Drama with the Dr. Oz Show

A producer from the Dr. Oz show recently contacted my office. They asked whether we could supply them with a volunteer patient from either my practice or the Track Your Plaque program who would be willing to appear on the show and discuss heart disease prevention. They needed someone to commit within 24 hours.

Despite the short notice, we identified a volunteer. He flew to New York the following week where he was interviewed along with several other men and women, all of whom had heart disease (heart attacks, stents, etc.). However, as this young man is very slender and follows most of the Track Your Plaque principles (e.g., vitamin D and omega-3 fatty acid supplementation; no wheat, cornstarch, or sugars, no restriction of fat, etc.), he apparently received less attention than the overweight, I-know-nothing-about-diet interviewees.

Then there was an odd turn of events: Dr. Dean Ornish, apparently a friend of Dr. Oz, will be providing the dietary counseling. The producer had made no mention of Dr. Ornish.

Now that's an odd collision of philosophies: Our Track Your Plaque version of low-carb with the guru of low-fat, Dr. Ornish.

The following week, Dr. Ornish called me and graciously asked whether I was okay with this. I'm not sure just how much he knew about the philosophy I advocate, nor how much I have bashed his program as a destructive approach to diet, nor whether he knew that I gained 30 lbs on the Ornish diet, along with a drop in HDL to 27 mg/dl, increased triglycerides to 350 mg/dl, and type II diabetes that I've talked about on this blog and the Track Your Plaque book and website. I suspect he knew little to none of this.

Anyway, I tried to diplomatically explain that my patient's cause for coronary plaque was small LDL particles that he expressed despite his very slender build, likely from excessive carbohydrates, controlled with carbohydrate restriction. Dr. Ornish maintained his usual arguments: Grains are good, provided they are whole grains, heart disease is "reversed" with his diet program, etc. (I didn't want to challenge him in a phone call and tell him that he never actually reversed coronary plaque, but just reversed endothelial dysfunction. But, as Dr. Ornish is not a cardiologist, I wasn't sure how far his understanding of these issues went.)

We agreed to disagree. This leaves my poor patient in an odd position: Being asked by Dr. Ornish and the Dr. Oz show to follow a low-fat program for the sake of entertainment, or adhering to the advice we follow that has so far served him well, given his small LDL particle size tendencies.

We'll see where this little drama leads.

Comments (27) -

  • preserve

    4/11/2010 2:10:12 PM |

    This can be very educational.  We can find out the effects of Dr. Ornish's diet, directly prescribed by him.  This provides a pretty comparison test.

  • Anne

    4/11/2010 3:12:55 PM |

    If I had been the person flown to NYC for the show and was told they wanted me to follow the Ornish plan, I would have told them "No way." and walked out.

    I tried the Ornish diet when I first started having problems with CAD and multiple stents. I found the diet very difficult and it left me hungry. I did the meditation too.  I don't know what my lipid levels were at that time. I then went to the AHA diet that caused my triglycerides, cholesterol and weight to all rise and the answer was to get on statins and I went on to have bypass.

    In 2008 I started following a TYP lifestyle plan. Here is what happened http://heartscanblog.blogspot.com/2009/06/beating-heart-association-diet-is.html

  • Ned Kock

    4/11/2010 3:54:15 PM |

    Interesting, particularly the involvement of Dr. Ornish. Dr. Oz seems to be changing his tone lately - less critical of fats or more of refined carbs.

    By the way, you mentioned several times on your blog that the  Friedewald equation is very imprecise, providing a fictitious measure of LDL, particularly as TGs go down.

    What is your opinion of the Iranian equation? It seems to be more precise for those with low TGs, and maybe more precise in general, as its parameters were estimated through multiple linear regression:

    http://healthcorrelator.blogspot.com/2010/04/friedewald-and-iranian-equations.html

    Of course, a VAP or equivalent test would be better, but a lot of people would like to have a more precise number based on their standard lipid profile results.

  • JD

    4/11/2010 3:57:26 PM |

    Dr. Oz's wife Lisa is a vegetarian and IIRC a producer of his radio show. Dr. Oz has been quoted as saying that "everything he knows about nutrition he learned from his wife". Given his source of nutrition education I am not surprised he is on good terms with Dr. Ornish. As Dr. Eades says, "Jesus wept".

  • Mark

    4/11/2010 4:06:06 PM |

    Subjects on Dr. Oz are chosen w/entertainment value in mind.  Dr. Oz consistently gives contradicting advice at different times aimed at large audiences with the air that one size fits all. I will stay with my individualized TYP approach and leave him and his advice to entertain the masses.

  • Alcinda (Cindy) Moore

    4/11/2010 5:25:48 PM |

    If it was me, no contest. I'd stick with you! I am not a fan or Oz....and can't stand Ornish!

  • Rantin' Rog

    4/11/2010 5:31:38 PM |

    While I don't agree with Ornish, I think this is an exciting development.  Maybe he will learn something from your patient!  Any common ground and exchange of ideas is a good thing.

  • Brett

    4/11/2010 9:08:37 PM |

    Why didn't Oz or Ornish simply invite you, Dr. Davis, to be on the show? You're (cough) down with the low-fat program, right?

  • pjnoir

    4/12/2010 2:13:45 AM |

    AMBUSH. Low FAT will always win the debate because they set the facts- its just like Alice in Wonderland. Nothing good can come of this. I saw Doc OZ pour some cooking oil in his hand and say to a women- see,image this running through your veins. If thats the case- Id hate to see what Oatmeal looks like in those veins. And don't get me started on DO.

  • Gina

    4/12/2010 4:17:48 AM |

    This is the reason I turned my TV off for good over 9 years ago!
    Oz and Ornish and entertainment...why do people believe every word theses guys say? Oh maybe because Oprha says they're the best. Good God, with a computer and internet available to almost anyone who can view a TV why don't they ask some questions and do some research. Oh maybe because this is all in the name of entertainment.
    Keep up the great work Doc. I love the blog!

  • Dr. William Davis

    4/12/2010 11:31:47 AM |

    I remind myself that Dr. Ornish et al are all trying to work towards the same goal: reduction of heart disease risk. It's just that we disagree on how we get there. I think his heart is in the right place, but I worry that he perpetuates a message that is outdated and, in many cases, destructive.

    Ned--

    The "Iranian equation" is definitely an improvement, despite being nothing more than a manipulation of numbers. However, it does not uncover the hidden sources of risk that are NOT expressed by the basic lipid numbers, no matter how much you massage them.

  • Peter

    4/12/2010 11:47:49 AM |

    I don't think your disagreements with Ornish are as black and white as you suggest: he has been telling people for thirty years to stop eating sugar and other refined carbohydrates, he thinks well enough of heart scans to have one himself (scored zero), and both you and he choose whole foods over processed foods in a heartbeat (that was a joke about heartbeat.) This is not to say that your views are the same.

  • Dr. William Davis

    4/12/2010 11:58:05 AM |

    I agree, Peter.

    While the differences are fundamental, there is perhaps 70% overlap. And we are indeed aiming for the same goal.

  • George

    4/12/2010 5:03:09 PM |

    Dr. Davis, Hopefully something good will come from this. I would love to see status updates of what develops here. Beginning/Ending lipid profiles, what changes your volunteer makes in their diet based on Ornish, etc. Very, very interesting, looking forward to see what happens. Do we know when this will possibly air?

  • Anonymous

    4/12/2010 5:38:02 PM |

    pjnoir is correct.  It is an ambush.

    Ornish is not 'growing', and Oz is not about to admit he's been wrong all this time.

    You are about to be mocked and held up as a quack.

    It is a shame that they have the megaphone and you don't, but that is our perverted medical/money/fame/power system.

  • Health Test Dummy

    4/12/2010 8:07:33 PM |

    Not that I think these types of doctors are 'dumb', per-say, however, it angers me as to their 'ignorance'. I have absolutely the highest respect for all doctors who search for the 'proactive' solution. I think anyone who sticks with the 'lemmings-style' mantra, in regards to science, is only asking for humiliation and self-destruction down the road. The Ansel Keys-inspired lipid hypothesis, I believe, has been absolutely shot down by CORRECT scientific methods for analyzing it's true health benefits. Throwing together some generalized 'meta-analysis' and touting it as 'truth' for the past 50 years shows us just how 'lemming-like' we truly are as a society. This information is a type of regurgitated (telephone game) bit of information that sticks to everything like glue, due to bad media and doctors who refuse to proactively search for alternative solutions based on true scientific formulas (have we all forgotten the 7th grade science class teachings of 'control group' and other forms of scientific analysis?).

    Anyway, it blows my mind. Meanwhile, I will continue to be mocked and viewed upon by my peers as 'weird' or 'out there', whilst they are all 10% + bodyfat % above me.

  • John

    4/12/2010 9:45:40 PM |

    I can vouch for the wisdom of Dr. Davis, I recently switched cardiologists to one that would listen to me about how I changed my diet since November of last year alas with the recommendations on this website I was so fortunate to come across.

    In November  
    Total Cholesterol 295
    LDL 191
    HDL 56
    TG 235
    I was immediately put on 5 mg of Crestor daily.

    Now today... after changing my diet (no wheat, no HFCS, low carbs) ( I cheat every once in awhile  but rarely, sushi with rice is my weakness..but one meal a week if at all) and still take the Crestor... after getting bloodwork from new cardiologist.

    New Numbers
    Total Cholesterol 200
    LDL 121
    HDL 61
    TG 90

    And the best part... I dropped 27 lbs and dropped a pants size...not bad for a 45 year old guy. At 6'4" and 209 pounds I'm ecstatic. Goal weight is 195 lbs that I was 15 years ago when I got married.

    Best thing is... my new cardiologist told me to take the 5 mg of Crestor EVERY OTHER DAY NOW... very happy about that. He said what you're doing with your diet and some exercise is reaping positive changes. He finished with we'll see you in 6 months to reevaluate your progress and go from there. Obviously my goal is to get off the statin for good and I think I can accomplish that with eating the Dr. Davis way.

    Thanks for the great advice you give Dr. Davis.

  • Lou

    4/13/2010 12:01:39 AM |

    Hope your patient is well prepared to provide information why she/he is doing all of that that you had him/her doing. Hope it turns out well for your patient and you.

  • Dr. William Davis

    4/13/2010 1:45:20 AM |

    I'm told that the Dr. Oz show featuring our patient will be aired Wednesday, April 14th.

    I'm not too worried about any bad press it might create. I have always been confident that the truth will win out.

  • Rob

    4/13/2010 9:37:38 PM |

    That is unfortunate. It would have been a great study, but unfortunately Dean Ornish's diet has no evidence to support it is healthy. I would politely refuse to have anything to do with that low-fat diet crap.

    http://productreviewratings.com/2010/02/fat-and-cholesterol-are-good-for-you/

  • Anonymous

    4/14/2010 5:08:46 PM |

    I just checked my Tivo and found this particular Dr. Oz show will be aired on WFLD in Chicago on April 14th at 4:00 pm and then once again on April 15th at 10:00 am.

    David

  • kdhartt

    4/15/2010 1:10:21 AM |

    Just watched it. Fish oil made the cut, not pills even, but something to have with your salad. 30 min exercise. Some yoga for stress. Impressive animations of arteries and plaque and rupture. A lot of low-fat dogma. I must say I learned nothing.

  • rhc

    4/15/2010 3:17:18 AM |

    I just watched the show and I must say it was VERY convincing since Dr. Oz had photos of the improved arteries of two of the patients. In addition, one of Dr. Ornish's original patients  who had been on the heart transplant list 25 years ago was also there - looking quite radiant and healthy. They showed pictures of his heart before and after as well.

    It is all so confusing to me since both sides have their 'proof' and scientific evidence. And let's face it most people will believe the benefits of 'lowfat' over 'highfat' any day.

    Dr. Davis could you please explain your answer to Dr. Ornish:
    “(I didn't want to challenge him in a phone call and tell him that he never actually reversed coronary plaque, but just reversed endothelial dysfunction. But, as Dr. Ornish is not a cardiologist, I wasn't sure how far his understanding of these issues went.)”

    I have no medical training, so forgive my ignorance, but it seems to me that if a diet reverses heart disease it doesn’t matter wether it is by reversing plaque or by reversing a dysfunction – the end result is what counts…doesn't it?

  • Anonymous

    4/15/2010 4:27:47 PM |

    Well I watched the show and couldnt tell which guest was the one that Dr D recommended.
    But certainly heart disease reversal was the predominate theme. Interesting graphics were used to explain plaque build up and blockage. But nothing on the components of cholesteral or small LDL. Nothing about blood sugar monitoring. On reversal startegies, weight control and exercise were trotted out as important elements ... not particularly new or enlightening. But when it came to diet there was almost a whole hearted endorsement of carbs ... oatmeal with plenty of fruit for breakfast, whole grain bread, rice etc.   Curiously fish oils where mentioned only briefly (almost in passing), and there was nothng on Vitamin D or Niacin.
    Not even statins (pro or con) were mentioned.

    All in all not at all informative! ... perhaps even misleading by what was not said ... a very poor performance imho.

  • Dr. William Davis

    4/15/2010 6:36:25 PM |

    I've so far only been able to view some of the introductory dietary comments, the "whole wheat cereal for breakfast" and "low-fat granola bar" for a snack.

    That little bit made me shudder. It brought back memories of all the low-fat blunders we made 15 years ago until we saw that substantial numbers of people were made pre-diabetic or diabetic with this routine.

  • kdhartt

    4/15/2010 10:46:31 PM |

    There was a 70% carbs, 10% fat pie chart. Must do to reverse heart disease. Nutritious meal (for six) portrayed as a death wish. Ornish as god. Not our cup of tea.

  • Anonymous

    4/16/2010 6:37:28 AM |

    Hey, at least they didn't attack you, Dr. D.  That's what I was thinking would happen.

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