The Rich Roll Podcast - Dr. Dean & Anne Ornish: The Power of Lifestyle Medicine To Undo Disease & Live Better

Episode Date: December 17, 2018

Today we explore what it truly means to live healthy and well. It's obvious that diet and exercise play a crucial role in this equation. Of course, mental health is key. And we're waking up to the importance of meditation and mindfulness. But what about spirituality? What role do connection, relationships and love play in the wellness equation? And how important is purpose? In truth, attention to all such factors is crucial. Because they are indeed connected. Interdependent. And absolutely necessary to live your best life. Our guides for this discussion are Dean Ornish, MD & Anne Ornish — the world-renown, pioneering power couple of lifestyle medicine. An early advocate and practitioner of preventive medicine long before it was trendy, Dr. Ornish is an absolute legend in the plant-based nutrition movement for his groundbreaking work in the holistic prevention and reversal of chronic lifestyle diseases such as atherosclerosis, America's #1 killer. Perhaps best known as the doctor who assisted President Clinton post heart procedure, Dean was trained in internal medicine at the Baylor College of Medicine, Harvard Medical School, and the prestigious Massachusetts General Hospital. He is currently a Clinical Professor of Medicine at the University of California, San Francisco and the president and founder of the nonprofit Preventive Medicine Research Institute in Sausalito. The author of six best-selling books, Dean was recognized as a “Time 100 Innovator”; by Life magazine as “one of the 50 most influential members of his generation”; by People as “one of the most interesting people of the year”; and by Forbes as “one of the world’s seven most powerful teachers. Highly trained and experienced in lifestyle medicine, yoga therapy, mobile applications and web design, Anne Ornish is extraordinary in her own right. The creator behind Ornish Lifestyle Medicine's digital platform, Anne is the powerhouse behind a new paradigm for health care by way of a groundbreaking program that trains health care professionals to support healthy lifestyle progression, better clinical outcomes, larger cost savings, and better adherence than ever before documented. Together they have co-authored a fantastic new book entitled, Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases* — a comprehensive and scientifically proven plan to help you prevent and reverse everything from cancer and diabetes to heart disease, weight gain, and even the aging process itself. A must read, it bookstores everywhere January 8 and is currently available now for pre-order now*. Given Dean and Anne's background, it would be fair to suspect that today’s conversation would be monopolized by diet. Of course we cover nutrition, including the scientific, peer reviewed research supporting the benefits of a plant-based lifestyle and how it measures up against other popular diet and nutrition protocols. But this exchange is also about the myriad of other crucial (and often overlooked or under-appreciated) factors imperative to consider in our personal health, wellness and longevity equation. We discuss the destructive role of stress and anxiety on the immune system. Enjoy! Rich

86% of the $3.6 trillion we spent last year on health care costs, which are really mostly sick care costs, are for treating chronic diseases that we now know are largely preventable or even reversible through changing lifestyle. And when people realize that it's not just about living longer, it's about feeling better and improving the quality of life, it really reframes that debate from fear of dying, which is not sustainable, to joy of living and feeling good and pleasure, which really are. There's no greater wisdom than our inner wisdom. Nobody knows what the feedback loop of our thoughts, our feelings, our behaviors inside ourselves. So the starting point is your personal answer to the question of why do you want to live longer? And not just to live longer and not just

to live longer, but to live better. That's Dean and Ann Ornish, and this is The Rich Roll Podcast. The Rich Roll Podcast. Hey, everybody. How you guys doing? What's happening? My name is Rich Roll. I'm your host. This is my podcast.

Welcome. If you're new, good to see you. Pull up a chair. We got a great show for you guys today. But real quick up top, if you're looking for a cool, a unique holiday gift for a friend or a loved one, anyone who's interested in eating healthier as we launch into 2019, might I suggest our Plant Power Meal Planner, which if you're new to the show and you don't know, is our amazing online recipe platform.

Thousands of delicious, super nutritious, easy to prepare, totally personalized plant-based recipes right at your fingertips, plus unlimited grocery lists that integrate with home grocery delivery in most metropolitan areas, plus an amazing team of expert food coaches at the ready to answer any and all of your questions

seven days a week, no matter how silly. The announcement that I wanna make is that we now have gift cards, which make amazing holiday gifts. So to learn more, get yours, or to sign up for yourself, go to meals.richroll.com. Okay, today's show. So today we're going to go deep into what it means to be and live healthy, to be fully well.

Not just food and diet and nutrition and exercise, which of course are all super important, but also mental health, mindfulness, spirituality, love, relationships, and of course, purpose. That's a big one because these things are all connected. They're all interdependent. They're all necessary to live your best self. And our guides for this discussion are none other than the pioneering lifestyle medicine power couple, Dean and Ann Ornish. For those unfamiliar, Dr. Ornish is an absolute legend. This guy is a trailblazer, a true giant, the OG rock star in not only the plant-based movement, but also as an early advocate of preventive and lifestyle medicine before it was all super cool and trendy. advocate of preventive and lifestyle medicine before it was all super cool and trendy.

Trained in internal medicine at the Baylor College of Medicine, Harvard Medical School, and the prestigious Massachusetts General Hospital, Dean is perhaps best known, you probably have heard of him because he was the doctor who helped President Clinton go plant-based after his heart surgery. Dean is currently the president and founder of the nonprofit Preventive Medicine Research Institute in Sausalito. He's a clinical professor of medicine at the University of California, San Francisco. And he is the author of six bestselling books. Dean was recognized as a Time 100 innovator,

by Life Magazine as one of the 50 most influential members of his generation, by People Magazine as one of the 50 most influential members of his generation, by People Magazine as one of the most interesting people of the year, and by Forbes as one of the world's seven most powerful teachers. And Anne, his lovely wife, is herself highly trained and experienced in lifestyle medicine, as well as yoga therapy, mobile applications, and web design. She's the creator, she's the force. She's the force behind Ornish Lifestyle Medicine's digital platform, which is this really cool groundbreaking program that trains healthcare professionals and all kinds of other people as well to support

healthy lifestyle progression, better clinical outcomes, larger cost savings, and better adherence than ever before documented. And together, Dean and Ann have co-authored a brand new book. It's called Undo It, and it hits bookstores everywhere January 8th. It's available for pre-order now. It's just great, so I highly recommend everybody pick it up. The dynamic duo is coming up in a couple few, but first. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety.

And it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care, especially because unfortunately,

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I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful, and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety.

And it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. I've, in turn, helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care. Especially because, unfortunately, not all treatment resources adhere to ethical practices. It's a real problem. A problem I'm now happy and proud to share has been solved by the people at recovery.com who created an online support portal designed to guide, to support, and empower you to find the ideal level of care tailored to your personal needs. They've partnered with the best global behavioral health providers to cover the full spectrum

of behavioral health disorders, including substance use disorders, depression, anxiety, eating disorders, gambling addictions, and more. Navigating their site is simple. Search by insurance coverage, location, treatment type, you name it. Plus, you can read reviews from former patients to help you decide. Whether you're a busy exec, Thank you. journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. All right, Dean and Ann Ornish. Ann, as you guys are soon going to discover, is extraordinary. The work she is doing in collaboration with Dean has really created a new paradigm of lifestyle medicine,

using lifestyle changes to treat and even reverse chronic illnesses. And if there's one doctor that I've wanted to have on this show from the very, very beginning of this podcast, it's Dean. It took six years to get him here, but here we are today. And you might suspect that today's conversation is going to be all about diet. And of course, we do cover this, including the research supporting a plant-based lifestyle

and how it measures up against current popular diet and nutrition protocols. But this conversation is also about a myriad of other factors to consider in the health equation, like stress and the impact of stress on the immune system and longevity. We go deep on mindfulness, meditation, and our epidemic of mental health, depression. How about purpose? Like I said, that's a big one. It's not just how to live longer, but the why behind that desire that we explore. And of course the importance of connection of meaningful relationships and love. So here we go.

Here's Dr. Dean and Anne Ornish. All right, we're finally doing this. I'm so excited. Thank you so much for coming out. I've been awaiting this conversation for a very long time. Super excited to have both of you here today. We're so grateful. Thank you.

Yeah, really appreciate it. We're big admirers of your work as well. Well, the Mutual Admiration Society is in full effect. Pioneer of not just the plant-based movement, but also lifestyle medicine in general. So it's truly an honor to have you guys here. Thank you. And excited to get into it. I think what I would like to do, what I think would be really interesting and effective is

kind of just address some conventional ideas that are swirling about out there and kind of talk through them. And the first one I want to talk about is this idea that the low-fat diet craze, the low-fat message that seemed to be conventional wisdom throughout the 80s, correct, seems to have been fallen by the wayside. People are saying, well, that didn't work, right? We talked about low-fat for a long long time and people just got fatter. So I'd love to hear your perspective on this. Sure. Well, first of all, unfortunately, because I debated Dr. Atkins so many times and he was the low carb guy, I got pegged as the low fat guy.

Our program has never just been about fat. It's really about a whole foods plant-based diet that's low in fat and sugar and stress management, moderate exercise, and what we call social support, which is really love and intimacy. Or eat well, move more, stress less, love more. That's it. But even the idea of fat, the problem was, number one, people say, oh, Americans have been told to eat less fat. We're fatter than ever. Low fat is dead.

It's all sugar. But we may have been told to eat less fat, we're fatter than ever, low fat is dead, it's all sugar. But we may have been told to eat less fat, but I went to the US Department of Agriculture database because they keep track of the entire food supply, not what people say they're eating, but what they're actually eating. And oftentimes there's a big discrepancy. And what we found is that in every decade since 1950, we may have been told to eat less fat, but we're eating a lot more fat, 67% more fat, more sugar, more meat, and more calories. More of everything. More of everything. So not surprisingly, we're fat, not because we're eating too little fat, but we're eating a lot more fat, 67% more fat, more sugar, more meat, and more calories.

More of everything. More of everything. So not surprisingly, we're fat, not because we're eating too little fat, but because we're eating too much of everything. Yeah. So the idea is that it's not that the low fat thing didn't work. It's that people didn't actually do it. And the other thing is, besides eating more fat, is people, when they did replace fat,

they would replace it with sugar. So you have the Snackwell cookies and the Intimid's cakes and things like that, and that's not a good choice. But I think if you actually look at all of the data, there's more evidence than ever that an optimal diet is low in fat and low in sugar. It's predominantly fruits, vegetables, whole grains, legumes, soy products in their natural forms. And we've been doing studies for 40 years. So having been in all these different diet wars and diet debates, I said, look, I'm done.

Every study that we've done has shown that these same lifestyle changes can reverse heart disease. We were able to show that for the first time. Type 2 diabetes, high blood pressure, high cholesterol, obesity. We're doing the first randomized trial now to see if we can actually reverse Alzheimer's disease. We found that when you change your lifestyle, it changes your genes. We're doing the first randomized trial now to see if we can actually reverse Alzheimer's disease. We found that when you change your lifestyle, it changes your genes.

Hundreds of genes, over 500 genes in three months, turning on the good genes, turning off the bad genes in just three months. We found that in a study we did, we published that with Craig Venter who first decoded the human genome. We did a study with Elizabeth Blackburn who got the Nobel Prize for discovering telomeres, the ends of our chromosomes that regulate how long we live. We've showed for the first time that in just three months, we can increase telomerase, the enzyme that repairs and lengthens telomeres, by 30%. And over a five-year period, we showed again for the first time, we can actually lengthen telomeres, in a sense reversing aging at a cellular level.

other level. So the more diseases we study and the more underlying mechanisms we look at, the more reasons we have to explain why these simple changes are so powerful and how quickly people can get better. What do you think that the challenges are that you face in trying to communicate this message? Because if you canvas the conversations that are occurring right now, they do tend to swirl around this new obsession with eating a high-fat diet and everything you ever heard about saturated fat is wrong and people are all about keto. And there's always a new thing coming, right? A new craze, a new trend.

This is something you've been immersed in this for 40 years at this point. And your message really hasn't changed from these studies that you did so long ago to date. I mean, they just sort of continue to confirm what you've been saying all along. Well, it may seem new, but it's not new. I mean, I've been hearing this for 40 years. It actually goes back to the 1800s. It's really just, it's an Atkins diet redux, whether it's an Atkins diet, a paleo diet, a ketogenic diet, it's all the same thing. And first of all, telling people what they want to hear is always a good way to sell books or magazines or newspapers or whatever. And as those media have been so disrupted, they're always looking for the next

thing that they can hook readers with. Number two is that the studies are showing quite clearly that, yeah, you can lose weight on these diets because most people do eat too many refined carbs. And so eating fewer refined carbs, you're going to lose weight. And Atkins and I agreed on that. It's what you replace them with. I'd love to be able to tell people that steak and burgers and so on are good for you, but they're not. And if you actually look at the ideas to lose weight in ways that enhance your health rather than mortgage it. And there was a study in the New England Journal of Medicine that Stephen Smith published a few years ago that showed actually pictures of what happens on different diets, what happens in your arteries. I mean, you can lose weight with

chemotherapy or smoking cigarettes or lots of ways of losing weight that aren't really good for you. Amphetamines are a good way of losing weight. And what they found is that on a whole foods plant-based diet, your arteries are clean. On a typical standard American diet, which has the great acronym of SAD, they're partially clogged. And on a high-fat, high animal protein diet, whether you call it an Atkins or a keto or paleo diet, they're severely clogged. And even if their weight and even if their blood pressure may be lower, because these often work through what are called non-traditional risk factors, things that people, you know, the little white blood cells that nibble your arteries and keep them clean and so on. And it's not even just about over long periods of time, even a single meal that's high

in fat and cholesterol can reduce blood flow to your brain, can reduce blood flow to your heart. There's, you know, the movie that James Cameron and Luis Sajoyos and others did, Game Changers, which will be coming out soon, has this great scene with three athletes, and they give them a plant-based meal, and then they measure the frequency and the hardness of their erections at night. And then they give them a meat-based meal the next night and did the same thing.

And they found they had 300% to 500% more frequent erections on a plant-based meal than a meat-based meal and 10 to 15% harder erections. In fact, I'm told the film crew became vegan after shooting. Yeah, that will definitely get God's attention. Because it takes it away from this fear-based approach like, oh, I can't do what I want. You know, am I going to live longer? Is it just going to seem longer? All those kinds of cliches to say, oh, these things are so much more dynamic than we once realized, that when you eat this way, your brain gets more blood flow. You can actually grow so many new brain neurons in just a few weeks.

Your brain gets bigger, and particularly those parts of your brain like the hippocampus, the control memory, that you want to get bigger. When people get older, they say, where did I leave my keys? And what was that person's name? A lot of that's reversible. Your skin gets more blood, so you don't age as quickly. Your heart gets more blood. We found you can reverse heart disease. Your sexual organs get more blood flow. And when people realize that it's not just about living longer, it's about feeling better and improving the quality of life, it really reframes that debate from fear of dying, which is not sustainable to joy of living

and feeling good and pleasure, which really are. Right. There seems to be a lot of confusion out there right now about saturated fat and cholesterol. For years, the consensus, the scientific nutrition consensus was that saturated fat was bad. High LDL is bad.

And then suddenly some studies came out that caught the attention of the media. And there were a lot of headlines and a lot of articles written about this idea that everything you ever heard about saturated fat is wrong. Cholesterol is something that we need and it's good. And you shouldn't worry about saturated fat that actually saturated fat is a health food so can you walk me through how we got to this point

and perhaps um you know clarify the record or share your perspective on on this i remember i was in davos at the world economic forum two and a half years ago when time magazine put uh a stick of butter on their car is back yeah and uh nancy gibbs was the editor-in-chief at the World Economic Forum two and a half years ago when Time Magazine put a stick of butter on their cover. Butter is back. Yeah. And Nancy Gibbs was the editor-in-chief at the time, and she was doing this one-on-one interview with me. And she said, so what did you think of our cover? And I said, well, not so well.

And she said, well, why not? I said, well, because it's not true. The studies are showing that saturated fat doubles your risk of Alzheimer's disease. For every one pat of butter, your risk of premature death from all causes, we look at 300,000 people in the Harvard Physicians and Harvard Nurses Health Study, goes up by 5%. So these things really are important. Now, cholesterol is good in the sense that your body needs cholesterol. It's a building block for sex hormones and nerve coverings and all kinds of

things. And precisely because it's so important, your body will make all the cholesterol it needs. The dietary requirement for cholesterol is zero. But getting all this extra cholesterol, we found in our studies that there was a dose-response relationship between the intake of dietary cholesterol and dietary fat and changes in the blockages in the arteries. This was also found in what was called the CLAS study that David Blankenhorst did at USC many years ago. It was one of the first studies to show that cholesterol-lowering drugs could reverse heart disease. And he found that the same dose-response relationship, the more fat you consumed, including saturated fat and especially saturated fat, the more clogged your arteries become.

And even a single meal, as we've been talking about, makes a difference. So, I'd love to be able to tell people that fat is good, that it's all sugar, but it's not. An optimal diet is low in both. Now, the third aspect is animal protein, which people, this whole fat versus carbs debate, I want to make sure that we cover animal protein because there's more and more evidence coming out showing that animal protein is inflammatory. It causes chronic inflammation, it causes oxidative stress, and independent of its effect on, you know, the fat versus carbs. One study came out that showed that people who ate a lot of animal protein had a 75% increased risk of premature death from all causes and a 400 to 500% increased risk of premature death from type two diabetes and prostate, breast and colon cancer. So, you know, again, people like to simplify things and it's like, it's all one thing. It's

not one thing. It's all these things. And it's not even just diet, but it's all these other lifestyle factors as well. I want to get into the animal protein thing. But before we do that, just to kind of continue this thread on saturated fat, explain to me the study that led to this misconception. And there was a study that came out, correct? And everybody kind of latched on to this. Well, there are a lot of studies that have come out. And the problem is they often do what are called meta-analyses where you combine and kind of lump together lots of different studies.

And in science, you're always trying to answer the question, is this a real finding or is this a chance finding? And by convention, if there's less than a 5% chance of it being due to chance, it's considered statistically significant or a real finding. The problem is when you mush together a lot of different studies, there's a lot of noise. People don't always tell you the truth about what they eat on diet studies. I mean, they tell you what they think you want to hear. So they'll... There's an adherence problem.

There's an adherence problem. But more than that, there's a lack of accurate information. Like people don't want to tell you oftentimes. I mean, in our studies, we work with smaller groups of people and we really hammer them about how important it is to tell us the truth. There's no shame, there's no guilt. Because if you, for example, I tell patients, if you tell us you're eating a healthy diet, and you're really not, then it looks like the diet's not working when you're really just not following it. And so oftentimes, people don't tell us the truth about or don't tell other people the truth about what they're actually eating. So the more noise you have, the harder it is to show significant differences.

So if you've got a lot of noise and people say, oh, well, saturated fat really isn't correlated with these things because it's not statistically significant, more often than not the real issue is because the information they were getting wasn't accurate in the first place. Interesting. Or it's skewed by other data. Yes, or it's skewed by other data.

Right. It's skewed by other data. Yes, or it's skewed by other data. Right. On the animal protein issue, is it something inherent in animal protein itself or is it everything that comes with the animal protein? Like what is the difference between how the body metabolizes animal protein versus plant protein?

Or is it like the saturated fat and cholesterol that generally is conjoined with the intake of animal protein versus plant protein? Or is it like the saturated fat and cholesterol that generally is conjoined with the intake of animal protein? Well, animal protein is harmful. And plant-based protein is not only not harmful, it's actually protective. There are literally hundreds of thousands of substances in fruits and vegetables and whole grains and legumes and soy products that have anti-cancer,

anti-heart disease and anti-aging properties. Things like phytochemicals, bio anti-cancer, anti-heart disease, and anti-aging properties. Things like phytochemicals, bioflavonoids, carotenoids, retinols, isoflavones, genosine, lycopene, there's a whole alphabet soup of these things. And where do you find them? With few exceptions, you find them in plant-based foods.

The animal-based foods, besides being high in saturated fat and dietary, I mean, you only get dietary cholesterol in animal products, is the animal protein itself is inflammatory. And in our new book, part of what this kind of unifying theory that we're putting together for the first time is, why is it that these same lifestyle changes are so powerful? The more diseases we study, the more underlying mechanisms we look at, the more reasons we have to explain why these changes are so powerful. And it's because although we tend to think of heart disease as being different than diabetes,

different than prostate cancer, and different than Alzheimer's disease, and so on, the radical idea here is this unifying theory is that they're not. They're different expressions of the same underlying disorders. The mechanisms like chronic inflammation, oxidative stress, overstimulation of the sympathetic nervous system, changes in the microbiome, changes in, as we've been talking about, in gene expression, in telomeres, in angiogenesis. And each of these mechanisms, in turn, is affected by what we eat, how we respond to stress, how much exercise we get, and how much love and support we have. And so, seen in this larger context, the animal protein activates all of these different

mechanisms in negative ways, which is what makes it harmful, independent of the fact that it's also high in saturated fat, dietary cholesterol, and other things like that. Well, and of course, the animal is a secondary source of the protein, the source of the protein, versus going right to the plant source of the proteins. I mean, you talk about the protein myth of living a plant-based way of life. Well, I mean, you know, it's like people say, oh, I'm not going to get enough protein on a plant-based diet. Then you say, well, ask Mr. Elephant, you know,

or ask Rich Roll. I mean, you're a living example of what can be done on a plant-based diet. I mean, most guys would be happy to do half of what you can do. Yeah, the animal protein myth persists. The idea that you can't meet your protein needs on a plant-based diet is a difficult hurdle for a lot of people to mentally overcome.

And I feel that question every single day. I'm sure you do as well. What do you tell people? You know, it's funny. I have like, I just, that's an always evolving response. There's always the retort of like, look at these gigantic herbivores, they don't have a problem.

But that generally leads to, yeah, well, they have different digestive mechanisms and then you have to go into the whole reason why that's not applicable, blah, blah, blah. I basically ask people, I say, well, what do you think protein is? What is protein? I think most people don't even know what it is.

We're just parroting what we've been heard our whole lives. If you say, look, protein is basically made up of these amino acids. They all are found in the plant kingdom. There's nine of them that you can't synthesize on your own. You need to get them from foods. And plant foods are rife with those nine amino acids. And I've never had a problem.

I just say, look, I've been doing this for 12 years. I've been able to go out and do these athletic things. I've never been hindered. At 51, almost 52, I still can build lean muscle mass and recover quickly in between workouts and perform at a high level. So, you know, do your own research on yourself. What do you say? I'm just laughing because when you say I can perform at a high level, that's like saying Michael Jordan used to be a pretty good basketball player. Yeah, well, you know, I mean, I think Game Changers is going to go a long way towards changing people's minds.

I agree with that. It's true. And even dietary cholesterol. I mean, if you actually, you know, some people eat so much dietary cholesterol, they'll say, well, if you have six eggs versus four eggs, it really doesn't change your blood cholesterol level. It's because those cholesterol receptors are already saturated. But there, you know But in our studies, we found there was a dose response correlation. The more dietary cholesterol you consume,

the more arteries, the more blockage we found in the people's arteries. So again, your body will make all the cholesterol you need. It's the excessive amount that leads to problems. Right. One of the criticisms that you've had to weather over the years is the fact that I know this new book has this unifying theory, but you've always had this unifying theory, which is that if you want to get well and stay well and prevent these diseases that are killing and disabling millions of people every year, it's not just one thing. It's diet, it's lifestyle, it's exercise, it's community, it's love, it's mindfulness,

it's stress reduction, it's all of these things. And yet that has exposed you to critique saying, "'Well, see, it's not the diet. "'It's the fact that he got these people to stop smoking "'and make all these other changes. So who's to say what was what? Well, this goes back to the larger question of what is science? And the whole point of science is to try to say, is this a real finding or is this a chance finding? And the classic way of doing studies is to say there's one independent variable,

you're doing one thing like just diet alone or just exercise alone, and then one dependent variable, we're measuring all the things that happen because of those changes. Or we give people a drug, a pill, and say, what happens? Now, if you're dealing with a pill, maybe you can control everything but one thing. But when you're changing lifestyle, you may think you're just changing one thing,

but you're never just changing one thing. Let's say we want to put people on an exercise program. So half the patients are exercising and half of them don't. We're going to measure the effects on whatever, on their cholesterol or their blood pressure or their weight or their heart disease or whatever. The problem is that you may think you're just doing exercise, but when you put someone on an exercise program, as I'm sure you know from your experience, they're generally exercising in a group of people. The group support is an important component of our program. You're giving people a positive group of people. The group support is an important component of our program.

You're giving people a positive sense of control over their lives. You're giving them a positive expectation. You're giving them a sense of control of what they're doing. When you exercise, you become more aware of your body. You generally tend to change your diet when you exercise because you're more aware of how what you're eating affects you. And so rather than saying, and there was a great study that was done of rabbits, you know, just to illustrate the point, this was in the journal Science,

which was generally a really prestigious, very often dry journal. And they had these rabbits, and they were all on the same diet, and they were all genetically pretty much the same. So they assumed that all the rabbits would get blockages in their arteries. It was a high fat diet. They assumed they would all get blockages in their arteries to the same degree, but they didn't. And they looked into it further and they found that the rabbits who were stacked in cages up to the ceiling, the ones up high got a lot more blockages in their arteries and their heart than the ones that were down low. And that didn't make any sense. They thought, well, maybe the air circulation or what, they couldn't come up with an idea. Finally, they figured it out. The lab technician who was short, when she would feed the rabbits,

would play with the ones in the lower cages because she could reach them and play with them and pet them and ignore the ones up high. So they did another study where they took a group of rabbits and they put them all, again, genetically the same, on the same diet. But one group they left alone, and the other group they would talk to them and pet them and play with them and love them and then kill them to look at their arteries. And they found they had 60% more blockages in the arteries that were ignored,

the arteries of the rabbits that were ignored than the ones that were touched, talked to, and played with, even though they were genetically comparable on the same diet. So this idea that you're only changing one thing is a myth. You're never just changing one thing. And so in our approach, we say, look, everything that we're doing, we know is independently linked with heart disease. There's certainly a lot of evidence that exercise is good for you, look, everything that we're doing, we know is independently linked with heart disease. There's certainly a lot of evidence that exercise is good for you, that managing stress is good for you, that a healthy diet is good for you, that love and support is

good for you. And there's a synergy that comes when you do all these things at the same time. So unlike most things we do as doctors, the only side effects of these are good ones. So we're saying taken as a whole, we're getting these outcomes. Now, to answer your question, say, well, how do we know that it's not all due to exercise and not to the diet? Well, first of all, no studies have ever shown that exercise alone or meditation alone or social support alone can actually reverse heart disease. Second, we've done what are called multiple regression analyses, where we can look at the relative contribution of each component statistically. And we found that each component is directly linked with the more you do these things, the more you, the more closely you adhere

to the diet, the more you exercise, the more meditation you do, the more love and support you have, the more improvement we measure in the arteries and in every metric we look at. And so, you know, we get held to a different standard than most studies do. But the fact is that the only side effects here are good ones. And I think also in science, you're always looking at average changes in one group versus average changes in another. But for one person, if you did an N of 1 study, who's really stressed out but eating pretty well,

the stress management is going to be more important. For someone else who's really stressed, I mean, eating badly but isn't so stressed out, the diet may be important. So you lump all these people together and you can say, on average, there are these changes. But all of these things are independently important. And like I say, no one has ever shown, the only diet that's ever been shown to reverse heart disease, for example, is a whole foods, plant-based diet that's low in fat and low in sugar.

And I would just challenge the people who are doing the paleo or keto or Atkins or whatever name you want to give to this to say, show me the data, show me a study showing that you can reverse heart disease on any of those diets and I'll be the first to say, great, but they don't exist. In fact, the studies show just the opposite. Are you familiar with the carnivore diet craze? I haven't heard that one. Oh, you haven't heard about this no so there's a there's a swath of people right now that are that are uh eating nothing but red meat basically and claiming all kinds of health benefits by the way you remember those

those uh i think it was metlife insurance ads they say my insurance why do you ask it was like a piano about to land on their heads you know i would them the same question. It's a weird catch-22 because human beings, by our very nature, are reductionist. We want to put things in neat and tidy categories. And the scientific method, in order to function at its best, needs to be reductive. And yet, that belies the truth that these things are much more complicated and they are interdependent. And even if you constructed the most rigorous study of all time, how are you going to measure the psychological impact on somebody who begins to make a change starts to feel better and then becomes more emotionally invested in um you know working on other areas

of their life like all of these things exactly work together so here's what we're doing in the new book okay i've been a veteran i can't tell you how many times i debated dr atkins and by the way his autopsy which those videos on on youtube are. There's a lot of them. I know. And all of his acolytes, the Gary Taubes and others. But I'm done with that. I mean, first of all, Dr. Atkins' autopsy report got released. It shouldn't have been, but it was. And it showed that he died of heart failure. I mean, he didn't die because he slipped and landed on his head. He died because he was in heart failure. That says it all right there. But in this new book, I'm saying, look, I'm done with all these diet wars. You can go around in circles and round and round and round and round.

We've been doing this work for 40 years. Every disease we study, every mechanism we look at, gets better. We were able to show we can reverse heart disease, diabetes, early stage prostate cancer, by extension breast cancer, high blood pressure, high cholesterol, obesity. And we're now doing the first randomized trial to see if we can reverse Alzheimer's disease, which I think is going to work. And so the message that we're giving to readers is to say, look, it works. The more diseases we study, the more mechanisms we look at, the more reasons to say, look, it works. Okay. The more diseases we study,

the more mechanisms we look at, the more reasons we have to explain why it works. Take it as a whole. Now we can parse out how many angels dance on the head of a pin, you know, what the relative contribution of each component is. But the fact is, is that the only side effects of each of these things are good ones and they work, you know? And so we're basically saying, look, here's what we did. Here's what we found. And did this fantastic section of the book on here's how you can do it. And boom, that's it. You know, if you don't want to do it, don't do it, you know, but if you want to do it, this has more science behind it than anything. Right back to what you were saying. Yes. The

intervention has remained the same over the last 40 years. And that that says a lot in itself with all the other fads that come and go. But what has evolved are those mechanisms and additional diseases that we've been able to study that have been basically reversed with our same lifestyle intervention. So I think that it's just a mounting case of evidence. Right. Right. I wanna talk about the book, but I think it would be worthwhile for people

that are listening or watching who are coming into this new and unfamiliar with both of you to track it back to the beginning. Like how did you get involved in this field to begin with? Like what made you interested in lifestyle medicine? What was the path that led you to this place? Oh, gosh. Long, long ago in a galaxy far, far away.

In a log cabin. No, that was a different lifetime. We can talk about different lifetimes. We're going to talk about your guru. We're trying to build our credibility here. I personally got interested in this when I was a freshman in college at Rice University in Houston and almost killed myself. I was so profoundly and suicidally depressed. And there's an old saying that when the student is ready, the teacher appears. And there was an ecumenical teacher

named Swami Satchidananda who came into our home in Dallas and changed my life. And it's a longer story, but I found I could take all the meaning out of life. I could, you know, who cares? So what? Nothing matters. Big deal. Why bother? You know, nothing matters. And I, you know, I felt like I was really stupid and that I was, you know, I somehow managed to fool the admissions committee into letting me in. And now that I was with a bunch of really smart kids, it was just a matter of time before they figured out what a mistake they'd made in letting me in. And now that I was with a bunch of really smart kids, it was just a matter of time before they figured out what a mistake they'd made in letting me in. But beyond that, I felt like nothing can bring lasting happiness.

I had this kind of spiritual vision that was more than I could handle at the time. And so the combination of feeling like I was never going to mount anything because I was stupid, and even if I did, it wouldn't matter anyway. I thought, well, what if I had really a lot of money or a lot of power or fame or whatever, that would do it. And I knew that it wouldn't. And so I was ready to do myself in. So my parents had this cocktail party for the Swami. This was back in 1972, because he really helped my older sister. And in walks this kind of central castings view of a idea of what a Swami should look like, long white beard and saffron robes, the whole thing.

And he gave a satsang, a lecture in our living room, and he started out by saying, nothing can bring you lasting happiness, which I'd already figured out, except I was about ready to do myself in, and he was glowing. I was like, what am I missing here? He went on to say, so it probably sounds like a New Age cliche,

which was that nothing can bring that to you, but we have it already if we just stop disturbing it. And then the great irony of life, that we run after all these things, if only I had more or whatever, then I'd be happy. And then the great irony of life that we run after all these things. If only I had more or whatever, then I'd be happy. And then until you get it, you're not happy.

If someone else gets it, then you're really not happy. And even if you get it, it's great for a little while, but then it's either now what? It's never enough or so what? Big deal. So I said, okay, I can always,

I move killing myself down to plan B. And so let me try this weird stuff. So part of what he said was eat a plant-based diet, meditate, exercise, you know, have more love in your life. Ultimately, he gave me this program. This lifestyle program really came from him. That's amazing. You know, and I thought... Hold on a second. All right. So did you have like hippie parents? Oh, no. I mean, how did you like... This is in like Houston? Are you in Dallas? I was in Dallas. You're in Dallas, right? So first of all, how do your parents even know how to get Satya Dhananda to come to your house?

My older sister was kind of a child of the 60s and it really helped her a lot. So when he came to Dallas to give a lecture, she let them know he was in town. So they decided to have a cocktail party for him. You can imagine how weird that was in Dallas in 1972. Yeah. I'm like, this is not Topanga Canyon, right? No. I mean, it would be weird today in Dallas, but it was especially weird back then. And you're like an 18-year-old kid? Yeah, I was 18 years old. And I said, okay, so I want to do this. I couldn't even sit still long

enough to meditate. So he taught me how to do a walking meditation. So I changed my diet, radically changed my diet from eating chilies and cheese burgers and chalupas and all kinds of meat five times a day to eating a plant-based diet and trying to meditate as best I could. And I began to get little glimpses of what it meant to be happy. And the whole message that he has, which I think is so profound in my limited experience, is where healing occurs at its deepest levels, is that our whole culture teaches us that our happiness and our health we get from outside of ourselves. And then it becomes, okay, how do I get all this stuff that's going to make me happy? And again, if only I had more blank, more money, more power, more beauty, more sex, more accomplishment, whatever you fill in the blank, then I'd be happy. But then in the process

of running after all these things, we disturb his his message is you have that already. It's our nature to be happy and healthy and not be mindful of that. And then what perhaps is the ultimate irony, we end up running after all these different things that we think are going to bring us what we are, what we could have already. But in the process of running after them, we disturb what we already have. So he said that the goal of all these various changes in your diet and spiritual practices, I mean, we're all going to die. It's just a question of when. So then the question is not just how long we live, but how well we live.

And he would say that the goal of all these different spiritual practices is not that they bring you health or they bring you a sense of peace. You have that already. We are easeful and we disturb that and get dis-eased. You know, we are fine and we define ourselves by I'm this, I'm that, you're not that, and we distance ourselves and isolate ourselves from that. And so the goal of all these things that Anne teaches so beautifully is to quiet down our mind and body, to experience that we have that already. And even if it's a glimpse of that.

So, I mean, I was at the point where I couldn't read a headline on a newspaper and tell you five minutes later what it said. I was so messed up and so disturbed. But then I began to try these things. I got little glimpses of what that meant. And that was enough to kind of encourage me to do more. And so, you know, people would later in life, he liked to make puns. People would say, what are you, a Hindu? He'd say, no, I'm an Undo.

This is where the title of our book came from. That's the title of the book, right? That's right. And also my favorite key on the computer Has always been the undo button I thought wouldn't it be nice If we had that in our lives And now we do

But so I tried that And so I began to get glimpses of that And it changed my whole life And I went back to school Graduated first in my class Gave the baccalaureate I mean it was And I say that not to be self-aggrandizing

But just to say I went from not being able to read a headline And tell you five minutes later what it said to doing extremely well. And just not to interrupt you, but in addition to changing your diet and adopting some type of meditation practice and sort of studying his teachings, what were the practices that you employed that allowed you to make that shift? The spiritual practices? Yeah. Meditation, exercise, you know, yoga type stretching, breathing, which is called pranayama, meditation, deep relaxation, and service, you know,

all the various aspects of yoga. You know, most people think of yoga, they think of just the hatha or the stretching, that's just really the beginning. The really, the goal of yoga. You know, most people think of yoga, they think of just the hatha or the stretching. That's just really the beginning. The goal of yoga is, and I kind of got into it backwards, you know, because the whole goal of yoga is to quiet down our mind and body to experience on one level that we have already everything we need. You know, we are already peaceful, we are already happy until we disturb it. And that becomes a very empowering thing, because instead of blaming other people, I can say, what am I doing that's disturbing my health and well-being? Because I can do something about that, not to blame, but to empower. Now, if you take meditation even further, it gives you this direct experience of non-duality, of oneness, that on one level,

you're separate. You're you and I'm me, and we can have fun having this conversation. But another level, we're part of something larger that connects us all, whatever name you give to that. I mean, even to give it a name is to limit what's really essentially an ineffable or limitless experience. And he would call that the double vision, that you can see the unity and the diversity. And you can really, he liked to use the analogy of in a movie projector,

the light behind the projector is the same, and then it gets filtered through the film and all these different dramas and names and forms but you can really only enjoy that if you don't get caught in it if you can remember that yeah this is really fun but ultimately we're that sense of oneness and even the word healing

comes from the word to make whole yoga comes comes from the Sanskrit to yoke, to unite, union these are really old ideas that were rediscovering so when I went back then I went to medical school It comes from the Sanskrit to yoke, to unite, union. These are really old ideas that were rediscovering. So then I went to medical school, also in Houston, at Baylor College of Medicine. And I was learning how to do bypass surgery with Michael DeBakey,

one of the eminent people who invented bypass surgery, one of the most eminent heart surgeons who ever lived. And we'd cut people open. We'd bypass their clogged arteries, you'd tell them they were cured, and more often than not, they'd go home and eat junk food and smoke and not manage stress, not exercise. Their new arteries would clog up, they'd come back, we'd cut them open again. So that became the metaphor.

They were literally bypassing the problem without treating the cause. And one of the nice things about being a medical student is you're not fully indoctrinated yet. So I started reading the literature, went to these buildings called libraries, and they had these things called books and journals that were dusty and you'd pull them off the shelves. And I got really obsessed with this. Like in dogs and cats and pigs and rabbits and monkeys, you could cause them to get heart disease if you put them on a high animal protein, high fat diet, or didn't let them exercise or made them smoke or isolated them or stress them. And you could reverse it if you change those things. I said,

why should people be any different? And everybody thought that was a crazy idea. So I took a year off between my second and third years of medical school, much to my parents' dismay, to do a pilot study of 10 men and women, put them in a hotel in Houston that donated their, I asked every hotel in Houston, find the last one, said, we'll give you 10 rooms. And the chief of medicine said, look, there's a dumb idea, but you'll learn something, go for it, you know? And it worked. And eight of the 10 people showed significant improvement in their blood flow to the heart. That had never been shown. And they, most of them became pain-free. And in fact, Michael DeBakey, the heart surgeon who was merciless to me at the time, he said, what year are you, son? I said,

I'm in second year. He said, oh, it's going to be so much harder to kick you out of school now with these crazy ideas you have. It's crazy that everyone thought that was a crazy idea. If it was working in lab animals, why would it not work in humans? That's the thing, because it just didn't fit. In fact, he called me a couple of years ago. He was 99 years old, right before he died. He said, I just, and I recognize his Louisiana accent. He said, I just want to thank you. I said, I almost fell over because this was the guy who was trying to kick me out of school at the time with these crazy ideas.

I said, well, thank you, but why? He said, well, because your ideas really kept me alive to age 99. And I just, I thought they were really dumb at the time, but I just want to thank you. And he died a few months later. It was, you know, so if you live long enough, you never know. Right. So then I did, then I went back and then went to Harvard and Massachusetts General Hospital. I mean, the things that seem so obvious to me, I remember when I was a senior resident at the Mass General, which was the number one hospital in the world at the time, probably still is. And one of the senior attending physicians who wrote the textbook said, Dean, you mean that you think the mind affects the body? What a stupid idea. And I looked at him, I said, Dean, you mean that you think the mind affects the body? What a stupid idea.

And I looked at him and I said, well, sir, have you ever had an erection? Yeah. I mean, just things that seem so obvious are really considered radical. And then, you know, they've been doing stents and angioplasties for 40 years. And then all the randomized trials have come out.

There are eight of them now that show that in stable patients, they don't work. They don't prolong life. They don't prevent heart attacks. They don't even reduce angina. And they're dangerous, invasive, expensive, and largely ineffective. Now they can be life-saving. You're in the middle of having a heart attack.

But profitable. But very profitable. That's the thing. And so it's not enough to have good science. That's why I spent 16 years to get Medicare to reimburse our program. Because through my nonprofit institute, we were training hospitals and clinics around the country. We got bigger changes in lifestyle, better clinical outcomes,

bigger cost savings, better adherence, and a number of the sites closed because we didn't have the reimbursement. So that set me on a 16-year journey to get Medicare coverage, which I'm grateful that they did. They created a new benefit category. Now most of the insurance companies are paying for it. So we're now training sites and really trying to create this whole new paradigm of healthcare. Yeah, that's a big deal when it becomes reimbursable by the insurance companies. I'm sure that was a tall mountain to climb. Oh, it was like 16 years. I had no idea it'd be so hard.

But if it's reimbursable, then it's sustainable. And so I'm really grateful that we were able to do that, but it was the hardest thing I've ever done. Anne, I want to bring you into this. I don't want it to be like I'm ignoring you. There are a lot of good points that need to get covered, baseline. Yeah, yeah, yeah. So how do you enter the equation here? Well, I was in many ways. I mean, Dean and I have worked together for 20 years.

And I am the director of our nonprofit as far as developing the Preventive Medicine Research Institute. So I direct program development. And one of the ways I do that is the digital platform. So I've built a learning management system that is what trains the healthcare providers to have a turnkey way to deliver this program. And all the hospitals and clinics around the country. Yeah, across the country. And then also the core curriculum for participants to attain that health literacy, to go from what are the nuts and bolts of living this way, ultimately until nine weeks later, really learning why do I want to live longer. And I think that's something that I would love to touch on because you know I think a lot of times fear is the motivator when we're working to

reverse a condition. People will have a diagnosis or some kind of pain, trauma that brings them into this way of living. But then what really allows them to continue this way of living for the rest of their lives is to ask themselves the question, and it's a unique answer for each of us, is why do you want to live longer? And Dean started saying, you know, when he was 18, he was so severely depressed, which is another epidemic in our country. You know, first is, you know, many people don't even really want to live longer. So I think that is a really core question. And I think going deeper into that inquiry is to say not only to live longer, but to live better. And so initially, it might be I want

to have the pain stop, I want to, you know, kind of have the rest of my life to look forward to. So then the question is, what? What is the meaning, the sense of purpose that's driving you to get up every day? And I just think that's so core, because again, it's not something outside of ourselves. It's not your doctor or your spouse telling you, you should do this. This is the good thing to, you know, this would be good for your health. That only works for so long. It really has to come from the inside and we have to identify with what that is for us personally. And then we need to kind of re-up with that and amplify that throughout our days with every choice that we make. Yeah. Let me just build on that real quickly because earlier we were talking about how I could take all the meaning

out of everything when I was so depressed. But later I learned we can actually put meaning into our lives. We can imbue our choices with meaning. And one way is by choosing not to eat certain foods, for example. I think that's why all religions, all spiritual paths, almost all of them have dietary guidelines, and they're often in conflict with each other. One religion, you can eat this, but not that,

or certain days of the week, or certain times of the day, or certain months of the year, whatever. Is God confused? I don't know. But whatever intrinsic benefit there is in making diet and lifestyle changes, just the act of choosing not to eat something that you otherwise could do, or the act of saying, I'm going to be in a monogamous relationship, or whatever. Is that deprivation? Well, it can be. That's often how it's portrayed.

Or is it, first of all, what I gain is so much more than what I give up. But beyond that, because these underlying biological mechanisms are so dynamic, but beyond that, it's like just the act of choosing not to do something, like not to eat certain foods, it imbues those choices with meaning and makes those choices sacred. Not sacred in the boring sense, but the most special, the most fun, the most erotic, the most pleasurable, the most meaningful. You know, Viktor Frankl wrote this book years ago called Man's Search for Meaning. And he interviewed concentration camp survivors in the most dire circumstances.

And he found that the ones who lived weren't necessarily the strongest or the healthiest. They were the ones who had the strongest sense of meaning and purpose. Like, I have to survive so that I can, you know, be reunited with my loved ones or bear witness or whatever it happened to be, just like Anna's talking about. So, when people enter our program, one of the first questions we ask them is, why do you want to live longer? People go, oh, no one's ever asked me that before. Yeah, I think that that goes directly to the crux of so much of what ails us as a society, as a culture. And systemically we're not raised or taught to think in those terms.

No, just the opposite. Led us to a grand crisis of consciousness that is really fueling this epidemic of depression and suicide. You can clean up your diet and eat a plant, you have the most pristine plant-based diet. And that will, I believe, catalyze other changes in your life. It will have this effect that will spill over into hopefully leading you to a more purposeful direction in your life. But

if you get stuck on the food and think that's going to solve all your problems, you're missing the big picture. And I really, I'm so glad to hear you say that, because I really think that that is, you know, more important than any of the, you know, epidemiological studies or meta analyses. It's like, if you can't find purpose and fulfillment in your life, then nothing else, what else matters? Well, that's the point. And so much of what we see now is, you know, and I ask people in our studies, because we would live together for a month at a time in our earlier studies, or meet regularly for years at a time. I'd say, teach me something. Why do you smoke?

Why do you overeat? Why do you drink too much? Why do you abuse opioids? Why do you work too hard? Why do you play so many video games? These behaviors seem so maladaptive to me. They kind of look at me, they go, you don't get it, do you? These behaviors aren't maladaptive.

They're very adaptive, because they help us deal with our pain, our loneliness, our depression. You know, there's been a radical disruption in our culture in the last 50 years with the disruption of the social networks that used to give people that sense of connection and community. Most people don't have a neighborhood that feels, you know, with two or three generations of people or a job that feels secure where you've been there for 10 years or an extended family you see regularly or a church or synagogue. And what we're learning is that people say things like, I've got 20 friends in this pack of cigarettes and they're always there for me. You're going to take away my 20 friends? What are you going to give me? Or you can build on that. To build on that is not only why do you want to live longer, but the compass of that is self-reflection and

self-awareness. And if we have that as much throughout the day so that we can connect the dots between what we're feeling, what we're thinking, and what we're doing, and then that feedback loop of how that makes us feel. So for somebody who's crutching along with their 20 friends in their pack of cigarettes or the video games or whatever it is, it's numbing them, and really the next level for them is like, that's just kind of my getting by standpoint.

But if you really look what's below the numbing, which is really where the the locus of control is and where the transformation takes place really is that if you can connect the dots that those things aren't actually moving the needle of you feeling any better right or you growing in any way and so the moment that you identify, or that, you know, I identify, you know, what my kind of personal roadmap of meaning is, what are my values? Who are the people that I want to be spending my time with? How do we spend quality time? Well, I have to feel good in order to spend quality time with the people I love, and to do things with them. So it comes from that place of self-awareness.

Because if you realize that underneath whatever numbing mechanism has allowed you to cope, that you're actually not feeling well enough to do the things that are most enlivening to you, then the way to repattern that is just it happens in the mind, which just really happens even deeper in the heart. So it's, it's, it's a, it's difficult for people to grasp that though. It's a very ephemeral concept. Like if you tell somebody, look, you got to cut out the cheeseburgers or you got to quit smoking, like they can wrap their head around that. It's a very tactile, you know, tangible thing that they can execute on. But when you're like, look, you got to go on this

inward journey. Like, look, I'm just trying to get my kids home from school and get through the day. And as somebody who's been in recovery for many years, one of the things that you learn very early is that the drugs and the alcohol aren't the problem. They're the solution to the problem. You can take away the drugs and the alcohol, but the problem, they're the solution to the problem. You can take away the drugs and the alcohol, but then you gotta deal with the underlying condition that compelled you to numb yourself out in that way. So you could tell somebody you gotta quit smoking, but yeah, that's their best friend

that you're removing from them. And if that person doesn't have the support or the tools to then address the underlying condition that was driving them to check out, whether it's a video game or your phone or gambling or sex or whatever it is, then that person is going to lapse back into that behavior or they're going to be very unhappy. That's why we've learned it's not enough to give people information alone. If it were, nobody would smoke. It's not like I say.

It's not an intellectual thing. Rich, I want you to quit smoking. It's bad for you. You go, oh, I didn't know smoking was bad for you. Everybody knows it's bad for you. It's on every pack of cigarettes. You have to say, why do you smoke? It's not enough to focus on the behavior.

We need to work at a deeper level. And so in our program, we have support groups. And the support groups are not like helping people stay on the diet or exchanging recipes or types of running shoes. It's really creating a safe environment to replicate what people had when they grew up. You know, when you grow up in an extended family or a neighborhood with truth and generations of people, they know you. They don't just know your Facebook profile or your bio sketch or all your awards or whatever. They know where you messed up and you know that they know and they know that you know that they know. And there's just something

profound. It's like in James Cameron's wonderful film Avatar. It's like, I see you. It's like, I don't just see you, which is really from an African proverb. It's not, I just see your bio sketch. I see where you messed up and I'm still there for you. And there's something really primal about that need for really authentic intimacy. In fact, there's a study that came out a few months ago that the more time you spend on Facebook, the more depressed you are. Why is that? Because it's not authentic. It's like, it looks like everybody has this perfect life, but you, you know, because people don't post, oh, my kid's on drugs or, oh, I'm having problems in my marriage or whatever. But in our support groups, that's what we, what people talk about. We encourage people to say,

what are you really feeling? Express it as a feeling because it's our feelings that connect us. And it's so easy to make fun of that. Oh, it sounds so touchy-feely. It is touchy-feely. We are touchy-feely creatures. We're creatures of community. That's how we've survived as a species. And so for someone to say, gosh, you know, I may look like the perfect father, but my kid's on drugs or heroin or whatever. And someone else will say, gosh, what am I feeling when I hear that? Oh, that sounds terrible. I'm so sorry to hear that. I used to have a drug problem, they might say, or gosh, my kid has another problem. It doesn't solve the issue, but suddenly you don't feel so isolated. And study after study has shown that people who are lonely and depressed are three to 10 times more likely to get sick and die

prematurely from pretty much all causes when compared to those who have a sense of love and connection and community. And I don't know anything, even diet, that has that big an impact or smoking. And now they all interrelate because you're much more likely, as you both have said, to choose those behaviors, to numb it out, just to kind of deal with that pain. But if you numb out pain, you also numb out pleasure. So you kind of have this kind of grey life and if people don't remember anything else about this wonderful podcast that we're having today is to say that the point of our program is not to help people live longer it's to live better as Anne was saying

because there's no point in giving up something that you enjoy unless you get something back that's better and quickly and because these underlying biological mechanisms are so dynamic when when you change your lifestyle, and ironically, it's sometimes easier to get people to make big changes all at once because when you make big changes in your lifestyle, you feel so much better so quickly. It reframes the reason for making those changes from fear of dying or fear of something bad happening or just numbing to get through the day to joy and pleasure and feeling good. And it gets into a virtuous cycle where you start to feel better and better. Do you want to build on that at all?

Yeah, just to say that all of these, the four pillars of the lifestyle, are equally weighted in the sense of what we've been talking about, about the synergy of those things. And when we talk about the love more component of the book and the program, it's, um, first it comes back to that self-awareness, which is really the stress less components. And so we start with the physical body to start to, um, on a physical level, kind of unwind it, calm down then we get to the um the mind and we get to see what is the the climate of the of the thinking pattern there is it racy is it calm and as we get it to that place of calm then we get to to drop into how are we actually feeling and so

very often people never get to the feeling place. They're just still in the thinking place, which they could be debating themselves in their own brain forever and never really... Or the numbing place, yeah. Or the numbing place. And so along the continuum of, you know, in that same spirit, I always say that the diet, if you will, is sort of like the Trojan horse of the lifestyle, that it's the one thing that we have to do, you know, three times a day. And so if we can solve

for that, then we get people on this kind of moving sidewalk of living better. And they start to feel better, like, I want to get up and start moving some more. And then they start moving more, and then they are in their body as Dean's saying, and then they start to have a sense of, wow, I had no idea what was going on inside, which then we go further into the stress-less component where we have more of that self-reflection. We heighten that sense of self-awareness. And then we bring that into our relationships and the love more component.

So they really all do kind of build, but it's from the inside out. Do you want to talk at all about in terms of what you gain is so much more than what you give up in terms of being in a committed relationship and the things that we're learning about that? I think just as one more example of going further in, going deeper instead of going wider in all of our pursuits to the extent that we're looking far and wide for our needs to be met. We spend a lot of our bandwidth. What does that mean to you? Well, first I'm saying just in general, I think, in a way of living and approaching life, that if we're looking out for it outside of ourselves

in as many varieties as possible, which can be fun at some standpoints, then we're not going deeper. And so I love the analogy of, you know, kind of digging up many different holes looking for water, but kind of giving up after, you know, you get to say three feet versus going down, say, you know, how far, far down to reach that well spring. And I think that's analogous to relationships and whether we're just going deeper with the relationships we have in all facets of our life. but I think especially romantically, I think it's a level of intimacy in that sense that allows, well, level of vulnerability that is really the key. To go deeper is to allow ourselves to be more vulnerable to ourselves and to those around us. And if we do that with our primary spouse, our partner, that level of intimacy is just an infinite kind of frontier, really. And I think that is something,

in my experience, is impossible to experience simultaneously while continuing to look and manage other relationships. So that, I can only speak personally, that's something that Dean and I reflect on, is how initially when we got together and we really realized, wow, this is my true love, the search is off, that it felt like there was this upwelling of so much life force that had been previously dispersed out into the searching mode versus the dropping in mode. Yeah, and to build on that, part of what I'm learning is that the other thing that's besides the keto diets and so on is this whole polyamorous thing that's going on, especially in the tech world.

And it's not a moral judgment. the tech world. And, you know, it's not a moral judgment. It's like, okay, what really brings you the most happiness? And part of what I'm learning is having tried a number of different things is that the more intimate it is, the more erotic it becomes. And instead of having the same kind of superficial experience with different people, you can end up having the most incredibly varied and erotic experiences with the same person that keep the relationship so fresh and juicy and fun because as as ann says you can only be intimate to the degree you can be vulnerable and open your heart and you can only do that to the degree you feel

safe so the paradox is that when you're in a committed relationship uh it allows a sense of safety that allows like the layers of an onion the heart to keep opening wider and wider and wider and the more open the heart is the more erotic and pleasurable it becomes. And I just want to say from a yogic perspective, it's about integration. Ultimately, the path to peace and happiness, if you will, is a matter of feeling fully integrated. So we have so many facets of ourself

and we have to play different roles in different parts of our life. But to the extent that we have relationships, a relationship primarily with ourself but with others, that reflect our wholeness, that in itself is healing. Yes. Yeah, it requires a huge amount of work to get to that place, to be able to have that kind of depth of intimacy and safety. One of the things Julie and I always talk about is this idea that in most relationships, we project an idealized version of our partner onto that person. And we're really in a social contract,

right? Like, I love you, but in your mind, you're like, well, I love you as long as you're this, this, this, and this. And the minute that you stop being those things, like, I will retract my love, right? And that is a transactional- It's business. That's why we used to say, that's not love, that's business. Right. Yeah, yeah, yeah. So, how do you transcend that say that's not love, that's business. Right. Yeah, yeah, yeah. So how do you transcend that to come to this place where you're able to love your partner in a more unconditional way? And I think if you can get to that place, then that person feels safe and they can be vulnerable because they feel like if they're vulnerable, they're not going to either be judged or abandoned. And what's deeper than that is that you're loving yourself unconditionally.

It's much harder to love somebody else unconditionally. Those kind of barriers are ultimately barriers that we're having with accepting ourselves. So it's actually a selfish act. Right, you have shame over something. So it's like, I don't even want to admit to myself that I do this, let alone admit to my partner. Yeah, it's like judgments, right? One of the nice things about being best friends for eight years before we became lovers is that you'll share things with your best friend you would never share if you were just dating. It's like, wow, you know that about me? You still love me? It's very liberating in that way.

And so it's like a subset of the larger issue about, oh, that's so deprived. I can't eat meat. I can't eat that, is that the ball and chain if you're in a committed monogamous relationship? Well, it can be, but it can also be the crucible of safety that allows both people to open their hearts more and more, which makes it that much more erotic and intimate. I worked my way through school as a photographer. First I was doing these big portrait photography from like the ages of 12 to 14 and on you know kind of manipulating images

and lighting and retouching and airbrushing this is before photoshop to make people look better than they were and then I started I actually studied for a couple of years with a well-known photographer named Gary Winogrand one of the great photographers of the 20th century and he would just take a little Leica

a little and just to go around and just see things as they are and not trying to change them into what you want them to be and he put a picture on the wall he'd say what do you do you see? And people say, oh, I see this. He'd say, well, how do you know someone have a gun right outside the frame? Or how do you know this? Or how do you know that? Just to try to challenge people's preconceptions, what Suzuki called beginner's mind, to really see things fresh without preconceptions, which is where true

innovation as opposed to imitation comes from. And that kind of beginner's mind, to be able to see without preconceptions, is where things are the most creative. And so when Anne and I have a date, we're not trying to recreate an experience that we've had before, however wonderful it might have been. We're open to all possibilities, all degrees of freedom. We try to approach that with beginner's mind and just say, I totally trust you. I surrender to you.

Let's see where this goes and just follow the energy. And it's just so much more interesting and erotic and pleasurable than anything I've ever even imagined, much less experienced before. And so then is that the ball and chain? No, it's anything but that. So you've been eating a plant-based diet. People say, oh my God, how can you do that? You must not like food or you must feel so deprived. You say, well, actually no, because what I gain is so much more than what I give up. Not preventing something bad 30 years down the road, but right here, right now. And we're always making choices. And so to me, part of the value of science and why we spent 40 years doing research is that it can redefine what's possible for people. Awareness is always the first step in healing.

And it can raise awareness. Like if you're willing to do these things, your chest pain will go away. So if you can't walk across the street without getting chest pain because you've got heart disease or make love with your spouse or play with your kids or go back to work.

And within a few weeks, you can do all those things. People say things like, yeah, I like eating meat, but not that much because what I gain is so much more than what I give up. Yeah, there's this, that's why ascetic practices breed free, you know, that's why they've survived over millennia, right? Because there's something about the giving up that is expansive. And it imbues those choices with meaning as well.

Yeah. All right. So, that took a turn. We were talking about polyamory. Like, all right. Again, it's not a value. We were talking about polyamory. Like, all right. Again, it's not a value judgment. It's not a moral judgment. I've certainly experienced parts of my life like that.

It's about saying, okay. I mean, when I decided not to kill myself when I was, to kind of go full circle, I said, okay, I don't know what's real. I don't know who to trust. I'm going to lead a messy life because I need to find out for myself what's true. And I'm going to make a lot of mistakes. I'm allowed to do stupid things and I'm going to learn from them. And as long as it's not going to hurt me permanently or hurt someone else, I'm going to try a lot of different things because there's a lot of wisdom that comes from making mistakes and learning from it. And in working with people who are dying now that I'm a

doctor, they generally don't regret what they did. They generally regret what they didn't do. Because if you do something and it turns out to be really a dumb idea, there's a lot of wisdom that comes from making mistakes and learning from it. Then you really know. But if you don't regret what they did, they generally regret what they didn't do. Because if you do something and it turns out to be really a dumb idea, there's a lot of wisdom that comes from making mistakes and learning from them. Then you really know. But if you don't do it, you just kind of wonder, you have regrets or whatever. So I said, I don't want to have those kind of regrets. And so it's not a value judgment. It's not a moral issue.

It's not a, you know, right or wrong. It's like, oh, these are the things that enable us to live, certainly in our lives, and I think in many others, many, many others that we've worked with, these are choices that enable us to live a life that's just joyful and pleasurable and fun and exciting and adventuresome as opposed to being depressed and boring and all of that kind of stuff. So what you gain is more than what you give up. It takes it out of the realm of a value judgment or a moral issue or you're bad or whatever. And just like, oh, this is the way to live the most joyful life.

I love spiritual teachers like the Dalai Lama, you know, and he said, my religion is happiness, you know, or be kind whenever possible. It's always possible, you know. Though the people that embody that kind of wisdom, you can feel it just being around them. That's why you want, I mean, that's why George Lucas sampled the Dalai Lama's laugh for Yoda, because it's just such a joyful, just on a vibrational level, you just feel it. I just love that it's empowering.

There are so many things that we're selling, pills, what have you, out there in the world that are saying, I've got this solution that's outside of you, and I'm going to give it to you, and you're going to pay me, but then you're going to need to come back for more. I love that these are concepts of how you can choose. You choose with your free will, like the most important thing, how to live your life. And that the more that you have the feedback loop experience of I'm feeling better and better, the more I'm making these choices, then it's coming and all the side effects are good ones. And it's self-generated.

It's exactly. Right. And the other thing that happens is when you really quiet your mind and body down, you become more in touch with your inner teacher. You know, that still small voice within that speaks very clearly, but very quietly. It gets drowned out by the chatter of everyday life. It's the one that wakes you up and says at three in the morning says, Hey, Dean, listen up, pay attention. You're not, you're missing something.

And I've learned I can access that voice much more directly. So at the end of a meditation or a yoga class or whatever, uh, or a run when I'm, my mind's more quiet to say, I'll, I'll, I'll ask that voice. What am I missing? What do I, what am I not paying attention to that I need to pay attention to and listen. And it's all of the studies that we've done, all the creative things that I've done in my life, I've learned to really trust that voice, and we all have that. And so one of the nice side effects of meditating, you know, the ancient swamis and rabbis and priests and monks and nuns

didn't develop these techniques to unclog their arteries or lower their blood pressure. They're really tools for quieting down our mind and body to experience that inner sense of peace and joy and well-being and to gain access to that inner wisdom and ultimately to transcend that and have that double vision of interconnectedness as well as the separateness that we all share. It truly is our birthright. It might sound very new agey, but actually there's no greater wisdom than our inner wisdom. Nobody knows what the feedback loop of our thoughts, our feelings, our behaviors, where the rubber hits the road inside ourselves. So ultimately, to empower people with the tools and support to empower themselves.

And just to build on that, when you see that interconnectedness, then the other aspects of eating a plant-based diet that you've spoken so eloquently about, that what's good for you is good for the planet. More global warming is caused by livestock consumption than all forms of transportation combined. All the suffering that comes from eating meat. If that's all you have, eat meat. Or as the Swami used to say, if you're in a crash on a Himalayan mountain and your fellow passengers are dead, eat them. But if you have all these great fruits and vegetables, you don't have to create suffering. I used to get in friendly debates with Al Gore, and he became a vegan, not just because of me,

but because he realized that more global warming is caused by livestock consumption. And he's a rancher, then all forms of transportation combine. But also, I was on the board of the San Francisco food bank for a few years. And I was, because I was shocked to hear that more, that one out of five kids in the Bay area goes to bed hungry every night with all the prosperity. That's just pitiful. But you know, when, when we learned that it takes 14 times more resources to make a pound of meat-based protein than plant-based protein, there's enough food today to feed everyone. No one need go hungry. And so it's so easy to feel overwhelmed. Like what can I do as one person with global warming or feeding the hungry or whatever. And when you realize that something as primal as what we put

in our mouths every day, what we eat, uh, imbues those choices with meaning to say, okay, I'm going to have, um, uh, you know, Susie Cameron has her book, uh,, coming out, One Meal a Day. I'm just going to have one meal a day that's plant-based. It's good for me. It's good for my family. It's good for my community. It's good for my planet. It imbues those choices with meaning. And as Anne said so eloquently, if it's meaningful, then it's sustainable.

Yeah, I think it speaks to the level of disenfranchisement that most people feel. They don't feel like they have agency over their lives. They don't feel like they're in conscious control of the direction of their lives. And they don't feel like the choices that they have can have meaning outside of their little cloistered existence. And if you can really help people to understand that those choices do have significance and meaning and that,

you know, every dollar that you spend on the food that you eat every day has ramifications. And if you invest those dollars more mindfully, that you can be doing what's not just right for yourself, but right for the planet and perhaps spare some animals along the way. I mean, it's rigged to set in motion this cascade of positive impacts. And I think when you can really connect with that, when you can quiet your mind and really connect with deeper consciousness and come to that still place,

you begin to understand and realize that your footprint can make a difference. And that's a beautiful thing. And I think that that is the fertilizing of a sense of agency that we all feel like we are lacking right now with so many people walking the planet. And to transcend that it's not a matter of blame, it's a matter of empowering.

Because otherwise, I remember when Bill, I've been working with President Clinton since 93, when Hillary asked me to train the chefs that cook for them at the White House and in Camp David and Air Force One, I come in for his annual physical at the Bethesda Naval Hospital. And then about 10 years ago, he had his bypasses clogged up and one of his cardiologists held a press conference that it was all in his genes. And I sent him a note. I said, it's not all in your genes. And I say that not to blame, but to empower you. Because if it's all in your genes, then you're a victim and you're

not a victim. You're one of the most powerful guys on the planet that's when he began eating a plant-based diet and he's been doing it now is he still on it how's he doing yeah i just saw hillary a couple days ago and he's still on it and he's doing well and his heart disease he's talked about publicly that it's getting better and if you know whatever your politics when a former president united states especially one who was known for not eating very healthfully can make these changes and i think it inspires everyone. Yeah, it's significant. It comes back to transformation, which you're such an incredible testimony

of really what's possible at any stage of life. Yeah, look at you. You inspire us. I don't know about that, but it's true. You know, we've had a dozen people that get off the heart transplant list in the past year. Yeah, one of them here at UCLA, a doctor himself, we wrote about in the book named Bob Troy Hertz, who is ejection for, you know, the heart pumps blood and the ejection fraction is the percentage of blood

that it pumps with each beat. So normally it should pump at least half of what's in there. 50% is the normal or higher. And his ejection fraction after a massive heart attack was down around 11 to 13%. It was barely pumping. And he was told he was going to die. And he said the only thing that could save him maybe would be a heart transplant. And while waiting for a donor, he went through our program at UCLA that we've been training around the country. And in nine weeks, his

ejection fraction improved from 11% to 30%. And now it's even higher. And so he got off the heart transplant list. We have over a dozen people like that. So people say, oh, Dean, you have this radical program. It's like compared to a heart transplant. And I remember when we were in these 16 years, we were trying to get Medicare to cover the program. I met with one of the heads of Medicare at the time. And he said, Dean, we have to get a letter

from the head of the National Heart, the head of the National Heart, Lung, and Blood Institute of the National Institutes of Health that it's safe for people to, older people to walk, meditate, eat vegetables, and quit smoking. I'd love more. Yeah. But don't blink an eye when we're going to crack their chest. I said, you must be joking.

And they weren't. And we actually had to do that. It's so, and it speaks to like the systemic problems that you have to overcome to scale what you're doing. But let's just look at what's going on. I mean, when you talk about heart disease, one out of every two people will suffer from some form of heart disease.

One out of every three is gonna die from it. 80% of American adults are obese or overweight. One third of kids are diabetes like half of the population half the population diabetic or pre-diabetic i mean it is bananas even when you look at depression which our program isn't you know set out to be an antidepressant but yet it is actually more powerful than some of the highly prescribed antidepressants depression scores are cut in half yeah but that's part of the opportunity. It's hard doing this work,

but one study showed, the EPIC study showed that 93% of people of diabetes is preventable today. I think it's closer to 99% of people with type 2 diabetes. That's right. It's not like we don't know what to do, but there are all these myths around that, oh, I can get my patients to take their statins to lower their cholesterol.

There's no way they're going to change their lifestyle. And yet this pharma company's own data show that only a third to half of people who are prescribed statins are taking them just four months later. And yet we're getting 94% of the 72 hours of our program people are actually able to do. And a year later, 85% to 90% of the people are still following it. are actually able to do and a year later 85 to 90 percent of the people are still following you it's the support though right it's the support and the follow-up well it's the support but also we've learned that fear is not a sustainable motivator

but joy and pleasure and feeling good and freedom are and when someone says here take this pill this this cholesterol lowering drug it's not going to make you feel better hopefully it won't make you feel worse to prevent something really awful like a heart attack or stroke from happening years down the road. And so people like, after someone's had a heart attack, they'll do pretty much anything that the doctor says for like maybe a month or maybe two. And that's it because they don't want to think that something bad is going to happen to them. So they don't, you know, we're all going to die, but we don't think about it most of the time. But when you change your lifestyle, because these mechanisms are so dynamic, and one of the biggest obstacles we have to face all the time is people

say, well, we're doing it today to prevent something really bad from happening down the road. I'm saying, no, no, no. You will probably help prevent something down the road, but you're doing it today because you'll feel so much better, because these mechanisms are so much more dynamic, and that really reframes the reason for change from fear of dying, which is not sustainable, to joy of living, which is, and the sense of meaning and purpose and pleasure. It's that virtuous circle. If it's pleasurable and if it's meaningful, then it's sustainable. Well, we're seeing the rise of lifestyle medicine.

More and more people are practicing medicine in this way that you have been doing it for a long time. But systemically, we still have major obstacles that prevent this from being the norm. Most doctors, well-intentioned, got into medicine to help people, but they're stuck in a system where they have 15 minutes to see somebody. 10 minutes now.

Is it 10 minutes? Yeah, sometimes eight minutes. They're incentivized to just diagnose and prescribe and move on to the next one. And from my perspective, we're not going to solve these problems until we change the system and start incentivizing practices like yours that are providing the real care that the patients need to develop that sense of agency, to go on this path, to get the support, to be able to build in all of these lifestyle practices that can prevent- I couldn't agree with you more. And that's why I spent 16 years. As I mentioned, we trained all these sites before we had the reimbursement. And even though we got these great outcomes, some of them closed down. That was the painful lesson,

that it's not enough to have good science, not enough to have good clinical outcomes. If it's not reimbursable, it's not sustainable. It's follow the money, or Crazy Eddie, Money Talks, Nobody Walks, or the rappers. It's all about the Benjamins, whatever. But now, because we do have Medicare coverage, and most of the major insurance companies are covering it, we're creating a new paradigm of lifestyle medicine, which is using lifestyle changes not only to help prevent, but even to reverse the most common chronic diseases. And it's working. And as I mentioned, we're getting bigger changes in lifestyle, better clinical outcomes, bigger cost savings, better adherence. And the American College of Lifestyle Medicine, which I helped found, has over 1,000 to 1,500 doctors now.

It keeps going up exponentially every year at the annual meetings. It's the most exciting trend in medicine today, and it's a wave that hasn't even begun to crest. And so when you change reimbursement, you change medical practice and even medical education. And our approach leverages the doctor's time. So instead of having a patient you see every 10 minutes, which most doctors wouldn't recommend medicine as a career for their kids, it's not fun for the doctor if you have to basically go through the electronic medical record. You listen to the heart and lungs. You write a prescription. They're out the door.

It's not fun for the doctor or the patient. But now we have 72 hours that Medicare is paying for. And we work with a doctor, but also a nurse, a meditation teacher. I mean, who would have thought Medicare would be paying for yoga, meditation? A dietician, an exercise physiologist, and a psychologist. So people come twice a week for four hours at a time for nine weeks. They get an hour of supervised exercise, an hour of yoga and meditation,

an hour of a support group, and an hour of a group meet with a lecture. And then after they finish their nine weeks, then Ann brilliantly developed this video conferencing way of continuing the support group. So they can all, using a technology called Zoom, where they'll say, okay, like from five to six on Thursdays, we'll all Zoom in together. And they have their support group because they've already bonded with each other. And that's why we're getting unprecedented levels of adherence because that sense of community is so powerful and it's so meaningful for people,

especially because we don't really often have places where we can be authentic with each other in those ways. And clearly, if you're able to enroll in our very high-touch program where you have a clinical support and the support of a cohort around you, that's optimal. At the same time, it's like we had a new electrician at our house this week, and I didn't even tell you this, but as he finished up his job and he's leaving he says you know every single person on my family has died of some

heart-related issue before the age of 50 so at age 35 I got your husband's book and I read it and you know I'm now like you know in his early 50s he had passed that 50 benchmark and he just he never had the a clinical team around him he never had a clinical team around him. He never had a cohort of people who he was in a support group with. But he was able to read the book and empower himself. And we hear these kinds of stories all the time. So it's not to say that you're dependent, again, on that. I would say, I guess I'd say I'm shocked, except he was an electrician.

But it's true. That's such a bad joke. He had to get one of those in there. But when we started working together in the late 90s with WebMD, it was such a transformative time for just the medical field, I felt, in the sense that we were coming out of an era of the passive patient, just listening to the sermon from the white jacket, the white coat, but more empowering ourselves, becoming a better educated,

more informed consumer of our health care. And so often participants, patients, are coming to their annual exam saying, these are the things that I've noticed about myself. These are the things that I think would help. What do you think? You know, and so they really are taking that agency more and more. And I think that is, along with the reimbursement, we're working it from the bottom up and the top down.

And it's so fun to practice medicine this way. You know, people, they say things like... Well, you get to see life change, right? I mean, I can't imagine the transformations you must have been able to participate in. Well, I mean, like when most people are prescribed drugs to lower their cholesterol, their blood pressure, their blood sugar, and they say, how long do I have to take this doctor? What does the doctor say? Forever, right?

The rest of your life. Exactly. And then all these other medications that deal with the side effects of that medication. Exactly. We find we can, and again, kids, you know, make sure you do this under your doctor's supervision, but most people can reduce or get off of these medications if they were told they'd have to take the rest of their life.

It's incredibly empowering, because, you know, if every day you're taking these pills, it kind of, that becomes your meditation. Oh, I'm sick, I'm sick, I'm sick, I have to take all these pills. And when people can actually reduce or get off these medications, and their chest pain goes away, in extreme examples, their heart, they don't need a heart transplant, you know, or they can avoid prostate surgery or whatever.

Then they go, wow, I'm getting better. And they get into this virtuous cycle, which makes them just that much more empowered in other aspects of their lives. But pharmaceutical companies can't be that happy about this though. Well- Do you get pushed back or is there like, how does that work?

Well, I'm always careful to say, look, drugs and surgery have their place and we've all benefited from them, you know? push back or is there like, how does that work? Well, I'm always careful to say, look, drugs, drugs and surgery have their place and we've all benefited from them, you know? Um, and certainly in a crisis that can be lifesaving, but, and sometimes when people are just beginning to change their lifestyle, the drugs are absolutely necessary until the lifestyle changes begin to take effect. So it's not this or that it's fine. It's using with things when they're most appropriate, but unfortunately what the drug companies say, well, okay, let's say you've got high cholesterol, try diet first, quote unquote.

But they know the diet that you're gonna try is, less red meat, more fish and chicken, take the skin off the chicken, four eggs a week, and your cholesterol is gonna go down maybe 5% or 8%. They'll say, well, you failed diet, now you have to go on these drugs the rest of your life. But what we've found is that the average LDL cholesterol went down by 40%.

That's comparable to what you get with statins, but without the cost and without the side effects, except for the good ones. Right. The next evolution beyond lifestyle medicine seems to be genomics and personalized medicine. Like where do you see this heading and like where are we at right now with this?

Well, I mean, I was on Craig Ventra's board for many years and learned a lot about genetics and genomics and personalization and so on. And if you're talking about a targeted immunotherapy for a particular type of melanoma, that's awesome. But for the vast majority of chronic diseases, the whole point of our new book is to say, I shared Google Health with Marissa Meyer back in 2007 to 2009, who went on to become

the CEO of Yahoo. And we were trying to come up with these really complex algorithms to say, you know, how can we personalize a diet and lifestyle intervention? And one day I said, you know, I don't know if you're ever these moments where you just realize this is not working, you know. And I realized that the science isn't there, but even if it were, I mean, there was a study that came out in JAMA last year from Stanford where they tried to personalize diets and they found it didn't really matter. And this new book that we wrote about is to say you don't need to personalize it for most chronic diseases because it's the same mechanisms that underlie all of them.

And let's say some people are genetically able to metabolize dietary refined carbs better than someone else can But if you're not eating that many to begin with those differences don't matter I mean look at china like in the china study or in japan Where the whole country is eating a diet that's basically plant-based low fat low sugar And they have you know almost non-existent at the time 50 60 70 years ago heart disease was as rare there as malaria is here Then they start to eat like us and live like us and now die like us, or they move to this country. And their rates of heart disease and prostate and breast and colon cancer are the same as ours. Their genes didn't change, but the expression of those genes changed. And so the point of our new

book is that you don't really need to personalize it. That these same lifestyle changes reverse all of these different chronic conditions because they all share the same underlying mechanisms. Now, an earlier book that I wrote called The Spectrum was based on the idea that if you don't have heart disease, if you're just trying to lose a few pounds or get your cholesterol or blood pressure down, to say, instead of saying, here's your diet, because part of what we've learned is that even more than being healthy, people want to feel free.

And as soon as I tell somebody, do this and don't do that, and eat this and don't eat that, they immediately want to do the opposite. And when I lecture sometimes, I say it's like the first dietary intervention when God said, don't eat the apple, and that didn't go so well, and that was God talking, and apples are good for you. Anyone who has teenagers also understands this phenomenon. And if you tell our 17-year-old son something's bad for them, that's just like motorcycles are dangerous.

That just makes it cool. It's actually counterproductive. So to say, look, if you go on a diet, chances are you're going to go off it because diets are all about what you can't have and what you must do. And then when you go off it, as Ann said, you kind of beat yourself up with all this anger and shame and guilt and humiliation, and those are really toxic to you. Those actually are bad for you.

And if you say, well, I might as well just finish a pot of ice cream because I'm a bad person. The whole language of behavioral change has this kind of fascist, moralistic, wagging your finger, I cheated on my diet. Or once you call foods good or bad, it's a very small step to say I'm a bad person because I eat bad food. It's all just a mess. And that's sometimes the rap that we get. Oh, you're the nanny, this kind of stuff. No, this is all about enjoying life and really having pleasure. So I say, look, instead of me telling you what you want to do, and instead of calling foods good or bad, we said group one are the healthiest foods, group five are the least healthy

foods. To the degree you move in that direction, there's a corresponding benefit. When I began doing these studies, I thought the younger people with less severe disease would do better, but I was wrong. It wasn't how old or how sick they were. The more they changed, the better they got at any age, which is a really empowering message to give people. Right, I think there's this idea that, oh, if you're 78 years old, then it's just... Not at all.

We found there's no upper limit to that. And so what I do is I'll say, okay, what do you want to accomplish? You say, well, I want to lose 10 pounds. I want to get my blood pressure down 10 points or my LDL down 50 points, whatever. I say, great. What are you doing now? Oh, I'm eating mostly unhealthy group four and five foods. Okay. How much are you willing to change? Oh, no one's ever asked me that before. They're always just telling me what to do. Oh, I don't know. I'll eat less of the unhealthy group four and five and more of the one through three, but I'll still eat some of the unhealthy foods too. Great.

How much exercise are you getting? Well, not that much. How much are you willing to do? I'll walk a half an hour a day. Cool. How much yoga and meditation are you doing? Zero. How much are you willing to do?

I'll meditate 20 minutes a day. Great. How much love and support do you have? Not enough, but I'll make a point to spend more time with my friends and family. Boom, that's it. Okay, well, support that degree of change. If they indulge themselves one day, it doesn't mean they cheated or they failed or they're bad.

Just eat healthier the next. You forget to exercise one day, do a little more the next. You don't have time to meditate. Taking the judgment out of it. Take the judgment out of it. And adding more of a journey of discovery. And it's like never stepping into the same river twice. Beginner's mind.

If you can sort of feel like, one, again, it's so important that people feel like they are making this choice. Yes. You know, your doctor, your spouse, whomever else, they're consultants, but ultimately you're the only CEO for yourself. ultimately you're the only CEO for yourself. And so I just, I think, you know, if people take it on as their own scientific experiment, say, just try it. Try it for two weeks, six weeks. See how you feel. Don't trust us. And then if that degree of change after two weeks or six weeks is enough to accomplish your goals, great. That's it. If not, if you say, okay, I wanted to get down 50 points, it came down 30 points. Great. Look, you're on the right track. Just do a little more. You'll get the rest of the way. And then it's the most compassionate way because there's no die to get on,

there's no die to get off. It's just saying, it's directional. To the degree you move in this direction, there's a corresponding benefit at any age. Right, but as I'm sure you've seen time and time again, when you give people that kind of control and agency and they make a few changes and they start to feel better than they want to do more.

Exactly, that's the whole point. And then it becomes a self-perpetuating machine. It's a Trojan horse that Ian talked about. Right. Let's talk about Alzheimer's a little bit. I had the Scherzes in here and they spoke at length about the amazing work and results that they're getting at Loma Linda with their institute right now. You've mentioned at the outset that this is also part of what you're addressing in the new book and that you're hopeful through this new clinical study that I guess you're about to embark on.

We just started. You just started. That you're going gonna be able to see not just prevention, but reversal. And it seems like reversal is the Holy Grail with this. Nobody's been really been able to figure out how to reverse this. Well, my mom died of Alzheimer's and she was brilliant.

She got her master's degree when she was 18. She ended to see someone whose mind was so brilliant, kind of deteriorating was just tragic in so many different levels. And there are no good drugs for treating or preventing Alzheimer's. So it's a perfect kind of virgin territory to look at lifestyle changes without being, it's kind of like 40 years ago

when we did our heart disease reversal studies before statins came out. We could look at the effects of lifestyle changes alone. So we're doing the first randomized trial in collaboration with Bruce Miller, who runs the Memory and Aging Center at UCSF, and others like him, Joel Kramer and others. And we're going to randomly divide men and women who have early to moderate Alzheimer's into two groups. We're going to give one group the lifestyle intervention but not the other.

We'll test both groups before and after. And we hope to be able to show, because again, Alzheimer's is just yet another example of a chronic disease that shares all these same underlying mechanisms. Again, that's the whole point of the book is that all of these different diseases, including Alzheimer's, really are different manifestations of the same disordered mechanisms, including chronic inflammation and oxidative stress and so on. And so we really believe that these same lifestyle changes that can reverse all these other conditions will likely reverse Alzheimer's. And the anecdotal case reports, the studies, there have been studies called like the finger study and

the mind study and others that use less intensive interventions can slow or stop the progression of it. Just like there were 40 years ago, less intensive interventions could slow or stop the rate of heart disease progression. We think a more intensive intervention can actually reverse it. Well, it'll be interesting to see. So how long will this study go on for? Like, break this down, the protocol. The protocol is we're taking 100 men and women, and we're giving them the program. We're testing both groups at baseline.

We're giving one group the intervention for four months, but not the other. We've learned that if you tell a group in the control group that they're not going to get it, then they do it on their own. That's what happened in the Women's Health Initiative study where they spent $2 billion and the women in the control group said, to hell with you, we're going to do it anyway. You can't keep us from doing it. It screws up the whole thing. It screws up everything because then you don't have any differences between the groups. But if you tell somebody, in fact, in the very first heart disease study, I remember a guy got randomized to the control group. He really wanted to change his lifestyle, and he was so upset he got angina or chest pain,

ended up in the coronary care unit, called me at four in the morning and said, basically, F you. I'm up. You're going to be up too. So I learned that in our study, we're going to say, look, if you end up in the – both groups are going to get the program. One group just has to wait four months. And if you tell somebody you're going to get it in four months, that's not very long.

And please don't change during that four months because it'll mess up our study. That's ethically defensible and it works. We'll test both groups again after four months, then we'll cross them over, give the first group an additional four months, the group that didn't get it, well, they'll get it for four months and test both groups again after eight months. Right. And the protocol that you're going to be using is basically what's in the book that's exactly that's the thing that's that's what makes that's why we're so excited about this new book is that it distills the 40 years of work to say look i'm done with all these diet wars i'm all these debates look it every disease we've studied gets better every mechanism we look at gets better

and these same mechanisms are what cause all these different diseases manifesting in different ways. And here's how you do it. And boom, that's it. You know, it starts with a quote by Albert Einstein who said, if you can't make it simple, you don't understand it well enough. You know, and the people who don't know anything can make it simple out of ignorance, but the people who spend their whole lives doing something, like I'm not sure if I asked you what the best way to exercise was. You could reduce it down to something really simple, where somebody else might just kind of go meander around. So it's basically the essence of what we've learned in a very simple way without being simplistic, and tying it all together in this

unifying theory about why these same lifestyle changes are so powerful in every way we can look at. You want to add anything to that? Amen. Do I hear a hallelujah? I know you don't want to get pulled into the diet wars, but I got a couple of questions I got to ask you before I let you go. And really for me, it's more of just getting your perspective on these issues to set the record straight. I think things that confuse a lot of people, you know, for example, what's wrong with the Mediterranean diet? I heard olive oil is good.

Like, you know, my doctor told me to go on the Mediterranean diet. Like, just some of the sort of things that, you know, I know for a fact are out there and are confusing people. It's a good question. The Mediterranean diet is a better diet than most people eat, no question. But it's not an optimal diet. The big study that made headlines was called the PREDIMED study. And it compared a, quote, Mediterranean diet to a, quote, low-fat diet. This is part of the meme that goes around that low-fat is dead.

They say, oh, the Mediterranean diet was so much better than low-fat diet. This is part of the meme that goes around that low-fat is dead. They say, oh, the Mediterranean diet was so much better than low-fat diet. So I looked at that study very carefully. And it turned out that the low-fat diet went from 39% fat to 36% fat, hardly any change at all. They replaced fat with sugar, which is never a good idea. And even with all that, they actually found that there was no difference in cardiovascular mortality or events in the two groups. There was a big difference in stroke rate because the Mediterranean diet, people are encouraged to eat salmon and fatty fish, which have the omega-3s in there, and that keeps blood from clotting. And blood clots account for 90% of stroke. So they showed a huge reduction in stroke, but they showed no difference in cardiovascular events, but they pooled the data together so that it looked like there was an overall reduction in everything, but it was really only an overall reduction in stroke. Now we've been adding omega-3s to our program for

30 years. My mentor at Harvard, Alex Leaf, who was the chief of medicine, came up with those ideas. And you can get them from fish oil, but you can also get them from plankton-based omega-3s. I mean, that's where the fish get them from, is from eating the plankton. And so, you know, you can get the benefits without the other stuff. So Mediterranean diet is better than most, because it's mostly fruits and vegetables and whole grains and so on, but you don't need the oils, you don't need the animal protein. And if you can go even further to reverse disease, you know, there's the ounce of prevention and pound of cure. The Mediterranean diet for some people may be enough to prevent disease, but there's no study that's ever shown

that it can actually reverse it. Whereas a whole foods plant-based diet that's low in fat and sugar, especially when combined with these other stress management and exercise and social support, we found overall, over and over, can actually reverse disease. And to the degree you make these changes, you show that much more reversal. we found over and over can actually reverse disease.

And to the degree you make these changes, you show that much more reversal. But Dr. Ornish, I get all of my beef from grass-fed farms. It's organic. That's another great. Telling people what they want to hear. That's why I love this Game Changers film that James Cameron did, the meal that they gave these athletes was a grass-fed organic chicken or beef

or pork, and it's still, when they ate a plant-based meal, they had 3-500% more frequent erections than 10-15% harder. Just one meal. There's not a single study showing that grass-fed beef is healthier than regular beef. It may be a little bit higher than the omega-3s, but that's hardly the best way to get omega-3s.

And lower in hormones and things like that. And lower in hormones, maybe. But even lower in hormones is not to eat the beef in the first place. Is it better? It's certainly better for the animal, but it's not healthy. It may be a little less unhealthy, but it's not good for you. All right. So what do you have to say to,

again, I'm pulling you into the diet wars. A very familiar place for me to be. Yeah, so you had these epic debates with Atkins going way back, but that tradition has sort of been inherited by Gary Taubes nina teicholz um you know who else is part of this mark high movement mark high well mark mark mark maybe less so than gary but yeah i would i would put him in there as well um you know mark wrote a book called

eat fat to get thin yeah and that book the way, has four pages on my work. And Mark just makes stuff up. It's unfortunate. I don't say that about most people. But he put in there, oh, Dean's Diet, in the 1998 JAMA study, they gained weight, their cholesterol went up, and their arteries got more clogged.

I said, Mark, their cholesterol went down by an average of 40%. They lost an average of 24 pounds and their arteries showed some reversal after one year and even more reversal after five years what are you talking about? and I had to threaten to sue him to get him to change that and he said, oh it was a transcription error

it was like just stupid stuff it was that misquoted people skew it's all about perception and so data can be presented in lots of ways well this wasn't a perception issue this was just wrong you know let me just jump let me just be really clear about that then gary thomas says things like uh and david ludwig oh all calories are not alike fat calories i mean carb calories calorie for calorie make you fatter than fat calories so um kevin

hall at the united national institutes of health did a metabolic ward study, which meant that they actually had people in the hospital for two weeks where they could literally control every calorie that they ate and measure it. And what did they find? They did find that all calories are not the same. But the opposite of what the Gary Taubes and David Ludwigs and others say, that calorie for calorie, fat calories make you, we're 67% more likely to end up in body fat than carb calories. Now, again, it's not fat versus carbs. They're both important. And again, it's not just fat versus carbs.

It's animal protein. But this idea that somehow that it's all, that fat is good for you and that it's all carbs is just ridiculous. And it's unfortunate carbs is just ridiculous. It's unfortunate because telling people what they want to hear, it gets picked up, it turns into a meme, it's broadcast. What we talked about earlier, Americans have been told to eat less fat, they're fatter

than ever, low fat is dead, it's all sugar. We're eating more fat than ever. We're eating more sugar than ever. We need to reduce both of them. People are always looking for that magic bullet that Ann talked about, the reductionistic approach. It's all of these things that make a difference. Yeah. I think the journalistic kind of culture has a big role to play in this as well because it's being driven by clicks and they need those headlines to be baity and they're going to jump on the next sort of crazy diet thing to drive traffic.

And it's just exacerbating the confusion. Well, that's the problem. Because, you know, I mean, it's hard to have print media. I mean, so many of the media are going under. Even Time Magazine, you know, Mark Benioff, thank goodness, bought it recently, but it was about to go into the trash bin just because. And journals are not immune from that either. You know, They have what they

call the impact factor. And so the more likely your article is to get picked up in the mainstream media, the more impact you have. So they're always looking for the things that they think are going to generate headlines. So the British Medical Journal had this article. This goes back to the saturated fat thing you were saying earlier. And in the abstract, it said saturated fat was not related to heart disease, diabetes, or all-cause mortality. And that made headlines around the world. I looked at that study very carefully, and I saw they looked at the data two ways. One was the unadjusted way, where they just looked at the raw data. And the other was what they call adjusted. They only put the adjusted data in the abstract but when you adjust for they would adjust for dietary cholesterol but invariably because cholesterol and saturated fat often travel together you're adjusting for

both so it wiped out the differences but if you looked at the raw data the unadjusted data which was in the manuscript itself but no one goes past the abstract nobody goes past the abstract but i did and so i looked at it and said, what did they find? They found that saturated fat was statistically significantly and clinically significantly linked with increased risk of diabetes, heart disease, prostate, breast, and colon cancer. Boom. Didn't even make it into the abstract.

And so that's the problem because they know that if they can say something that tells people what they want to hear and it's going to make headlines, their impact factor goes up. So much of this is really unfortunate and you know with donald trump and and uh you know facts are not facts and you know they're you know we that's to me i think we really just need to um be absolutely clear about what the facts show because if we can't believe that, then we just have chaos. I've said this before, but it's right out of the playbook from the cigarette manufacturers. Absolutely.

Doubt is our product, and if you just cast the slightest amount of doubt, then it paralyzes people and just keeps them stuck in their unhealthy ways. Well, that's with people like know, they're like the Donald Trump of medicine. They just make stuff up, you know, because they know it'll sell books. I mean, I can't really attribute motivation to anybody, but I can just say that, you know, buyer beware, you know, and it's unfortunate, but it's just, that's how people get rewarded these days.

You know, there's some aspect of read the fine print, follow the money, but also be your own experiment. See what the results are for yourself. I think there's no greater... That's a good point because if you just do it for a week, you will see the benefits. You do your N of 1 study. If you do it for 10 days to

two weeks, check your cholesterol, check your weight, check your blood pressure. You'll see the difference. If you have heart disease, we found a 91% reduction in the frequency of chest pain due to heart disease in 24 days. We found that we could show significant improvements in blood flow and the ability of the heart to pump blood in three to four weeks. If the intervention is intensive enough, again, because these underlying biological mechanisms are so dynamic, most people feel so much better so quickly. It then reframes the reason for making these changes from fear of dying or fear of something bad happening, which is not sustainable, to joy and pleasure and feeling good, which really

are. All right. So, undo it. Walk me through the protocol. I mean, it's everything that we've been talking about, right? Eat well, move more, stress less, love more. I mean, really, it's that simple. And I think if you are trying to reverse a disease,

you get to practice stress management for up to an hour a day. And just as one example, that's something that initially is like, wow, how am I going to find an hour to do this? But within days, let alone weeks, it's like how could I go a day without doing this? It's become such an essential part of how I feel and how I identify with myself. If you're trying to reverse disease.

But again, if you're just trying to stay healthy, then to whatever degree you do it, there's a corresponding benefit. Precisely. But she's absolutely right. But the undo it is, again, it's based on the idea that our bodies have this remarkable capacity to begin healing, and much more quickly than we had once realized, if we treat the underlying cause. And the underlying cause comes down to what we eat, how we respond to stress,

how much exercise we get, how much love and support we have. And the more diseases we study, and the more biological mechanisms we look at, the more evidence we have to show why these simple changes are so powerful. People think, oh, it has to be a new drug, a new laser, something really high-tech and expensive. And I think our unique contribution has been to use these very high-tech, expensive, state-of-the-art scientific measures to prove how powerful these very simple and low-tech and low-cost interventions can be. But what makes this book unique is that we've taken all this 40 years of work

and reduced it down to its essence. Steve Jobs used to say he was more proud of what he left out of the iPhone than what he put into it. Because if you really understand something, you can reduce it down to what's really important and leave all the other stuff out. So if somebody's listening to this and they realize that they need to make some changes,

they're headed down that path, but they're living in a place where there is no lifestyle medicine clinic. They can't come and see you. And their doctor is telling them, look, you gotta be on these drugs. That's the way it is. And, you know, just get with the program.

That's very, you know, emotionally, it's very difficult. Like, oh, I have to go in and challenge my doctor. My doctor's telling me to do this. You're, I'm listening to a podcast. This guy's telling me to do this radical thing. And now I gotta go tell my, you know, it's frightening for a lot of people. It's intimidating. So how can we, you know, walk somebody through taking those initial steps to, you know, put the best foot forward? Well, first of all, I think that if you find a doctor that's more supportive,

that's a good thing. But even if you don't say, okay, I'm on blood pressure pills, let's say they might say, or let's say they're on high cholesterol lowering drugs. Okay, so I'm gonna go on those drugs like my doctor wanted me to do, but I'm gonna change my lifestyle too. And I'm gonna get a blood pressure cuff to measure my blood pressure at home. And chances are what they'll find

is over the next few weeks, their blood pressure starts to get so low. Too low, right? They gotta get off. They're starting to pass out. The doctor will say, you gotta take stuff. So then you go back to the doctor and say, gosh, your blood pressure is really doing well.

Let's, and they say, well, I'd like to cut back my dose because I'm starting to pass out here, and my blood pressure has been like 90 over 50. Oh, okay, well, let me cut it in half. And then suddenly now you become the teacher for your doctor because they are – we don't – I mean, my total – I wrote a paper with some of my colleagues where we found like the average amount of nutrition is like an hour per year in medical school. And even that's like vitamin C and serving. This has got to change.

Well, I think, again, the fact that we've changed reimbursement is going to change that. But the point is that you can become a teacher for your doctor by your example, which is always the best teacher. And if somebody wants to seek out a lifestyle medicine doctor, are there online resources where they can go and see who's... Yeah, Anna is so brilliant. She developed our website, our whole learning management system. She's so beautiful that people don't realize how brilliant she is until she opens her mouth. It really is dismaying for a lot of people.

But Ornish.com, she designed completely. Everything on there is free. So there's a lot of information. There's testimonials. Maybe you can just talk about it because you built it. Yeah, so basically there is what we call a site directory on ornish.com, and so you can find a site nearest you. We also do residential retreats.

So if you can't do a nine-week outpatient model somewhere geographically close to you, you can come join us for a residential, more immersion retreat. Which, by the way, Medicare will pay for if they have heart disease. And many insurance companies are expanding the coverage beyond heart disease to include diabetes or sometimes even two or more risk factors. the new book undo it, we're going to be developing a new community platform that will be direct to consumers. So to the general public, a place that you can start or join a support group based on your lifestyle goal. So we really for free, because we really see that that support piece is once you have you say, Okay, I have this, this lifestyle goal, how am I going to get there? Well, support is not only supportive, but it helps you be accountable and it makes it more fun. I mean, if you're not having fun,

it's not going to be sustainable. So we can match you with people who share your goal and together you can achieve it. That's a beautiful thing. You guys gets us out of bed. It's cool. I love how you guys are working together too. It's really cool. When we started writing the book, we're like, I don't know, either we're going to get a divorce, or, but actually I will say, you know, there were some, you know, there was some turbulence from time to time, especially it was a little bit of a menage a trois with the publisher

and the editor, but... Actually, the only chapter we fought about was the love chapter, where the irony was not lost on us at the time. Yeah, yeah, yeah. He loves to say that, but it was more because it was the first chapter that we wrote, so it really defined our writing style and voice separated yet together. Yeah, and also I wanted to be a little more self-disclosing about our personal life than she felt.

That'll be in a future book. That'll be a future book. Yeah. I'm proud. 65 years old. Well, cool. And Anne, is this your first book? This is my first book. It's exciting. It is exciting.

After 20 years, it felt like low-hanging fruits. So we're excited about it. It's a beautiful thing. To have so many different... I feel like I'm married to this harem of different people because we play so many different roles with each other. It's really beautiful. It keeps it really interesting.

We did, fortunately, in undoing it, we're able to fall in love again more than ever because I do think that when you join forces with people who share your sense of mission, whether it's a lifestyle goal or a partnership of any sort, it's a thrilling experience to be able to do things that you couldn't do alone with others it's also an opportunity to confront your character defects because if you're working with your spouse or your partner on something that

you feel very strongly about you're gonna you're it's all gonna come out right that's for sure and that's an opportunity to work through that, which can lead you to deeper intimacy or just explode the relationship. Were you there with this? Because it sounds like that. But as you know, I work with Julie on a bunch of stuff. I've walked this path. It takes one to know one.

Absolutely. But we know how this works. Yeah, and we try to be clean mirrors for each other. Because they say you teach what you want to learn. And we're always learning and growing. And we can reflect back to each other what we most need to hear. And because we trust each other so much, we know it's coming from a good place, even if it isn't always expressed as clearly or cleanly as we'd like. All right, well, we've got to wrap this up.

But my favorite question to kind of end these conversations that I have with doctors and medical professionals is this. If you awoke in a parallel universe and found yourself in the position of being surgeon general, what are the policies and changes that you would like to see implemented? Like, what would your agenda be? Well, I've actually thought about that because- Yeah, I that. You were in a position where that was a possibility. Yeah, more than a possibility.

But yeah, I'd like to see that, again, our work is all about dealing with the cost. And so I'll give you an example. I consulted in 1999 with the CEO of McDonald's and people that I thought had lost their mind. Because I thought, you know, I have 43 million customers a day, and even incremental change on that level can be good. So I was able to persuade them to put salads on the menu. Not necessarily for the right reasons, but I said, look, all you sell is junk food.

You're going to be like the big tobacco. They're going to come after you. At least if you could say that we have salads, then at least you could say we're offering a variety of choices. So they did. And they were great salads they had, edamame and all kinds of wonderful things in them. But they ultimately failed because the salad was $5.95, the burger's 99 cents. And if you're on a fixed income, you get more calories for your buck by eating junk food because the

junk food is subsidized and the healthy food is not. And also it doesn't price into the real cost of society. So if I were a Surgeon General, and I've tried to do this when Senator Harkin was a senator, is to work with the Farm Bill, to work with subsidizing healthy foods and not the junk foods, making them more plentiful and available, to work with, I've also consulted with some of the big food processors to say, can you make healthier foods, even healthier versions of the foods, just to move in that direction. And again, in our fee-for-service,

to make the kinds of lifestyle medicine programs that we've been doing greatly expanded because we know that we've already shown that we can cut health care costs in half in the first year. Five percent of people account for 80 percent of health care costs. These are the five% with chronic diseases. And it's like 75% of all healthcare costs are attributable. Is it 86?

It's up to 86%. 86% of the $3.6 trillion we spent last year on healthcare costs, which were really mostly sick care costs, are for treating chronic diseases that we now know are largely preventable or even reversible through changing lifestyle. And then we can make better care available to more people at lower costs.

And again, the only side effects are good ones. Yeah. That's a worthy agenda. What would you do? I think those are all systemic things to do. And so again, that would be sort of like top-down. And I'd say from bottom-up, I think it's really from the earliest ages, really allowing people to get the right starts from our education system to

integrate, obviously nutrition, the value of physical activity, the self-awareness, inner tools for stress, which is also epidemic in our society, and the ability to have these support groups. I think they should be part of, I think it would be very beneficial for them to be better integrated into our school systems, into the way we work, because we're spending more time either at school as a student or at work as an adult. We need to not say, this is how I live when I'm not working or when I'm not at school. We need to have this more integrated way of living together. Like Alice Waters has done with her edible schoolyard,

which will have vegetables growing. People can see where they come from and really integrate that into their lives. It's beautiful. Well, school lunch is a disaster, and the education system as a whole needs revamping as we usher in the age of AI. The idea that we're still teaching kids the way that we were teaching them

in the dawn of the industrial era is insane. Well, you know, I worked with Alan Haas, and Dan Glickman, when he was Secretary of Agriculture back in 1993, to see if we could change the school lunch program. And there was such pushback from the industry. It was astonishing. Yeah.

Like farm subsidies and the farm bill, there's so much invested in that system. It's going to be very difficult to overcome it, but that's another war worth fighting. But I do believe that over time, things are directionally moving in a good direction. There's a convergence of forces that really make this the right idea at the right time. At the same time that studies are showing that stents don't work in stable patients, that men with early stage prostate cancer who do nothing live as long after 10 years as those who have surgery or radiation,

that getting your blood sugar down if you have diabetes with drugs doesn't work nearly as well as getting it down with lifestyle. We're also seeing that these lifestyle changes can reverse and prevent most of these chronic diseases. Yeah, there's plenty of room for optimism, but it's like an arms race, right? 86% of healthcare costs go into these diseases. 80% of Americans obese or overweight, one out of every three die. It's like, so what's gonna happen first? You know, like as, you know, it's like, we're getting greater and greater awareness around healthy habits and lifestyle practices

that can alter this landscape. But at the same time, the number of people that are dying and becoming disabled from these diseases is like a mushroom cloud. It's true. And if you look at those CDC maps of the percentage of people who are obese over time, it looks like an alien force is taking over the country, which in some ways it is. And at the same time, as Margaret Mead says, change, were you about to say the same?

Go ahead, you say it. Yeah, you say it. I want to hear more from Anne. Yeah, I was going to say. Well, just that change has always happened, not by 90% of the population, but a much smaller, even less than 20%. It's really a small group of organized individuals that are devoted to change and progress. And that's the way it's always happened. I mean, you look at the women's suffrage movement or any big change, civil rights, it always was a small group of people that again, were well organized and devoted to their mission. So we don't have to go after,

you know, we just got to get that critical mass, and we have to turn that tide, and we go where the energy is. So we start with the people where that awareness is already and the readiness is already there and we just get the movement going that's why it's so powerful about what you're doing i was gonna say the same thing you're you're raising the awareness is the most powerful thing that can be well one of one of the great things about new media is is you're your own distribution platform and a message like yours has traditionally been throttled because the doctorauses and the doctors and the network TV shows and the whatever

are underwritten by the pharmaceutical companies and the fast food industry and the breakfast cereal. It's like, they don't want you talking about what you're talking about on their television program because it will negatively impact their bottom line. And so, I think it then becomes incumbent upon podcast hosts and bloggers and, you know, self-publishing authors, anybody who can be a vessel for a healthy message outside of the traditional constrictions of our traditional media system to really advance, you know, the work that you're doing.

Well, just to be an unabashed request of people, if this is something that appeals to you, you know, pre-order our book on Amazon or Barnes and Noble because the publishers pay attention to that, you know, and if it then gets on the bestseller list, as fortunately all six of my earlier books have, then that generates its own awareness and its own interest. And if it then gets on the bestseller list, as fortunately all six of my earlier books have, then that generates its own awareness and its own interest. And then we can ultimately affect change in a much larger group of people and magnify it in that way. Yeah, cool. All right. Parting words. Somebody's listening to this. They're like, okay, I'm ready. I've been stuck for a long time. I'm ready to undo it.

Just leave me with some kind of inspiration or just a starting point for somebody. The starting point is your personal answer to the question of why do you want to live longer and not just to live longer, but to live better. That's where it all comes from. You're a beautiful human being Ann Ornish she is in every way

thank you both super honored to spend some time with you guys today much love and best of luck with the new book everybody pre-order it immediately undo it, available wherever you buy fine books, of course

ornish.com, pmri.org, right? Is the foundation website. Any other places where people can track you down? Richroll.com. There you go, listen to the podcast. All right, you guys, so awesome. Come back and talk to me again, please. Thank you, it's a pleasure.

Thank you guys, please. Thank you. Thank you guys. Peace. Plants. You're really good at this. Such an incredible wealth of inspiration and information. Those guys are really hope you enjoyed that. You know, it's that time of year when we're starting to take stock and inventory of how 2018 went down, like what worked, what didn't work, did we achieve our goals? What new goals do we want to set for ourselves in 2019? And my hope

is that this conversation instilled in you not only some inspiration for how you want to map out 2019, but also a toolbox, a set of tools to help forge that trajectory with some solid takeaways to make 2019 your healthiest year yet. A quick reminder that you can watch our entire conversation on YouTube at youtube.com forward slash Rich Roll. And if this conversation or that video piques your interest, please be sure to pre-order their new book,

Undo It, How Simple Lifestyle Changes Can Reverse Most Chronic Diseases. It's available January 8th, or check out one of Dr. Ornish's many successful other books that he's written. I got links to all of them up in the show notes at richroll.com, where you will also find all kinds of other

great information and resources to extend your experience of this conversation beyond the earbuds. Do me a favor, hit Dean and Ann up on the social networks and let them know how this one went down for you. Dean is at Dean Ornish MD on Twitter and Instagram and Ann is at Ann underscore Ornish on Instagram, although it doesn't appear to be too much activity there,

but you know what? Hit her up anyway, let her know how it went. Final reminder that our new gift cards for the Plant Power Meal Planner make great holiday gifts. So check them out at meals.richroll.com. And if you would like to support our work here on the podcast, there's a couple easy ways to do it. Tell your friends about your favorite episode. Share the show on social media or across the dinner table at your next holiday gathering. Subscribe to the show on Apple Podcasts, on Spotify, YouTube, Google Podcasts, wherever you enjoy this content.

Leave a review on Apple Podcasts. That's very helpful. And you can also support the show on Patreon at richroll.com forward slash donate. I wanna thank everybody who helped put on the show today. Jason Camiolo for production, audio engineering, show notes, interstitial music, a lot of behind the scenes stuff. Blake Curtis and Margo Lubin for videoing the podcast and for creating the graphics. And Jessica Miranda as well, who's stepping up on the graphics front. DK, David Kahn for

advertiser relationships and theme music as always bynalima. Thanks for the love you guys. See you back here next week as our recap, our annual recap. I've been doing this since the very beginning. Our recap of 2018 begins with the best of RRP 2018 part one. It's a good one. I think you guys are gonna enjoy it. Until then, live long and prosper.

Peace. Thank you.