What Is the Ornish Diet?
Introduced in 1977 by Dr. Dean Ornish, a clinical professor of medicine at the University of California, San Francisco, and the founder of the nonprofit Preventive Medicine Institute in Sausalito, California, the Ornish diet is a low-fat eating approach. This dietary plan is renowned for its potential to reverse chronic diseases and contribute to overall improved health.
Promoting the consumption of a diverse range of plant-based foods, including fruits, vegetables, whole grains, and legumes, the Ornish diet, according to Sarah Schlichter, a registered dietitian in Frederick, Maryland, does not endorse the intake of meat, fish, or poultry. However, it allows for limited consumption of nonfat dairy products and eggs, following a lacto-ovo vegetarian approach.
Organizing food into five groups, ranging from the most healthful (group one) to the least healthful (group five), the Ornish diet constitutes one of the four essential components of the Ornish Lifestyle Medicine by Sharecare program pillars. The other pillars include stress management, fitness, and the concept of "love," which underscores the importance of social connections and joy in maintaining good health, along with social support.
Family friendly. Family members can easily eat all the meals together with little or no modification. The food options are healthy and balanced enough for all ages.
Budget friendly. Foods for this diet are easy to find at a typical grocery and don’t require expensive or specialty food items.
Planet friendly. This diet considers the environmental effects of food choices. It’s largely plant-based and/or the foods are mainly sustainably grown or produced.
Vegan or vegetarian friendly. Recipes can be easily modified for a vegan or vegetarian diet.
Gluten-free friendly. Recipes can be easily modified and still follow a gluten-free diet.
Halal friendly. Recipes can be easily modified and still follow the diet.
Kosher friendly. Recipes can be easily modified and still follow the diet.
Low-carb. This diet recommends eating fruits, vegetables and whole foods, while limiting foods high in refined carbohydrates.
Low-fat. This diet emphasizes foods that have little to no saturated fat.
How Does It Work?
You won't need to restrict calories unless you’re trying to lose weight.
If you’re following the diet for reasons other than weight loss, you’re encouraged to eat predominantly unprocessed fruits, vegetables, whole grains, legumes, soy products, nonfat dairy and eggs in their natural forms.
Refined carbohydrates, processed foods and added sugars are permitted in limited amounts, but strongly discouraged in favor of unprocessed foods.
You’re also encouraged to use stress management techniques to navigate daily stressors.
You should consume 4 grams a day of healthy fats (fish oil, flaxseed oil, nuts, seeds and plankton-based omega-3 fatty acids). Fats should make up 10% of your daily calorie consumption.
Trade full-fat dairy for low-fat or nonfat versions.
Add meditation or another stress-management technique to your morning routine.
The Ornish diet emphasizes consuming healthy, plant-based and whole foods and limiting animal products and processed foods. It doesn’t prohibit any foods outright, though it does limit nonfat dairy products, eggs and animal-based meats. The diet also calls for 30 minutes of daily exercise and recommends using stress-reduction approaches as part of a holistic approach to health.
Can I Lose Weight on the Ornish Diet?
Research published in the past several years has shown that whole food, plant-based diets may help weight weight loss and chronic disease prevention (1, 2).
Short-Term Weight Loss
In a study of over 1,000 Ornish plan participants over the course of a year, average body mass index decreased by almost 8%, taking the participant average from the "obese" category to the "overweight" category of BMI (3).
A controlled but very small, short study found that reducing fat calories led to 67% greater weight loss among adults with obesity than reducing the same number of calories from carbohydrates, which is in line with the Ornish plan's recommendations (4).
Long-Term Weight Loss
Weight loss may not be tied to lower fat intake. Many experts maintain that the number of calories you take in – not whether you get them from fat, carbs or protein – drives weight loss, especially in the long run.
One study of over 800 overweight adults showed no significant difference in weight loss between participants getting 20% of their calories from fat and those getting 40% of their calories from fat (5).
Weight Maintenance and Management
Ornish can help maintain weight and weight loss.
In the extension study to Ornish's heart disease-reversal trial, a small group of Ornish dieters who had lost an average of 24 pounds after one year on the diet maintained a loss of 13 pounds from their original weight after five years (6).
Do: Load up on complex carbs and veggies.
What Does the Ornish Diet Cost?
Many health insurance companies will reimburse patients with cardiac disease for the cost of the program. Ornish notes that some insurers are also covering the diet and lifestyle program for Type 2 diabetes, or even for those who have two or more risk factors for chronic disease.
Medicare covers the Ornish program as part of its coverage of intensive cardiac rehab programs, which extends to 18 four-hour sessions (twice weekly over nine weeks) to reverse heart disease. In addition, virtual participation is now covered as a result of a May 2020 rule from the Department of Health and Human Services in response to the COVID-19 pandemic.
What Costs Are Related to the Ornish Diet?
You can purchase books Ornish has written or co-authored about the diet. There are also a number of Ornish diet cookbooks available for purchase online and essential guides, such as "The Spectrum" and “UnDo It,” in paperback, hardcover, audio and e-book formats.
Purchasing fruits, vegetables, whole grains, legumes, nuts, seeds and egg whites – the basics of the Ornish diet – may initially seem expensive. However, you may find that you save money by not purchasing as much meat and processed foods. Additionally, the health savings will stack up over the years.
“I would suggest looking at the long-term cost savings on health care by eating a healthful diet like this versus what may be a slightly higher cost of food compared to a standard Western diet,” Panoff adds.
Doing the Ornish Diet on a Budget
Buy fruits and vegetables in season.
Purchase non-perishable items, such as whole grains and brown rice, in bulk.
Stock up on canned vegetables without additional sodium and canned fruits without added sugar.
Shop at local farmers markets, which often have lower prices..
If you have the time, prepare a few days’ worth of meals ahead of time.
Is the Ornish Diet Easy to Follow?
The Ornish diet should be easy to follow and sustainable in the long run. The foods you would need are easily obtainable at most grocery stories, and the diet allows for a variety of dishes. If you're taking the Spectrum approach, which allows you to make decisions based on your priorities, tastes and level of commitment, it should be relatively easy.
If you're aiming to reverse heart disease, the program is more restrictive and can be tougher to follow. Ornish contends, however, that it's easier in the long term than taking a cholesterol-lowering drug, like statin, since the program boosts your quality of life enough to make you want to continue. Ornish claims that most patients report substantial reductions in chest pain, called angina, within the first few weeks of following the program.
Still, research shows most dieters have a hard time sticking to a plan that restricts fat to 10% of daily calories.
Overall, if your health doesn't depend on it (i.e., you don't have heart disease), working with a slightly higher fat intake or trying the spectrum approach may help you stick with the diet. Ornish, too, supports making more moderate changes that fit with your lifestyle before making bigger ones as you see the benefits.
Pros
No counting carbs, points or calories.
Filling – it's rich in high-fiber foods.
Has proven health benefits.
Cons
Tedious portioning, meal planning or prep.
What Can I Eat? Do’s and Don’ts
Foods to Eat
Whole grain breads.
Soy products (edamame, tempeh, miso, soy foods and soy milk).
Lentils and beans.
Nuts and seeds.
Foods to Avoid (or Limit)
No foods are off-limits on the Ornish diet. However, if you’re following the Nutrition Spectrum Reversal Program, there are certain restrictions. For example, you can’t eat animal products, except for egg whites and nonfat milk products.
On any version of Ornish, you will greatly limit these types of foods:
Animal products.
Processed foods (snack chips, cakes, cookies).
Vegan and Following the Ornish Diet
Although egg whites and nonfat dairy products are allowed on the Ornish diet, you don’t have to eat these foods. Tofu, tempeh, beans and legumes will help to boost your protein intake without relying on animal products. See all vegan diets.
Vegetarian and Following the Ornish Diet
The Ornish diet is a lacto-ovo vegetarian diet. Egg whites and nonfat dairy products are allowed, but plant-based protein sources are emphasized. See all vegetarian diets.
Gluten Free and Following the Ornish Diet
A gluten-free diet is completely compatible with the Ornish plan. Choose grains like brown rice, quinoa and buckwheat. See all gluten-free diets.
Halal and Following the Ornish Diet
Because land animals, domestic birds and fish are not eaten on the Ornish plan, it’s naturally halal. See all halal diets.
Kosher and Following the Ornish Diet
Because the Ornish diet is essentially a lacto-ovo vegetarian diet, it should be easy to remain kosher while on this heart-healthy plan. See all kosher diets.