There have been two major health studies in recent years that have the potential to radically affect medical practice. They dramatically show how dietary changes and other lifestyle changes can prevent and in some cases reverse diseases.

The first study, the Lifestyle Heart Trial, was conducted by Dean Ornish, M. D. of the Preventive Medicine Research Institute in Salusito, California, and his medical colleagues. It's aim was to study if changes in diet, exercise, and stress levels can unblock clogged arteries and save lives, without the use of expensive surgical techniques or drugs.

Ornish's initial study involved 48 patients with severe heart disease. He randomly divided them into two groups: 28 received his experimental regimen, and the other 20 were put into a control group, so that they could serve as a basis of comparison. The experimental group was put on a strict vegetarian diet, eating only egg whites and one cup daily of nonfat milk or yogurt. Their dietary fat content was a very low 10 percent of calories, and their cholesterol intake was only 5 mg per day. To control stress, they did stretching exercises, meditated, and performed other relaxation techniques. In addition, they walked for at least a half hour three times a week, and met as a support group twice weekly.

The results of the study were extremely significant. After one year, most of the experimental group indicated a complete or nearly complete disappearance of chest pains. Arterial clogging was reversed for 82 percent of the patients. In one case, the change was especially dramatic. Werner Hebenstreit, a 75 year old retired businessman, who reported that before starting the program he could barely cross the street without chest pains, was able to hike for 6 hours in the Grand Tetons at 8,000 feet by the end of the program. Other patients also experienced significant improvements.

What makes the results even more spectacular is a comparison with the findings for members of the control group. They received standard medical care, following the recommendations of the American Heart Association: up to 30 percent fat in their diets; dietary cholesterol limited to 300 mg per day; no red meat, but chicken without the skin and fish were permitted; they did a moderate amount of exercise, but there were no set stress reduction activities. None of these patients got better, and in almost all cases, their arterial blockages worsened significantly, and they reported an increase in chest pains. Evidently, the standard recommendations of the medical establishment are not sufficient, at least with regard to reversing heart disease.

Although Dr. Ornish initially found it difficult to find funding for his study because of the medical establishment's skepticism about reversing heart disease without surgery or drugs, there are several indications of the increasing acceptance of his approach:

1. His initial findings were published in the Lancet, a highly respected British medical journal, in 1990, and later results were published in the Journal of the American Medical Association, in 1995.

2. In a break from previous policies of medical insurers, which only reimbursed patients who underwent surgery or drug-related therapies, Mutual of Omaha, a major insurance company reimburses patients who receive the Ornish treatment. They found that of the patients motivated enough to try the Ornish approach, 90% stuck with it, and of those, almost 80% avoided bypass surgery or angioplasty; since these surgical approaches are much more expensive than Ornish's approach, Mutual of Omaha is saving about five dollars for every dollar invested. (Recently, many more insurance companies have followed in Mutual of Omaha's path.)

3. At least 8 hospitals throughout the United States, including Beth Israel in New York City, now provide treatment by the Dr. Ornish approach;

4. There have been many television programs and news reports about the success of the program.

Dr. Ornish spells out the philosophy, science, and diet behind his approach in his book, Dr. Dean Ornish's Program for Reversing Heart Disease (see the Bibliography) In the book, he stresses the main conclusion of his study: many patients who are willing to make major changes (involving diet, exercise, and stress reduction) can stop or reverse their heart disease. Ornish also addresses some important nutritional half-truths; for example, why taking aspirin to prevent heart attacks may be a bad idea, and why taking fish oil can increase cholesterol levels and may cause health problems. The book has received much critical acclaim. Since it was found that his technique also resulted in significant weight losses, Ornish wrote a companion book, Eat More, Weigh Less.

Since more Americans die from heart and blood vessel diseases annually than all other cause of death combined and more money is spent in the United States on the treatment of heart disease than any other illness. Ornish's results have the potential to revolutionize health care.

As important as Dr. Ornish's study is, there is another study that has the potential for even greater changes in health practices. This is the China, Cornell, Oxford Study, a collaborative effort between Cornell University, represented by T. Colin Campbell, Ph. D., the Chinese Academy of Preventive Medicine, the Chinese Academy of Medical sciences, and Oxford University, England, as well as scientists from the United States, Britain , France, and other countries. Unlike the Ornish controlled study, the China Study is an epidemiological study that looked at the eating habits and diseases of 6,500 people in 65 Chinese provinces.

The China Project differs from other scientific studies in several important ways:

1. It utilizes the most comprehensive data base on the multiple causes of disease ever compiled; the Chinese government provided background data on 80 million Chinese people;

2. It examines relationships between health and diet in a holistic way, by considering ways in which complete diets and other lifestyle patterns affect health. By contrast, most contemporary studies focus on relationships between single nutrients and foods and single diseases;

3. China provided a "natural (living) laboratory" for the study of nutrition and disease that is unmatched anywhere else in the world; while people in most of the world's countries frequently change their places of residence, and eat foods from many different regions of the world, most Chinese live their entire lives in one area, and eat the same kinds of locally grown food throughout their lives. Yet, diets and disease rates vary sharply from one area to another.

The China Project has received much critical acclaim. Jane Brody, nutrition editor of the New York Times, called it "the grand prix" of epidemiology, and stated that it produced "tantalizing findings" from "the most comprehensive large study ever undertaken of the relationship between diet and the risk of developing disease." The East West Journal called the study, "one of the most rigorous and conclusive (studies) in the history of health research", one which has "unprecedented authority." Computerland Magazine stated that the information provided is "certain to have a global impact.

Here are some of the "tantalizing findings" that can (and should) have a global impact:

1. The Chinese diet, composed primarily of rice and other grains, vegetables, and legumes, such as soy products, is far healthier than the standard American diet. While Americans get an average of 37% of their calories from fat, Chinese get an average of 14.5%, with a range of about 6% to 24%, Chinese get only 10% of their protein from animal sources, while Americans get 70%. One result of their healthier diets is that the range of cholesterol levels in China vary from 70 mg to 170 mg, while in the United States, the average cholesterol level is over 200.

2. In China, regions in which people ate the most animal products had the highest rates of heart disease, cancer, and other chronic degenerative diseases. In many cases, the differences were extremely large; for example, in one part of China, men died of esophageal cancer 435 more often than men in another region, and 20 times as many women in one county suffered from breast cancer than women in another county.

3. Degenerative diseases were associated with high levels of blood cholesterol and urea nitrogen (what is left over after the metabolism of protein in the body), and both of these factors increase as people eat more meat, dairy products, and eggs.

4. The more a diet is composed of foods of plant origin, the better, and there is no lower threshold on the amount of animal products in the diet in terms of health benefits received. Even small increases in the amount of animal products (meat, eggs, and dairy products) consumed result in significant increases in chronic degenerative diseases; hence, the ideal diet has no animal products in it at all.

5. Because cholesterol levels in China are only slightly more that half those in the West, heart disease deaths among American men occur 17 times more often, per thousand men, than it does for Chinese men. Also, Chinese at the lower end of the Chinese range have significantly less cancer and heart disease than those at the upper end.

6. Deaths from breast cancer are associated with 5 factors that are associated with diets high in animal-based foods: high intakes of dietary fat, high levels of blood cholesterol, high amounts of estrogen, high levels of blood testosterone, and early age at first menstruation. The Chinese plant-based diets give them benefits in each of these areas. For example, Chinese girls reach menstruation when they are 15 to 19 years of age, significantly later than the 10 to 14 years of age for most American girls.

7. Chinese people eat very little dairy products, and low levels of calcium-rich foods, yet get far less osteoporosis than people in the Western nations; For example, hip fractures per thousand people in China are only one-fifth of what they are in the West. This reinforces the theory that excessive animal protein causes calcium to be excreted from the body.

8. While the Chinese people eat an average of almost 300 calories per day more than Westerners do, they are generally much less obese. Dr. Campbell believes that in a very low-fat diet, a higher percentage of calories may be burned up, rather than being stored as fat.

9. The amount of animal protein in the diet correlated well with overall cancer rates; hence, dietary protein may be a bigger health problem than dietary fat; thus a shift from red meat and fish is not helpful since, while dietary fat is reduced, dietary animal protein is not; this is consistent with the results for the control group in Dr. Ornish's study.

Taken together, Dr. Dean Ornish's study and the China Project, along with many other recent scientific studies, clearly show that a shift to plant-based diets can have enormous health benefits and can sharply reduce current huge health care expenditures. It can only be hoped that increasing numbers of people will become aware of the "tantalizing findings" from these studies and change their dietary habits accordingly. The health of billions of people and, ultimately, the entire planet are at stake.
