Jimmy Moore’s Interview With Dr. Dean Ornish–The Conclusion: Part 4 of 4 (Episode 118)
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Dr. Ornish, level 6 Elven cleric, as he appears in the computer game “Journey To Wild Divine: Wisdom Quest“
Hello and welcome back to the world’s number one low-carb podcast, “The Livin’ La Vida Low-Carb Show With Jimmy Moore!” Today we present the conclusion of our host Jimmy’s interview with low-fat diet icon Dr. Dean Ornish, who we thank for his cooperation and bravery for facing a fairly–and perhaps rightfully so–mistrustful audience.
Wrapping it all up in Episode 118, Jimmy continues his debate with Dr. Ornish over his latest book, The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health. Dr. Ornish claims he is trying to “get past” the debate over low-carb versus low-fat. Is this a case of “Let’s stop arguing and just agree that I’m right?” YOU be the judge!
Jimmy says that while he and Dr. Ornish vehemently disagree on some fairly basic principles, they did find some areas of common ground and a level of mutual respect. Let us know what you think about this interview segment in the show notes below!
LINKS MENTIONED IN EPISODE 118:
- Part 1 of this interview
- Part 2 of this interview
- Part 3 of this interview
- Jimmy Moore’s previous interview with Dr. Ornish in October 2006
- Part 1 and Part 2 of the audio of that interview
- Dr. Ornish on Wikipedia
- Dr. Ornish’s Preventive Medicine Research Institute
- The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health
From over 400 pounds to 230, Jimmy Moore is 
It sounds as though Ornish has proven going on a partial low-carb diet is better than a high carb diet. No low-carber will disagree with that. Most of us, however, do even better by going “all the way”.
Well said, Clair! And that’s what I was trying to get him to admit is that for some people lowering your carbs even more and increasing your fat can be just as healthy as his plan. He would have NONE of that in his “spectrum.”
Jimmy:
What credence to you give to carb cycling? Going higher and lower, not just keeping the same amount every day?
I know that can work for some people Alex. But since I’m especially sensitive to carbohydrate I cannot eat more than 50g in a day without weight gain. That’s not true for everyone which is why people should find what works for them.
Jimmy,
An excellent 4 part interview. As I have stated in an earlier email post, in the past I was a big Ornish fan. I just could not sustain it for any significant period of time. The amount of effort, lack of satiety just didn’t translate in significant health benefits to myself. After seeing Gary Taubes on CNN, bought the book, and gave Adkins a try. Boom went from 215 to 200lbs with no effort whatsover… Triglicerides went down, total cholesterol went down (128) LDL slightly up, HDL slightly down (not sure why) but all my ratios are great. Back to the interview, kudos to you on the civility and respect that you displayed and Ornish in return. Clearly Ornish, to his credit, has moved some to the low carb side as much as he disdains that concept. I wish the two of you would have spent more time directly confronting the major difference between the two you, the safety and role of saturated fat in a healthy diet. I would have appreciated some specific studies that Taubes cites (Kraus’ studies p.173 on the impact of carbs on the atherogenic profile, Volek’s work, etc) and Ornish’s response. One of few critiques of GCBC is that Taubes only cites Ornish twice and doesn’t more aggresively challenge Ornish’s tenets and studies that he uses to advocate a lowfat/high carb diet. Ornish prides himself in letting the science speak for itself, so what of these recent studies and Taubes survey of the studies that demonstrate that saturated fat is benign. Saturated Fat is and continues to be the white elephant in the room, I just wish this topic was discussed more in the podcast. But overall, a great podcast. Keep up the good work. Perhaps you can do a podcast with Taubes and more directly address Ornish’s, Willits, Angaston’s concerns about Saturated fat.
I cited Volek’s work in Part 2 or 3, but Dr. Ornish zoomed past that and went into research he had conducted. It was civil, but a bit frustrating that he would not even acknowledge the work of people like Volek, Kraus, Westman, Feinman, Phinney, Vernon, Wortman, and others while showing complete and utter disdain for Gary Taubes because he wasn’t a real researcher and only a journalist. Come on, that’s intellectually bankrupt and he knows it!
As for interviewing Taubes, it just so happens I will be next month in Phoenix, Arizona at an obesity conference out there where the latest studies on saturated fat will be shared with the attendees. All of the above aforementioned researchers will be there sharing their work and Taubes will also be speaking. I’ll be doing many podcasts that weekend for rebroadcast in April and beyond. In fact, I’ll try to get in some video footage as well.
THANK YOU for your feedback, George! I wanted to get into the saturated fat issue more, but as you heard in the final segment today, Dr. Ornish cut the interview short when I started pressing him further. I’m grateful for the chance to speak to him, but he needs to get off script and just speak from what he believes more.
I found this exchange very frustrating. Dr. Ornish kept asserting that red meat, butter, cheese, eggs, etc. were not healthful, but where is the science to prove this? As Gary Taubes’ book points out, just claiming something is true doesn’t make it so! The trick of stating repeatedly that “we agree” is the same trick that many food manufacturers are doing now. Many labels on products that are low carb are being touted on the label as “Low calorie.” It’s all smoke and mirrors as they try to blend the low carb with low fat (and hence lower calories). Dr. Atkins warned about trying to do low carb with low fat and low calories. It just doesn’t work. And I’m sorry, but my taste buds have NEVER become accustomed to skim milk! (and whole milk has been shown to provide greater muscle development than those types with less fat).
Another comment re: the salt discussion: I couldn’t disagree more with Dr. Ornish. I, too, considered myself to be salt sensitive. I was also prescribed large doses of prednisone for 5 years (for an autoimmune condition that I actually didn’t have!). The results of that were 80+ pounds of fat and massive fluid retention. Diuretics were then prescribed. Those worked for awhile, but then I developed gout. All of these conditions were generated by the idiot doctors that I had trusted! I then did my own research and found a website that outlined the benefits of natural, complete, Celtic sea salt. Sodium is sodium, right? WRONG! I switched, and within days my horribly swollen feet were nearly normal, even as I was weaning off of the steroids. I haven’t had a problem with fluid retention since.
Dr. Ornish touted the results of his study with those with type II? I’m assuming he refers to the May 2007 study published in the American Journal of Cardiology - Comparison of Coronary Risk Factors and Quality of Life in Coronary Artery Disease Patients With Versus Without Diabetes Mellitus.
In the above study, researchers sought to investigate the effect of dietary modification in those with coronary artery disease (CAD), some of the subjects included also had diabetes. The subjects included 440 individuals - 347 men (55 with diabetes) and 93 women (36 with diabetes). All were placed on a very low-fat vegan/vegetarian diet (target 10% or less calories from fat), provided weekly counseling and support, and advised to exercise and practice stress management daily as they were followed for one-year.
Over the period of one-year, the researchers tracked changes in BMI, weight, cholesterol levels, blood pressure, exercise capacity, changes in medication requirement, and physical and emotional health.
Unfortunately, the researchers did not track, or at least did not publish, changes in fasting glucose, glucose tolerance, insulin levels, HbA1C or other risk markers considered important to evaluate in those with diabetes.
The researchers did publish details about the number of subjects taking diabetic medications at baseline and at one-year.
Of the 91 followed for the year, 5 dropped out so we have no data for their medication changes; 62 experienced no change in their medication regiment (68%); 12 discontinued their diabetes medications; 6 no longer required insulin but did require an oral antiglycemic; and 6 experienced a worsening of their condition that required medication not taken at baseline.
Of the 62 who did not change medication, 16 started with no medication and remained free of diabetic medication requirements. That’s a good thing and I believe this sub-set should have been reported as a separate group.
Of the remaining 46 reported as “no changes” in medication, we are provided no detail about dosing requirements! While their medication regiment (oral or insulin) may not have changed, we have no details as to whether their dosage increased, remained the same or decreased during the period of one year. This data is critical to understand if this type of dietary intervention is slowing progression of the disease or not.
In the 6 subjects who experienced a worsening of their condition we are also not provided details to better understand why their condition may or may not have been made worse by the diet and/or lifestyle interventions of the study.
When we read through the data, the reduction in LDL cholesterol did not reach statistical significance in those with diabetes; HDL remained unchanged in the diabetic women and declined slightly in the diabetic men (not statistically significant); and the triglycerides declined slightly in the diabetic men and rose in the diabetic women (not statistically significant), remaining well above the “high risk” target of 200mg/dl in both the men and women.
Critical missing data in the published paper - details about the diet composition.
We are provided only one small piece of data - the fat content, as percentage of calories. The fat content was 14.2% in the diabetic men and 19% in the diabetic women when they started the dietary modification (baseline). This was significantly modified in the trial - at one-year the men consumed 6.4% of total calories as fat and the women 8.9% of calories as fat.
What we don’t know is just as important - how many calories did they consume at baseline and after one-year? How much protein? How many carbohydrates? How much fiber? What type of carbohydrates? What did the micronutrient profile look like at baseline and one-year? What did they eat to achieve the consumption pattern? How did calorie intake and composition change from baseline to one-year?
There are more unknowns here than I believe is acceptable in a study modifying diet!
My last concern with the study is that it was a multi-faceted intervention: diet, exercise, stress management and intensive support. On its face, these modifications are all considered good interventions and worthy of investigation in a controlled trial.
The problem lies with teasing out which ones were meaningful in the results. Was it the diet, the exercise, the reduction of stress, the support, the weight loss from diet and exercise, or a combination of two or more? We don’t know because each potentially plays a role and each is considered a “confounding variable” if not controlled for specifically….so for him to suggest it’s his dietary approach is intellectually dishonest (something he likes to accuse others of doing).
While I applaud the researchers for convincing a good number of individuals to stick with this trial for the year - a very low-fat vegan/vegetarian diet is extremely difficult to follow faithfully - the fact remains the published data remains lacking in sufficient data and control that could have been included, and thus is not strong enough to make specific recommendations on dietary change from.
His continued insistence that someone with diabetes, who has experienced significant improvements in their health, HbA1c, glycemic control, triglycerides, HDL and more, by following a low-carb diet….will somehow do better if they go further and reduce fat, reduce animal protein and return whole grains to their diet (true whole grains, not pretend ones)…..to Dr. Ornish I ask…
WHERE IS THE DATA?
Where is the data with such a population with type II, who have experienced a benefit with low-carb, whom modified to your dietary approach and experienced even greater improvements after doing so?
WHERE IS THE DATA?
THANKS for your comments, Kathy! It was quite annoying having Dr. Ornish constantly assert “we all agree” when very clearly we didn’t all agree. I’ll be discussing this in my post-interview blog post in the next couple of days.
Well, Regina, you’re not supposed to actually READ the details of Dr. Ornish’s studies, you’re supposed to just take his word for what they mean without discussion. He’s very clearly not interested in seeing any real data that would run counter to what he KNOWS to be true based on his own flawed research. That’s why asking him if he read Good Calories, Bad Calories or any research from Volek, Westman, Phinney, Wortman, and many others is completely futile. He doesn’t seem to care!
He doesn’t seem to care!
Oh, but he does care Jimmy….don’t under-estimate the power of self-preservation here - he knows the data you spoke of and was quite intent to divert the conversation back to where he wanted it with his talking points because to actually engage you and discuss those studies you sought to discuss would expose the vulnerability of his data and beliefs.
Okay, the perception is that he doesn’t care about the research that runs counter to his own. He dismisses it publicly as if it has no relevance since his studies are the be-all, end-all. But you are right in your assessment…he doesn’t wanna admit he may be even a teeny tiny bit wrong at all. It would devastate the whole premise of his life’s work.
Dr. Ornish’s claim that “we agree” and that low carb vs. low fat are artificial distinctions made me think of how the standard are constantly changing when it comes to what actually constitutes low carb and low fat programs. What, precisely, is low fat? The classifications keep changing. A long time ago, the original Weight Watchers program allowed NO added fat. Then it was modified to permit one tablespoon of added fat per day, or 100 calories. In contrast, today The Biggest Loser food program, as set forth by Prevention magazine, allows for nearly that amount at EACH meal, plus an extra 30 calories of fat per snack. That’s more than 3 times as much per day, yet that plan isn’t considered high fat (of course, it’s from the so-called “good” fat categories, not butter, or lard, or coconut fat, but still…) And this is on a 1350 calories/day allowance! Interestingly, the portion of whole grains permitted per meal is 50 calories; per snack, maybe 50 if whole grains were chosen over fruits and vegetables. That amount translates into about 1/4 cup per meal! Why even bother with it?? Who would care about that tiny amount of brown rice? How much fiber could there actually be in that miniscule amount of whole grains that couldn’t be made up for with nonstarchy vegetables? And this amount is supposed to confer those fantastic health benefits touted by Dr. Ornish? I must conclude that the Biggest Loser food program is actually fairly low in carbohydrates, and could be made even lower very easily, yet no one will dare say LC. I watch The Biggest Loser, and just recently I heard Jillian say to her group in the kitchen that they don’t want to be grabbing sandwiches for lunch because they’re not good for you! What?? Bread is not good for you? Not even whole grain bread? She wanted them to prepare chicken and vegetables in those steam bags. Oh, noooo, that’s not low carb. More smoke and mirrors…
I LOVE YOU, Kathy! GREAT comments and you are so right. People complain that there’s no real definition for low-carb, but nobody ever says that about low-fat where it is MUCH more convoluted. Dr. Ornish said that a high-refined-carb, low-fat diet is not what he advocates and yet that’s EXACTLY the kind of diet most people follow when they go on “low-fat.” We’ve got to get over the taboo nature of livin’ la vida low-carb and stop fawning over low-fat everything as being healthy before we can more forward and help people seriously deal with their obesity in America.
I eagerly downloaded Part 4 and listened on my way to work. Oh, Jimmy, it was just excruciating! I couldn’t bear it, yet I couldn’t stop listening. I’m so grateful to you being levelheaded enough to conduct this interview in as civil a manner as you did, because I was spluttering and shouting the whole way through!
I lost whatever I respect I might have had for Dr. Ornish. All he did for four podcasts was dodge and weave, evade and parry. You would press him to a point, and he would just slip out. You would ask him things point blank, and he would just not answer. Oh, he would respond, all right. But not answer. He just repeated again and again the claim that the studies of his lifestyle prove that the people wind up healthier and with lower “risk factors.” He never EXPLAINED a darn thing. He never explained how insulin works, how fat cells store fat, what cholesterol does in the body, or anything. You know why? Because whenever you hear an explanation of how those things work, his recommendations don’t make any sense!
High fat is bad for diabetes? How exactly would that work? No answer from Dr. O. Because there is no answer.
What really got my goat: his insistence that the low fat versus low carb “wars” are over. Well, that’s one way to score a victory — just declare the contest over, and yourself as winner.
Sorry, Dr. Ornish, more and more thinking people are discovering the cracks in the shoddy foundation that the low-fat, high-carb castle is built upon. Just putting a new sign out front calling it the “Spectrum” isn’t going to keep it from tumbling down.
Well said, Vesna. It was difficult maintaining some semblance of civility, but you could tell Dr. Ornish was agitated towards the end of our interview when he declared “this will have to be the last question.” I could have been rude, but that’s not my style. I asked the questions and let his answers speak for themselves. And I think they did loud and clear. THANK YOU for your comments!
Ornish’s approach has been labeled low fat/high carb because that was his main thrust 30 years ago. Now he (and Andrew Weil and many others) believe that there are good carbs and bad carbs, and good fats and bad fats. It’s not surprising he gets uptight when you keep describing him based on what he thought several decades ago.
Ornish, Weil etc. think flour and sugar lead to diabetes and heart disease (which you agree with) and that saturated fats lead to cancer and heart disease (which you don’t agree with.) You and he agree about good fats (omega 3’s) but you don’t agree about what he calls good carbs, namely whole grains. It’s good to have a dialogue about this.
I wish that there was more of the kind of evidence that Ornish uses to study his diet (looking at arteries and hearts with high tech machines) for the diet you like, then we could compare oranges to oranges. Both Taubes and Ornish agree that looking at blood markers is not necessarily enough, and is sometimes misleading: you need to look at what actually happens to arteries, and who eventually gets sick and who doesn’t. It will be very helpful when those kind of studies are done on the people who like your kind of diet, but I imagine they’re very pricey. Probably you can’t pick up a gismo that looks at your arteries on eBay, and invite your low carb/high fat friends over for a barbecue/photo shoot on Saturday.
Actually, Peter, there IS someone who has developed a way to look at the arteries–Dr. William Davis, a Milwaukee, WI-based cardiologist who uses sophisticated “Heart Scan” technology to detect plaque build-up. You may want to visit his web site and fantastic blog to learn more about this.
It’s a fantastic blog, as you say. I’m going to get the book. Have you had the scan?
I haven’t personally had the scan because nobody in my area does this kind of work. I’ve considered going up to Milwaukee to meet with Dr. Davis and having him perform the scan himself at some point. I’d be VERY interested in what my arteries look like. If I had to guess, I’d be willing to bet they’re pretty clean.