The greatest challenge is stating the problem in a way that will allow a solution.

Sunday, February 26, 2012

Preventative Medicine



Mission Statement

Preventive Medicine Research Institute
PMRI is a non-profit research institute that performs scientific research investigating the effects of diet and lifestyle choices on health and disease.

Our work is grounded in compassion and dedication to service. PMRI achieves its mission by:

  • Publishing research that informs the practice of medicine and allows the individual to take personal responsibility for health
  • Collaborating with leaders in the scientific community
  • Educating and training health professionals and the public about preventive medicine and the benefits of lifestyle change

The Proven Lifestyle

People often think that advances in medicine have to be a new drug, a new laser, or a surgical intervention to be powerful—something really high-tech and expensive. They often have a hard time believing that the simple choices that we make in our lives each day—what we eat, how we respond to stress, whether or not we smoke, how much we exercise and the quality of our relationships—can make such a powerful difference in our health, our well-being, and our survival, but they often do.
Awareness is the first step in healing. When we become more aware of how powerfully our choices in diet and lifestyle affect us—for better and for worse—then we can make different ones. It’s like connecting the dots between what we do and how we feel.
Part of the value of science is to raise our awareness by helping us to understand the powerful effects of the diet and lifestyle choices we make each day—and how changing these may significantly, sometimes dramatically, improve our health and well being. In many cases, these improvements may occur much more quickly than people had once believed possible.
In our studies, we used the latest in high-tech, expensive, state-of-the-art measures to prove how robust these very simple, low-tech, and low-cost interventions can be.
For more than 30 years, Dr. Dean Ornish has directed a series of scientific research studies showing, for the first time, that the progression of even severe coronary heart disease can often be reversed by making comprehensive lifestyle changes. These include a very low-fat diet including predominantly fruits, vegetables, whole grains, legumes, and soy products in their natural, unrefined forms; moderate exercise such as walking; various stress management techniques including yoga-based stretching, breathing, meditation, and imagery; and enhanced love and social support, which may include support groups.
These studies also documented that other chronic diseases may be reversible simply by making comprehensive lifestyle changes. These findings are giving millions of people worldwide new hope and new choices, options that are more caring and compassionate that are also more cost effective and competent. 
More recently, Dr. Ornish and colleagues published a randomized controlled trial in collaboration with Peter Carroll, M.D. (Chair of Urology at the School of Medicine, University of California, San Francisco) and William Fair, M.D. (Chair of Urologic Oncology at Memorial Sloan-Kettering Cancer Center, now deceased) showing that the progression of early-stage prostate cancer may be stopped or perhaps even reversed by making similar changes in diet and lifestyle. This was the first randomized controlled trial showing that the progression of any type of cancer may be modified just by changing what we eat and how we live. What’s true for prostate cancer may be true for breast cancer as well.
Recent studies at PMRI are continuing to show how dynamically lifestyle changes can improve our health and well-being, even on a genetic and cellular level.  In November 2008, The Lancet Oncology published PMRI’s study showing that changing lifestyle significantly increases telomerase and, thus, telomere length.  Telomeres are the ends of our chromosomes that control how long we live.  As your telomeres get longer, your life gets longer.  This is the first time that any intervention, even drugs, has been shown to significantly increase telomerase.  
This is the same cohort of patients in whom we reported changes in gene expression in the Proceedings of the National Academy of Sciences in May 2008 (Dr. J. Craig Venter was the communicating editor).  In that study, we found that changing lifestyle changes genes.  After only three months, over 500 genes were beneficially affected—upregulating (“turning on”) disease-preventing genes, and downregulating (“turning off”) genes that promote cancer, heart disease, inflammation, and other illnesses.  This is the first time that comprehensive lifestyle changes have been shown to beneficially affect gene expression in men with prostate cancer. 
These studies show how powerful comprehensive lifestyle changes can be, how dynamic these mechanisms are, and how quickly benefits may occur.  It’s not all in our genes. 
When you make comprehensive lifestyle changes, most people find that they feel so much better, so quickly, it reframes the reason for changing from fear of dying to joy of living. Joy and love are powerful, sustainable motivators, but fear and deprivation are not.
You have a full spectrum of nutrition and lifestyle choices. It's not all or nothing. To the degree that you move in a healthful direction along this spectrum, you're likely to look better, feel better, lose weight and gain health.
People have different needs, goals and preferences. What matters most is your overall way of eating and living. If you indulge yourself one day, you can eat more healthfully the next. If you're a couch potato one day, exercise a little more the next. If you don't have time to meditate for 20 minutes, do it for one minute—the consistency is more important than the duration. Then, you're less likely to feel restricted. Studies have shown that those who eat the healthiest overall are the ones who allow themselves some indulgences.
If you’re trying to reverse heart disease or prevent the recurrence of cancer, you may need the “pound of cure”—that is, bigger changes in diet and lifestyle than someone who just wants to lower their cholesterol levels a few points or lose a few pounds. If you have a strong family history, or if genetic testing shows you to be at higher risk, then this information can be a powerful motivator to make bigger changes in diet and lifestyle than you might have otherwise made. Also, it may be possible to tailor pharmacologic interventions more effectively and efficiently.
If you’re basically healthy, then you can thrive on the “ounce of prevention.” And if you’re somewhere in between—if you have some worrisome risk factors for heart disease (high cholesterol, high blood pressure)—then you can begin by making moderate changes in diet and lifestyle, progressively more intensive as needed. If that’s enough to achieve your goals, great; if not, then you may want to consider making bigger changes.
For example, most people in this country have elevated cholesterol levels. They are initially advised to follow a diet based on the National Cholesterol Education Program or American Heart Association guidelines—i.e., less red meat, more skinless chicken, etc. For some, that’s sufficient to lower their cholesterol levels enough, but not for most people. Many are then told, "Sorry, it looks like diet didn't work for you" or, “You failed diet.” Then, they are usually prescribed cholesterol-lowering drugs, which they are told they will need to take for the rest of their lives.
In reality, most people can make progressively bigger changes in nutrition and lifestyle to achieve their goals—often without medications. If moderate changes in diet and lifestyle aren’t sufficient to lower your cholesterol sufficiently, bigger changes in diet and lifestyle usually are. How much you want to change is up to you.
Likewise, you have a spectrum of choices in how much you exercise and how much of the stress management techniques you choose to do. Even 20-30 minutes per day of walking provides most of the health benefits of more intensive exercise while minimizing the risks. And even a few minutes a day of yoga and meditation can make a profound difference in your well-being.