Published in The Lancet

Authors: Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Ports TA, McLanahan SM, Kirkeeide RL, Brand RJ, Gould KL

In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography. The average percentage diameter stenosis regressed from 40.0 (SD 16.9)% to 37.8 (16.5)% in the experimental group yet progressed from 42.7 (15.5)% to 46.1 (18.5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61.1 (8.8)% to 55.8 (11.0)% in the experimental group and progressed from 61.7 (9.5)% to 64.4 (16.3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.

Key Takeaways:

  • Coronary heart disease patients that participated in a one year intervention program that included a low-fat vegetarian diet, stress management training, moderate exercise, and stopping smoking were compared to a control group of patients undergoing usual care without these interventions to determine any effects or changes in coronary artery stenosis (narrowing).
  • Intervention group patients showed significant regression in areas of artery stenosis while control group members displayed increased narrowing of coronary arteries.
  • Intervention group patients who made the greatest changes in lifestyle showed the greatest improvement in coronary arteries.
  • Comprehensive lifestyle changes can help to reverse the coronary atherosclerosis process and coronary artery stenosis in only one year.