Lifestyle changes and heart disease.
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Aged↗
Biomedical subjects
D Ornish
Publications and source records attributed to D Ornish.
Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial.
In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography. The average percentage diameter stenosis regressed from 40.0 (SD 16.9)% to 37.8 (16.5)% in the experimental group yet progressed from 42.7 (15.5)% to 46.1 (18.5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61.1 (8.8)% to 55.8 (11.0)% in the experimental group and progressed from 61.7 (9.5)% to 64.4 (16.3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.
Adult↗
Plasma lipoprotein levels in vegetarians. The effect of ingestion of fats from dairy products.
The influence of dairy foods in the diet on plasma levels of total, low-density lipoprotein, and high-density lipoprotein cholesterol (TC, LDL-C, and HDL-C, respectively) was studied in 75 adult lactovegetarians living in the northeastern United States. Dairy products were the major sources of dietary saturated fat and cholesterol. The plasma TC level was positively correlated with dietary saturated fat and dietary cholesterol, and inversely correlated with the ratio of polyunsaturated to saturated fats in the diet. Correlations between the LDL-C level and the nutrients were similar to those of the TC level. The HDL-C level was not significantly related to any nutrients in the diet. The cholesterol levels of the lactovegetarians were compared with those of strict vegetarians. Lactovegetarians had 24% higher LDL-C levels and 7% higher HDL-C levels than strict vegetarians. Analysis within and among vegetarian populations suggests that ingestion of fatty dairy products raises the LDL-C level on a percentage basis about three times more than it raises the HDL-C level.
Adult↗
Effects of stress management training and dietary changes in treating ischemic heart disease.
To evaluate the short-term effects of an intervention that consists of stress management training and dietary changes in patients with ischemic heart disease (IHD), we compared the cardiovascular status of 23 patients who received this intervention with a randomized control group of 23 patient who did not. After 24 days, patients in the experimental group demonstrated a 44% mean increase in duration of exercise, a 55% mean increase in total work performed, somewhat improved left ventricular regional wall motion during peak exercise, and a net change in the left ventricular ejection fraction from rest to maximum exercise of +6.4%. Also, we measured a 20.5% mean decrease in plasma cholesterol levels and a 91.0% mean reduction in frequency of anginal episodes. In this selected sample, short-term improvements in cardiovascular status seem to result from these adjuncts to conventional treatments of IHD.
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The impact of emotions on cardiovascular health.
Recent research suggests that the maintenance of emotional well-being is critical to cardiovascular health. People who feel lonely, depressed, and isolated have been found to be significantly more likely to suffer illnesses and to die prematurely of cardiovascular diseases than those who have adequate social support. Consequently, the development of appropriate interventions to improve the emotional health of people with certain psychosocial risk factors has become an important research goal. It is anticipated that such interventions will increase the life expectancy of people at risk and that it may also save millions of dollars in medical care costs. First, however, researchers in this field must identify specific emotional risk factors and must agree upon a working definition of "good emotional health." Such explicit definitions, as well as additional data, are essential to educating physicians and insurers so that consideration of emotional health can be integrated into basic medical care.
Cardiovascular Diseases↗