How low should you go?

American Fitness, Nov-Dec, 2004

Concerned that diets recommended by the National Cholesterol Education Program (NCEP) and the American Heart Association (AHA) were not effective in lowering weight or LDL-cholesterol, Dean Ornish, M.D., and his colleagues at the non-profit Preventive Medicine Research Institute and the University of California, San Francisco, decided to do their own checking. Collecting data from 551 participants at 22 hospitals, they assessed the impact of what they considered to be a "more optimal diet" (10 percent of calories from fat, low in simple carbohydrates and high in complex carbohydrates from fruits, vegetables, whole grains and legumes in their natural, unrefined forms) along with moderate walking and stress management techniques, such as meditation and support groups. After three months, they found that

* men lost 6 percent of their body weight, women 5.5 percent;

* men lost 12.5 percent of their body fat, while women lost 8 percent of theirs;

* those who weighed the most showed the greatest amount of weight loss

* a year later the participants had maintained their weight loss

Other randomized controlled trials involving the "more optimal diet" found

* some reversal of coronary arteriosclerosis after one year and even more reversal after five years;

* 99 percent of the patients were able to stop or reverse the progression of heart disease as measured by cardiac PET scans;

* there were 2.5 times fewer cardiac events, such as heart attacks, angioplasty and bypass surgery operations;

* the average patient lost 24 pounds and kept half of this weight off for at least five years.

A study from Highmark Blue Cross/Blue Shield of Pennsylvania compared medical costs in patients who were advised to follow an "optimal diet" to a group of patients who were advised to follow the NCEP/AHA "low-fat diet." After a year, they found a 50 percent claims-utilization reduction for those following the "optimal diet," whereas the comparison group showed no reduction in costs.

Despite the conception that people are unhappy when eating a very low-fat diet, these participants reported marked and rapid improvements in all measures of their psychosocial well-being. For example, after three months, depression decreased by 46 percent, energy levels improved by 43 percent and hostility decreased by 19 percent. These improvements were maintained after one year. These significant improvements in well-being are one of the primary reasons why there was still a high adherence to this diet a year later.