#283: Dean Ornish, MD - Hope for Alzheimer's: The Power of Plant-Based Nutrition to Reverse Cognitive Decline
In June 2024, Dr. Dean Ornish and his team at the Preventive Medicine Research Institute revealed for the first time that an intensive lifestyle intervention—including a whole-food, plant-based diet—can significantly improve cognition and even halt the progression of Alzheimer’s disease!
Dr. Dean Ornish shares details of his compelling protocol and insights into his randomized controlled clinical trial study that demonstrated the effectiveness of dietary and lifestyle changes in reversing early stages of dementia.
With nearly 7 million Americans currently living with Alzheimer's, the potential to shift this alarming trajectory offers a sense of hope. Dr. Ornish's study highlights not only the importance of nutrition but also the critical role of exercise, stress management, and social connections in promoting brain health.
It's an inspiring conversation that underscores the power of simple, yet transformative lifestyle choices in combating one of the most feared diseases of our time.
Takeaways:
Nearly 7 million Americans are currently living with Alzheimer's, with projections rising dramatically by 2050.
Dr. Dean Ornish's lifestyle intervention significantly improves cognition and function in Alzheimer's patients.
A whole food plant-based diet is central to reversing the progression of Alzheimer's disease.
The study found that 71% of participants in the intervention group showed cognitive improvement.
Lifestyle changes can effectively reduce Alzheimer's symptoms, contrasting with traditional drug treatments that only slow decline.
A supportive community and love are crucial components in managing Alzheimer's and improving quality of life.
Episode Highlights
2:57 The Global Burden of Alzheimer's
7:12 Dr. Ornish's Groundbreaking Research
9:22 Understanding the Study's Methodology
17:28 His Lifestyle Intervention Explained
25:46 The Impact of Exercise on Brain Health
28:31 The Power of Social Connections
32:47 Control Group Insights
33:57 Personal Reflections on the Research
36:30 Future Research Aspirations
40:57 Meaningful Living vs. Longevity
Episode Resources
Read More About Dr. Ornish’s Alzheimers Study from the American College of Lifestyle Medicine
Link to Dr. Ornish Alzheimer’s Study
The Last Alzheimer’s Patient with Dr. Sanjay Gupta (article and links to the documentary)
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Full Episode Transcription via Transcription Service
I'm Rip Esselstyn, and you're listening to the PLANTSTRONG Podcast.
Introduction to Alzheimer's and Hope
[0:04] According to statistics provided by the Alzheimer's Association, nearly 7 million Americans are currently living with Alzheimer's. And by 2050, this number is projected to rise by nearly 13 million. It's an absolutely alarming headline. but what if I told you there's an intervention that has been proven to significantly improve and even halt the progression of this disease without dangerous drugs? Here to share the remarkable results of his latest groundbreaking study is none other than the pioneer of lifestyle medicine, Dr. Dean Ornish. And we'll have this exciting news right after this message from PLANTSTRONG.
[0:53] All right, folks, I've got some great news for you. In our goal to make plant-based living easier, more delicious, and most importantly, sustainable, the PLANTSTRONG plan is officially here and it is live. We've curated a powerhouse product bundle that's packed with the essentials to fuel you for a full week or more of real plant-based goodness. There's no guesswork, no overwhelm, just a simple joy of knowing that you've got all the tools plus a handy grocery list and daily meal plan to make this lifestyle work for you right out of the box. Think hearty meals like veggie packed chilies, savory burgers, comforting bowls, and even pizza night. All designed to be quick, easy, and super satisfying. So whether you're a seasoned plant-based pro or you're just getting started.
[1:51] The PLANTSTRONG Plan is your fast track to a week of health, energy, and vibrant living. Head to PLANTSTRONG.com to get your bundle today, and let's make this year of effortless, delicious, plant-based living last. Stay PLANTSTRONG. Another special announcement to share with you all, Dr. Dawn Musalem of the Mayo Clinic, expert in cancer treatment and prevention, and a dear, dear friend to PLANTSTRONG. She's appeared on the PLANTSTRONG podcast and joined us at PLANTSTRONG in 2024, has agreed to join us this April at our upcoming Sedona Retreat to share her wisdom, her caring expertise, and her endless energy with everyone. Come hear her personal story, get answers to your questions, and try, just try to keep up with this passionate, plant-powered doc. I know I can't wait. Visit liveplantstrong.com today to learn more, and I hope to see you in Sedona this April. Ask anyone.
The Burden of Alzheimer's
[2:57] And the one disease that people fear most is the diagnosis of dementia or Alzheimer's disease. In fact, the current lifetime risk of developing Alzheimer's is one in five for women and one in 10 for men. Not only is it devastating for the patient, but the toll on caregivers is equally traumatic. And health and long-term care costs for people living with dementia are projected to reach $360 billion by 2025 and nearly $1 trillion in 2050. It is a physical, emotional, and financial burden that is unbearable for many, and it need not exist to the extent that it does. Now, I understand that this is hard to hear, but my guest today, Dr. Dean Ornish, offers a word that we could all use, hope. Dr. Ornish completed a randomized controlled clinical trial study that demonstrated for the first time that an intensive lifestyle intervention, which includes a whole food plant-based diet.
[4:05] Significantly improved cognition and function in patients with early dementia and Alzheimer's disease. The groundbreaking findings were published last June in Alzheimer's Research and Therapy, which is the leading peer reviewed Alzheimer's translational research journal. And the results were so compelling that even Dr. Sanjay Gupta from CNN produced a documentary about it called The Last Alzheimer's Patient. If you're ready to hear the good news, let's welcome Dr. Dean Ornish.
[4:41] Dr. Dean Ornish, welcome back to the PLANTSTRONG Podcast. It has been three years since you were on and the last time we talked about Undo It, How Simple Lifestyle Changes Can Reverse Most Chronic Diseases, wonderful book that you had written. And the last thing that we spoke about was how you were starting some research on Alzheimer's disease. And I said, when that's completed, I'd love to get you back. And that's where we are right now. You are a research machine and what you've done, obviously, your work with the heart, your work with the prostate, your work with telomeres, and now with the brain, with Alzheimer's. I think that this officially catapults you from one of the demigods of lifestyle medicine to the god of lifestyle medicine. Thank you. That's very sweet of you. Yeah, yeah. Well, you deserve it. But it's funny, you know, between the heart and the prostate and the brain, Dean, it's almost as if everything is somehow connected. No, that's a pretty radical thought. I know.
[5:53] It's why what's good for your heart is good for your brain, as you know, because they all share the same underlying biological mechanisms. And the Undo It book that you mentioned that my wife, Anna, and I wrote together, we've been working together for almost 30 years, puts forth what I thought was a fairly radical unifying theory. In other words, why is it that these same lifestyle changes can affect so many of the most common and costly chronic diseases? I mean, we were all trained in different diseases, different diagnoses, different treatments, and yet a whole foods, plant-based diet, low in fat and sugar, moderate exercise, meditation and yoga-based stress management and support groups or to reduce it to its essence, to eat well, move more, stress less, and love more. Why are these simple changes so powerful and so far-reaching? And the answer is that these different diseases really aren't as different as we thought. They all share the same underlying biological mechanisms, chronic inflammation, oxidative stress, changes in the microbiome, the 100 trillion cells that live in our gut, telomeres, gene expression, angiogenesis, immune function, over-stimulation of the sympathetic nervous system, and so on. And these mechanisms, in turn, are directly influenced, for better and for worse, by what we eat, how we respond to stress, how much exercise we get, and how much love and social support we get.
Dr. Ornish's Groundbreaking Research
[7:13] And Alzheimer's is just the latest version of that. And I think what got me interested in doing this, besides my own personal interest, my mom died of Alzheimer's. I have one of the Alzheimer's genes, the APOE4 genes, and all of her siblings and just seeing her beautiful mind decay was just so heartbreaking. But also...
[7:31] We're at a place with Alzheimer's that reminded me of where we were back in 1977 when I did my first study as a medical student on reversing heart disease. Back then, it was thought, once you had heart disease, the best you could hope to show was that you could slow down the rate at which you got worse. And then we were able to show that if you make bigger changes and a lot of things at the same time, that instead of getting worse and worse, you could often get better and better. And then we found that with other diseases that you mentioned, with prostate cancer, high blood pressure, high cholesterol, type 2 diabetes, gene expression, like the telomeres, and now Alzheimer's is just the latest example of that. And so the reason that I spend so much of my time doing these studies, they're really hard to do. They're hard to get funding for. If you want to get NIH support, National Institutes of Health Support, it's like, is it 500 milligrams of a drug or 250 milligrams of a drug that has a better effect. You know, those kind of incremental questions. But if you're doing something that's really disruptive, that goes against the conventional belief system, it's a bit of a catch-22. Without the funding, you can't show that it works. And if people don't think it works, then they don't want to say, well, why should we waste our money? Everybody knows you can't reverse Alzheimer's. And so all the funding ends up going to drugs, for example. And they've spent billions of dollars on these drugs. And the drug's.
[8:47] Have generally failed. Only three have been approved in the last 20 years, and all three just slowed down the rate at which you get worse. But getting worse more slowly is still getting worse. And so the suicide rate within a month after being diagnosed is seven times higher because they basically tell people, I'm sorry, you're only going to, at best, you can slow it down a little bit, get your affairs in order. There's not much we can do. So if there's anything you want to do, do it soon because you don't have much time. And that diagnosis itself can almost be self-fulfilling. It's like the brain starts to shut down as an adaptive response to hearing such devastating news.
Understanding the Study's Methodology
[9:23] Properly done, you know, in a randomized trial as we've done in all of our studies and with the leading investigators and published in the leading peer-reviewed journals, in this case with Alzheimer's, can redefine what's possible. And by doing so, that can also be self-fulfilling. It can give many people new hope and new choices. And it has implications for prevention as well because some of the newer AI-powered technologies can pick up based on your voice or your retina or your ability to stand in one leg. The likelihood of you getting Alzheimer's years before it becomes clinically apparent. A lot of people say, why would I want to know if I'm likely to get this horrible disease if I can't do anything about it? It just makes me crazy. Like there are sort of Damocles. But now if you can often reverse it, then presumably it works even better to help prevent it and you probably don't have to make such big changes to prevent it. And then people might want to know if they're likely to get it because then they can actually intervene at a time when it's most likely to have its greatest benefit. The earlier you intervene, the more likely it is to be preventive. So let me take a step back. And so for our listening audience.
[10:29] You completed what's called a randomized controlled phase two trial and included 50 men and women, if I'm correct, that were diagnosed with mild Alzheimer's. So let's start. When you say it's a randomized, controlled phase two trial, what exactly does that mean?
[10:48] Well, it wasn't mild Alzheimer's. It was early Alzheimer's. These are people who had significant Alzheimer's. These are people who couldn't read a book because they would start to read a book and they'd forget what they read. Then they'd have to start over again. Or they couldn't watch a TV show or a movie because they couldn't keep up with the plot. Or they had to stop cooking because they'd leave the gas on or those sorts of things. So they were fairly impaired. Yeah. A randomized trial, in any scientific study, it really is just trying to answer one simple question, which is whatever you're doing, whether it's a drug or a laser, or a surgical intervention or a lifestyle intervention.
[11:21] The question you're trying to answer is, if you see an effect, is it due to this intervention or is it due to chance? In other words, is this really causing the outcome or is it just associated but not really causative? And so by convention, in the scientific community, if the likelihood of these findings, whatever they are, is less than 5% likely due to chance, then it's considered statistically significant. Well, how do you get to be less than 5% likely due to chance? Well, either you have to have big changes in smaller groups of people or smaller changes in bigger groups of people. And you also want to use measurements that are accurate and reproducible. The more noise there is, the harder it is to know if it's a real finding or not. It's kind of like if you had a speedometer and it says you're going 60 miles an hour, and it's plus or minus 3 miles an hour, then you're going somewhere between 57 and 63 miles an hour. If it's plus or minus 30 miles an hour, then it's just a lot of noise. It really doesn't have much useful information. So in our studies, we ask people to make really big changes with smaller groups of people and use very accurate and reproducible measures. And the reason why we change a lot of things at the same time, a multifactorial or multimodal, or just different ways of saying intervention, is that.
[12:36] Like, let's use the drug trials. All three drugs, they work by, in a sense, pulling amyloid out of your brain. And amyloid is a protein that kind of gunks up your brain, like short circuits the neurons there. And the amyloid hypothesis has been the kind of predominant theory among neurologists of what causes people to get Alzheimer's, is that they get more and more of this gunk in their brain in short circuits and they can't think clearly. So the drugs pull the amyloid out of the brain, but all three drugs, they only slow down the rate at which you get worse because the amyloid is just one of many mechanisms that affects cognition, just like we talked about, you know, chronic inflammation, oxidative stress, all the things we talked about earlier. Whereas the lifestyle changes one of the things we learned uh for the first time was that we actually measured the amyloid in their blood just like they do in the drug trials and we found the same pattern that we were in effect pulling amyloid out of the brain but much more gently, so 21 of the people in these drug trials because the amyloid is getting pulled out kind of you know.
[13:39] I don't know what the word would be aggressively you know 21 of people get side effects like bleeding into your brain or brain swelling or things that are really awful. Whereas I didn't find that with people who do it through lifestyle. But there's a measure called the A-beta-42-40 ratio, which is just a measure of how much amyloid. And we found the same pattern that we were pulling amyloid out of the brain, but in a more gentle way. But we're also changing these other mechanisms. So the amyloid alone may account for some of the improvement, but it's only enough to slow it down a little bit. Whereas when you change your lifestyle, you are changing the amyloid, but you're also changing these other factors as well. Hmm. What was the size of your study? How many men, how many women?
[14:18] Yeah, it was 51 people total. About half of them got the program and half of them don't. And the reason you do what's called a randomized trial is that if you take people who they all have Alzheimer's, you know, the same degree, and half of them randomly get the program, whatever, in this case, this lifestyle program or it could be a drug or whatever, and half of them don't, then if there are any differences in the group that you're not aware of like the drinking water or the weather or you know could be an infinite number of things that you don't know about there's likely to end up in one group as the other so then if you do show differences then you can say with more confidence that it's due to whatever your intervention was in this case lifestyle or it could be a drug or something now some people think well gosh if you only have 51 patients is that really enough to say anything and the answer is yes in fact if you can show statistically significant differences in a smaller group of people, it just means your intervention is that much more powerful. It's affecting people to a greater degree, and a larger percentage of people are doing that. And that's what we found. We found that in the people who are in the lifestyle intervention group.
[15:22] That overall, that one of the tests we use, which is using the drug trials, is called the clinical global impression of change score. And we found that 71% of the patients stopped to reverse the progression of their disease. By They're reversed, meaning that their cognition improved overall using four standard measures that are used in the FDA drug trials. So 71% stopped or improved their disease. Whereas in the control group, the usual care group that was just doing what they were doing before, 68% of them got worse. And three of the four measures showed overall worsening in the control group, whereas in the intervention group, three of the four measures, people were actually getting better. And so you don't need 1,000 people when you have those clear trends. It'd be kind of like if in 1950, you started giving penicillin to 50 patients or 51 patients who had pneumonia, pneumococcal pneumonia, you wouldn't need a thousand people to know that the people who got the penicillin were doing better because they were doing so much better than the group that didn't get it. Yeah, yeah.
[16:20] That's pretty amazing results. 71% were able to reverse, and in the other group, 68% got worse. To stop or reverse. But if you can stop it from getting worse, that's for many people, that's encouraging as opposed to everybody being told it's only going to get worse over time. What was the length of the study, Dean? It was only 20 weeks, which is a very short time because we know that Alzheimer's occurs over a period of decades. And that's part of what we learned in all of our studies is that, and what your dad found in his study, is that these biological mechanisms are much more dynamic than we think about. You know, for better and for worse, you can get better quickly and you get worse quickly. You know, even a single meal can often cause acute changes in blood viscosity and platelet aggregation and the likelihood of the arteries to constrict or dilate, how well the blood can flow and so on. And so by making big changes in a lot of things at the same time, we can show improvement. Whereas if you just have a drug that just works on one mechanism, it may only slow it down a little bit. And of course, the only side effects are good ones when you're changing lifestyle. Yeah.
The Lifestyle Intervention Explained
[17:28] So what I'd love to do right now is specifically dive into the diet that you had these people on, the role of exercise, stress reduction, social connections and love that are such core tenets of your programs so let's start with let's start with diet right you and i are obviously i think both completely aligned on whole food plant-based nutrition but i'd love to know where there are specific foods nutrients supplements that you recommended uh for brain health yeah and the book that my wife and i and co-authored called undo it yeah it's exactly the same program that we use for heart disease is for Alzheimer's. So although I haven't written a book on Alzheimer's, it's all in that book for those of you who are interested in learning more about it. The diet is essentially a vegan diet. It's fruits, vegetables, whole grains, legumes, soy products, things as close as possible as it comes in nature, minimally processed, very low in fat, very low in sugar and refined carbs. We also include some supplements, some of the omega-3 fatty acids with curcumin.
[18:36] The multivitamin, CoQ10, vitamin C, vitamin B12, lion's mane from Paul Stammen's work, which is a mushroom extract that has some improvement with cognition in some studies, magnesium, just things that weren't that expensive. I mean, I designed this lifestyle program to not require any special equipment and to be available to anybody. So you need a plant-based diet, as you know. I mean, you know, Winkies are vegan, but I mean, The whole foods, plant-based diet is a third-world diet. This is the way people can't afford to eat the way that most Americans eat. Meditation and yoga-based stress management, it doesn't cost anything to do that.
[19:15] Walking for half an hour a day for an hour, three times a week with some resistance training. More exercise if you can do it and support groups you know designed to not just help people stay on the diet but to create a safe environment where people can talk authentically and openly about what's really going on in their lives without fear that someone's going to judge them or criticize them or give them good advice or abandon them you know growing up 50 years ago i had an extended family that i saw regularly i had a neighborhood with two or three generations of people who grew up together. There was a church or synagogue or mosque or club or something that people went to on a regular basis. They had a job that felt secure that they'd been at for 10 years or more and got to know their coworkers. And many people today don't have any of those. And I wrote a book back in 1998 called Love and Survival that reviewed what were then hundreds and now literally tens of thousands of studies showing that people who are alone, depressed are three to 10 times more likely to get sick and die prematurely than those who have a sense of love and connection and community.
[20:16] So we're, in a sense, recreating that with our support groups by creating a safe environment where people can really just talk about what's really going on in their lives. And it's a part of the program, the love more part of our program, you know, eat well, move more, stress less, love more to produce it to its essence. You'll say, well, love more, what's that about? You know, it's about anything that brings us together is really healing and anything that creates separation can lead us to chronic illness. And people say, well, what about the internet? Doesn't that bring us together? But most people, when they interact on the internet, in fact, one of the studies that Ann and I wrote about in our book is that the more time you spend on Facebook, the more depressed you are. It's like, why is that? Well, because it's not an authentic intimacy. And an authentic intimacy, when you grow up in a neighborhood with a few generations of people, they really know you. They saw when you got busted or were suicidal or broke that window or whatever, and you know that they know and they know that you know. There's just something you don't find about, like, I see you, like, warts and all, and I'm still there for you. Whereas on Facebook, it looks like people don't post their dark side and their demons. It looks like everybody has this perfect life but you, and this makes people feel more isolated.
[21:25] Going back to diet, was there a certain percentage of fat that you wanted these people to be consuming? You know, I've gotten away from the idea of percent fat and more towards the type of foods. Good. And we included some seeds and nuts. We've been doing that now for, I don't know, 10 years or more for all of our work. There's just something really in the research that just really convinced me that people who have moderate amounts of seeds and nuts really do better than those who don't. And I think it's just kind of a, it's not a scientific thing to say, but there's a germinative quality. You know, seeds and nuts are all about life waiting to burst forth. And despite the fact that they might be a little higher in fat. But I think there is something really valuable about that. When you say a moderate amount of nuts and seeds, are we talking about one ounce, two ounces? I mean, I know people always want to know exactly. I don't know the exact, but I think it's like a handful. Sure, sure. That's about an ounce-ish. Yeah.
[22:27] Okay. And so 20 weeks, what were you able to do with the people that raised their hands and said, I'm going to do this? Was there anything you did to ensure that they were compliant as far as, you know, eating this way? Yeah, because when you're doing a randomized trial, we know from our previous studies that the reason we were the first to prove you could reverse all these different diseases is that it's really hard. You have to make really big changes. You know, It's the pound of cure, if you will, as opposed to the pounds of prevention. You don't have to make such big changes to stay healthy. It's to reverse something.
[23:00] And we knew the only way we could really, especially with Alzheimer's patients, we thought if they really followed the diet and lifestyle program close to 100%, and it didn't work, that'd be disappointing, but it'd be an important finding. You know, people need to not fool themselves. But if they only followed it at like 75%, that for most people, that'd be a big change, but it probably wouldn't be enough to stop or reverse its progression. We actually went to great expense. You know, we spent millions of dollars. We sent the people in our study who were in the intervention group, they and their spouse or caregiver, three meals a day and two snacks a day. And basically said, just eat the food we give you for these 20 weeks, which is what we did. And we did find a dose-response correlation between the degree of adherence to not just the dying of it, to all four aspects of the program and the improvement in cognition. We also found that there was a dose-response correlation statistically significant between the degree of lifestyle change and the degree of change in the, again, the A-beta-4240 ratio, the amount of amyloid that was in their blood. That gives us more biological plausibility of not only that people are getting better, but why they're getting better. We found markers of inflammation, for example, also showed improvement to the degree that people made these changes. Do you know what the stats are as far as what percent of people have Alzheimer's?
[24:22] It's growing exponentially as the population ages. I don't know the exact number of people that have it, but I know that it's increasing and it's going to be like a trillion dollars in healthcare costs before long. Yeah. But more than that, it's just, you know, when you lose your memories, you lose everything. And it just, it's devastating for people who get it. And I have to tell you, there, you know, it was just so rewarding to start to hear their stories. People would say things like, you know, I was told it would only get worse because your affairs are in order. I used to love reading. I could read a book in a day or two. Now it's taken me more than a month. And now I can read a book again in a day or two. You know, my sense of self-worth is coming back. A guy who was a chief financial officer of a big company who said, I used to handle all kinds of stuff. I couldn't even balance my checkbook. Now I'm managing my financing again. And my sense of who I am was really taking a major hit. And now I'm hopeful again. And so hearing those kinds of stories over and over again, Sanjay Gupta, the chief medical officer of CNN, who's a neurosurgeon himself, filmed our first cohort of patients when they enrolled five years ago now. And they filmed them again earlier this year and did a documentary for CNN. It's called The Last Alzheimer's Patient. And one of the patients that he followed has been doing it now for over five years. And she's better now than she was five years ago, even though her sister and mother can't even recognize them anymore.
Impact of Exercise on Brain Health
[25:47] That that is phenomenal yeah i think i've heard something like almost 50 percent of people over the age 50 have some sort of alzheimer's cognitive decline so it's rampant um so, obviously exercise is a big part of it i'm just wondering can you explain to us.
[26:08] Physiologically what exactly is going on with the brain and exercise and blood flow that kind of helps with that? Yeah, I don't think there's a, you know, there's, I mean, to answer your question, there's about 10-11% of people over the age of 65 have diagnosed Alzheimer's disease. As you get older, that number goes up. Exercise just makes everything better in ways we understand and in ways we don't fully understand. Whether it's blood flow, whether it's changes in your metabolism, changes in your, you know, people are exercising, generally are eating healthier, you know, some combination of all of those things. Hmm.
[26:42] So I'm just digging a little deeper into the love and social connections with this intervention group. How were they able to connect with each other? Did you have weekly meetings or how did that work? Yeah. So we met with them three hours, excuse me, three times a week, four hours at a time for 20 weeks.
[27:01] Now, Medicare is covering my program for reversing heart disease. They've been doing that for the last 14 years and they've been covering it when done virtually via Zoom. So initially we were meeting with people in person. And then when COVID hit, we couldn't do that anymore. So we started doing it by Zoom and I didn't think it would work because I thought it was just too high touch to do that. And I was wrong. It worked even better. And so now we could have patients all over the country doing it. And so with the Medicare, they pay for 72 hours of training. If someone has heart disease and is watching this, go to Ornish.com. And if you have Medicare or some of the other insurance plans, it'll pay the whole cost of it. We meet twice a week, four hours at a time for nine weeks for heart disease. They get an hour of exercise with an exercise physiologist. Then, if you imagine on a Zoom screen, 15 people, an hour of a support group with a psychologist, then an hour of a meditation and yoga class with a yoga meditation teacher, and then an hour of support group. But we did it even more intensively for the Alzheimer's patients because I thought, let's just err on the side of doing too much so that if we don't show anything, then we don't think, gosh, maybe we should have done a little more. So it's three times a week, but the same pattern, an hour of exercise, an hour of meditation, an hour of support group. in an hour of a lecture.
[28:15] The support group was designed to create a safe environment. So part of what we've learned is that if you talk about your feelings, it's a way to really connect deeply. I can actually show you. Can we just do a little quick exercise here? I'd love to. Okay, so close your eyes for a moment, Rip. Okay.
The Power of Social Connections
[28:31] Close your eyes, take a couple of deep breaths, and just center yourself for a moment.
[28:41] Tell me how you feel when I say the following, keeping your eyes closed. You know, I think you're a jerk and I think you're wrong. And then open your eyes. Now, how did that feel? Get defensive and go, what are you talking about? Yeah, I mean, you know I'm just serious. But even so, at some visceral level, you feel it, right? So what was that feeling like? Generally, people have two responses when they feel attacked. One is you started to say like, no, I'm not a jerk. You're a jerk, right? You attack back or you withdraw, you, you know, you stop listening or you may just go out of the room. Now, if intimacy is healing, neither one of those responses is taking us in the right direction. Let's try it again in a different way. So take, re-center yourself and close your eyes and tell me how it feels when I say this.
[29:35] I feel angry and I feel upset. completely different how so well because it wasn't you weren't attacking me precisely and so we can argue about lots of things but we can't argue about because only i know that if i think you're a jerk we can argue about maybe you are or not but if i say i'm angry that's that's a true statement by definition yeah but also it makes me vulnerable a little way because i'm sharing myself with you in a bit and our we hear our feelings connect us and our thoughts often separate us. Now, I know that sounds, you know, living in Marin County in Northern California, it's so easy to make fun of that, but it's true. We are touchy-feely creatures in a way. And so our support groups are based on the idea that our feelings connect us. And so before you talk in a group, say, what am I feeling? Then express it as a feeling.
[30:26] I might say, gosh, you know, I may look like the perfect, dad but my kid's on strung out on fentanyl or whatever and somebody else might say gosh my kid's having a drug problem too now it doesn't change the fact that these kids have drug problems but suddenly you don't feel so isolated you don't feel ashamed you don't feel powerless you can connect with someone on a very deep level and so we could talk more about this but yeah create a sense of that what goes in the group stays in the group whatever you share you don't have to worry that someone else is going to hear and it's the part of the program that people often have the most skepticism about or even apprehension, but almost invariably it's the part that is the most meaningful because, again, we don't have those things that we had 50 years ago in terms of an extended family or a neighborhood or a place we go to regularly. And so even after the nine weeks of our heart disease program, most people continue it, 85% continue to be on their own, sometimes for decades. That's particularly meaningful with Alzheimer's patients because it's an inherently isovating disease. They're told, you know, your world starts to shrink, Like, I don't want to go out because I don't want to embarrass myself. And the next thing you know, they're taking your keys away. So now you can't drive and you don't leave the house by yourself. Don't wander off. And, you know, you're only going to get worse. And so it's like everything starts to shut down. So being with other people who and their caregivers who really know what it's like to go through this because they've been going through it themselves is even it doesn't fix the problem. It fixes the isolation that is in many ways as big as the problem itself. Yeah.
[31:55] Tell me this. the control group versus the intervention group, at the end of the study, was the control group informed of the results of the intervention group? And then did they want to be part and, or I should say, did they then want in on that? Yeah. Well, that was the deal we made with the control group because the biggest problem in a lifestyle medicine intervention is that you can't keep the control group from changing during the study. If I'm testing a new drug, I can get one group the drug and one group a placebo, and they can't get the drug otherwise. But if it's lifestyle, you've told them exactly what you're doing before they even randomize them, so they know exactly what you're doing, because you have to say, if you end up in the intervention group, would you be willing to make all these changes? And they say yes, and they end up in the control group. Now they know exactly what you're doing, and they've been told nothing else
Control Group Insights
[32:46] works, like, well, why wouldn't I do it? And that's why we picked 20 weeks, because we thought, based on our experience, that's about as long as we can keep somebody from making these changes but if both groups change then you can't show any differences between them so it's a total waste of time so the deal we made with the control group was just to eat your normal food that you've been eating you know do the normal daily activities don't do more or less than what you've been used to doing and then after 20 weeks we'll give you the program as well so that's five months 20 weeks is five months.
[33:14] At the end of the study, what were your thoughts? Were you like, wow, this was a super success. I am so pleased with the results. Where did that fall with you? Yeah, well, it was the most meaningful work I've done in the 47 years I've been doing these studies. Because at least with heart disease or type 2 diabetes or prostate cancer or high blood pressure, high cholesterol, whatever, there are other interventions that have some benefit. But nothing works with Alzheimer's. And so to take the disease that people are most afraid of, that nothing else works, and find that something as simple as these exact same lifestyle changes can often make a difference to the degree people make these changes. There are no guarantees, but overall, that's what we found. It probably got better, but most people did to the degree they made these changes.
Personal Reflections on the Research
[33:58] It's incredibly meaningful. That's what gets me out of bed every day.
[34:02] When I was in college, I became suicidally depressed because I found I could take all the meaning out of my life. I also learned that I can imbue my life with meaning by doing acts of service. And what could be more meaningful than giving people hope now worldwide in the area that matters most that nothing else works in? Now, clearly, this is not the study to end all studies. Like any study, it needs to be replicated in larger numbers of people over longer periods of time. But so far, this was done with the heads of neurology at Harvard and Mass General and the Caroliskitude and UC San Francisco and UC San Diego and Renown and Duke and other places. So we're working with the top people in the field. We published it in the leading peer-reviewed translational Alzheimer's journal. And we're going to be following these people for a total of 40 weeks to see what happens over a longer period of time. Obviously, more work needs to be done. And we hope that reimbursement will follow since nothing else works. And again, the only side effects are good ones instead of bleeding into your brain and things like that. When did you finish up this research? When was it let out into the universe? We published it in May of this year. How has that been received? Have you been happy with the amount of attention that it's gotten? Has it been buried at all or is it out there as far and wide as you'd like?
[35:15] Well, it's never as far as wide as you'd like because awareness is always the first step in healing and if people don't know about it, then they can't benefit from it. So we always want it to be wider. But as I mentioned, Sanjay Gupta did a documentary that was shown worldwide multiple times. It was featured on Time Magazine and Good Morning America and Fox News. You know, to me, it's.
[35:36] Like I say, awareness is the first step in healing. And so that's why I appreciate the chance to be on this podcast is because we can share what we're learning with people who can benefit from it. Yeah. So you mentioned that you have a family history of Alzheimer's. You said your mother. Is that correct? Right. Do you personally have the gene as well? I have one of the two genes. Right. That only increases your risk by being 13%. Having both genes can increase to like 80-something percent. But, you know, the drugs, these three drugs that have been approved are contraindicated in people who have both genes. And yet we had several patients who had both genes who got better from the lifestyle changes alone. So, again, that's especially encouraging for people who have one or both of the Alzheimer's genes. Any thoughts on, is there another frontier after Alzheimer's that you want to tackle or are you going to focus on this one for a while longer?
Future Research Aspirations
[36:31] Well, I'm going to focus on this for a while longer, but I'd love to do a study on breast cancer. We showed that early stage prostate cancer, the progression of that could be affected beneficially through lifestyle changes. Slow stop, in some cases, reverse it. What's true for prostate cancer will be true for at least some forms of breast cancer. There are lots of things I'm interested in doing, but right now, the Alzheimer's is taking up a lot of my work.
[36:53] Are you close or friends with the Shure's Eyes? I know they've done a lot of good work in terms of preventing Alzheimer's and me Akiva Pelto published a paper, around the same time that we did that's showing a more moderate multimodal lifestyle intervention slowed down the rate at which people got worse but it takes a much more intensive one to actually stop her in some cases reverse its progression and that's what we found in all of our studies and that's why with your dad being an exception most people don't go far enough to show that you can improve it as opposed to just get worse more slowly.
[37:27] So you know i had tony robbins on the podcast a couple years ago he wrote life force as you know he had a whole chapter on you and your brilliant work i'm wondering you know since you run in those circles is there anything else that really excites you to think that wow we're gonna live to 120 just because of how fast it seems that with AI and these, how everything seems to be accelerating, that there's things out there that we can't even dream of right now. Yeah, well, we are living in an exponential world that things are exponentially increasing, especially with AI. I mean, every three months, it's doubling in its capacity. And so, Yeah. Any technology, it can be used for good or for bad, but the potentially good things in terms of being able to find new patterns, new outcomes, new approaches, I think that we can really learn a tremendous amount, you know, recognizing the dangers that are there as well. So I think we're living in one of the most exciting times in history. Whether we can survive it is still an open question.
[38:42] Let me ask you this, Dean, as we wrap things up. If you could live to 150, do you think you'd like to? Well, it depends. I think that, especially here in the Silicon Valley world, there's such an interest in longevity. I mean, we did the first study showing that any intervention could lengthen telomeres with Liz Blackburn. We got the Nobel Prize for discovering it. When we published it, the Lancet editors sent out a press release calling it the first study showing that lifestyle changes can improve slow aging at a cellular level. But it really gets to more spiritual questions, really. Like, how do you view death? Is death going into a dark coffin by yourself forever? To me, that's a good definition of hell, you know, like ultimate isolation experience. Or is it the river returning to the ocean, to the source? And my own experience is that, you know, having come very close to committing suicide when I was 19, that got my death has always been very close to me. And that can be really helpful. you know it's given me the courage to do studies and nobody in the right.
[39:46] You get funding to do these studies you know without the funding you can't show something works and i don't think it's work like why should we waste our money everybody knows it can't be done so we generally raise the money as we go along which is an insane way to do a study because at any point if you don't raise the money you have to shut down the study and somehow we've always been able to make that work but, Um, my own experience from many years of meditation and other ways of having those states is that on one level, we're separate, you know, you're, you and I'm me and we can enjoy having this conversation, but another level, we're not, we're part of something larger that connects everyone and everything.
[40:21] Like um if you go into an old style movie theater and they have a a light going through the film of the movie that goes onto the screen and has all these names and forms and dramas and so on but you can get lost in that if you don't also remember oh it's just a movie i'm just you know it's the same light just manifesting in all these different heroes and villains and whatever and so i think that the people who really you know want to have what they call escape velocity that you can keep extending your lifespan just beyond where you're going to die, often have a real fear of death.
Meaningful Living vs. Longevity
[40:54] And I think to me, it's more how well we live than how long we live. Now, of course, I want to live as long as I can. I find meaning watching my kids grow up and want to dance at their wedding and all the kinds of things that most people want. But I think the idea is to square that curve. You don't just get all these chronic diseases, you get older, and you can live fully and then you know, you die. You don't have to necessarily wither away like that. Dean, thanks so much for coming back on and talking about your research. You continue to be such an amazing beacon of light, such a pioneer in making the world healthier and better. Thank you so much. Well, right back at you, my friend. Thanks for all the light you're shining. And I take a lot of solace in knowing that the light drives out the darkness. So thanks for shining so brightly. Yeah. All the best in 2025. Thank you.
Closing Thoughts and Call to Action
[41:46] Imagine regaining your confidence and a sense of self-empowerment with a whole food, plant-based diet, movement, meditation, community, and all without expensive drugs that have horrific side effects. Instead of thinking there's nothing that you can do to prevent the onset of dementia, take this as proof that you can take powerful but simple steps to halt the progression. And what better way to start the year than with some really good news. I'll be sure to link up to the study and the documentary in today's show notes and of course, if you know of any loved ones who may benefit from hearing this episode, share it with them. As Dr. Orner says, awareness is key and we have to keep spreading the message about these optimistic findings. Until next week, you know what to do for your heart, your body, and your brain always, always keep it PLANTSTRONG.
[42:48] The PLANTSTRONG podcast team includes Carrie Barrett, Laurie Kortowich, and Ami Mackey. If you like what you hear, do us a favor and share the show with your friends and loved ones. You can always leave a five-star rating and review on Apple Podcasts or Spotify. And while you're there, make sure to hit that follow button so that you never miss an episode. As always, this and every episode is dedicated to my parents, Dr. Caldwell B. Esselstyn Jr. And Anne Crile Esselstyn. Thanks so much for listening.
