Ornish Program

Mel, the reason I'm focused on Ornish, is that he has published studies showing a reversal of CAD. Its very difficult to reverse CAD, which is, generally speaking, a progressive disease. He, and Dr Caldwell Esselstyn of the Cleveland Clinic, have proven that a plant based diet, can often generate reversal. Without drugs. Part of this, is no oils, which they believe inflames and damages the epithelial lining of the arteries. Medit diet has a lot of oil.

Also, the Ornish program, is not just about diet, a big part of it is stress reduction, exercise, and support groups (run at the center in the live program)
Honestly, i don't know if i am capable of doing it. Even with all that i have learned about this disease, and my specific condition (heavy calcium) i still find myself cheating once in a while. I have not been able to go all plant based/vegan. I am however, miles better than i used to be.
I beat myself up sometimes for having lived my life, in terms of diet exercise and stress, they way i did for so many years before changing my ways a few years ago. I might not have been in this position.

Jack, why do you keep up the incessant drumming of criticism of others choices after the fact? Most of us who have been on the receiving end of it are fed up with it. Live and Let Live is a great motto to live by.

I truly believe that as his knowledge of PC grows Pratoman has the potential to offer HW/PC newcomers a lot based on his journey. (halbert has definitely shown recent signs of the light coming on)

Pratoman said...
You guys are scaring me. So I can expect within several years to have more blockage, if I don't get on some kind of strict program??

Sorry, Prato, forgot how much you worry so maybe I(we) should not have pointed that(i.e. the obvious) out. Sorry.

Still, surely you must realize that- just like cancer- the normal course of untreated heart disease is to progress? To whatever degree either you or I might have heart disease right now, I'm sure you don't think we had just as much 10 years ago assuming no treatment.

Besides, don't you and your doctors already have you on a strict program of drugs, diet and exercise? It may not be Ornish exactly, but clearly you are trying to do something already. Hopefully it will benefit you.

Post Edited (BillyBob@388) : 12/31/2015 11:08:14 AM (GMT-7)

Pratoman,

You are spot on focusing on Ornish. I believe he was involved in the original (June 19, 1987 Journal of the American Medical Association) research that showed that the atherosclerotic process could be reversed. It was the basis of the 1989 publication I have used for many years, "The 8-Week Cholestrol Cure".

Historically, I believe the first person who really started to push the verges was Nathan Pritikin /en.m.wikipedia.org/wiki/Nathan_Pritikin

Post Edited (RCS) : 12/31/2015 2:21:58 PM (GMT-7)

Me too, Tud..Med diet is good, not doing it..well, sort of, but you know what I mean. :)
Prat, The only problem I found with the fitbit is it works best when you are moving your arms, I get 10,000 steps easily mowing hay and steering the tractor for 3 hrs...but got only 1,000 unloading 100 bales of hay, seems like it must be the way you move your arms...don't know. Does seem like a good idea to keep you moving , though. The thing with Ornish is it the program is so danged severe..hard to follow .

Pratoman said...
BillyBob, no worries, I'm not crazed, I used scared as a figure of speech, I'm not that nuts LOL.

You're not? Phew, that's good to know, that takes a load off! Now, me OTOH, crazed is a word I hear fairly often about myself from family and even some friends, so, take anything I say with a rather huge grain of salt!

Pratoman said...
YEs, I'm on a program of diet exercise and meds. But it's funny, the meds came from my Dr. The diet and exercise, I'm on my own, and figured it out myself. I think most Drs are all about meds, which sucks, but it's what they do.
My Dr is a great diagnostician, I've seen it myself and I've been told as much by other Drs in the community. But he also knows his limitations. Or maybe it's that he knows that I am a pretty well educated patient. Still, he should probably have discussed it with me.
When I was walking around with triglycerides in the 6-700's about 10 years ago, and on 3 meds for it, he referred me to a nutritionist who really helped me.

Yes, it's what they do. But when I read something like that sometimes it makes me more bonkers than usual. On 3 meds for triglycerides? Did it at least help a lot, hopefully with no apparent SEs? You probably already think I am indeed crazed for suggesting that decreasing saturated fat decreases HDL, which as far as I know all agree is very helpful in high #s, not low. But as crazy as I must sound, since this is the opposite of what most docs teach us, you must admit I had some pretty good back up with the study links I provided. Plus like I said before there is my personal experience in my study of 2. (N2, good enough for me, plus I have repeated this test for myself more than once since about 1998, always with the same good results)

So now, going on from HDL to Triglycerides: I had previously stated that when I cut carbs a lot for 6 months(while eating enough fat and protein to satisfy hunger, not that much extra really) that my triglycerides dropped 75%. My friend who did the same had about the same results. I think there is a line or two in those linked studies I provided which showed higher fat and saturated fat= higher HDL which also indicated lower carbs = lower triglycerides. But if not, consider this:
www.ncbi.nlm.nih.gov/pubmed/19082851

Somebody said...
Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet...........................We specifically tested the idea with a 12-week study comparing two hypocaloric diets (approximately 1,500 kcal): a carbohydrate-restricted diet (CRD) (%carbohydrate:fat:protein = 12:59:28) and a low-fat diet (LFD) (56:24:20) in 40 subjects with atherogenic dyslipidemia. Both interventions led to improvements in several metabolic markers, but subjects following the CRD had consistently reduced glucose (-12%) and insulin (-50%) concentrations, insulin sensitivity (-55%), weight loss (-10%), decreased adiposity (-14%), and more favorable triacylglycerol (TAG) (-51%), HDL-C (13%) and total cholesterol/HDL-C ratio (-14%) responses. In addition to these markers for MetS, the CRD subjects showed more favorable responses to alternative indicators of cardiovascular risk: postprandial lipemia (-47%), the Apo B/Apo A-1 ratio (-16%), and LDL particle distribution. Despite a threefold higher intake of dietary saturated fat during the CRD, saturated fatty acids in TAG and cholesteryl ester were significantly decreased,

( triacylglycerol (TAG) is just another fancy name for triglycerides. Do you see that 51% reduced TAG?)

Or this one: www.ncbi.nlm.nih.gov/pubmed/15601959

Somebody said...
Our research group began studying physiological responses to very-low-carbohydrate ketogenic diets (VLCKDs) in the late 1990s because we felt there was a significant void in the literature and limited understanding of metabolic responses to VLCKDs...........Compared with low-fat diets, short-term VLCKDs consistently result in improvements in fat loss, fasting and postprandial triacylglycerols, high-density lipoprotein-cholesterol, the distribution of low-density lipoprotein-cholesterol subclasses, and insulin resistance. These are the key metabolic abnormalities of metabolic syndrome, a problem of epidemic proportions in the United States.

Etc, Etc, Etc. The trouble with most studies on so called low carb diets is that they never really reduce the carbs enough for a ketogenic effect, so the results are not nearly as dramatic. But when they do, as in my experience, triglycerides are decreased impressively. Now here is why I have copied all of those studies and keep going on about my experience: Did the doctors, who as you say "are all about meds, which sucks, but it's what they do. ", who had you on 3 meds for your high triglycerides, did any of them ever suggest that maybe you should try significantly reducing your carbohydrate intake? Do any doctors ever recommend that as an alternative to drugs or low fat diets? Very few I am afraid.

I have just about finally decided that, as soon as the holidays and my birthday are over, I'm going back on the low carb wagon to get this holiday weight off and drastically improve my lipid lab results to make my doctor happier(even though I scored zero on the calcium score, t will make him feel better). The only thing that has been holding me back is my caution over eggs and chicken for guys with PCa. That does worry me. Then again, you can count on it the vast majority of guys who were eating lots of chicken and eggs were also heavy on the carbs, aka insulin. And who can say for sure that was not part of the problem? OTOH, I have read in many places that insulin is a huge problem when it comes to all cancers, really helps them to grow. Did you notice in the above studies that insulin, just like triglycerides, was slashed by 55% in the low carb eaters? So maybe the decrease in insulin will negate the negative effect of eggs and chicken on my PCa? Who knows, but it sure will shrink my gut and improve my blood lipids, or at least it always has in the past.

In followup to Tud's suggestion, I remind everyone that there is Rule 3.

3. No posts that attack, insult, flame, defame, or abuse others. Respect other members' opinions regarding treatment decisions. Decisions about health and well-being are highly personal choices. We should respect all points of view. Flaming will not be tolerated.

sheepguy said...
Yeah, but chicken..boiled, with skin, without, barbecued..dark meat light meat..blah blah blah, the more bland you cook the chicken the better it is for you. :) But overall not that bad. Eggs? Yolks, no yolks,boiled, fried (perish the thought) in general eggs are not very high in calories , but high in protein...a good food.
Low carbs? Sure, that's where most of our calories come from..you'll lose weight for sure. That's why paleo works for weight loss.
Insulin and PCa? who knows you can probably find some retrospective study that say yes, no, maybe, can you repeat the question? LOL

Sheepguy, I ate a ton of chicken and eggs (and everything else also)for a lifetime before being diagnosed with PC. Then I read a large study out of Harvard. The good news was that neither red meat nor even processed red meat had any correlation at all with a recurrence of PC in treated men. The bad news was that both poultry(especially with skin) and what come out of chickens, eggs, were highly correlated with recurrence. Like anywhere from 2 to 4+ times more likely to recur, the more you ate the more likely to recur. But even 1 egg a week was significant.

Of course, that is just one study. I am anxiously watching for the study that thoroughly trashes this study!

But also, like I said, you can count on it that the vast majority of these egg eaters were also eating a high carb, high insulin generating, high sugar(carb=sugar once they hit the blood stream more or less) diet with those eggs. So if you cut the carbs/sugar/insulin with those eggs and chicken, who knows? I would like to know!

Sheepguy said...
Insulin and PCa? who knows you can probably find some retrospective study that say yes, no, maybe, can you repeat the question? LOL

Well, you know how there seems to be some hope in the benefits of Metformin, which "decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity". Rxlist:

www.ncbi.nlm.nih.gov/pubmed/25862373

Somebody said...
Metformin inhibits the proliferation of human prostate cancer PC-3 cells via the downregulation of insulin-like growth factor 1 receptor.
Kato H1, Sekine Y2, Furuya Y2, Miyazawa Y2, Koike H2, Suzuki K2.
Author information
Abstract

Metformin is a biguanide drug that is widely used for the treatment of type 2 diabetes. Recent studies have shown that metformin inhibits cancer cell proliferation and tumor growth both in vitro and in vivo. The anti-tumor mechanisms of metformin include activation of the AMP-activated protein kinase/mTOR pathway and direct inhibition of insulin/insulin-like growth factor (IGF)-mediated cellular proliferation. However, the anti-tumor mechanism in prostate cancer remains unclear. Because activation of the IGF-1 receptor (IGF-1R) is required for prostate cell proliferation, IGF-1R inhibitors may be of therapeutic value. Accordingly, we examined the effects of metformin on IGF-1R signaling in prostate cancer cells. Metformin significantly inhibited PC-3 cell proliferation, migration, and invasion. IGF-1R mRNA expression decreased significantly after 48 h of treatment, and IGF-1R protein expression decreased in a similar manner. IGF-1R knockdown by siRNA transfection led to inhibited proliferation, migration and invasion of PC-3 cells. IGF-1 activated both ERK1/2 and Akt, but these effects were attenuated by metformin treatment. In addition, intraperitoneal treatment with metformin significantly reduced tumor growth and IGF-1R mRNA expression in PC-3 xenografts. Our results suggest that metformin is a potent inhibitor of the IGF-1/IGF-1R system and may be beneficial in prostate cancer treatment.

Post Edited (BillyBob@388) : 12/31/2015 6:04:59 PM (GMT-7)

Pratoman,

Based on what I know of you, I think you should give the Ornish program a try if Medicare will pop for the bill. If you don't, you'll always wonder whether it would work for you. All the best on your choice.

Tim

P.S. I found a website called "Oldways" because of my interest in the Mediterranean Diet and ran across this video featuring Dean Ornish at a recent nutrition conference. Here's a link in case you are interested: (Ornish is preceded by another presenter on the video)

/www.youtube.com/watch?v=rmFeNJ3SHu4&list=PL8bdCoYqX-yEIUojHDO6kG0BPQ8iXCyMp

Post Edited (Tim G) : 12/31/2015 11:33:29 PM (GMT-7)

Pratoman said...

Interesting that there was no reversal. The idea of reversal would be my only goal, as i believe i can stop or slow progession from here by continuing to do what i am doing - weight loss/maintenance, sensible diet, no read meat, low fat, high protein, low low sugar, and daily exercise.

Pratoman said...
Thus I'm thinking Ornish. But i was disappointed to hear about the two friends of Sheepguy, who went thru the Ornish program and stopped progression, but did not see any reversal.
.

A few points.
I would suspect that if Sheepguy's friends did have followup angiograms, it can often be very difficult to tell if there is a 0% or 1% or even 3% reversal. Analysis of angiograms is not at all precise. That is why you seldom hear someone saying they had a 88% or 93% blockage. Instead you hear, 80% or 90%...or perhaps 95%. Now, those two guys had already had stents. Leaving a fairly substantial opening in the area previously narrowed.
I would guess that even if they had a 2% or 3% reversal, it often wouldn't be noted as such given the variability of the readings. The doctor would be happy to note "no progression"

I was wondering, do you have a good feel for what constitutes reversal in the Ornish studies and the degree to which those subjects followed the diet?
If you have not done so, you need to read in great detail, the 1998 JAMA article.
It gives a idea of what "reversal" is, quite unlike what some are led to believe.
Very small reversals are typical.
Average after 5 years was 3%.... Less than that at end of a year or two.
For those in the least adherence tertile (1/3), there was only halting..no significant reversal.
The overall average was 3%... The followups on Sheepguy's friends might not even record that as a reversal... IF they were even part of the average overall adherence.

As to what average overall adherence means in terms of diet... well, the percentage of caloric intake as fat was only 8.5%. That is very strict over 5 years. Little to no room for kind of following only some parts of the dietary program.

If you have not done so, read the details and pay attention to Fig 1 and Figure 2.
See what happens for the control group.
Note, the study did not include statins for the experimental group. A statin might help with reversal while on the program, but that is uncertain.
Most of those in Esselstyn's study were on statins.

http://www.ornishspectrum.com/wp-content/uploads/Intensive-lifestyle-changes-for-reversal-of-coronary-heart-disease1.pdf

One other point. Neither Ornish or Esselstyn encourage high protein. I'm not sure Ornish says to avoid it, but he does not encourage it. I don't know what to think about it regarding reversal.

It is unclear how much of the measured reversals the Ornish diet was responsible for. I would suspect the diet was the main factor. But we don't know for sure.
I would also suspect that it is harder or very likely impossible to reverse that portion of a blockage that is made up of calcium. Next most difficult is the fibrous portion. I believe the most likely portion available for actual reversal is the fatty portion.

We don't know what the make up of Sheepguy's friends blockages were.
Also, in some individuals there is a initial rebound after the stent is introduced and begins to be covered.
In some, that process can be rapid and ends up in restenosis... back where they started.
In most, if they don't change diet and lifestyle in a huge way, they will slowly being to re-block the openings.
Just halting the process after being stented would seem a admirable goal though it doesn't sound so sexy.

I don't think you should get so stuck on reversal as the primary goal.

As to the make up of most blockages... percent of calcium, fibrous, and fatty materials, you should watch this guy who has been a expert for 40 years and has real practical experience

https://www.drmcdougall.com/health/education/videos/advanced-study-weekend-experts/william-c-roberts-md-macc/

Hope some of this helps your understanding and future plan decisions.

sheepguy said...
.but by the same token a high fat blockage is a vulnerable plaque, susceptible to rupture and complete blockage..which depending on where it is would drop you like a bad habit if your were in the CCU.
Neither of my friends had a high calcium score..so the plaques were probably not too much calcium but that's about all they would know without examining the plaques.which they obviously can't unless they resort to CABG somewhere down the line.

Statins and diet (on a slower time frame) can alter the composition of the blockages even when they don't reverse the total percentage blockage.

http://www.journalofcardiologycases.com/action/showFullTextImages?pii=S1878-5409%2811%2900025-9

BillyBob - re your post on Carbs vs low fat (too long to quote)... I am not at all surprised. When I was seeing a nutritionist regularly for my triglycerides, I remember asking her specifically about sugar free chocolate pudding vs fat free, and she told me, always choose sugar free (I.e. Carb free) vs fat free, sugar and carbs in general are the worst thing for triglycerides. I was NOT aware that carbs could suppress HDL, effect LDL particle size, etc (another problem I've had, small particle size)

Also, in answer to your questions,....
1. The Dr who had me on 3 meds for TGL, did mention stay away from pasta, bread, etc, but didn't dwell on it. He did refer me to a nutritionist for that info
2. The three meds did help, got my triglycerides down from 700s to mid 300s. It was diet that got me down to 150. Then he started taking me off the meds, one at a time (just like he put me on them one at a time). Right now I'm down to one med for TGL (4 meds altogether, BP, Blood thinner, Statin and TGL)

Another thing Worth mentioning...... When I first started my weight loss journey, I felt I needed a kick start. So I started the Medifast diet. It is based on almost no carbs, and is designed to put you into ketones. I lost a lot of weight really fast. And my TGL plummeted. So there's that!
Now, it's not sustainable long term. And when I went off it my TGL rose, but I watched food intake carefully and they didn't rise back to where they were, and I kept about half the weight off.

So yes there is a lot of evidence that low carbs are a way to go. And yet, increasing saturated fat does seem to go against the grain.

I'm printing out the study you cited and will take it with me to the nutritionist appt.

P.S. I do wonder, in these studies, whethervtherevis a differentiation between simple, and complex carbs. Are carbs from whole whet bread or pats, for example, not detrimental, while carbs from white bread or other enriched wheat products are? Are carbs from Apples, broccoli etc, of a type that do NOT suppress LDL and TGL? Another question to ponder .

Post Edited (Pratoman) : 1/1/2016 7:51:45 AM (GMT-7)