[MUSIC PLAYING] JACK: Very, very special
guest today with us here on Main Campus in
building 43 at Google. This individual who’s going
to speak with us today is somebody who has
revolutionized medicine and health care, both
here in the US and abroad, with a 35-year career. And we’ll hear very soon
about the early part of his career, where
he really started on a very different track– a track that took him
to a lot of new ideas that have brought us
to a lot of revolutions across cardiac care,
diabetes, and now Alzheimer’s and other diseases as well. Our guest today has six
books, all best sellers on “The New York Times”
Best Sellers list. Our guest today graduated from
the Baylor College of Medicine and then did his fellowship
at Harvard and Mass General. Please help me welcome
Dr. Dean Ornish. [APPLAUSE] DEAN ORNISH: Thank you. JACK: Dean, it
really is a pleasure to have you here today. Here at Google, we’re
very, very concerned about looking at health care
from many different points of view. You actually chaired– you
were one of the former chairs– of the Google Health Initiative
back in 2007 to 2009, so you’ve had– DEAN ORNISH: With Adam
Bosworth and Marissa Mayer. JACK: Yeah, so you’ve had
a lot of good involvement with Google over the years. Let’s actually start
at the beginning. You’re in medical school. You’re in the first, second
year of medical school, and right off the bat,
something is strange about you. What is strange about you, and
what realization did you have, and what study did you conduct– even just as a medical student,
right then and there– that led you down this new pathway? DEAN ORNISH: I have
to say, no one’s ever asked me a question about
how strange I was early on. [LAUGHTER] I guess that
would make me Dr. Strange. JACK: Yes, exactly. DEAN ORNISH: The beginning,
actually, was even before that. It was when I was in college
at Rice University in Houston, and I became
suicidally depressed. And it’s a long story,
but I met a swami named Swami Satchidananda
who, when I was really ready to do myself in– because first I felt like I was
an imposter, like I was stupid and then somehow managed to fool
people into thinking otherwise. And now that I was with a bunch
of really smart people– kind of like maybe some people
feel when they come to Google, I felt like it was
just a matter of time before they figured
out that they had made a big mistake in letting me in. But I also had a
spiritual vision that was really more
than I could handle at the time, which
was that nothing can bring lasting happiness. Nothing external can
bring lasting happiness. And so the
combination of feeling like I was never going to amount
to anything, but even if I did, it wouldn’t matter,
was like, well, why don’t I just kill myself? Because people who are
dead look like they’re happy and peaceful. And I was all set to do
that, but I got so sick– I’d run myself down so much
with infectious mononucleosis– that my parents
realized I was a mess. I went home to Dallas. And as crazy as this sounds,
as strange as this sounds, I wanted to get well enough and
strong enough to kill myself. But in the meantime,
my older sister, who had been a child
of the ’60s and who had studied with this ecumenical
swami had really helped her. And so my parents
decided to have a cocktail party for the swami. Now, in Dallas in 1972,
this was pretty strange, as you would say. And he started off by
saying a little lecture in our living room. Nothing can bring you lasting
happiness– which I’d already figured out, except I was
ready to do myself in, and he was glowing. I was like, what
am I missing here? And he went on to say
what probably sounds like a new-age cliche, but
it turned my life around, which is that nothing can bring
you lasting peace and happiness and health, but it’s our nature
to be happy and peaceful. And our whole culture
teaches us that if we just get more stuff– more money,
more power, more beauty, more accomplishment–
then we’ll be happy. And he would say, once
you set up that dynamic– that view of the world– however it turns
out, you’re generally going to be miserable, because
until you get it you feel bad. If someone else gets it
and you don’t, then you feel really bad. And it confirms that we
have this very hostile, zero-sum game, dog-eat-dog
view of the world. But even if you get it,
it’s great for the moment. It’s very seductive. I got it. I’m happy. But invariably, it’s
soon followed by– well, now what? It’s never enough. Or so what? Big deal. It doesn’t really provide
that lasting sense of meaning. So then we say, well, this
didn’t, but maybe that will. And one patient years
ago told me– he said, the letdown that comes
from getting something that I thought would make
me happy was so great, I always make sure I’ve
got a dozen projects going at the same time so I can
immediately shift my attention. So– JACK: So you had
this epiphany moment just in the college years– DEAN ORNISH: Yes. JACK: What led you to decide,
then, to go to medical school? DEAN ORNISH: Well, I always
wanted to go to medical school. Actually, I was going
to be a photographer, and there was a photographer
named Philippe Halsman who did over 100 “LIFE” magazine
covers in the heyday of life. And I said, I want to be
a photographer like you. He said, oh, no, don’t
be a photographer. It’s a terrible life. Be a doctor. So then you can take
all the pictures you want and you don’t have
to worry about pleasing an editor and so on. But I actually always
wanted to be a doctor, too. And so I went from not being
able to read the headline on a newspaper when
I was in college and tell you five minutes later
what it said to doing really well and graduating
first in my class and giving the baccalaureate
and all of that. And I say that just to say
how powerful these beliefs are for better and for worse
and affecting our lives. So when I went to
medical school, I was learning how to do bypass
surgery with Michael DeBakey the heart surgeon, who was
one of the inventors of bypass surgery. And we cut people open. We bypass their
clogged arteries. You tell them they were cured. And more often than
not, they would go home and do all the things that
had caused the problem in the first place– eat junk food, smoke cigarettes,
not manage stress, not exercise. And their new bypasses
would clog up, and we’d cut them open again,
sometimes multiple times. So that, for me, became the
metaphor– the paradigm, or the guiding principle that
all of my work for the next 40 years, which is that– instead of literally or
figuratively bypassing the problem, let’s
treat the cause. Sometimes when I
lecture, I’ll show a cartoon of doctors mopping up
the floor around a sink that’s overflowing, and no one’s
turning off the faucet. And the idea is that
what we’re finding is the more diseases
we study, the more underlying biological
mechanisms we do research on, the more reasons
we have to explain why these simple
changes are so powerful and how quickly
people can get better to the degree they
make them at any age. It’s an incredibly powerful
and motivating and empowering message. So we were able to
show for the first time that heart disease
was reversible, that diabetes and high blood
pressure and high cholesterol. People get put on
these drugs and they say, doctor, how long
do I have to take these? What does the
doctor usually say? Forever, right? How long do I have
to mop up the floor? Well, why don’t we
turn off the faucet? So we can routinely
reduce or get people off of these medications. We can reverse heart
disease, diabetes. It turns out, now,
that getting your blood sugar down– half
the population today is diabetic or pre-diabetic. Getting your blood
sugar down with drugs doesn’t really prevent all
the horrible complications– blindness and amputations
and heart attacks and impotence and so on. Getting it down
with lifestyle, you can prevent virtually
all of them. And the same is true
for prostate cancer. JACK: But back
then, in the ’70s, when you first had some
of these realizations, it was really almost heresy
to say that you could stop, let alone reverse,
heart disease. DEAN ORNISH: Oh, yeah. JACK: I mean, in
a sense, would you say it was a naivete of somebody
just fresh in medical school who maybe didn’t know better
that gave you that impetus to say, hey, I’m going to
try this and see if it works? DEAN ORNISH: Yes, that was
definitely a big part of it. And the other part was– having
decided not to kill myself, I figured, OK, if I’m
going to choose to live, I’m going to lead a
really messy life. I need to know what’s
real and what’s not. I need to find out for myself,
because I didn’t really trust anyone at that point. And that means I was going
to make a lot of mistakes. And I said, I can live
with making mistakes. In fact, later when
I became a doctor, most people on their deathbeds
don’t regret what they did. They generally regret
what they didn’t do. Because if you do
something and it fails, then you learn something
really powerful. And there’s a lot
of wisdom that comes from making mistakes– as you
know– and learning from them. But if you don’t try,
then you just don’t know. So I figure, what’s the
worst that could happen? So I took a year off between
my second and third years of medical school, much
to my parents’ dismay, and began this study. And fools rush in. I didn’t know what
I didn’t know. And so I said, let’s try it,
and whatever it turns out, we’ll learn something. JACK: But one of your professors
was supportive of it, right? DEAN ORNISH: Oh, yeah. They were very supportive. And that was the nice
things about going to medical school
in Texas, where they have this pioneering ethos. It’s a crazy idea. It’s going to fail, but
you’ll learn something. Go for it. We’ll support it. When I went to Harvard,
it’s so hierarchical there. You have to wait till
you’re 40 and work in someone else’s
lab for 10 years before you even get a chance
to do anything like that. And I remember, by the way– I mean, things have
changed so much since then. The idea, even, that
the mind affected the body was a crazy idea then. JACK: So take us through
the four pillars– let’s start with
the heart program. And it’s very similar
for the other programs, but let’s just start
with the four pillars that you have now shown. And I want to talk about
the data in a minute, because here at
Google, obviously, we’re very data-focused. And what’s, I think, very
interesting about your program is it’s not just, oh,
people are feeling better. Clinically, as you
measure their blood, as you measure their
biomarkers, through a course of a 12-week program
doing these four pillars, you’re actually seeing
the biomarker data change over time. So take us through the
four different parts of how someone can go from
having heart disease, worsening heart disease, and now
stop it and then begin to reverse that clinically. DEAN ORNISH: Yeah, they
not only feel better, they are better in every
way we can measure. And we’re using these
very high-tech, expensive, state-of-the-art scientific
measures to prove the power of these very simple and
low-tech and low-cost and often ancient interventions. So we started with
heart disease. And we found that
in just a month, the blood flow to
the heart improves– using specthalium scans. There was a 91% reduction of the
frequency of angina, or chest pain. Most people who couldn’t
walk across the street without getting pain or
make love with their spouse or play with their kids or go
back to work, within a week, are pain-free. And it wasn’t just
a placebo response, because the heart was
actually getting more blood in ways we can measure. We then did a
randomized trial, and we found after just 3 and 1/2
weeks, the ability of the heart to pump blood
improved– using a test called radionuclide
ventriculography. After my medical training, we
did the most definitive study using cardiac Positron
Emission Tomography, or PET, to measure blood
flow to the heart. And we found a 400%
improvement in blood flow compared to the
randomized control group. And quantitative arteriography
to measure the blockages in the arteries, and we
found that they actually got less clogged after
one year, and even more improvement after five years– JACK: And again,
Dean, this is all without pharmaceutical
or surgical intervention? DEAN ORNISH: That’s right. The program is– JACK: So give us the four
pillars of this program. DEAN ORNISH: And
it’s been the same in all of these programs, which
I’ll talk about in a moment. It’s basically a whole
foods, plant-based diet that’s naturally low in fat
and refined carbs or sugar. It’s not low fat
versus low sugar. It’s really both. And also– JACK: Would you say
it’s– on the diet side, would you say it’s close to the
Mediterranean-oriented diet, or how should people
think about the diet? DEAN ORNISH: It’s fruits,
vegetables, whole grains, legumes, soy products in their
natural, unrefined forms. So that’s the diet. The exercise is walking
a half an hour a day or an hour three times a week. Various meditation
and yoga techniques, which has been great at Google. [INTERPOSING VOICES] JACK: The third is meditation. [INTERPOSING VOICES] DEAN ORNISH: That’s right. JACK: You’ll be happy to know we
have meditation rooms in almost every building, so, yeah. DEAN ORNISH: I know,
and I love that. And that was one of the
things we did back in the day when we were running
Google Health– that and trying to make
healthier food here, which was fun. And the fourth is what we call
psychosocial support, which is really love and intimacy. Or if you reduce it
down even further, it’s eat well, move more,
stress less, love more. That’s it, boom. And the more diseases we study
and the more mechanisms we look out, the more we find that
these same lifestyle changes have impacts– to the degree people make them. We’ve found it to reverse heart
disease, diabetes, prostate cancer, change your
gene expression, lengthen your telomeres. JACK: Now, I want to get
to genes in a second. But first, I want to drill in– I think all of us
would really understand that changing your diet,
moving more– yeah, definitely would have an impact
on the physiological self. But let’s drill
into the second two. Let’s talk more
about how meditation, these mindfulness
exercises, really affect the physiological. And talk to us– I think there was a Canadian
study called InterHealth. There’s other studies that
you’ve cited and been part of and leading over
the years showing the physiological impact of
something like meditation. Let’s talk about
meditation first, then let’s move to the social
impact of friend circles and things like that. DEAN ORNISH: Yeah,
well, meditation is a powerful way of bringing
your mind to one focus. And when that happens,
your fuse gets longer, for lack of a better
way to put it. Some people say things
like, I’ve got a short fuse and I explode easily. Well, your fuse gets longer. Things don’t bother you as much. And when you’re under
stress, your body goes through the fight
or flight response. So all of your
arteries constrict. Your blood pressure goes up. Your eyes dilate. These are things that
are designed to help you. If a mythical saber tooth tiger
jumps out in front of you, you want your arteries to
constrict and your blood to clot faster, for example,
because if you get bitten, you don’t bleed as quickly. But we’ve evolved to deal with
these intermittent stresses. So you’re walking in the jungle. The tiger jumps out. Either you run away from the
tiger, you kill the tiger, it eats you. But one way or the
other, it’s over. JACK: But it’s done. It’s not a continual– yeah. DEAN ORNISH: Today, it’s
just chronic and relentless throughout the day. And so these same mechanisms
that have evolved to protect us can harm us, or even
kill us, because it’s not just the arteries in
your arms and legs that can go into spasm or blood
clots that can form there. It can form in your
heart and cause a heart attack, or in your
brain and cause a stroke. So anything that can
manage stress better– virtually every illness
has been found to– you’re more likely to have it
if you’re under chronic stress. And the other side of that
is the social factors. One of the real radical shifts
in our culture in the last 50 years has been the breakdown
of the social networks that used to give people a sense
of connection and community. 50 years ago, most people
had an extended family they saw regularly. They had a neighborhood with two
or three generations of people that grew up together. They had a job that
felt secure they’d been at for 10 years or more. They had a church or
synagogue they went to. And today, most people
don’t have any of those– maybe one. And we know that
those things affect the quality of our
lives, but they actually affect our survival. And to a much larger degree– one of the books I wrote was
called “Love and Survival,” back in 1998. And it reviewed what were
then hundreds– and now literally thousands–
of studies showing that people who are lonely
and depressed and isolated are three to 10 times more
likely to get sick and die prematurely from pretty
much everything than those who have a sense of love
and connection to community. So I think– JACK: And one of the
studies, also, that you cite looks at predictors based
in high school and college years of prediction of health
over this 40-year period. And it was the social
bonds, actually, that were very much
determining a lot of that health over many years. DEAN ORNISH: That’s right. They also did a study at
Harvard Medical School where they gave
one questionnaire to a group of Harvard students
and said to rate how close they were with their parents. 30 years later, only
15% of the people that were close
with their parents had chronic diseases in
midlife, and yet the majority of those who weren’t did. Now, you might say, well,
how could one questionnaire do that? Well, how you– JACK: So note to the
audience– everyone should call their
parents after this. OK. DEAN ORNISH: So
intimacy is healing. Anything that brings
us together is healing. Even the word healing comes
from the root to make whole. Yoga is from the Sanskrit
to yoke, to unite, to bring together, union. These are really,
again, old ideas. And so when we have that
sense of love and connection and community, it
not only improves the quality of our lives,
it improves our survival. More than any other
factor– more than smoking, more than anything. And it also
interacts with those. People are more
likely to abuse them– we tend to say– at Google, there’s this– we are drowning in
information, which is awesome. I just love, because I
can just pick out anything anytime I need it in Google. But information is not
enough for most people to change their behavior. I mean, if it were,
nobody would smoke. It’s not like you go, hey, Jack,
I want you to quit smoking. It’s really bad for you. JACK: Right, the rational
argument itself does not seem to be sufficient. DEAN ORNISH: Yeah. If I say, Jack, I want
you to quit smoking. It’s bad for you. I didn’t know. I’ll quit today. Everybody knows
it’s bad for you. It’s on every pack
of cigarettes. But so then I ask,
why do you smoke? Why do you overeat? Why do you drink too much? Why do you abuse yourself? And I used to ask
patients in our studies, because we got to
know each other. I’d say, teach me something. Why do you do these things? They seem so maladaptive. And they say, you don’t get it. They’re not maladaptive. They’re very
adaptive, because they help us deal with our
loneliness, our depression. They say things like,
I’ve got 20 friends in this pack of cigarettes, and
they’re always there for me, and nobody else is. You’re going to take
away my 20 friends? What are you going to give me? Or food fills that void,
or alcohol or opioids numb the pain, or
working all the time is a more socially acceptable
way of numbing the pain, or video games or whatever. So we’ve learned that it’s not
enough to give information. It’s not enough to
focus on the behavior. We need to deal with
the deeper issue– the loneliness, the
depression, the pain. And so we create support
groups that are not really designed to help people
stay on the diet. They’re designed to
create a safe environment to recreate what people had 50
years ago– a safe environment. I mean, right now– social networking was
supposed to really bring us all together. Facebook has, what,
1.6 billion people? But it actually has, often,
a way of making you feel more lonely and more isolated,
because most people don’t– if you grow up in a family
with two or three generations, they know where you messed up. And you know that
they know, and they know you know that they
know, and they’re still there for you. And there’s something
really primal about that. JACK: There was an analysis
called “Bowling Alone”– [INTERPOSING VOICES] JACK: –which is all about how– ’50s and ’60s, there were
these bowling leagues, and people had their shirts and
they had their bowling ball. They had the initials. My dad has a bowling ball
still with his initials on it, and he had a bowling
league growing up. DEAN ORNISH: So that’s why. JACK: But now we’re, quote,
“bowling alone,” because we don’t have those types of– [INTERPOSING VOICES] DEAN ORNISH: Yeah, or you look
at someone’s Facebook profile or their Facebook feed,
and it looks like they have the perfect life. And it’s like, why don’t I? Or their bio sketch,
they look great. They don’t talk about all
the things they’ve messed up. And so in our support groups,
we just create an environment and say, look, let down
your emotional defenses. Just talk openly and
authentically about what’s really going on
in your life without fear that someone’s
going to judge you or criticize you or
give you glib advice. So somebody might say, I may
look like the perfect dad, but my kid’s on
whatever– some drug. And instead of someone
else saying, oh, well, why don’t you send them
to a drug rehab program– like they hadn’t thought
of that– it’s like, what feeling does
that evoke in you? And share it as a feeling. Oh, I’m really sad to hear that. Or gosh, my kids
have other problems, or I used to have a
drug problem, whatever. Suddenly, it doesn’t
fix the problem, but it fixes the loneliness and
the shame and the isolation. It’s the part of my program
that most people have the most apprehension about. Most people think it’s
all diet, and it’s not. But also, it’s the part that’s
invariably the most meaningful. And we have people that were
in our study 30 years ago– they’re still meeting. And they didn’t like each other
when they first got together. They just happened to
be going to the cath lab at the same time. Because that need for
connection and community is a primal,
fundamental human need. And even if you’ve just
scratched the surface of that, you can create a Facebook or
a multibillion-dollar company. So whatever people out here
are doing in the world, to the degree that
you can create real, authentic
connections between people, it’s going to be that much
more successful, and ultimately that much more healing. JACK: So Dean, let’s
talk about genetics now. What’s interesting is,
again, people often think of genetics as
something hereditary. I have what my parents gave me,
and that’s what I’m stuck with. But what you’ve shown is
that these kinds of lifestyle changes– not only, again, the
diet and the exercise, but the stress reduction
with meditation, the bonds– are actually changing the
expression of the genes. And so across 500 genes, both
in terms of up-regulating good ones and down-regulating
bad ones– we’ll get to
telomeres in a second, but let’s just talk about
those kind of studies that you’ve been involved
with where you’ve shown– again, with actual
sequencing– to show that the genetic
expression has changed with these kinds of changes. DEAN ORNISH: Well, just that. I mean, so often, people say
to me, oh, I’ve got bad genes. What can I do? In fact, Bill Clinton
is a good example. When his bypasses clogged
up, one of his doctors had a press conference. He said, oh, it’s
all in his genes. His lifestyle had
nothing to do with it. So I sent him a note,
and I said, actually, it has everything
to do with it– not to blame, but to empower. Because if it’s all in your
genes, you’re a victim. What can you do? I said, you’re not a victim. You’re one of the most
powerful guys in the world. And so he began
making these changes, and he’s still doing it
now, nine years later, which I think sets a
great example, whatever your politics, when a
former president who was known for not eating
particularly healthily does that. But we found that, again, it’s
another example of how dynamic these mechanisms are. In just three months, we found
over 500 genes were changed. As you say, up-regulating
the healing genes and down-regulating the– JACK: So three months
of change in lifestyle? DEAN ORNISH: 501 genes. JACK: 500 genes. DEAN ORNISH: And we published
this with Craig Venter in the “Proceedings of the
National Academy of Sciences,” and we particularly
down-regulated chronic inflammation– genes that
cause chronic inflammation– oxidative stress, and what
are called the RAS oncogenes that promote prostate,
breast, and colon cancer– just like that. Again, it’s amazing
how dynamic people can get better or worse when
they make these lifestyle changes. JACK: Let’s talk
about telomeres now. Talk to us– you’ve been
interacting with one of the founders of the
whole telomeric medicine– DEAN ORNISH: Liz Blackburn. JACK: –science. Liz Blackburn– won
the Nobel Prize. Talk to us about what are
telomeres, first of all, for those in the YouTube
land who may not know yet? And what findings
did you show in terms of the impact of
these kind of changes on telomeres themselves? DEAN ORNISH: Well,
telomeres are– the analogy that Liz
Blackburn often gives is they’re like plastic tips
on the ends of your shoelace to keep your shoelace
from unraveling. They keep your DNA
from unraveling. And as we get older, our
telomeres tend to get shorter. And as our telomeres
get shorter, our lives get shorter, and
the risk of premature death from heart disease, diabetes,
most forms of cancer, Alzheimer’s, goes up
proportionate to that. Now, she had done
an amazing study with Elissa Epel where
they found that women who are under chronic
emotional stress because they were
caregivers of either parents with Alzheimer’s or
kids with autism– the more stress they
felt and the longer they felt that way, the
shorter their telomeres were. And they calculated
that the difference between the high
and low-stress women was nine years in terms of–
excuse me, 17 years in terms of longevity. But what was even
more interesting to me is that it wasn’t
an external cause. It was how the
women were reacting to it that determined its
effect on their telomeres. In other words, even if
you’re in a bad situation, you can mitigate and
modulate that by doing the kinds of things we’re
talking– by meditating, by eating healthily,
by exercising, by having social support. And so I thought,
well, OK, if bad things make your genes shorter– I mean, your telomeres
shorter– maybe good things make them longer. So we did a study
together, and we found that after just three
months, the telomerase– which we published in
“The Lancet Oncology”– increased by 30%. And after five
years, the telomeres got 10% longer, whereas they got
shorter in the control group. It’s still the
only control study showing that any
intervention can actually make your telomeres longer. And when “The Lancet”
sent out a press release, they called it “Reversing
Aging at a Cellular Level,” which I think is true. And so many of these things
that we think are in our genes, we really have a lot
more control over. Again, not to blame,
but to empower. JACK: So let’s talk about the
medical establishment itself. You’ve had a deep
engagement there. What’s great is that you
went through med school. You went to Harvard for
fellowship, Mass General. And so you’re deeply familiar
with the core establishment. And in fact, you’ve
been invited, now– over the past number of
years, particularly– to some of the key
establishments to give rounds, to actually
describe your science. So no longer is
it something like, what is Dean doing over there? You’re now inside
the Cleveland Clinic. You’re inside Mass General. You’re inside these areas. Yet, if you look at the
curriculum of med school, if you ask most doctors till
today how they were trained and how they’re
being trained, we don’t see enough of
the kind of science that you’re talking about. Again, not just feel-good stuff,
but core science and impact. What will it take, or
what do you recommend as a prescription, as it
were, to the med schools– as you talk to deans of med
schools around the country– what do we need to do? DEAN ORNISH: Well, it’s
a really good question. I used to think if we just had
good science that would change medical practice and education. And to some degree it did,
but not nearly as much as I thought. What I finally learned– and
I learned this the hard way when– I started a nonprofit institute
called The Preventive Medicine Research Institute,
and we’ve been training hospitals and
clinics and physician groups around the country and
doing research and so on. And so through that,
in the early ’90s, we trained 53 hospitals
around the country. We got bigger
changes in lifestyle, better clinical outcomes,
bigger cost savings, and better adherence than anyone’s ever
shown, and a number of them closed down because we didn’t
have the reimbursement. So the painful lesson is–
if it’s not reimbursable, it’s not sustainable. JACK: So you went on
a quest– an odyssey. DEAN ORNISH: So I
went on a quest. JACK: And it took you
what, just a few months? Joke. DEAN ORNISH: Yeah, right. It took 16 years, actually. Because I’d been working
with the Clintons since ’93, and when he was
president, I also was working with Newt
Gingrich’s daughter, who had had some health issues. And so we had the President
of the United States, the Speaker of the House,
20 members of the Senate, 30 members of the House– they
all said, this is a great idea. And they still took 16 years
to get Medicare to cover it. But they did, and I’m really
grateful that they finally did. JACK: Just to clarify that–
so when people now want to do these lifestyle changes
of the diet, the exercise, the stress reduction,
and the bonding– that program, now,
is now covered? Even though– again,
highly unusual situation, because typically, most
insurance companies want to cover a pharmaceutical
intervention, a drug, a surgical intervention– DEAN ORNISH: Or a device. JACK: –but now they’re
going to cover– they’re covering something,
now, that is not that? DEAN ORNISH: That’s
what took 16 years. And they’re covering
it as a Dr. Dean Ornish program, which is great. So we partnered with a company
called Sharecare which is– excuse me– Jeff Arnold, who
started WebMD, and Mehmet Oz– Dr. Oz– and Don Whaley
and others, and we’re training hospitals, physician
groups, health systems, and clinics around the country. And again, we’re getting the
same thing– bigger changes in lifestyle, better clinical
outcomes, bigger cost savings, better [INAUDIBLE]. We’re also doing these
12-day retreats where people can come from anywhere. And Medicare is paying for it,
and most insurance companies are paying for it, too. And so what I’m learning is that
when you change reimbursement, you change medical practice,
and even medical education. And it is changing. It’s slower than I would like. It’s been 40 years I’ve
been doing this work. The president of
the American College of Cardiology, last year– Dr. Kim Williams– found
that his own LDL cholesterol was really high. Didn’t want to go on statins
the rest of his life. Did a literature review. Came across my work. Went on my program. His LDL came down 50%. Wrote about it in all
the medical literature. And at the American College of– JACK: This is the head
of the American College of Cardiology himself– DEAN ORNISH: That’s right. JACK: OK. DEAN ORNISH: And he
headed a six-hour seminar on lifestyle medicine. And lifestyle medicine is using
lifestyle to reverse disease and to treat it, not
just to prevent it, which I think is the most
exciting trend in medicine today. And we did a seminar
on lifestyle medicine, and over 1,000
cardiologists came. That wouldn’t have happened
five or 10 years ago. So things are changing, and
it makes me really happy to see them. JACK: So we talked
about cardiology. We talked about diabetes. Let’s talk about cancer. You’ve now shown– you did a
series of studies on prostate cancer to begin with,
and now, I believe, maybe on some other cancers– showing
that, again, these kinds of non-pharmaceutical
interventions did have a powerful effect,
for example, in prostate. Talk about that study. DEAN ORNISH: Well,
prostate cancer is the number one cancer in
men other than skin cancer. And there was a major study
that came out a year ago that looked at a 10-year
study of randomized trial– in “The New England
Journal of Medicine.” And what they found is that
men who had the conventional treatments– which were
surgery or radiation– didn’t live any
longer than men who did nothing who had
biopsy-proven early-stage prostate cancer. And yet, the complications
of the treatments tend to maim guys in the most
horrible and personal ways. You’re wearing diapers
because you’re incontinent, and you can’t have sex because
you’re impotent, in many cases, for no benefit at
huge economic cost. So I did a collaborative
study with Dr. Peter Carroll, who’s the Chair of Urology at
UCSF, and the late Dr. Peter Carroll– excuse me, Bill Fair–
who, at the time, was the Chair of Urology at
Memorial Sloan Kettering Cancer Center. When you’re doing
something disruptive, it’s good to work with
the most respected people, because it’s easier to
get things published. People believe it. And we did a randomized trial,
and we found that these same lifestyle changes
could slow, stop, or reverse the progression
of men who have early-stage prostate cancer– just the lifestyle
changes alone. So if a guy has a biopsy– their PSA goes
up, gets a biopsy. The doctor will invariably say,
you’ve got prostate cancer– if they have it– and you
need to have it taken out, or you need to have radiation. But most guys don’t
want to do that, but they don’t want to,
quote, “do nothing.” This idea of watchful waiting– waiting for something
bad to happen– is like sitting under
a sort of Damocles, waiting for the
other shoe to drop. People don’t want to do that. They say, I’ve got
this cancer growing. I’ve got to do
something about it. So we give people a
third alternative. An aggressive– if you want to
put it in more macho terms– nonsurgical, non-pharmacologic
intervention. And then Dr. Carroll has
developed these algorithms where they can monitor people
very carefully and find out, who is that 1 out of 50 people
who really would benefit from surgery or radiation? And the others can do this. And unlike most things, the
only side effects are good ones. JACK: That’s great. So what is next? You’ve done, now,
cardiac, diabetes, cancer. Now you’re thinking about
Alzheimer’s as well. DEAN ORNISH: And by
the way, before I forget, if it’s true
for prostate cancer, it’d almost certainly be
true for breast cancer. And Dr. Laura Esserman, who
runs the Buck Breast Cancer Center at UCSF, and
I have been talking about doing a study for
a long time to show that. And I’m quite sure that’ll
be the case as well. JACK: For breast cancer as well? DEAN ORNISH: For
breast cancer as well. JACK: Great. DEAN ORNISH: So what
we did– we just began the first randomized
trial to see if we can reverse Alzheimer’s disease. People are more afraid of
Alzheimer’s than anything. In fact, James Watson– you
know, Watson and Crick– when he had his genome
first sequenced, he said, I want to know about everything
except the APOE4 gene, which is the one that increases
your risk of Alzheimer’s. Because why would I want to
know if I can’t do anything about it? So we think you actually
can do something about it. I think we’re at a place with
respect to Alzheimer’s very much like we were 40 years
ago when I first started doing research on heart disease. There’s every reason
to think it’ll work. There are animal studies,
epidemiological studies, anecdotal case reports,
randomized trials where they use less intensive
lifestyle interventions that could slow or
stop the progression. I think a more intensive
lifestyle intervention can actually reverse it. So we’re doing a collaboration
with Dr. Bruce Miller and Joel Kaplan at the Memory and Aging
Center at UCSF, who run that. And we’re going to take
100 men and women who have early-to-moderate
Alzheimer’s, randomize them into two groups, put half on
the program and not the other, and compare them using
PET to look at amyloid and MRI to look at
hippocampal volume and looking at cognitive
function testing and biomarkers and so on. And we’ve raised most of the
money that we need to do this, so we’ve already started it. We just got our IRB
approval last week, and we’re ready to begin. And I’m cautiously optimistic. You never know, but I’m pretty
sure this is going to work. And it runs in my
family, too, so I have a personal interest in this. And if we could show
that we can reverse the progression of
early-to-moderate Alzheimer’s by changing lifestyle,
that would really give millions of people
new hope and new choices. Because when you lose your
memories, you lose everything. JACK: Particularly as– in
society, our demographic’s getting older. [INTERPOSING VOICES] JACK: People age– DEAN ORNISH: Exactly. JACK: –and live longer, this
is going to be more prevalent. So before we turn to
audience questions, let me just ask a very practical
question for folks here, and also watching on YouTube. In terms of the kinds of
things that people should do, in addition to the
diet, the lifestyle, meditation, stress reduction,
and the social bonding, are there certain– in terms of the diet that we
get– the nutrition we get, I want to use– the
word nutrition may be even better than diet. People sometimes confuse
diet for a diet– some kind of– DEAN ORNISH: A way of eating. JACK: –bizarre regimen. But the kind of
supplements that people should think about using or
not thinking about using– fish oil supplements,
good or bad? Mushrooms? I don’t mean shrooms. I mean mushrooms. [LAUGHTER] JACK: What are the
kinds of things– DEAN ORNISH: Actually, there’s
some good studies on shrooms, as well. JACK: What are the kinds
of things that people should or should not consider? DEAN ORNISH: Before
I answer that, let me say one thing
that I forgot to mention, which is that with all this
interest in personalized medicine, it’s the same
lifestyle program that we found could do all of these things. It can down-regulate
all these mechanisms that could reverse all
these different conditions. And I think it’s
because they share certain common underlying
biological pathways, although we tend to silo them
as being different diseases, they really may be more
different manifestations of the same kind of
underlying processes. Now, if you’re trying to
do a targeted immunotherapy for melanoma– like
you so brilliantly– I mean, I don’t know if
you know Jack’s dad– is it OK to talk about your dad? JACK: Sure. DEAN ORNISH: Jack’s
dad developed melanoma. Now, most people, when
their dad develops melanoma, they go, oh, that’s so bad. I’m so scared. Jack, who’s not an
oncologist, decided he would learn everything he
could about melanoma, developed a treatment– an immunotherapy–
and his dad is cured. So that’s Jack. JACK: I didn’t
develop it myself. We supported other
people’s work. DEAN ORNISH: Yeah,
but you were the one who actually directed that. It wasn’t just
giving them money. It was actually saying,
let’s study this. Let’s see what happens. It was really your work
that they put into practice. So if you’re doing
something like that, I think a targeted immunotherapy
or whatever is brilliant. But for the vast majority
of chronic diseases, it’s these same
lifestyle changes that can prevent and reverse them. And it’s not all or nothing. I wrote a book called
“The Spectrum,” which was based on the finding
that in all of our studies, the more you change, the
more you improve in every way we can measure. So if you have a
life-threatening illness, that’s more of
the pound of cure. You really do have
to make big changes. That’s why we were the
first to proe that, because most people
didn’t go far enough. But if you’re otherwise healthy,
if you indulge yourself one day, eat healthier the next. If you don’t have time
to exercise one day, do a little more the next. You get the idea. In terms of supplements,
the ones that I take– I take fish oil every day. I think in general, it’s better
to get your nutrients from food, but I think Omega-3s
may be an exception to that if you’re going to
eat fish, because– JACK: I guess
that’s my question. In other words, it’s obviously
better to get it from food, but what is available
to us in the average– even organic–
grocery, what do you feel is missing from
that general availability that we may want to
think about [INAUDIBLE]?? DEAN ORNISH: I think
the Omega-3s and fish oil are really worth
doing, because there are no clean fish. All fish are contaminated with
either mercury, dioxin, PCBs– bad stuff in varying degrees. But when you take the fish oil,
if you take certain brands, they remove all the
bad stuff so you just have the pure [INAUDIBLE]. Or you can take the
plankton-based Omega-3s, which are vegan, which is really
where the fish get it from anyway–from eating
the plankton. And then you don’t get
the bad stuff, either. So I think three grams of
fish oil or flaxseed oil or a plankton-based Omega-3s
a day are a really good idea. I think that depending on– I think the probiotics,
actually– there’s a lot of– we’re actually also doing some
studies on the microbiome. JACK: The microbiome. Let’s talk about the
microbiome a second. Just describe that. DEAN ORNISH: Well,
you know, there are trillions of
cells in our body that we exist in a
homeostasis with, and we’re just realizing
how powerful those are– and again, how dynamic
you can change your microbiome. We did a pilot study. We found in just three days, we
could show significant changes in the microbiome in
healing directions. So I think for most
people, if you’re not eating a particularly
healthy diet, taking one of the microbiome
supplements can be a good thing. The Omega-3s we’ve talked about. I think most people
don’t get enough vitamin C in their diets, so taking
500 or 1,000 milligrams of that is a good idea. The turmeric– I know you
like to drink turmeric tea, which we share– [INTERPOSING VOICES] JACK: Right here. Here it is. DEAN ORNISH: Turmeric is a very
powerful anti-inflammatory. This is one of the
reasons why it’s been linked with reducing
Alzheimer’s, but also other conditions. Most people aren’t going to
drink enough turmeric tea or eat it in their
diet– or curcumin– so I take a supplement. It doesn’t make you smell like
curry, and those were good. So those are the
things that I think most people can benefit from. JACK: Cool. Let’s turn to the audience. Is there questions
from the audience? Why don’t we start? You have a question? Yeah, let’s use the microphone. Make sure the microphone’s on so
our YouTube audience can hear. AUDIENCE: I guess it’s on. JACK: Yes. Tell us your name and
what your question is. Let’s keep your questions
short, because we want to get a lot of questions in. Go ahead. AUDIENCE: My name
is [INAUDIBLE].. Thanks for coming and giving
us this excellent talk. DEAN ORNISH: Thank you. AUDIENCE: My question
is about– so my dad– so I’m an Indian, and
my dad lives in India and he’s having heart disease. So my question is, how are your
diets mapping to Indian food? Because food, as you said,
is a major part of the plan. But if the food is– so Indian food is typically
pretty [INAUDIBLE].. But if we move into a
different kind of diet, then he will not like it and
he’ll probably reject it. So how is that going? DEAN ORNISH: There are a
couple of doctors in India that are offering
my program there. And it’s working really well. They have thousands
and thousands of people who have gone through. But you’re right, the
traditional Indian diet, even if it’s vegetarian,
is generally high in fat with all the oils
and so on, and also generally high in ghee and
butter and things like that, and saturated fat and so on. So there’s a lot of
room for improvement. And for whatever reason,
people of Indian descent are usually more
predisposed particularly to type II diabetes, and
often to heart disease. So these lifestyle changes
are even more important. And unfortunately,
what’s happening in India is happening
in China, is happening in most of
the developing world– is that they’re starting to
eat like us and live like us, and all too often die like us. And 50 or 60 years ago,
heart disease and diabetes were really pretty rare
in India and in China. And now they’re by far the
number one causes of death. And it’s diverting a lot
of precious resources from things that really do
require drugs, like AIDS, TB, and malaria– the things that can be largely
prevented, or even reversed, by changing lifestyle. So copy our successes,
but not our mistakes. JACK: Thank you. Other questions, please. AUDIENCE: So I
have two questions. JACK: Your name and
then question, please. AUDIENCE: My name
is [INAUDIBLE].. Two questions. So is there some effort to
develop the recipe books for, let’s say, different
parts of the world? So I suppose you’ll need like
20 different recipe books for different parts of India. DEAN ORNISH: Can you say
it just a little slower? AUDIENCE: Sure. [CHUCKLES] So are
there some efforts to develop recipe books for the
different parts of the world? JACK: Recipe books? AUDIENCE: Yeah. JACK: Yeah. AUDIENCE: Customized to
the spices and ingredients found in different parts
of India, for example? The second question is, do
you have books or something for teenage kids? So what are we doing
about teenage kids in USA? JACK: Teenage kids, yeah. DEAN ORNISH: Yeah,
yeah, well, we don’t have anything that’s
specific to India for spices. But I’d love it if you or
someone like that could– JACK: We have some recipe books. But I don’t think– DEAN ORNISH: Oh, we
have [INAUDIBLE].. Yeah, there are hundreds of
recipes in all of my books but nothing specific
to Indian food. JACK: So maybe a new
collaboration, I think. DEAN ORNISH: Yeah, maybe so. That would be great
if you could do that. JACK: How about teenage– DEAN ORNISH: I’ve
got a 17-year-old son and he was vegetarian until
he hit about 14 or 15. And he said, look, Dad,
it’s either meat or heroin. What do you think? So I said, meat, good choice. [CHUCKLES] He had to
rebel in some way. But when he was younger,
I learned that even more than being healthy,
whether you’re six or 60, people want to feel
free and in control. And he’s a pretty
strong-willed kid. And Jack has been mentoring him,
which we’re very grateful for. And I knew that if I told him
he couldn’t have certain foods, he’d want them. And he’d probably develop
an eating disorder. So I said, look, the rule in our
family is nobody can tell you what to eat, not even
me, and I’m your dad, and I know more about
food than a lot of people, because it’s your body. You control it. This is why we eat what we eat. But you decide what
you want to have. And so we taught him
how to read labels. So he’d go into a store and say,
oh, that has too much of this. Or I don’t think I
should have that. Now that all shifted when
he went through puberty. But I think that the idea
of empowering your kids and teaching them
and if you can help them grow food and actually
see where it comes from or visit a farm if you don’t
want to do it yourself, it’s magic to them. And they get their
taste when they’re younger, their
taste preferences, which are really malleable. So if you tend to
feed them healthy food from the beginning, they
begin to actually prefer those kinds of foods. So I haven’t read a book yet
like that, but I’d like to. But Bill Sears has written
some good books about that. JACK: Bill Sears? DEAN ORNISH: Yeah. JACK: Yeah. I think it’s so challenging,
because particularly here in the US, there’s so much
packaged food and even, quote, “healthy” packaged food. It does make it easier
for a very busy parent. You’re a busy parent. You have lots of kids. You’re feeding things
like that, and you just get a lot of packaged food. But it is disconnecting us
from the source of the food and where things are from. DEAN ORNISH: It’s true. JACK: It’s something
that unfortunately is a major challenge that– DEAN ORNISH: Well, to the
extent at least the meal kits or whatever can be used to– the meal kits are different than
the frozen foods, and so on, because you’re
actually making dinner. But they just have
done the hard part. So it makes it easier. And there are studies that show
that just when the family sits down together to have a meal
together, just the sitting down together, there’s better
academic performance, lower truancy, lower illness, all the
kind of things that you want. Again, it goes back to the
social factors and the power of community and family. JACK: Great. Other questions, please. Your name? AUDIENCE: Hi, my
name is [INAUDIBLE].. My question is about
what are the things we can adopt and encourage
that can help build a stronger immunity against diseases. JACK: Stronger immunity, yeah. DEAN ORNISH: Well, one of the
most powerful things you can do is to actually have more love
in your life, believe it or not. There was a study that was
done by Sheldon Cohen that was in the “Journal of the
American Medical Association.” And I don’t know how he got
this through the Institutional Review Board, but
he got volunteers. And he dripped rhinovirus that
causes colds in their noses. 100% of them got infected. But not everybody that got
infected actually got sick. And they found that the
more social contacts they had– the more
friends visiting them, the more phone
calls, the more love that they had– they had
four times fewer signs and symptoms of a cold, even
though they were all infected. So [INAUDIBLE] is we have
this idea that the bacteria or the germ causes the disease. But it’s a necessary but
not always sufficient factor, even with
people who are– Margaret Chesney did a study at
UCSF where she found that men and women who were HIV-positive
who were lonely and depressed were more than twice as likely
to develop AIDS and die from it than those who weren’t. So diet is important. Exercise is important. These all affect our
immunity, but probably more than anything, these
social factors. And we tend to think that the
time we spend with our friends and family is a luxury
that we do after we’ve done the important stuff. And to me, the
value of the science is that it increases awareness. So we understand just how
powerful those things are, and that the time that we spend
with our friends and family is not the stuff we do after
we’ve done the important stuff, that it is the important stuff. JACK: And that’s also a
message for employers. I mean, obviously, here we
put a lot of emphasis on that. People are encouraged
to take their vacations, go home, be with their
families, things like that. So it’s a real message around
if you want your employees to be healthy, that it’s just not a
nice-to-have, it’s a must-have. DEAN ORNISH: And
it’s unfortunate that the startup tech
world is often the mythical let’s stay up all night and eat
pizzas and really run ourselves into the ground. And yet, you can do
that for a short time. But if you really want to keep
your creativity at its maximum, as you know, taking
care of yourself makes you smarter and makes
you work more effectively. JACK: Great. Other questions. Please, right here in the front,
and then– oh, good, good. There, and then the front. We have two mics? OK. There– yeah. AUDIENCE: So my
name is [INAUDIBLE],, and my question is
regarding caffeine. There’s a lot of confusion
regarding whether it’s good or, if so, how much. I would love to
hear your thoughts. DEAN ORNISH: Why do
you want to know? [LAUGHTER] That’s what I’m like when
I have too much caffeine. I’m very caffeine-sensitive. If I even have decaf,
it’s like, hurry up! Can’t you go any faster? [CHUCKLES] It’s really– it
makes me very aggressive. And I’ve learned to avoid
caffeine in all of its forms. But my wife can drink three
cups of coffee and go to bed. So there is a lot of individual
variation around that. The problem with caffeine is
that for some people like me, it makes your fuse shorter. It can potentially add stress. It makes you more likely
to be stressed out. For other people,
it doesn’t do that. And there are other
things that are in coffee besides caffeine– the polyphenols, and so on– that actually may be protective
against some of the more common chronic diseases. So you decide. If you find that you don’t
have those negative side effects from doing
caffeine, then that is probably good for
you, up to a point. JACK: This one
right in front here, and then we’ll go to the back. DEAN ORNISH: I’m like
Robin Williams on speed if I have caffeine. [LAUGHTER] AUDIENCE: So thanks for the
really interesting talk. I’m [INAUDIBLE]. JACK: Sorry, is the mic on? Just make sure it’s on. AUDIENCE: Oh, sorry. JACK: Good. AUDIENCE: I’m [INAUDIBLE]. And so my question is on– so a lot of the
improvements you describe, they’re these very human
lifestyle improvements. So I was curious about whether
there’s any sort of technology that’s emerging that you’re
excited about that might also effect these improvements
in people’s lives. DEAN ORNISH: Yes, technology
is a powerful force. I don’t have to say
that here at Google. But it can be used to
bring us closer together. It can isolate us more, as
we talked about earlier. If you look at other
people’s Facebook profile, it makes you separate. But on the other hand, we
found that support groups are so powerful. And after they finished
their Medicare– and most insurance companies
are paying for 72 hours of the people meet twice
a week for 9 weeks, or a 12-day immersion retreat– and afterwards, we found that
because they’ve developed a sense of trust already– and trust is really everything,
because you can only be intimate to the degree
you can open your heart and be vulnerable. And you can only do that to
the degree you feel trusting. And so that’s why trust is
really fundamental to healing. And so once you develop that
sense of trust with a group of people, we then meet–
instead of having them come in a central place
which we found was hard, and particularly if they came
for a tour or retreat from different parts of the
country, they can all use– we use Zoom as a technology. But we could use Google or
anything to say, OK, between– they pick a day, like
Thursdays, from 5:00 to 6:00, we’re going to have
our support group. It’s 15 people. And they all chime in. I like Zoom, because whoever
is talking immediately fills the screen. Except for people who
are not very tech-savvy, it’s an easy way to do that. And so that’s just one example
of how technology can really be healing in a powerful way. AUDIENCE: One really
quick follow-up question, what about machine learning? So this is something I work on,
so I was just curious as to– JACK: Artificial intelligence,
machine learning. DEAN ORNISH: Yeah, well,
you’re talking to the man here. He’s having a conference
here for the next three days on that. What particular aspect of
that are you asking about? AUDIENCE: So one thing people
are excited about in machine learning at least, in
health applications, is trying to take image
data and try and spot sort of the progression
of diseases, for example. So– yeah. DEAN ORNISH: Well,
certainly, we’re already seeing
things in pathology that artificial intelligence
can actually diagnose cancers more accurately and
sooner than even the most experienced radiologists. But I defer that
question to you, Jack. JACK: Sure. Yeah, I would say, it’s
a very exciting field. I think we’re just
at the beginning. If you look at medical
imaging as an example, and there are several
projects across this campus and other startups and lots
of people beginning down this road, the good news
is I started my career in medical imaging at NIH. And it’s one of the fields
that has been most digitized. So the good news is, coming
out of most major scanners– Phillips, GE, so on
and so forth, Siemens– you get a digital file. Unfortunately,
most of those files get stored away in
some data center. And no one ever
looks at them again. We’re beginning now as
a technology community to begin to tap into that
and then hook that up with the electronic medical
records, which again can be our ground truth as
to what did, in fact, happen to this person? What were they diagnosed as
based on the medical imaging? And then what was the ground
truth over the next five, six years of what
actually developed? And that becomes a rich
source of supervised learning possibility for neural
networks or other models that we can use. So I do expect this
kind of technology to really enhance the
role, say, for example, of the radiologists,
where the radiologist now is not just popping
something up on a screen. I literally still
visit hospitals today where people are
printing out films. And so it’s still
happening today, where rather than looking at it
in a high-resolution monitor, they’re still printing out film. So that is changing. There are other parts– there are still a lot of records
that are not electronic yet. There is a lot of movement
to make that happen. And even when they
are electronic, we have to be
very, very careful. It’s clear now that
we have to be– as we’re ingesting
this data for the role of supervised
learning, there’s often errors in terms of the labeling. And we have to be careful
about what we’re training, what we’re not training. We also to make sure that
we have a diversity in terms of the demographics that we’re
ingesting into these AIs. And so if we’re
going to do this, we want to make sure that we
have population pools that are drawn from a
wide gamut of society so that we haven’t inadvertently
trained the AI to do a great job on this
part of the demographic when their medical
image is taken in, but not that part
of the demographic. And I also think it’s important
to do this on a global scale. There are some initiatives
in other countries to begin to add
to this database. But it’s really just beginning. So my biggest concern right
now is about diversity, is about making sure that
as we’re going through this, we have a real wide
diversity of patients that are coming into this thing. But yeah, go ahead. DEAN ORNISH: Let me
say one more thing. There’s a company called
Lark that Julia Hu organized with a group of MIT
people that actually does AI text-based messaging. So it feels like there’s a
health coach on the other end, but there’s not. And actually, you can scale
that for virtually nothing, because you don’t have to
have a coach on the other end. And so it’s actually
getting increasingly effective at motivating people
to make behavioral changes that can be scaled at
virtually no cost. JACK: Yeah. The one real-world example
I would also point people to in the UK is something
called Babylon Health. People in the audience
and viewing this can check out that company. That company has not
just created a fun app which you can use to engage
on your health issues and also triage– the National Health Service
of England, of the UK, uses it to actually
officially triage 1.5 million citizens in the UK. And so it’s actually
an official part. DEAN ORNISH: Yeah,
it’s beautiful. JACK: It’s one of
the first examples that I’ve seen of a health
service incorporating this technology in
an official capacity. DEAN ORNISH: And
by the way, TRICARE is using the AI in
their app as well. So I think we’re seeing
this more and more. And I think it’s really
the wave of the future. JACK: Yeah. I think we had a
question back here. Yeah, please, your
name and– go ahead. AUDIENCE: Hi. My name is [INAUDIBLE]. I’m interested to know that
most people coming from India suffer from vitamin
D deficiency. And so we’ve been
prescribed by the doctors to take it as a supplement. What are the precautions
actually needed to mix it [INAUDIBLE]? And there are some
articles that I read online that you shouldn’t take
it with this supplement. You shouldn’t take calcium
supplements along with iron. There are so many
confusing things about taking supplements. Can you clarify it? DEAN ORNISH: Well, it’s
not just people from India. Most people in this country
are vitamin D3 deficient. And so I think that I would add
that to my list of supplements for most people is take 1,000
units of vitamin D every day. And I wouldn’t worry so much. Vitamin D is a pretty innocuous
thing about combining that with other supplements. I’m not aware that
that’s really going to create any major
problems for most people. JACK: Cool. Question here in the
front, we have a– great. AUDIENCE: Hi, this is
Alexis [INAUDIBLE].. Thank you so much, Dean. I have a question around sleep. We haven’t touched on that. And I think all of us
would agree that it’s increasingly important. And it’s, in fact, one
of the most important. So what are your thoughts? DEAN ORNISH: Well,
sleep is one of the ways that your brain
detoxifies itself. And so there are a lot
of people who think, I don’t need much
sleep, and so on. But Bill Clinton famously
said that the worst decisions he ever made were when
he was sleep-deprived. And I think Arianna
Huffington has done a of work in raising the awareness
about the importance of that. So I think if you want to really
be creative and innovative, as opposed to imitative,
try to get more sleep. It can really make
a big difference. JACK: Yeah, I think what’s
interesting about sleep also is that we don’t
fully know the science yet of how sleep is helping us. And so I think a
lot of times, we’re willing to cut corners
on sleep, because we don’t have that immediate
knowledge about what is actually happening in
the brain during the sleep. But obviously,
it’s now come out. And it’s very clear
from many studies. DEAN ORNISH: Well, I think,
even from an evolutionary standpoint, why would we
evolve to do something that’s going to make us use
up so much of our life, make us completely vulnerable to
predators while we’re sleeping, unless it was really important. And I think that’s
part of why when I’m in the middle of
the night and wanting to get up and do work, I have to
remind myself of these things. [CHUCKLES] JACK: Exactly, great. We have one more
question back here. AUDIENCE: Hi, my
name is [INAUDIBLE].. My question is about the
prescription, the four pillars which you mentioned. Does that change based on the
ethnicity or the underlying problem which a person
is trying to treat, like obesity or heart disease
or cancer or those things? Or is it all [INAUDIBLE]? DEAN ORNISH: Not really so much. I mean, we fine-tune
a little bit. Some people can metabolize
refined carbohydrates or gluten or things like that
better than others. But for the vast majority
of it, it’s really the same. And when I started doing
this work, I predicted– incorrectly, as it turns out– that the younger people
who had less severe disease would do better. And what we found,
it wasn’t a function of age or disease severity. It was simply a function of
the more you change your diet and lifestyle in these
areas, the more you improve in every
metric we looked at and every disease we studied. Now, there may be ways
of fine-tuning this as we learn more. But what I’m still
so struck by is that these same
lifestyle changes, the more diseases we study and
the more biological mechanisms we research, the
more reasons we have to explain why they
are so powerful. And it’s so hard for a
lot of people to believe, like, you mean talking
about my feelings is going to help me live longer? Are you kidding me? [CHUCKLES] Is that
the best you can do? It’s like, yeah, as a
matter of fact, it is. I mean, David Spiegel
did a landmark study at Stanford years ago,
where he took women with metastatic breast
cancer, randomized them into two groups. Both groups were
getting the same chemo and radiation and surgery. But one group had a
support group once a week for an hour and a
half for a year, in the same way as we
were talking about. And then they stopped. Five years later, he told me
he almost fell off his chair when he looked at the data. Those women lived twice as long. So these simple
things can really make a powerful difference. JACK: Great. With that, thank you
very much for coming. Thank you to our
YouTube audience. Thank you, Dean Ornish. DEAN ORNISH: Thank you. [APPLAUSE] JACK: Let me just mention that
if folks want more information, I believe your
website is ornish.com? DEAN ORNISH: Yep. JACK: Your nonprofit
is PMRI.org. DEAN ORNISH: Yep. JACK: And the general
website is ornish.com for people to get more info. DEAN ORNISH: That’s it. Thank you. JACK: Thank you, Dean. DEAN ORNISH: Thank you, Jack. JACK: Thank you. [APPLAUSE]