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Very Low-Fat Diets for Coronary Heart Disease: Perhaps, But Which One?-Reply FREE

Dean Ornish, MD
JAMA. 1996;275(18):1403-1403. doi:10.1001/jama.1996.03530420030030
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In Reply.  —Unlike the patient described by Dr Siguel and colleagues, almost all of the patients in the experimental group of the Lifestyle Heart Trial1 and in an earlier study2 described improvements in well-being, energy, stamina, and concentration. Also, these patients reported a 91% reduction in frequency of angina after 1 year and a 71% reduction after 5 years.High-density lipoprotein cholesterol decreased and triglycerides increased slightly, although not significantly. However, HDL-C and triglycerides are only risk factors, not diseases. These patients showed some overall regression in percent diameter stenosis after 1 year and even more regression after 5 years. There was a dose-response correlation between adherence to the lifestyle program and changes in atherosclerosis at 1 year and at 5 years. Cardiac positron emission tomography scans showed overall improvement in myocardial perfusion in these patients after 5 years. Dr Gould's analyses indicated that the progression of disease

REFERENCES

Ornish DM, Brown SE, Scherwitz LW, et al.  Can lifestyle changes reverse coronary atherosclerosis? the Lifestyle Heart Trial. Lancet . 1990;;336:129-133.
Ornish DM, Scherwitz LW, Doody RS, et al.  Effects of stress management training and dietary changes in treating ischemic heart disease. JAMA . 1983;;249:5459.
Gould KL, Ornish D, Scherwitz L, et al.  Changes in myocardial perfusion abnormalities by positron emission tomography after long-term, intense risk factor modification. JAMA . 1995;;274:894-901.
Sacks FM, Ornish DM, Rosner B, McLanahan S, Castelli WP, Kass EH.  Dietary predictors of blood pressure and plasma lipoproteins in lactovegetarians. JAMA . 1985;;254:1337-1341.
Ornish D. Eat More, Weigh Less . New York, NY: HarperCollins; 1993;:25-26.

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Ornish DM, Brown SE, Scherwitz LW, et al.  Can lifestyle changes reverse coronary atherosclerosis? the Lifestyle Heart Trial. Lancet . 1990;;336:129-133.
Ornish DM, Scherwitz LW, Doody RS, et al.  Effects of stress management training and dietary changes in treating ischemic heart disease. JAMA . 1983;;249:5459.
Gould KL, Ornish D, Scherwitz L, et al.  Changes in myocardial perfusion abnormalities by positron emission tomography after long-term, intense risk factor modification. JAMA . 1995;;274:894-901.
Sacks FM, Ornish DM, Rosner B, McLanahan S, Castelli WP, Kass EH.  Dietary predictors of blood pressure and plasma lipoproteins in lactovegetarians. JAMA . 1985;;254:1337-1341.
Ornish D. Eat More, Weigh Less . New York, NY: HarperCollins; 1993;:25-26.
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To understand the clinical management of acute heart failure syndromes.
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