In an op-ed in the New York Times called “The Myth of High-Protein Diets,” Dr. Dean Ornish asserts that eating protein and fat from animal products will send you to an early grave. Provocative? You bet. For two days it was the most-read and most-emailed article at nytimes.com.
Dr. Ornish has been ringing this same bell for a long time. He was probably the most influential diet-book author of the 1990s, with two bestsellers—Dr. Dean Ornish’s Program for Reversing Heart Disease, and Eat More, Weigh Less—promoting super-low-fat, plant-based diets.
But his ideas have been out of fashion for at least a decade. Why is he getting so much attention now? Is there anything new to say?
Let’s start with his case against red meat. A 2012 study in Archives of Internal Medicine, combining the results of two large, long-running studies, found that those who eat the most red meat have a slightly higher risk of dying from any cause, compared to those who eat the least. The real danger, though, seems to be associated with processed meat. Over the course of an up to 28-year followup, those who ate the most processed meats like bacon and sausage were 20 percent more likely to die during that period—of any cause—than those who ate the least.
The authors suggest that you aim for a maximum of 42 grams a day of red meat. That’d be the equivalent of eating a 12-ounce steak over an 8-day period. Better choices, they say, include fish, poultry, nuts, legumes, low-fat dairy, and whole grains. You’ll notice that three of those suggestions contain animal protein, which Dr. Ornish believes is harmful.
So what’s the beef against protein?
Obesity researcher Stephan Guyenet, Ph.D., tackled that recently in his magnificent nine-part series on meat and health. The power of protein comes from the fact that it speeds things up. Just eating more of it increases your metabolism, and when the extra protein helps you build muscle over time, that increases your metabolic rate even more.
Both of those are hugely beneficial when your goal is to look, move, and feel better. Who doesn’t want more muscle with less fat?
The only problem, Guyenet notes, is that “firing on all cylinders” also speeds up aging at the cellular level. That, in theory, could lead to future health problems, suggesting a tradeoff between the benefits you get now and the length and quality of your life decades down the road.
“It’s a beautiful theory,” he writes, “but real life is complicated.”
One complication was noted already: If animal protein speeds up aging, then why is there no risk associated with fish, poultry, or dairy? Exercise also cranks up your metabolism, and we have lots of evidence that the fittest, strongest people live the longest, with the least risk of disability.
Which brings us to the biggest problem with Dr. Ornish’s anti-protein argument: Anyone who’s actually lost weight and kept it off will tell you that a successful diet requires a lot more than a grocery list. In fact, no one in recent years has made a stronger case for full-spectrum lifestyle changes than Ornish himself.
Origin of an Anti-Fat Crusader
Dr. Ornish promotes his extreme diet for heart health and weight loss, but that’s not why he started using it. As recounted in a 1998 story in the Times, it was 1972, and he had just dropped out of college because of mononucleosis and depression: “At his parents’ home in Dallas, Dr. Ornish met Sri Swami Satchidananda, who had been teaching Dr. Ornish’s older sister meditation and relaxation techniques.”
The swami told him to become a vegetarian, meditate, practice yoga, exercise, and help other people. Dr. Ornish agreed, liked the results, returned to college, and a few years later, in medical school, began to test the multifaceted program with cardiac patients. He taught them yoga and led a support group, while also working with them to change their diets. “Probably the most important reason that many people smoke or eat too much is because it helps them deal with stress and loneliness and isolation,” he told the Times.
Two obvious questions arise from Dr. Ornish’s origin story:
1. He met a swami in his home, in Texas?
2. Does any of this work without the intensive, small-group attention he was able to provide those patients?
We’ll have to take his word on the swami. The second question, though, remains unanswered, for the simple reason that the diet itself is nearly impossible to use. The landmark A to Z Weight Loss Study, published in the Journal of the American Medical Association in 2007, pitted Dr. Ornish’s diet against its opposite, the super-low-carb Atkins diet, along with two others: the Zone (40 percent carbs, 30 percent fat, 30 percent protein) and LEARN, a low-fat diet based on the government guidelines at the time.
The headline finding from the study was that Atkins worked slightly better than the others; subjects lost an average of 10 pounds over 12 months. Ornish dieters fared the worst, losing just under 5 pounds, even though they reported eating the fewest calories overall.
But the most important finding of the study had nothing to do with weight: No one was able to stick to any of the diets. By the end the Ornish group was getting 30 percent of their calories from fat, which is three times what he recommends. The Atkins dieters got 35 percent of their calories from carbs, nearly tripling their target of 50 grams a day.
Dr. Ornish pointed this out in a letter to the editor: “The real conclusion of this study is that it’s hard for many people to follow a diet just from reading a book and a few sessions with a dietitian. This is hardly news and very different from the reported conclusions.”
It would be nice to take the Dr. Ornish who wrote that letter, and who personally conducted support groups and yoga classes for cardiac patients, and introduce him to the Dr. Ornish who wrote the scaremongering op-ed in the Times. That would be an interesting conversation.
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