Dr. Dean Ornish, the California guru whose radical approach to diet has been shown to reverse heart disease, settles in at the corner table at the Ritz cafe, facing Temptation.
Temptation, his luncheon partner one recent winter day, points to the lobster bisque, the special Ritz cheeseburger with aged cheddar, the Boston cream pie.
“They sound good, but I think I’ll try something different,” says Ornish, 42, whose tastes — and recommendations — run to fruits, vegetables, grains, beans, nonfat dairy products, egg whites and not a whole lot more.
With no added oils of any sort, this amounts to a diet that is 10 percent fat, with almost no cholesterol.
As the maitre d’ hovers, Ornish, clearly unconstrained by conventional expectations or printed menus, begins the serious negotiations.
“Can you make me a cup of minestrone with no cream and no butter? Can you make up just some pasta, angel hair pasta, and can you make a marinara sauce without any oil, not even olive oil? And grill up some vegetables?”
(Temptation orders the penne with portobello mushrooms and cepes, swimming in olive oil.)
Ornish settles back, takes a hefty swallow of water and launches into a plug for his latest book, “Everyday Cooking with Dr. Dean Ornish,” and his new program at Beth Israel Hospital, where for $7,000 or so each — some insurers cover it — about 100 people this year will try Ornish’s approach to reversing heart disease.
Just as Ornish is warming to his tale of healthy hearts, legumes and yoga, the waiter swoops over. Would it be all right to add just the tiniest bit of oil to cook the onions for the marinara sauce?
It would not.
“Why not just leave the onions out?” suggests Ornish. Heads nod: Of course.
Eating the way he does, says Ornish, who is 6 feet tall, weighs 170 (he’s gained 15 pounds pumping iron) and has a total cholesterol level of 130, is ”not a moral issue.”
“This is just a choice I prefer. Once you start categorizing food as good or bad, soon you’re a good or bad person,” he says, noting that he grew up eating meat five times a day in Texas but now loves his plant-based, meat-free diet.
Once you get used to it, he says, food tastes better, you feel better fast, and you even come to prefer healthful things like skim milk. Besides, he contends, making big, radical changes in lifestyle and diet is easier and more effective than chipping away at the problem with small, incremental changes.
Over the years, Ornish’s approach has been controversial. At first, other doctors doubted that clogged arteries and chest pain could be reversed by something as low-tech as diet and behavior modification. Lately, critics have worried that his program is just too tough for the average person to stomach.
But it seems to work. Several years ago, Ornish published a study of 48 people that showed that blockage of coronary arteries was significantly reversed in 82 percent of patients after one year on the diet and a behavior modification program.
Last fall, he published a five-year followup on the same people. Using scans that measure blood flow to the heart, he found that 99 percent of patients were able to halt or reverse progression of heart disease.
Nationwide, about 1,000 patients so far have enrolled in Ornish programs at eight hospitals, and many, he says, have been able to avoid expensive bypass surgery or angioplasty to open their arteries. In fact, Mutual of Omaha insurance company, which has followed more than 40 Ornish patients, has saved $5.55 for every dollar it spent on the program, he says.
The heart of the regimen, says Ornish, who is director of the Preventive Medicine Research Institute in Sausalito, Calif., is its multidisciplinary approach.
At Beth Israel, for instance, patients exercise — that is, walk — a minimum of half an hour a day, or one hour three times a week. They also spend an hour a day doing yoga, relaxation exercises and meditation, and have regular cardiac checkups and group counseling.
Richard Murphy, a 54-year-old plumber from Hanover who has been in Beth Israel’s pilot program since September, attests to both the rigor of the program, and its results.
After a heart attack seven years ago, Murphy says, he stuck to a healthful diet and exercise program for a few years, but gradually slipped back. Last year, he began having angina, the chest pains that are a hallmark of clogged coronary arteries.
When his insurer, John Hancock Co., offered to foot 90 percent of the bill for the Ornish program, Murphy jumped at the chance. Since September, he has lost 15 pounds, feels “excellent” and says he has “a bounce to my step I didn’t have before.” And his angina is gone.
Back at the Ritz, lunch arrives, and Ornish is thrilled.
“Doesn’t that look good,” he says. “You did a very nice job. My compliments to the chef.”
His plate is filled with grilled vegetables that glow with health and color atop a pile of pasta. There is not a droplet of oil.
“You can go out to eat and order this,” says Ornish, relishing every bite. People hesitate to ask restaurants for what they want, he says, because ”they don’t want to look weird or different — but my plate looks better than yours.”
It does.
“And if you eat low-fat all the time, you begin to prefer it,” he says.
Temptation eyes the oil at the bottom of her plate.
Finally, the dessert menus arrive. “Tiramisu?” asks the maitre d’.
At first, Ornish hangs tough. “What kind of sorbet do you have?” Then, saying he’d “rather eat chocolate if I’m going to eat fat,” he caves: “Do you have any chocolate desserts?”
Invited to split a chocolate mousse, he agrees to have a taste.
It’s OK, he says, because he knows he’s free of heart disease. Besides, the real reason to stick to a healthful diet, says the guru, is that “you’ll feel better. It’s the joy of living, not the fear of dying, that sustains you.”
The mousse arrives. It’s gorgeous. Ornish slips his fork into it, puts a tiny bit into his mouth. Conversation stops. It is the moment of truth.
He closes his eyes to savor it. No wonder. It’s the only bite he takes.