Written by Luc Geeraert and the CAM-Cancer Consortium.
Updated January 20, 2017

Ornish diet and lifestyle modification programme

Does it work?

Only a limited number of studies have been carried out to date, with investigations limited by reliance on surrogate biomarkers (PSA, PSA doubling time, and serum-induced changes in growth and apoptosis of LNCaP prostate cancer cells), sample size, and duration. To determine the clinical relevance of the findings from these studies on disease-specific survival, and to help define optimal dietary patterns and lifestyle factors important for prostate cancer management, larger, well-designed, and longer-term studies are needed.

Clinical trials

The Ornish diet and lifestyle modification programme was tested in a randomized trial in 93 men with early biopsy-proven prostate cancer (PSA 4-10 ng/ml, Gleason scores less than 7) who had chosen not to undergo any conventional treatment 3. After 1 year, intensive lifestyle changes resulted in a PSA decrease of 4% and an inhibition of the serum-stimulated growth of LNCaP cells of 70%, compared to a 6% increase of PSA and only 9% LNCaP growth inhibition in the control group (not following the Ornish diet and lifestyle modification programme, but making lifestyle changes as advised by their physician). None of the 44 patients in the treatment group, but 6 of the 49 control patients had to undergo conventional treatment (e.g., radical prostatectomy, radiotherapy, or androgen deprivation therapy) due to an increase in PSA and/or progression of disease on magnetic resonance imaging. After 2 years, 2 of the 43 experimental patients and 13 of the 49 control patients had undergone conventional prostate cancer treatment; at this time point no significant differences in PSA change were found between the experimental and control patients (excluding patients who had undergone conventional treatment), and adherence to the intensive lifestyle changes remained high (95%) 10. Experimental patients showed greater improvements in cardiovascular health parameters than did control patients. Patients in the treatment group appeared to experience overall optimism and hope, make gains in their emotional availability, and highly value a peer/staff community experience 16. Patients in both the treatment and the control group who improved their lifestyle showed enhanced physical health-related quality of life and decreased perceived stress after 1 year, but no significant differences in quality of life were found between the groups 9. All recommended dietary reference intakes were met by the intervention, only vitamin D intake was less than adequate 17. After 1 year, the intake of several dietary constituents that may reduce the risk of many chronic diseases was increased, while the intake of constituents implicated with an increased chronic disease risk was decreased in the intervention group compared to controls 18. The levels of insulin-like growth factor 1 (IGF-1) increased in both groups over 1 year, whereas an increase in the levels of IGF-1 binding protein (IGFBP-1) and a trend towards lower fasting insulin levels were observed in the experimental group only 19.

In an uncontrolled pilot study in 30 men with biopsy-diagnosed low-risk prostate cancer under active surveillance, the Ornish diet and lifestyle modification programme was found to significantly modulate biological processes playing critical roles in tumorigenesis 11, and to significantly increase telomerase activity in PBMCs 12. Total PSA did not change significantly, although percent free PSA was improved 11. Overall, patients were able to adhere closely to the lifestyle modifications, a significant decrease in cardiovascular disease risk factors was found, and patients reported significant reductions in psychological distress associated with prostate cancer. The intervention was safe and no adverse events were observed. From the intervention group, 10 men were enrolled in a follow-up study where they continued the Ornish diet and lifestyle modification programme, and were compared to 25 external controls with biopsy-proven low-risk prostate cancer under active surveillance 21. After 5 years, the relative telomere length had increased in the intervention group and decreased in the control group; this difference between both groups was significant. A better adherence to lifestyle changes was significantly associated with more increased relative telomere length.

Citation

Luc Geeraert, CAM-Cancer Consortium. Ornish diet and lifestyle modification programme [online document]. http://cam-cancer.org/The-Summaries/Dietary-approaches/Ornish-diet-and-lifestyle-modification-programme. January 20, 2017.

Document history

Most recent update and revision in January 2017 by Luc Geeraert.

Summary assessed as up to date in September 2013 by Barbara Wider.
Update and revision in November 2012 by Luc Geeraert.
Summary first published in September 2011, authored by Luc Geeraert. 

References

  1. Deanornish.com [Internet]. Dean Ornish, MD, Bio. 2011. [cited 19th December 2016]. Available from: http://deanornish.com/about/.
  2. Ornish D. The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health. New York: Ballantine Books, 2007.
  3. Ornish D, Weidner G, Fair WR, Marlin R, Pettengill EB, Raisin CJ, Dunn-Emke S, Crutchfield L, Jacobs FN, Barnard RJ, Aronson WJ, McCormac P, McKnight DJ, Fein JD, Dnistrian AM, Weinstein J, Ngo TH, Mendell NR, Carroll PR. Intensive lifestyle changes may affect the progression of prostate cancer. J. Urol. 2005 September;174(3):1065-1069.
  4. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74. doi: 10.3322/caac.21142.
  5. Ornish D. Can life-style changes reverse coronary atherosclerosis? Hosp. Pract. (Off. Ed.). 1991 May 15;26(5):123-126, 129-132.
  6. Ornish D, Scherwitz LW, Doody RS, Kesten D, McLanahan SM, Brown SE, DePuey E, Sonnemaker R, Haynes C, Lester J, McAllister GK, Hall RJ, Burdine JA, Gotto AM Jr. Effects of stress management training and dietary changes in treating ischemic heart disease. JAMA. 1983 January 7;249(1):54-59.
  7. Ornish D, Scherwitz LW, Billings JH, Brown SE, Gould KL, Merritt TA, Sparler S, Armstrong WT, Ports TA, Kirkeeide RL, Hogeboom C, Brand RJ. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998 December 16;280(23):2001-2007.
  8. Ornish DM, Lee KL, Fair WR, Pettengill EB, Carroll PR. Dietary trial in prostate cancer: Early experience and implications for clinical trial design. Urology. 2001 April;57(4 Suppl 1):200-201.
  9. Daubenmier JJ, Weidner G, Marlin R, Crutchfield L, Dunn-Emke S, Chi C, Gao B, Carroll P, Ornish D. Lifestyle and health-related quality of life of men with prostate cancer managed with active surveillance. Urology. 2006 January;67(1):125-130.
  10. Frattaroli J, Weidner G, Dnistrian AM, Kemp C, Daubenmier JJ, Marlin RO, Crutchfield L, Yglecias L, Carroll PR, Ornish D. Clinical events in prostate cancer lifestyle trial: results from two years of follow-up. Urology. 2008 December;72(6):1319-1323.
  11. Ornish D, Magbanua MJ, Weidner G, Weinberg V, Kemp C, Green C, Mattie MD, Marlin R, Simko J, Shinohara K, Haqq CM, Carroll PR. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proc. Natl. Acad. Sci. USA. 2008 Jun 17;105(24):8369-8374.
  12. Ornish D, Lin J, Daubenmier J, Weidner G, Epel E, Kemp C, Magbanua MJ, Marlin R, Yglecias L, Carroll PR, Blackburn EH. Increased telomerase activity and comprehensive lifestyle changes: a pilot study. Lancet Oncol. 2008 November;9(11):1048-1057.
  13. Cooperberg MR, Broering JM, Kantoff PW, Carroll PR. Contemporary trends in low risk prostate cancer: risk assessment and treatment. J. Urol. 2007 September;178(3 Pt 2):S14-S19.
  14. Klotz L. Low-risk prostate cancer can and should often be managed with active surveillance and selective delayed intervention. Nat. Clin. Pract. Urol. 2008 January;5(1):2-3.
  15. Zeng W, Stason WB, Fournier S, Razavi M, Ritter G, Strickler GK, Bhalotra SM, Shepard DS. Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries. Am Heart J. 2013 May;165(5):785-92. doi: 10.1016/j.ahj.2013.01.018.
  16. Kronenwetter C, Weidner G, Pettengill E, Marlin R, Crutchfield L, McCormac P, Raisin CJ, Ornish D. A qualitative analysis of interviews of men with early stage prostate cancer: the Prostate Cancer Lifestyle Trial. Cancer Nurs. 2005 Mar-April;28(2):99-107.
  17. Dunn-Emke SR, Weidner G, Pettengill EB, Marlin RO, Chi C, Ornish DM. Nutrient adequacy of a very low-fat vegan diet. J. Am. Diet Assoc. 2005 September;105(9):1442-1446.
  18. Dewell A, Weidner G, Sumner MD, Chi CS, Ornish D. A very-low-fat vegan diet increases intake of protective dietary factors and decreases intake of pathogenic dietary factors. J. Am. Diet Assoc. 2008 February;108(2):347-356.
  19. Dewell A, Weidner G, Sumner MD, Barnard RJ, Marlin RO, Daubenmier JJ, Chi C, Carroll PR, Ornish D. Relationship of dietary protein and soy isoflavones to serum IGF-1 and IGF binding proteins in the Prostate Cancer Lifestyle Trial. Nutr. Cancer. 2007;58(1):35-42.
  20. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000.
  21. Ornish D, Lin J, Chan JM, Epel E, Kemp C, Weidner G, Marlin R, Frenda SJ, Magbanua MJ, Daubenmier J, Estay I, Hills NK, Chainani-Wu N, Carroll PR, Blackburn EH. Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study. Lancet Oncol. 2013 Oct;14(11):1112-20. doi: 10.1016/S1470-2045(13)70366-8.