The present study evaluated the changes in emerging cardiac biomarkers, cognitive
function, and social support measures after a comprehensive lifestyle intervention
that included a low-fat, whole-foods, plant-based diet, exercise, stress management,
and group support meetings. We conducted a prospective cohort study of 131 participants
(59.2% women and 43.1% with diabetes mellitus), 56 with coronary heart disease (CHD)
(37.5% women and 27.3% diabetes mellitus), and 75 at high risk with ≥3 CHD risk factors
and/or diabetes mellitus (76% women and 54.7% diabetes mellitus). The measurements
were taken at baseline and 3 months after the intervention. Improvement in all targeted
health behaviors was seen in both high-risk and CHD groups (all p <0.001) at 3 months,
with reductions in body mass index, systolic and diastolic blood pressure, waist/hip
ratio, C-reactive protein, insulin, low-density lipoprotein, high-density and total
cholesterol, apolipoproteins A1 and B (all p <0.009) were observed. Nuclear magnetic
resonance spectroscopy analysis of lipoprotein subclass particle concentrations and
diameters showed a reduction in large very-low-density lipoprotein particles, size
of the very-low-density lipoprotein particles, total low-density lipoprotein particles;
total, large, and small high-density lipoprotein particles (all p <0.009) and small
very-low-density lipoprotein particles (p <0.02). Increases in fibrinogen (p <0.03)
and B-type natriuretic peptide (p <0.001) were seen, and these changes correlated
inversely with the changes in the body mass index. The observed increase in B-type
natriuretic peptide can be explained by the metabolic changes related to adipose tissue
lipolysis. The quality of life, cognitive functioning, and social support measures
significantly improved. In conclusion, lifestyle changes can be followed by favorable
changes in traditional and emerging coronary heart disease biomarkers, quality of
life, social support, and cognitive function among those with, or at high risk, of
CHD.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Intensive lifestyle changes for reversal of coronary heart disease.JAMA. 1998; 280: 2001-2007
- The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the Multisite Cardiac Lifestyle Intervention Program.Ann Behav Med. 2007; 33: 57-68
- Biomarkers in Heart Disease.Blackwell Publishing, Malden2008
- Emerging risk factors for atherosclerotic vascular disease: a critical review of the evidence.JAMA. 2003; 290: 932-940
- Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).National Institutes of Health, Bethesda, Maryland2001
- Human blood pressure determination by sphygmomanometry.Circulation. 1993; 88: 2460-2470
- The MOS 36-item short-form health survey (SF-36).Med Care. 1992; 30: 473-483
- A global measure of perceived stress.J Health Soc Behav. 1983; 24: 385-396
- The CES-D scale: a self-report depression scale for research in the general population.App Psych Measur. 1977; 1: 385-401
- Proposed hostility and Pharisaic-virtue scales for the MMPI.J Appl Psychol. 1954; 38: 414-418
- Social networks and coronary artery disease: a comparison of the structure and function of social relations as predictors of disease.Psychosom Med. 1987; 49: 341-354
- Summary and discussion of MOS measures.in: Stewart A. Ware J. Measuring Functioning and Well-Being: the Medical Outcomes Study Approach. Duke University Press, Raleigh-Durham1992: 345-371
- Lifestyle and health-related quality of life of men with prostate cancer managed with active surveillance.Urology. 2006; 67: 125-130
- A very-low-fat vegan diet increases intake of protective dietary factors and decreases intake of pathogenic dietary factors.J Am Dent Assoc. 2008; 108: 347-356
- LDL particle subclasses, LDL particle size, and carotid atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA).Atherosclerosis. 2007; 192: 211-217
- Measurement issues related to lipoprotein heterogeneity.Am J Cardiol. 2002; 90: 22i-29i
- Value of low-density lipoprotein particle number and size as predictors of coronary artery disease in apparently healthy men and women: the EPIC-Norfolk Prospective Population Study.J Am Coll Cardiol. 2007; 49: 547-553
- Low-density lipoprotein particle number and risk for cardiovascular disease.Curr Atheroscler Rep. 2004; 6: 381-387
- Lipids and lipoproteins in patients with type 2 diabetes.Diabetes Care. 2004; 27: 1496-1504
- Dietary intake and cognitive function in a group of elderly people.Am J Clin Nutr. 1997; 66: 803-809
- Dietary fat intake and cognitive decline in women with type 2 diabetes.Diabetes Care. 2009; 32: 635-640
- Fat intake at midlife and cognitive impairment later in life: a population-based CAIDE study.Int J Geriatr Psychiatry. 2008; 23: 741-747
- Meditation experience is associated with increased cortical thickness.Neuroreport. 2005; 16: 1893-1897
- The measurement of regional cerebral blood flow during the complex cognitive task of meditation: a preliminary SPECT study.Psychiatry Res. 2001; 106: 113-122
- Cerebral blood flow during meditative prayer: preliminary findings and methodological issues.Percept Mot Skills. 2003; 97: 625-630
- Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment.Cochrane Database Syst Rev. 2008; 3 (CD005381)
- Lack of social support and incidence of coronary heart disease in middle-aged Swedish men.Psychosom Med. 1993; 55: 37-43
- Psychosocial correlates of survival in advanced malignant disease?.N Engl J Med. 1985; 312: 1551-1555
- Natriuretic peptides: a new lipolytic pathway in human adipocytes.FASEB J. 2000; 14: 1345-1351
- B-type natriuretic peptide levels increase with a reduction in body mass index following comprehensive lifestyle changes.Am J Cardiol. 2010; 105: 1570-1576
Article Info
Publication History
Published online: May 30, 2011
Accepted:
March 29,
2011
Received:
May 29,
2009
Footnotes
This study was supported by Department of Defense, United States Army Medical Research Acquisition Activity contract W81XWH-06-1-0565, Bahna Foundation (Stamford, Connecticut); DeJoria Foundation (Los Angeles, California); Kerzner Foundation (New York, New York); Bernard Osher Foundation (San Francisco, California); Walton Family Foundation (Bentonville, Alaska); Jeff Walker Family Foundation (Wilton, Connecticut), Mats and Jessica Lederhausen (Wilmington, Delaware); Alexander von Humboldt Foundation (Bonn, Germany); and the German Research Foundation (Bonn, Germany).
Dr. Ornish is a consultant for Safeway (Pleasanton, California), PepsiCo (Purchase, New York), and Mars (Hackettstown, New Jersey) on manufacturing healthy foods and is chair of the Google Health Advisory Council (Mountain View, California). The other authors declared no conflicts of interest.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
