CHICAGO (AP) -- The longest study yet of Dr. Dean Ornish's radical heart-treatment regimen found that more than two-thirds of patients stuck with the ultra-low-fat program for at least five years, and their heart health steadily improved.
In contrast, heart patients assigned to conventional care -- a moderately low fat diet and, in some cases, cholesterol-lowering drugs -- steadily worsened over the same five-year period, Ornish and his colleagues reported in Wednesday's Journal of the American Medical Association.
Without drugs, Ornish's 28 patients suffered half the rate of heart attacks and other adverse heart "events" such as bypass operations and angioplasty procedures, the study found. Twenty of the 28 completed all five years of follow-up.
Skeptics in the medical establishment also say there is no proof these dramatic improvements would occur in the population at large -- all ages and races, and both sexes.
Ornish's regimen calls for patients to become vegetarians, and limit dietary fat to no more than 10 percent of total calories. Patients in the study exercised regularly, received stress-management training and attended support meetings.
His study and others that are similar, however, do not make clear which aspects of Ornish's program work, said Dr. Robert H. Eckel, chairman of the heart association's nutrition committee.
"We need to create recommendations that can be followed by the general public," he said. Too little evidence exists "to recommend that Americans as a whole embrace this highly involved lifestyle."
The results are useful, but there needs to be studies involving thousands of patients before public health recommendations can be made, he said.
But for most people, the AHA guidelines are too moderate to stop heart disease from worsening, Ornish said Tuesday from Sausalito, California, where he directs the nonprofit Preventive Medicine Research Institute.
"It probably worsens more slowly than if you did nothing, but it still gets worse," said Ornish, a Harvard-trained researcher and professor of medicine at the University of California, San Francisco.
The total number of heart "events" among Ornish's 28 patients was 25, compared with 45 among the 20 members of the conventional-care group.
The Ornish patients suffered two heart deaths, two nonfatal heart attacks, two bypass surgeries and eight angioplasties. Blockage of coronary arteries decreased by 3.1 percentage points over five years.
The conventional-care group suffered one heart death, four nonfatal heart attacks, five bypass surgeries and 14 angioplasties. Artery blockage increased by 11.8 percentage points over five years.
The conventional-care group reduced its dietary fat from 30 percent to 25 percent, while the study group reduced fat intake from 30 percent to 8.5 percent.
An expert not involved in the research, Linda Van Horn, professor of
preventive medicine at Northwestern University Medical School, applauded
Ornish's findings but agreed they are too preliminary to form the basis
for sweeping public health guidelines.
