Clinical Nutrition · Topic of the Week

Topic of the Week: Dr. Dean Ornish

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As I’ve mentioned, this week I started a new rotation at a rural hospital.  While I’m there I get the chance to work with 3 RD’s.  I was with one for the first two days and today I got to go to one of the hospital’s satellite locations in a different town to work with one of the other RD’s.  Her job is awesome! A main part of her job is helping with the Intensive Cardiac Rehab program they have at this location.  Since she’s only been there for about a year and new to helping with the program, this time around she’s participating in it.

So this meant that today I got to participate too!

The group meets on Monday and Wednesday from 1:00-5:00 and the entire program is 9 weeks long.  They spend the first hour in a group counseling session, the next hour working out, the hour after that doing relaxation exercises, and the last hour doing a cooking class.  I got to jump in during the work out portion and utilize the facility’s gym for that hour.  While I walked on the treadmill I decided to read a portion of one of the books my preceptor had in her office.

The Intensive Cardiac Rehab program is based on Dr. Dean Ornish’s Program for Reversing Heart Disease.  That, conveniently, is also the title of the book that I was reading.  We went over the program a little bit when I first got there but I wanted to take more time to really understand what the patients in the program were being expected to follow.

This book was written in 1990 so there were definitely some things in there, mostly research, that were outdated.  However, the research supporting Dr. Dean Ornish’s program has yet to be disproven and does work to reverse heart disease.  The program as a whole is about “healing the heart-physically, emotionally, and spiritually.”  He was the first to prove that heart disease is reversible with lifestyle change and it can be life changing for many people.

The specific program in this book was called the Opening Your Heart Program. The steps of this include:

  1. Techniques for increasing intimacy and managing stress more efficiently
  2. Diet very low in fat and cholesterol
  3. Systems to help you stop smoking and let go of other addictions
  4. A program of moderate exercise

All of these things are included in the 4 hour program provided at the facility I was at today.  There are two versions of diet for the program, the reversal diet and the prevention diet.  The reversal diet is the one this program uses, since in order to qualify patients have to have a previous cardiac event.

This diet is really restrictive. No animal products except egg whites and non fat dairy, no added oils or concentrated fats, moderate amounts of sugar, alcohol, and salt, and no caffeine or other stimulants.  Even with all the restrictions, all the recipes we made in the cooking class were really good!  It was really great to see all the participants share their knowledge and try and enjoy the new foods.

Before today I would probably never have understood the purpose of such an incredibly restrictive diet.  For the most part, I think it’s better to start small and find out what the patient is capable of doing and what they are willing to do.  It is a totally different story with these patients though, they are literally to the point where they have no choice but to make a serious lifestyle over haul.

I think today was by far the best day of my internship so far AND I feel like I really learned a ton.

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