Ounce of Prevention Equals Pound of Cure
Jeyling Chou
Features Editor
In his talk on October 31 at UCSF, Dr. Dean Ornish encouraged his audience to put down their mops.
Ornish, beginning with this household analogy, continued to outline the powerful potential of lifestyle change.
“In medicine,” he explained, “we spend so much time mopping up the floor without turning off the faucet.” In other words, the unsustainable expense and inefficiency of the current healthcare system are largely due to treating the symptoms rather than the cause, the disease rather than the patient.
Ornish is a leading voice in the movement of preventive medicine, UCSF Clinical Professor of Medicine, founder and president of the non-profit Preventive Medicine Research Institute. On a day devoted to fun-size Snickers and candy corn, he presented the argument for diet and lifestyle as not only tools for prevention, but also as adjunct therapy – not only as adjunct therapy, but one day, the standard of care.
In a series of studies, Ornish outlined the beneficial impact of lifestyle change in reversing coronary heart disease, reducing tumor growth in prostate cancer, increasing the length of telomeres. Lifestyle change is not only non-invasive and potent, he demonstrated, but it also has a positive dose-response curve: the more people changed their lifestyles, the better they got.
“Our genes are just our predisposition, our genes are not our fate,” Ornish said, “This is a very powerful message to give people.”
Feel-good motivation, it turns out, is more effective than scare-tactics when it comes to making sustainable change. Lifestyle change give people a sense of freedom and empowerment whereas the threat of increasing risk factors for a chronic disease instill emotions of shame, guilt, and humiliation-- the most health-toxic emotions.
On a lighter note, Ornish indicated that the first fear-based dietary intervention occurred with Eve and the apple in the Garden of Eden. We all know how that story ends.
“And that was God talking,” Ornish said.
So how do we improve our lives and reverse disease via lifestyle? Ornish quickly enumerated: consume mostly plants and unprocessed foods. Reduce the intake of refined carbohydrates and sugars. When possible, eat organic. (Because, according to Ornish, what’s good for us is also good for the planet.) Take 4 grams of fish oil a day. But perhaps more importantly, take the time to relax and develop personal relationships.
“We tend to think of the time we spend with our family and loved ones as what we do after we’ve finished all the important stuff,” Ornish said. As future health professionals, he hopes we can increase the awareness of what really is the important stuff.
For the first time, the paradigm might be shifting. The unsustainable increase in healthcare costs, the efforts of Michelle Obama in addressing the obesity epidemic, the fact that more money is spent out of pocket on alternative therapies than traditional medicine has created the perfect storm for change.
The biggest obstacle to change up until this point, Ornish said, has been Medicare reimbursement. The current system of reimbursement created a culture such that open-heart surgery could be conventional treatment for heart disease, while recommending fruits and vegetables is considered the radical approach.
As of this summer, Medicare announced it would start covering Ornish’s comprehensive program of lifestyle change. Hopefully that’s a sign that something as low-tech as diet and exercise can be compatible with our fast-paced, increasingly digital world.
“It’s very easy to get into the technology of medicine, all the algorithms and all of that stuff,” Ornish said. “But pretty soon that’s all going to be on an iPad or iPhone anyway.”
“If all you are is a technician, you’re going to be replaced,” he continued. “But I think the reason we all went into medicine in the first place is that we want to be healers as well as technicians.”
Jeyling Chou is a first-year medical student.
This article appeared in the November 17, 2011 issue of Synapse.