Wellness Reset at Fifty – The Dr. Dean Ornish Framework

“Fitness and diet are key for lifelong wellness. However, we can’t minimize the importance of managing stress and fostering love in our life.”

The Problem(s) To Be Solved

Other than our recent 30 day HCLF dietary challenge, we have not written an article fully focused on the work by Dr. Dean Ornish. Finding My Psych was largely conceptualized and inspired by the wellness framework established by Ornish in the early 90s. I was first turned on to his work in my graduate program. My major professor introduced me to his book, “Program for Reversing Heart Disease.” At the time, I knew very little about the concept of lifelong wellness and lifestyle medicine. This book launched my interest in Behavioural Medicine, and later Health Psychology in understanding healthcare systems and pathways to care.

Today’s article will be written in the first person as the problem that has emerged is directly about me and the dangerous path I seek to step off of. I have come by the problem(s) honestly by way of a global pandemic and clinical depression pushing through the veil along the way. But, if I am honest, the problem started long before then in a much more insidious fashion – I am somewhat ashamed to admit that I was aware the entire journey.

In short, the problem(s) I am trying can be summed up as the cessation of adaptive habits I once practiced predicting wellness, concurrent with the return of the bad. This has resulted in health consequences that I will face in force down the road should I not take control of the wheel. I am turning to Ornish, as I have in the past, to guide the changes I seek.

Focus of this Article

In an effort to structure a real life example and review of the Ornish approach to wellness, I will describe my starting point for what is going well, what is not going well, followed by a detailed overview of the framework Ornish suggests in his lifestyle transformation focused program.

I will then reveal the pathway I am committing to as part of an overall change in my approach to the food I eat, fitness, mental health, and substances. In wrapping up the article, I will tell you about the tools I am using to track and report on my progress I am making as I step onto my wellness path. I will also talk about my commitment to building a support system for accountability and sustainability.

My Starting Point – It’s Not That Great!

Whats Going Well

There are several areas in my life that are considered assets supportive of the changes I am seeking to make. I am blessed with the following:

1. My marriage is solid and my husband supports my wellness efforts. When I try a new recipe, he is supportive even if it is something he will never eat.
2. My fitness is not terrible – I can run a solid 5k with little impact the following day. I can run a 10k with significant effort but can complete without stopping. While this is not the level of fitness I was at training for my first marathon in 2016, the base I have continued promotes mental and physical wellness.
3. I eat a plant-based vegan diet, a perfect starting point in entering the nutritional guidelines described in this article. I also like “healthy” vegan foods (i.e., rice, beans, etc.). There are few things I wont give a try (except Durian Fruit).
4. I have a clinical background that provides me the tools needed to manage my mood and anxiety. I understand the core principles of CBT, have advised patients on how to best utilize them, and have applied them in my own life.
5. I am sober. While I do not have a substance use problem, I made this commitment in support of others in my family.

Whats Not Going Well

While I am privileged to have many of the assets described above, there are other areas in my life that require attention:

1. I am overweight, enough to make running feel difficult and cause muscle and joint pain. While I will not disclose my weight as this metric carries a level of controversy, suffice it to say, my weight is piling on and feels out of control, even as a vegan. The extra pounds are predictive of chronic disease.
2. My plant-based diet has devolved. I find it far too easy to plug-in the air fryer and heat plant-based analogue meats, especially with my busy schedule. I also graze late into the evening.
3. My weekly klicks has decreased as a result of poor motivation and increased weight. In turn, my mood has decreased overall. This is important as the most important effects on mood from running comes from long distances, not to mention, it makes me feel really high!
4. I work in a high stress environment. My job often leaves me feeling drained at the end of the day. I experience significant anxiety while at work. Working in healthcare is stressful. I have fallen out of the habit of using stress management tools such as PMR, cognitive reframing, etc.

The Dr. Dean Ornish Framework

Ornish has written several books reviewing the concepts found in lifestyle medicine. Two stand out for me. These are, “Undo It – How Simple Lifestyle Changes Can Reverse Most Chronic Diseases,” and “Dr. Dean Ornish’s Program for Reversing Heart Disease.” While the latter is the focus of today’s article, “Undo It,” is an essential companion. I am most drawn to the sections written by his wife, Anne Ornish. Anne is the vice president of program development at the Preventive Medicine Research Institute.

Ornish Essentials for Reversing Heart Disease

Fundamental to all of Ornish’s work is diet. However, it should be noted that he is also known for his focus on fitness, stress management, and the importance of fostering loving relationships. Each of his books take this holistic perspective, forcing the reader to acknowledge that no one tool by itself is adequate. You will notice that in my own pathway development below, I force myself to account for each.

In terms of specifics of the diet, the Ornish plan easily fits into the category of High Carb Low Fat (HCLF). This includes focusing on the following proportions:

10% (+/- 5) comes form fat, 20% (+/- 5) from protein, and 70% (+/- 5) from complex carbohydrates.

From: Dr. Dean Ornish’s Program for Reversing Heart Disease.

While his diet does allow for some animal products, the dietary approach he promotes are easily considered plant-based. While not entirely vegan, the vegan lifestyle community has adopted the HCLF approach by eliminating egg whites, fish, and low fat yogourt, all found in the Reversal Diet Plan.

Ornish found that with those suffering from arterial sclerosis, going on a HCLF diet with moderate exercise, showed the most positive outcomes, even reversal, compared to those that took medications alone. However, you will notice that in his heart healthy program, proponents are encouraged to participate in stress management skills (PMR) one hour per day. This added element is a clear signal that wellness is biopsychosocial, even spiritual in nature.

Charting My Pathway of Health and Wellness

Ornish offers an evidence based biopsychosocial approach to wellness focused on lifelong wellness. When building your personalized plan to wellness, you must include nutrition, fitness, mental health, and substance use as part of your path to wellness. My path will include the following:

Nutrition

I am implementing a high carb, low fat diet as part of my wellness promoting lifestyle. In the past, this formula worked for me. Whenever I have wanted a kickstart, HCLF eating works every time. My plan includes:

1. Counting calories.
2. Adhering to 10% (+/- 5%) of my calories coming from fat.
3. Staying focused on protein – My goal is to get at least 120g per day.
4. Supplementing with the usual B12, and vegan omega-3s.
5. Avoiding raw sugar added to foods (oatmeal, etc.).

Fitness

My heart is in running, long distance running specifically. As a runner, I plan to continue my efforts combined with a moderate amount of cross training. This will include doing long walks on non-running days, and the occasional bike ride. My plan also includes focusing on stretching after runs and on rest days.

Mental Health

As indicated above, I have struggled with clinical depression and anxiety. Running is my medicine. Nevertheless, while exercise tends to level out my mood, anxiety consumes me. I am offered many opportunities to find appropriate responses internally to the stressors I face during the day. As part of my plan:

1. I will log two mindful breathing minutes per day using my Apple Watch.
2. Pause in stressful situations and reframe any emerging self-doubt.
3. Spend time in meditation and/or prayer (Hallow app) once a day.

Substance Use

I am committed to not drinking alcohol moving forward. At Finding My Psych, we support both controlled drinking and abstinence to manage the negative effects of alcohol consumption. I have recently made a lifelong commitment to not consuming alcohol in support of my family where alcohol use has impacted us significantly. Being abstinent from alcohol helps you consume less calories, improves mood and anxiety, and once removed from the formula, improves athletic performance, especially as we age.

Keeping Track and Organized

I am admittedly obsessed with data. As part of my path, I will use the following to both track of my progress and keep organized. I will do this for as long as is required – In other words, until each of the above areas feels fully incorporated into my wellness focused life.

• I will track of my caloric intake and macros using MyFitnessPal.
• I will keep track with alerts cuing me to take supplements using Apple Health.
• I will use the Zero Longevity app for Circadian Rhythm Fasting (13 hrs) to decrease caloric intake at night.
• I will track of my resting calories and exertion from walking, running, or bicycling using my Apple Watch Ultra or my Garmin Epix.
• I will journal my experience in sobriety using DayOne.
• I will journal my current level of anxiety and challenges with mood.

Building My Support System

Dr. Dean Ornish describes the importance of fostering love and support in our lives. This step cannot be skipped. The outcomes we seek are only as good as our ability to elicit the needed support of others. We are not an island. Each outcome is not owned by the individual, but those that came together to support the changes needed for longevity.

It is important that I promote close connections between myself and others. My tendency is to isolate. This is best done by taking the time to be with people I want to be close to, who through mutual support, seek companionship, happiness, and therefore fulfillment.

Watch Progress on YouTube

On the Finding My Psych YouTube Channel, you will find our latest series tilted, “Nailing Fitness In My 50s: The Ornish Wellness Reset.” We are releasing an update each week covering a variety of wellness topics that inform my fitness journey. Please like and subscribe to our channel and watch the playlist each week for added content.