What is the best diet to maintain health over the years, or even reverse health problems caused by years of unhealthy eating habits? The virtues of both diets overlap: abundant fruits, vegetables, legumes, and whole grains with virtually no red meat, sweets, or processed snack foods. But is it better for your heart to sauté those vegetables in olive oil, or steam them?
Introduction
The Ornish and Mediterranean diets are two popular eating plans often touted for their health benefits, particularly for cardiovascular health. Both emphasize whole, plant-based foods and limit processed items, but they differ significantly in their fat content and other key components. This article provides a detailed comparison of the two diets, examining their principles, benefits, drawbacks, and overall effectiveness.
Core Principles
The Ornish Diet
The Ornish diet, developed by Dr. Dean Ornish in 1977, is a very low-fat, plant-based diet combined with exercise, stress management, and social support. It aims to improve overall health, longevity, and quality of life, and was initially designed to reverse heart disease.
- Fat Restriction: Limits fat intake to 10% of total calories.
- Emphasis on Plant-Based Foods: Focuses on vegetables, fruits, whole grains, and legumes.
- Limited Animal Products: Avoids most meat-based proteins and allows only small amounts of nonfat dairy.
- Avoidance of Refined Sugars: Restricts simple carbohydrates and saturated fats.
- Holistic Approach: Incorporates exercise, emotional support, and stress management techniques.
The Mediterranean Diet
The Mediterranean diet is inspired by the traditional eating patterns of people living in the Mediterranean region, particularly Crete, Greece, and southern Italy. It emphasizes whole foods and healthy fats, without strict limitations on fat intake.
- Emphasis on Whole Foods: Rich in fruits, vegetables, whole grains, legumes, nuts, and seeds.
- Healthy Fats: Includes olive oil as a primary fat source and encourages the consumption of fish and poultry.
- Limited Red Meat and Dairy: Restricts the intake of red meat and dairy products.
- Moderate Wine Consumption: Often includes a glass or two of red wine with meals.
- Lifestyle Integration: Promotes physical activity and social interaction.
Typical Foods
Ornish Diet
- Foods to Enjoy: Fruits, vegetables, whole grains, green tea, legumes, nonfat dairy foods, tofu, egg whites, and limited amounts of alcohol and nonfat sweets.
- Foods to Avoid: Added oils and fats, chocolate, caffeine (except green tea), dairy foods containing any fat, egg yolks, high-fat plant-based foods (avocados, olives, coconut), meat, poultry, seafood, nuts, and seeds.
Mediterranean Diet
- Foods to Enjoy: Plenty of fruits, vegetables, fish, poultry, olive oil, nuts, seeds, and legumes.
- Foods to Limit: Low amounts of dairy and red meat.
Health Benefits
Ornish Diet
- Reversal of Heart Disease: Demonstrated in small trials to reduce artery plaque and heart attacks in those with established heart disease.
- Control of Type 2 Diabetes and Prostate Cancer: Follow-up studies suggested the lifestyle plan might help manage these conditions.
- Weight Loss: Studies show the Ornish plan is moderately effective for weight loss.
- Reduced LDL Cholesterol: Significant reductions in LDL cholesterol have been observed during the Ornish maintenance phase.
Mediterranean Diet
- Reduced Risk of Cardiovascular Disease and Stroke: Multiple trials have shown a reduction in the risk of these conditions.
- Lower Risk of Neurodegenerative Diseases: Associated with a lower risk of Parkinson’s disease and Alzheimer’s disease.
- Cancer Prevention: Linked to a lower risk of certain types of cancers (colorectal, prostate, oropharyngeal, and breast).
- Reduced Mortality: Superior to minimal intervention for the prevention of all-cause mortality and cardiovascular mortality.
Potential Downsides
Ornish Diet
- Restrictive Nature: May be difficult for some people to stick with due to the strict limitations on fat and animal products.
- Nutritional Deficiencies: Reduced fat intake may lead to deficiencies in essential nutrients, such as omega-3 fatty acids.
- Digestive Problems: High fiber content may initially cause bloating, constipation, diarrhea, and gas.
Mediterranean Diet
- Lack of Specific Guidelines: No single definition, which can lead to confusion.
- Potential for High Calorie Intake: The inclusion of olive oil and nuts can lead to a high calorie intake if not moderated.
- Wine Consumption: While moderate wine consumption is often included, it may not be appropriate for everyone.
Adherence and Sustainability
- Ornish Diet: Requires significant lifestyle changes and may necessitate 72 hours of training with an exercise physiologist and registered dietitian for long-term adoption.
- Mediterranean Diet: May take less time to learn but may still require a few hours of counseling from a dietitian. It is often considered more sustainable due to its less restrictive nature.
Research Findings
- Network Meta-Analysis: A network meta-analysis of 40 eligible trials with 35,548 participants found that Mediterranean dietary programs were superior to minimal intervention for the prevention of all-cause mortality, cardiovascular mortality, stroke, and non-fatal myocardial infarction. Low-fat programs also proved superior to minimal intervention for the prevention of all-cause mortality and non-fatal myocardial infarction.
- Weight Maintenance Study: A randomized crossover study found that during weight maintenance, the Atkins diet (high fat, low carbohydrate) was associated with higher total cholesterol and LDL-C compared to the South Beach and Ornish diets, and reduced endothelial vasoreactivity compared to the Ornish phase.
- Cognitive Function Study: A Spanish study found that participants on a Mediterranean diet supplemented with extra nuts or olive oil performed better on cognitive tests.
Practical Considerations
- Cost: The Ornish diet can be expensive to maintain due to the emphasis on fresh, whole foods and the potential need for supplements. The Mediterranean diet can also be costly, depending on the quality and source of ingredients.
- Accessibility: The foods allowed on the Ornish diet are generally easy to find. The Mediterranean diet also relies on readily available foods.
- Personal Preferences: The best diet is one that aligns with individual preferences and lifestyle. If you prefer some meat and healthy fats, the Mediterranean diet may be a better fit. If you are drawn to vegetarian eating and a holistic approach to health, the Ornish diet might be a good choice.
The DASH Diet
Researchers have also found health benefits such as reversal of hypertension from the Dietary Approaches to Stop Hypertension (DASH) diet. It includes about 20 to 35 percent of calories from fat - somewhat less than the 30 to 40 percent of calories allowed on the Mediterranean diet plan and more than what’s allowed on the Ornish plan. The DASH plan has the same emphasis on fruits, vegetables, and whole grains but limits sodium intake and alcohol and emphasizes potassium-rich foods such as bananas.
Read also: Is the Ornish Diet Right for You?
Other Diets
- Intermittent Fasting: In animal studies, intermittent fasting has been shown to decrease inflammation, improve glucose regulation, and increase stress resistance. Ketone bodies (compounds produced when you metabolize fat) have been shown to regulate the expression and activity of many proteins that are known to influence health and aging. Downsides: Intermittent fasting can be difficult to maintain, especially in the early stages, when people may feel fatigued.
- Ketogenic Diet: The keto diet has been associated with faster weight loss than some of the low-fat diets; however, this difference disappears over time. Downsides: It is a very restrictive diet and difficult to sustain. It can lead to fatigue, nausea, constipation, and insomnia.
- Paleolithic Diet: Recent studies have shown that people who follow the paleo diet have increased levels of trimethylamine-n-oxide (TMAO), a compound produced in the gut that is associated with an increased risk of heart disease. The diet is restrictive and fairly expensive to sustain.
- Vegan Diet: The vegan diet can be very difficult to follow, and people may be missing essential nutrients in their diet such as B12 and choline.
- Vegetarian Diet: The vegetarian diet, however, is less restrictive in that it allows the consumption of animal-based products such as dairy and eggs.
- Whole 30: The diet may help people identify uncomfortable symptoms triggered by certain foods. Downsides: Whole 30 is very restrictive by design and can be expensive to maintain.
- HCG Diet: The diet has been associated with increased fatigue, depression, and edema as well as the enlargement or swelling of breast tissue in men and boys (“gynecomastia”).
- Detoxes and Cleanses: These cleanses are potentially dangerous and harmful to one’s health and are therefore discouraged.
Read also: Ornish Program and Prostate Cancer
Read also: The Hoxsey Diet
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