Excerpt: Dean Ornish's 'The Spectrum'

It's important to treat not only the problem but also its underlying causes. Otherwise, the same problem often recurs (for example, bypass grafts or angioplastied arteries clogging up again), a new set of problems may happen (such as side effects from medications), or there may be painful choices (such as keeping 47 million Americans from having health insurance because it's too expensive to treat everyone with the drugs or surgery that they may need).

We found that many people with coronary heart disease, diabetes, high blood pressure, elevated cholesterol levels, and other chronic conditions are able to reduce or even discontinue these medications (under their doctor's supervision) when they make the diet and lifestyle changes that are outlined in this book.

With the legitimate concerns about pandemics of AIDS and avian flu, it's easy to forget that cardiovascular disease kills more people each year worldwide than any other disease. It's the biggest pandemic of all time. Heart disease is so common that we've become accustomed to it, thinking of it as a natural cause of death. Yet there's nothing natural about it.

Diabetes and obesity are also becoming pandemic. In just the past ten years, the incidence of diabetes in the United States has increased 70 percent among people in their thirties, in large part because of the obesity pandemic. In India, a recent study conducted by the Delhi Diabetes Research Centre among schoolchildren ages 10 to 16 found nearly one in five to be either overweight or clinically obese. A major complication of diabetes is heart disease, along with nerve, eye, and kidney damage.

However, coronary heart disease, type 2 diabetes (once known as adult-onset, though an increasing number of younger people are now getting it), and obesity can be prevented in almost everyone simply by making sufficient changes in diet and lifestyle. We don't have to wait for a breakthrough in technology or a new drug; we just need to put into practice what we already know. If we did, these pandemics could be as rare as malaria is in the United States.

In addition to our research, the landmark INTERHEART study, led by Canadian scientists, followed 30,000 men and women in fifty-two countries on six continents. It found that nine factors related to nutrition and lifestyle accounted for almost 95 percent of the risk of a heart attack in men and women in almost every geographic region and in every racial and ethnic group worldwide. These factors were: smoking, cholesterol level, hypertension, diabetes, obesity, diet, physical activity, alcohol consumption, and psychosocial issues such as emotional stress and depression.

In other words, the disease that kills the most people each year worldwide and accounts for the single largest expenditure of health care dollars is almost completely preventable just by changing diet and lifestyle in ways described in this book.

Despite this, relatively little of the money spent by most insurance companies has gone toward teaching people how to prevent or treat cardiovascular disease and other chronic diseases by changing their diet and lifestyle. Much of it goes to pay for surgical procedures such as angioplasty and bypass surgery.

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