The one thing more difficult than following a regimen is not imposing it on others.
I just had a piece of chocolate. Dark chocolate. Really high-fat gourmet dark chocolate. It was delicious. I have a little chocolate almost every day.
Now, you may be wondering if I’m cheating on my very own diet. Well, no, I’m not. I’m enjoying my very own diet.
I’m writing this book to help you understand that you have a broad spectrum of choices when it comes to what you eat, how much you exercise, how you manage stress, and how you live. It’s not all or nothing. In the process, I hope to dispel some misconceptions about what I recommend.
In short, this book will show you how to personalize a way of eating and living that’s just right for you, based on your own needs and preferences. It has been scientifically proven to help you feel better, look better, lose weight, and gain health.
It works! Why? Because it’s based on pleasure, not pain; abundance, not deprivation; science, not myth; freedom and power, not restriction and manipulation. Joy of living is sustainable; fear of dying is not.
There are many myths and false choices that are confusing to many people. These include:
•If I live and eat healthfully, am I going to live longer or is it just going to seem longer?
•Is it fun for me or good for me?
•Low-fat or low-carb?
•Fast food or good food?
•Atkins indulgent or Ornish ascetic?
You really don’t have to make these choices.
This is a book about how to enjoy life more fully while enhancing your health and well-being. It’s based on our latest research showing that you can actually change how your genes are expressed just by changing what you eat and how you live.
In short, this book can empower you to transform your own life.
By now, many people are thoroughly exasperated by the seemingly contradictory information they read about what a sound nutrition and lifestyle program should be. Nowhere are the claims more conflicting than in the area of diet. I often hear, “Those damn doctors! They can’t make up their mind. To hell with ’em, I’ll eat and do whatever I want and quit worrying about it!”
I understand why many people feel that way. It can be really confusing when even the experts don’t seem to agree.
Fortunately, at a time when people are more confused than ever, there is an emerging consensus about what to eat and how to live. The jury is in: a convergence of scientific evidence can help us resolve conflicting claims and distinguish what just sounds good from what is proven to be true.
Now it is possible to cut through the confusion and to customize a diet and lifestyle program just right for you based on your own needs and preferences. You have a spectrum of choices.
People have different needs, goals, and preferences. The medicine of the future is personalized medicine, which this book brings you today.
The recipes and cooking instructions, by the renowned chef Art Smith, are for foods that taste good and also make you look good and feel good. Many of them have several versions, so you can customize them to meet your own needs and preferences.
It seems that many people have misconceptions about what I eat and how I live my own life. For example, a few years ago, the playwright and producer Mike Nichols came up to me at a benefit for a foundation and said, “Hey, Dean, I’m on your diet—if it tastes good, I can’t eat it”—echoing Mark Twain, “The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not.”
This is the most common misunderstanding about my work—that I recommend one really strict diet and lifestyle program for everyone. “Yes, it works, but it’s almost impossible to follow.”
It’s understandable why so many people believe this. Many of the media stories on the work my colleagues and I have conducted have focused on our research showing that heart disease and other chronic diseases can be reversed—and they often can!—just by making comprehensive lifestyle changes. Reversing a disease does require the stricter version of the diet and lifestyle program—the pound of cure— whereas if you’re just trying to feel good and stay healthy you need only the ounce of prevention. However, for people who aren’t sick, I recommended a spectrum of choices.
In this book, I’m not trying to get you to do—or not do—anything. Food and lifestyle choices are deeply personal decisions. Having seen what a powerful difference changes in diet and lifestyle can make, I want to share these findings with you so that you can make intelligent choices in what you eat and how you live. How much or little you want to change, if at all, is entirely up to you. More on this later.
Whenever I go out to dinner, people often comment on what I’m eating or apologize for what they’re eating—“I have to be careful what I eat around you”—as though I’m going to be the sheriff or the vice principal of the high school waving my finger at them, judging them, and shaming them into eating differently.
In reality, nothing could be further from the truth. So I usually make a sign of the cross and say, jokingly, “You are forgiven,” and we all have a good laugh about it. I then tell them that it doesn’t matter to me what they eat or how they live as long as they’re happy. When I order dessert, they often feel both surprised and relieved.
What makes this book unique is that it’s based on three decades of research proving what works, what doesn’t, for whom, and under what circumstances. Most books are written based on anecdotal testimonials (which are often unreliable), or on the experience of others, or on wishful thinking. They may make promises that often remain unfulfilled.
Instead, this program is grounded in science, and it’s been proven to work:
•My colleagues and I at the nonprofit Preventive Medicine Research Institute have proven that this program works to help prevent, and to slow, stop, and even reverse the progression of the most common and most deadly diseases, including coronary heart disease, prostate cancer, diabetes, hypertension, obesity, elevated cholesterol levels, arthritis, and many other chronic diseases.
•We recently conducted the first study in men with prostate cancer showing that our program of comprehensive lifestyle changes may change how your genes are expressed—in general, turning on (upregulating) the good parts of the genes and turning off (downregulating) the harmful ones. More on this in chapter 4.
•We recently conducted the first study showing that comprehensive lifestyle changes may improve how quickly your cells age. Telomeres are the ends of your DNA, and they affect longevity. As they become shorter and their structural integrity is weakened, cells age and die more quickly. In simple terms, as your telomeres get shorter, your life gets shorter. In our new study, we found that the telomerase enzyme (which repairs telomeres) increased significantly in those who went through our diet and lifestyle program after only three months.
•We learned what really works to motivate people to make and maintain comprehensive lifestyle changes in the real world. We’ve consistently shown that our program can motivate many people to make and maintain bigger changes in diet and lifestyle, and to achieve better clinical outcomes and larger cost savings in diverse groups of people than have ever before been demonstrated.
Let’s examine these.
THE PROGRAM WORKS TO PREVENT AND REVERSE DISEASE
People often think that advances in medicine have to be a new drug, a new laser, or a surgical intervention to be powerful—something really high-tech and expensive. They often have a hard time believing that the simple choices we make in our lives each day—what we eat, how we respond to stress, whether or not we smoke, how much we exercise, and the quality of our relationships—can make such a powerful difference in our health, our well-being, and our survival, but they often do.
Awareness is the first step in healing. When we become more aware of how powerfully our choices in diet and lifestyle affect us—for better and for worse—then we can make different ones. It’s like connecting the dots. In my experience, many people are not afraid to make big changes in their lives if they understand the benefits of doing so and how quickly they may occur.
Part of the value of science is to raise our awareness by helping us understand the powerful effects of the diet and lifestyle choices we make each day and how changing these may significantly—sometimes dramatically—improve our health and well-being. In many cases, these improvements may occur much more quickly than people once believed possible.
In our studies, we used the latest in high-tech, expensive, state-of- the-art measures to prove how robust these very simple, low-tech, and low-cost interventions can be.
For more than thirty years, I’ve directed a series of scientific research studies showing, for the first time, that the progression of even severe coronary heart disease can often be reversed by making comprehensive lifestyle changes. These include a very-low-fat diet including predominantly fruits, vegetables, whole grains, legumes, and soy products in their natural, unrefined forms; moderate exercise such as walking; various stress management techniques, including yoga- based stretching, breathing, meditation, and imagery; and enhanced love and social support, which may include support groups.
In these studies, we also documented that other chronic diseases may be reversible simply by making comprehensive lifestyle changes. Our findings are giving literally millions of people worldwide new hope and new choices, options that are more caring and compassionate as well as more cost-effective and competent.
More recently, we published the results of a randomized controlled trial in collaboration with Peter Carroll, M.D. (chair, Department of Urology, School of Medicine, University of California, San Francisco) and William Fair, M.D. (chief of urologic surgery and chair of urologic oncology, Memorial Sloan-Kettering Cancer Center, now deceased) showing that the progression of early-stage prostate cancer may be slowed, stopped, or perhaps even reversed by making similar changes in diet and lifestyle. This may be the first randomized controlled trial showing that the progression of any type of cancer may be modified just by changing what we eat and how we live. What’s true for prostate cancer may be true for breast cancer as well, as I describe in chapter 14.
Our research has been conducted in collaboration with the most credible scientific investigators at major academic medical centers. Our findings have been published in the leading peer-reviewed medical journals, including The Lancet, The Journal of the American Medical Association, The American Journal of Cardiology, Circulation, Journal of Cardiopulmonary Rehabilitation, Journal of Urology, Yearbook of Medicine, Yearbook of Cardiology, The New England Journal of Medicine, Homeostasis, Urology, Journal of the American Dietetic Association, Hospital Practice, Cardiovascular Risk Factors, World Review of Nutrition and Dietetics, Journal of Cardiovascular Risk, Obesity Research, Journal of the American College of Cardiology, and others.
Our program has also been featured in the leading standard medical textbooks, including Harrison’s Principles of Internal Medicine, Clinical Trials in Cardiovascular Disease (companion to Heart Disease, the Braunwald standard cardiology textbook), Harrison’s Advances in Cardiology, and Clinical Trials in Cardiovascular Disease (second edition), as well as a number of general-interest books, including Bill Moyers’s Healing and the Mind, among others.
Research findings documenting the benefits of our program have been presented at numerous scientific meetings, including the annual scientific meetings of the American College of Cardiology, beginning in 1982; the American Heart Association, beginning in 1983; and the Society of Behavioral Medicine, beginning in 1988, as well as many other scientific and medical conferences. On several occasions, our research was highlighted at these meetings and featured at press conferences convened by these organizations.
I say this just to emphasize that the program described in this book has been proven to work in the most rigorous and credible peer- reviewed evaluations. And that matters. A lot.
I have spent so much of my time conducting scientific research because it’s important to be able to substantiate and validate whatever health promises are made. In 2000, I was appointed to the White House Commission on Complementary and Alternative Medicine Policy. More than a thousand people testified before our committee.
I learned that more money is spent out of pocket for alternative medicine than for traditional medicine. Why? Many people have become disenchanted with conventional medicine and have embraced a variety of alternative interventions. However, they may find themselves disillusioned with some of these approaches as well because many of them do not have scientific evidence to support their claims.
Seen from this perspective, our program is (as of this writing) one of the most scientifically documented alternative medicine approaches. It integrates the best of traditional and nontraditional approaches to health and healing.
I also understand the limitations of science. As Albert Einstein once said, “Not everything that can be counted counts; and not everything that counts can be counted”—for example, love and joy, as I’ll describe later—but many things that are meaningful are also measurable. Also, part of the reason that the public receives so much conflicting information is that there is a lot of bad science out there. In this book, I’ll show you how to critically analyze some of these studies.
In our cardiac studies, beginning in 1977, we found that there was a 91 percent reduction in the frequency of angina (chest pain) after only a few weeks, and most of these patients became pain-free. These were patients with very severe coronary heart disease, many of whom literally could not walk across the street without getting severe chest pain and shortness of breath when they began.
After one year, there was a 40 percent average reduction in LDL cholesterol levels. This is comparable to what can be achieved with statin drugs like Lipitor without the costs (more than $15 billion last year) or side effects (both known and unknown).
In the Lifestyle Heart Trial, there was significant reversal in coronary artery blockages in the group that went through our program after only one year, whereas those in the randomized control group, who made more conventional changes, showed a worsening of their coronary artery blockages.