish. There are TED Talks (16min: 2004), and several clinics that promote his methods. There is extensive free advice about what to eat in order to make yourself more healthy. The Ornish program also involves exercise, stress management and social engagement. Dr Ornish's work has been criticised because it involved a small group of subjects, and it did not control for smoking.

[Personal observation, JSV] Dr Ornish in my view has developed a very strict form of the food pyramid. During my training as a marathon runner starting 30 years ago, I was taught that lots of carbohydrates, potato, bread and cereals provided good energy food. I could easily agree with Dr Ornish's findings. However, in the fifteen years since I stopped running so far, I've learned from my own life experience that these foods are not good for me. Certainly not in large quantities, as I was used to eating. I now believe that this thinking is wrong. I now believe the Swedish Diet, a low-carb diet is desirable if weight control is your objective. It appears, from recent science, that the much maligned Dr Atkins was right after all. [/Personal observation, JSV]

Dr. Ornish recommends a vegetarian diet, avoidance of all dairy foods, most oils, nuts, seeds and olives, avocados and alcohol. His very strict diet, and the associated exercise, stress management and social engagement, involves more lifestyle changes than most people choose to tolerate. Still the achievement is impressive, and worth understanding.

These include:
Reversal of heart disease in many people.
Helping many people avoid heart surgery.
Stopping the progression of prostate cancer.
Improved vascular health, often improving sexual function in men.

Measurable benefits include:
Lower blood pressure.
Weight loss.
Improved score on the body mass index.
Lower Cholesterol.
Huge reduction in angina pain. (No pain for most.)
Reduced depression and hostility.
Increased vitality and sexual performance.

Dr Ornish said, "The body has the ability to heal itself. All we need to do is stop doing what's causing the problem." He goes on to advocate a significant change in the lifestyle for most of us. He also claims that age is not a critical factor, "anybody who adopts this diet at any age will benefit", and that the benefits to the individual are apparent in weeks. Further, the body will become more and more healthy over many months.

In a more sane world people would do more to live in a way the encouraged good health. We could do more to feed ourselves well, exercise regularly and actively engage in the social world, knowing that this is how to avoid a future health crisis.

I've also been introduced to the dietary ideas of Caldwell Blakeman Esselstyn Jr.
From Wikipedia:
"Caldwell Blakeman Esselstyn Jr. (born December 12, 1933) is an American surgeon and former Olympic rowing champion. He is a "leading proponent" in the field of "plant-based diets" and starred in the 2011 American documentary, Forks Over Knives. Esselstyn's book, Prevent and Reverse Heart Disease (2007), influenced former U.S. President Bill Clinton."

Dr Esselstyn, has been conducting a one man crusade, with no official support, and resources out of his own medical practice. Like Dr Ornish, Dr Esselstyn's study is of a small group, 24 people. They were ALL non-smokers. They ALL had a history of cardiovascular disease. They committed to a strict vegetarian diet with one target, to get cholesterol levels below 150 mg/dL. They were monitored ever two weeks for FIVE years, then every month for five more years. Six dropped out during the first two years, leaving 18 in the study. The results were remarkable. You should follow up by reading Dr Esselstyn's own words. "A Strategy to Arrest and Reverse Coronary Artery Disease:" and "Updating a 12-Year Experience With Arrest and Reversal Therapy for Coronary Heart Disease."

Dr Esselstyn is scathing about the way the medical system treats the symptoms of heart disease, and does nothing to cure heart disease. He says that, "coronary artery bypass surgery, atherectomy, angioplasty, and stenting, do NOT reduce the frequency of new heart attacks or prolong survival except in small subsets of patients." He continues, "It is time to call this approach by it's true name: palliative cardiology. "These mechanical interventions treat only the symptoms, not the disease. It is therefore not surprising that patients who receive these interventions often experience progressive disease, graft shutdown, restenosis, more procedures, progressive disability, and death from disease. Thus, the leading killer of men and women in Western civilization is being left untreated."

George E Vaillant in the Grant Study, could find no evidence the high or low cholesterol measured when men were 55 made any difference to later cardiovascular disease or death rates. So can we find a way to square this circle? Maybe. Esselstyn's 22 volunteers had a mean cholesterol level of 246 mg/dL when they entered the study. The target was less that 150 mg/dL, and this is achievable. Vaillant's high cholesterol group was over 254 mg/dL and the low cholesterol group was below 206 mg/dL. Dr Esselstyn claims that 35% of heart disease in people who have cholesterol less than 200 mg/dL, but the heart disease in people with cholesterol below 150 mg/dL is virtually unknown. Remember too that there was no control over what the Grant Study men did between 55 and the time of their deaths.

Doctors might be able to eliminate some of our leading killers by advising people about the underlying causes of chronic disease. This would be better than nearly any medical intervention. Why don't more doctors do it? Partly because doctors are not paid to tell you how to live a healthy life. But mostly because from experience, when they do tell people what to do, people don't take any notice, and may even object to the "advice". If you want access to the doctors knowledge, ASK. The problem is in your own hands.

Contrast what I've just been saying with the evidence below. Maintaining continued good health is a wicked problem, and there is a lack of consistency in what the experts choose to tell us.

The Swedish Low-Carb Diet, proposed in the 1920's, rediscovered 2000's

This dietary advice of a low-carb high-fat diet has been around since the 1920's, when the ketogenic diet was developed at John Hopkins Hospital to cure epilepsy in children who did not respond to drugs.

Sweden has become the first western nation to recommend a lower-carbohydrate, higher-fat diet as part of an effort to reduce the national prevalence of obesity, diabetes, and to improve markers of heart health. Following a literature review of 16,000 studies on diet and obesity, Swedish government advisors at the Council on Health Technology Assessment have adopted a low-carb, high-fat diet may be the key to reversing obesity and obesity-related illnesses.

This is the first time anywhere in the world that official dietary guidelines have been based on the better modern science.

Essentially, the Council suggests that a diet moderately-low in carbohydrate (40% of total calories) would see some of these improvements and a greater increase in good (HDL) cholesterol without having any adverse effects on bad (LDL) cholesterol, while an even lower carbohydrate intake (20% of total calories) would result in more benefits including improved blood sugar levels for individuals with obesity and diabetes and marginally decreased levels of triglyceride. (This lower level, is still twice the amount of carbohydrate, that the Banting Diet suggests.)

Breakfast cereals are therefore a BAD idea. Cereals set you up to be hungry again in two hours. Bacon and eggs, or quality sausages and tomato, are a much better idea. My father used to eat like that. I never have.

Advisors to the Swedish government speak to other benefits of an Atkins-like diet that permits higher-fat foods. Those benefits highlighted include both satisfaction and satiety, which are in large part, responsible for greater long-term sustainability.

One of the committee members was Prof. Fredrik Nyström, from Linköping, Sweden – a long-time critic of the low-fat diet and a proponent of the benefits of saturated fat, from sources such as butter, full fat cream, and bacon.

Some quotes from Prof. Nyström:
“I've been working with this for so long. It feels great to have this scientific report, and that the skepticism towards low-carb diets among my colleagues has disappeared during the course of the work. When all recent scientific studies are lined up the result is indisputable: our deep-seated fear of fat is completely unfounded. You don't get fat from fatty foods, just as you don't get atherosclerosis from calcium or turn green from green vegetables.”

Dr Atkins seems to have been on the right track after all.

Nyström has long advocated a greatly reduced intake of carbohydrate-rich foods high in sugar and starch, in order to achieve healthy levels of insulin, blood lipids and the good cholesterol. This means doing away with sugar, potatoes, pasta, rice, wheat flour, bread, and embracing olive oil, nuts, butter, full fat cream, oily fish and fattier meat cuts. “If you eat potatoes you might as well eat candy. Potatoes contain glucose units in a chain, which is converted to sugar in the GI tract. Such a diet causes blood sugar, and then the hormone insulin, to skyrocket.”

These are things you can do for yourself. It seems easy, but it must be very hard because most people find it impossible to do.

What you THINK, is critical here. Nothing I can say will really make a difference for you. What YOU have to say is important. Making the effort to say what you are thinking, to your partner, to your doctor, to a friend or to me, will help you to discover what you really think. Another way to develop your own thinking is to join a discussion group to talk about health.