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Practice English Speaking&Listening with: Dean Ornish: "Transforming Lives and Healthcare" | Talks at Google

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[MUSIC PLAYING]

JACK: Very, very special guest today with us here

on Main Campus in building 43 at Google.

This individual who's going to speak with us today

is somebody who has revolutionized medicine

and health care, both here in the US and abroad,

with a 35-year career.

And we'll hear very soon about the early part

of his career, where he really started

on a very different track--

a track that took him to a lot of new ideas

that have brought us to a lot of revolutions

across cardiac care, diabetes, and now Alzheimer's

and other diseases as well.

Our guest today has six books, all best sellers

on "The New York Times" Best Sellers list.

Our guest today graduated from the Baylor College of Medicine

and then did his fellowship at Harvard and Mass General.

Please help me welcome Dr. Dean Ornish.

[APPLAUSE]

DEAN ORNISH: Thank you.

JACK: Dean, it really is a pleasure

to have you here today.

Here at Google, we're very, very concerned

about looking at health care from many different points

of view.

You actually chaired-- you were one of the former chairs--

of the Google Health Initiative back in 2007 to 2009,

so you've had--

DEAN ORNISH: With Adam Bosworth and Marissa Mayer.

JACK: Yeah, so you've had a lot of good involvement

with Google over the years.

Let's actually start at the beginning.

You're in medical school.

You're in the first, second year of medical school,

and right off the bat, something is strange about you.

What is strange about you, and what realization did you have,

and what study did you conduct--

even just as a medical student, right then and there-- that

led you down this new pathway?

DEAN ORNISH: I have to say, no one's

ever asked me a question about how strange I was early on.

[LAUGHTER] I guess that would make me Dr. Strange.

JACK: Yes, exactly.

DEAN ORNISH: The beginning, actually, was even before that.

It was when I was in college at Rice University in Houston,

and I became suicidally depressed.

And it's a long story, but I met a swami named

Swami Satchidananda who, when I was

really ready to do myself in--

because first I felt like I was an imposter, like I was stupid

and then somehow managed to fool people into thinking otherwise.

And now that I was with a bunch of really smart people-- kind

of like maybe some people feel when they come to Google,

I felt like it was just a matter of time

before they figured out that they had made

a big mistake in letting me in.

But I also had a spiritual vision

that was really more than I could handle

at the time, which was that nothing

can bring lasting happiness.

Nothing external can bring lasting happiness.

And so the combination of feeling

like I was never going to amount to anything, but even if I did,

it wouldn't matter, was like, well,

why don't I just kill myself?

Because people who are dead look like they're

happy and peaceful.

And I was all set to do that, but I got so sick--

I'd run myself down so much with infectious mononucleosis--

that my parents realized I was a mess.

I went home to Dallas.

And as crazy as this sounds, as strange as this sounds,

I wanted to get well enough and strong enough to kill myself.

But in the meantime, my older sister,

who had been a child of the '60s and who

had studied with this ecumenical swami had really helped her.

And so my parents decided to have

a cocktail party for the swami.

Now, in Dallas in 1972, this was pretty strange,

as you would say.

And he started off by saying a little lecture

in our living room.

Nothing can bring you lasting happiness-- which I'd already

figured out, except I was ready to do myself in,

and he was glowing.

I was like, what am I missing here?

And he went on to say what probably sounds

like a new-age cliche, but it turned my life around,

which is that nothing can bring you lasting peace and happiness

and health, but it's our nature to be happy and peaceful.

And our whole culture teaches us that if we just

get more stuff-- more money, more power, more beauty, more

accomplishment-- then we'll be happy.

And he would say, once you set up that dynamic--

that view of the world--

however it turns out, you're generally

going to be miserable, because until you get it you feel bad.

If someone else gets it and you don't, then you

feel really bad.

And it confirms that we have this very hostile,

zero-sum game, dog-eat-dog view of the world.

But even if you get it, it's great for the moment.

It's very seductive.

I got it.

I'm happy.

But invariably, it's soon followed by--

well, now what?

It's never enough.

Or so what?

Big deal.

It doesn't really provide that lasting sense of meaning.

So then we say, well, this didn't, but maybe that will.

And one patient years ago told me-- he said,

the letdown that comes from getting something

that I thought would make me happy was so great,

I always make sure I've got a dozen projects going

at the same time so I can immediately shift my attention.

So--

JACK: So you had this epiphany moment

just in the college years--

DEAN ORNISH: Yes.

JACK: What led you to decide, then, to go to medical school?

DEAN ORNISH: Well, I always wanted to go to medical school.

Actually, I was going to be a photographer,

and there was a photographer named Philippe Halsman who

did over 100 "LIFE" magazine covers in the heyday of life.

And I said, I want to be a photographer like you.

He said, oh, no, don't be a photographer.

It's a terrible life.

Be a doctor.

So then you can take all the pictures

you want and you don't have to worry about pleasing

an editor and so on.

But I actually always wanted to be a doctor, too.

And so I went from not being able to read the headline

on a newspaper when I was in college

and tell you five minutes later what it said to doing really

well and graduating first in my class

and giving the baccalaureate and all of that.

And I say that just to say how powerful these beliefs are

for better and for worse and affecting our lives.

So when I went to medical school,

I was learning how to do bypass surgery with Michael DeBakey

the heart surgeon, who was one of the inventors of bypass

surgery.

And we cut people open.

We bypass their clogged arteries.

You tell them they were cured.

And more often than not, they would go home

and do all the things that had caused the problem

in the first place--

eat junk food, smoke cigarettes, not manage stress, not

exercise.

And their new bypasses would clog up,

and we'd cut them open again, sometimes multiple times.

So that, for me, became the metaphor-- the paradigm,

or the guiding principle that all of my work for the next 40

years, which is that--

instead of literally or figuratively bypassing

the problem, let's treat the cause.

Sometimes when I lecture, I'll show

a cartoon of doctors mopping up the floor around a sink that's

overflowing, and no one's turning off the faucet.

And the idea is that what we're finding

is the more diseases we study, the more

underlying biological mechanisms we do research on,

the more reasons we have to explain

why these simple changes are so powerful

and how quickly people can get better

to the degree they make them at any age.

It's an incredibly powerful and motivating and empowering

message.

So we were able to show for the first time

that heart disease was reversible,

that diabetes and high blood pressure and high cholesterol.

People get put on these drugs and they

say, doctor, how long do I have to take these?

What does the doctor usually say?

Forever, right?

How long do I have to mop up the floor?

Well, why don't we turn off the faucet?

So we can routinely reduce or get

people off of these medications.

We can reverse heart disease, diabetes.

It turns out, now, that getting your blood

sugar down-- half the population today

is diabetic or pre-diabetic.

Getting your blood sugar down with drugs

doesn't really prevent all the horrible complications--

blindness and amputations and heart attacks

and impotence and so on.

Getting it down with lifestyle, you

can prevent virtually all of them.

And the same is true for prostate cancer.

JACK: But back then, in the '70s,

when you first had some of these realizations,

it was really almost heresy to say that you could stop,

let alone reverse, heart disease.

DEAN ORNISH: Oh, yeah.

JACK: I mean, in a sense, would you

say it was a naivete of somebody just fresh in medical school

who maybe didn't know better that gave you that impetus

to say, hey, I'm going to try this and see if it works?

DEAN ORNISH: Yes, that was definitely a big part of it.

And the other part was-- having decided not to kill myself,

I figured, OK, if I'm going to choose to live,

I'm going to lead a really messy life.

I need to know what's real and what's not.

I need to find out for myself, because I didn't really

trust anyone at that point.

And that means I was going to make a lot of mistakes.

And I said, I can live with making mistakes.

In fact, later when I became a doctor,

most people on their deathbeds don't regret what they did.

They generally regret what they didn't do.

Because if you do something and it fails,

then you learn something really powerful.

And there's a lot of wisdom that comes

from making mistakes-- as you know-- and learning from them.

But if you don't try, then you just don't know.

So I figure, what's the worst that could happen?

So I took a year off between my second and third years

of medical school, much to my parents' dismay,

and began this study.

And fools rush in.

I didn't know what I didn't know.

And so I said, let's try it, and whatever it turns out,

we'll learn something.

JACK: But one of your professors was supportive of it, right?

DEAN ORNISH: Oh, yeah.

They were very supportive.

And that was the nice things about going

to medical school in Texas, where they

have this pioneering ethos.

It's a crazy idea.

It's going to fail, but you'll learn something.

Go for it.

We'll support it.

When I went to Harvard, it's so hierarchical there.

You have to wait till you're 40 and work

in someone else's lab for 10 years

before you even get a chance to do anything like that.

And I remember, by the way--

I mean, things have changed so much since then.

The idea, even, that the mind affected

the body was a crazy idea then.

JACK: So take us through the four pillars--

let's start with the heart program.

And it's very similar for the other programs,

but let's just start with the four pillars

that you have now shown.

And I want to talk about the data in a minute,

because here at Google, obviously,

we're very data-focused.

And what's, I think, very interesting about your program

is it's not just, oh, people are feeling better.

Clinically, as you measure their blood,

as you measure their biomarkers, through a course

of a 12-week program doing these four pillars,

you're actually seeing the biomarker data

change over time.

So take us through the four different parts

of how someone can go from having heart disease, worsening

heart disease, and now stop it and then begin

to reverse that clinically.

DEAN ORNISH: Yeah, they not only feel better,

they are better in every way we can measure.

And we're using these very high-tech, expensive,

state-of-the-art scientific measures to prove the power

of these very simple and low-tech and low-cost and often

ancient interventions.

So we started with heart disease.

And we found that in just a month,

the blood flow to the heart improves--

using specthalium scans.

There was a 91% reduction of the frequency of angina, or chest

pain.

Most people who couldn't walk across the street

without getting pain or make love with their spouse

or play with their kids or go back to work, within a week,

are pain-free.

And it wasn't just a placebo response,

because the heart was actually getting more blood

in ways we can measure.

We then did a randomized trial, and we

found after just 3 and 1/2 weeks, the ability of the heart

to pump blood improved-- using a test

called radionuclide ventriculography.

After my medical training, we did the most definitive study

using cardiac Positron Emission Tomography, or PET,

to measure blood flow to the heart.

And we found a 400% improvement in blood flow

compared to the randomized control group.

And quantitative arteriography to measure the blockages

in the arteries, and we found that they actually

got less clogged after one year, and even more

improvement after five years--

JACK: And again, Dean, this is all

without pharmaceutical or surgical intervention?

DEAN ORNISH: That's right.

The program is--

JACK: So give us the four pillars of this program.

DEAN ORNISH: And it's been the same

in all of these programs, which I'll talk about in a moment.

It's basically a whole foods, plant-based diet

that's naturally low in fat and refined carbs or sugar.

It's not low fat versus low sugar.

It's really both.

And also--

JACK: Would you say it's-- on the diet side,

would you say it's close to the Mediterranean-oriented diet,

or how should people think about the diet?

DEAN ORNISH: It's fruits, vegetables, whole grains,

legumes, soy products in their natural, unrefined forms.

So that's the diet.

The exercise is walking a half an hour a day

or an hour three times a week.

Various meditation and yoga techniques,

which has been great at Google.

[INTERPOSING VOICES]

JACK: The third is meditation.

[INTERPOSING VOICES]

DEAN ORNISH: That's right.

JACK: You'll be happy to know we have meditation rooms in almost

every building, so, yeah.

DEAN ORNISH: I know, and I love that.

And that was one of the things we did back in the day

when we were running Google Health--

that and trying to make healthier food here,

which was fun.

And the fourth is what we call psychosocial support, which

is really love and intimacy.

Or if you reduce it down even further,

it's eat well, move more, stress less, love more.

That's it, boom.

And the more diseases we study and the more mechanisms we

look out, the more we find that these same lifestyle changes

have impacts--

to the degree people make them.

We've found it to reverse heart disease, diabetes, prostate

cancer, change your gene expression,

lengthen your telomeres.

JACK: Now, I want to get to genes in a second.

But first, I want to drill in--

I think all of us would really understand

that changing your diet, moving more-- yeah,

definitely would have an impact on the physiological self.

But let's drill into the second two.

Let's talk more about how meditation,

these mindfulness exercises, really

affect the physiological.

And talk to us--

I think there was a Canadian study called InterHealth.

There's other studies that you've cited and been part of

and leading over the years showing

the physiological impact of something like meditation.

Let's talk about meditation first,

then let's move to the social impact of friend circles

and things like that.

DEAN ORNISH: Yeah, well, meditation

is a powerful way of bringing your mind to one focus.

And when that happens, your fuse gets longer,

for lack of a better way to put it.

Some people say things like, I've got a short fuse

and I explode easily.

Well, your fuse gets longer.

Things don't bother you as much.

And when you're under stress, your body

goes through the fight or flight response.

So all of your arteries constrict.

Your blood pressure goes up.

Your eyes dilate.

These are things that are designed to help you.

If a mythical saber tooth tiger jumps out in front of you,

you want your arteries to constrict and your blood

to clot faster, for example, because if you get bitten,

you don't bleed as quickly.

But we've evolved to deal with these intermittent stresses.

So you're walking in the jungle.

The tiger jumps out.

Either you run away from the tiger, you kill the tiger,

it eats you.

But one way or the other, it's over.

JACK: But it's done.

It's not a continual-- yeah.

DEAN ORNISH: Today, it's just chronic and relentless

throughout the day.

And so these same mechanisms that have evolved to protect us

can harm us, or even kill us, because it's not

just the arteries in your arms and legs

that can go into spasm or blood clots that can form there.

It can form in your heart and cause

a heart attack, or in your brain and cause a stroke.

So anything that can manage stress better--

virtually every illness has been found to--

you're more likely to have it if you're under chronic stress.

And the other side of that is the social factors.

One of the real radical shifts in our culture in the last 50

years has been the breakdown of the social networks that

used to give people a sense of connection and community.

50 years ago, most people had an extended family

they saw regularly.

They had a neighborhood with two or three generations of people

that grew up together.

They had a job that felt secure they'd

been at for 10 years or more.

They had a church or synagogue they went to.

And today, most people don't have any of those--

maybe one.

And we know that those things affect

the quality of our lives, but they actually

affect our survival.

And to a much larger degree--

one of the books I wrote was called "Love and Survival,"

back in 1998.

And it reviewed what were then hundreds-- and now

literally thousands-- of studies showing

that people who are lonely and depressed and isolated

are three to 10 times more likely to get sick and die

prematurely from pretty much everything than those

who have a sense of love and connection to community.

So I think--

JACK: And one of the studies, also, that you cite

looks at predictors based in high school and college

years of prediction of health over this 40-year period.

And it was the social bonds, actually,

that were very much determining a lot

of that health over many years.

DEAN ORNISH: That's right.

They also did a study at Harvard Medical School

where they gave one questionnaire

to a group of Harvard students and said to rate how close they

were with their parents.

30 years later, only 15% of the people

that were close with their parents

had chronic diseases in midlife, and yet the majority

of those who weren't did.

Now, you might say, well, how could one questionnaire

do that?

Well, how you--

JACK: So note to the audience-- everyone

should call their parents after this.

OK.

DEAN ORNISH: So intimacy is healing.

Anything that brings us together is healing.

Even the word healing comes from the root to make whole.

Yoga is from the Sanskrit to yoke, to unite,

to bring together, union.

These are really, again, old ideas.

And so when we have that sense of love and connection

and community, it not only improves

the quality of our lives, it improves our survival.

More than any other factor-- more than smoking,

more than anything.

And it also interacts with those.

People are more likely to abuse them--

we tend to say--

at Google, there's this--

we are drowning in information, which is awesome.

I just love, because I can just pick out anything

anytime I need it in Google.

But information is not enough for most people

to change their behavior.

I mean, if it were, nobody would smoke.

It's not like you go, hey, Jack, I want you to quit smoking.

It's really bad for you.

JACK: Right, the rational argument itself does not

seem to be sufficient.

DEAN ORNISH: Yeah.

If I say, Jack, I want you to quit smoking.

It's bad for you.

I didn't know.

I'll quit today.

Everybody knows it's bad for you.

It's on every pack of cigarettes.

But so then I ask, why do you smoke?

Why do you overeat?

Why do you drink too much?

Why do you abuse yourself?

And I used to ask patients in our studies,

because we got to know each other.

I'd say, teach me something.

Why do you do these things?

They seem so maladaptive.

And they say, you don't get it.

They're not maladaptive.

They're very adaptive, because they

help us deal with our loneliness, our depression.

They say things like, I've got 20 friends

in this pack of cigarettes, and they're always there for me,

and nobody else is.

You're going to take away my 20 friends?

What are you going to give me?

Or food fills that void, or alcohol or opioids

numb the pain, or working all the time

is a more socially acceptable way of numbing the pain,

or video games or whatever.

So we've learned that it's not enough to give information.

It's not enough to focus on the behavior.

We need to deal with the deeper issue--

the loneliness, the depression, the pain.

And so we create support groups that are not really

designed to help people stay on the diet.

They're designed to create a safe environment

to recreate what people had 50 years ago-- a safe environment.

I mean, right now--

social networking was supposed to really bring us

all together.

Facebook has, what, 1.6 billion people?

But it actually has, often, a way of making you feel more

lonely and more isolated, because most people don't--

if you grow up in a family with two or three generations,

they know where you messed up.

And you know that they know, and they

know you know that they know, and they're still there

for you.

And there's something really primal about that.

JACK: There was an analysis called "Bowling Alone"--

[INTERPOSING VOICES]

JACK: --which is all about how--

'50s and '60s, there were these bowling leagues,

and people had their shirts and they had their bowling ball.

They had the initials.

My dad has a bowling ball still with his initials on it,

and he had a bowling league growing up.

DEAN ORNISH: So that's why.

JACK: But now we're, quote, "bowling alone," because we

don't have those types of--

[INTERPOSING VOICES]

DEAN ORNISH: Yeah, or you look at someone's Facebook profile

or their Facebook feed, and it looks like they

have the perfect life.

And it's like, why don't I?

Or their bio sketch, they look great.

They don't talk about all the things they've messed up.

And so in our support groups, we just create an environment

and say, look, let down your emotional defenses.

Just talk openly and authentically about

what's really going on in your life without fear

that someone's going to judge you

or criticize you or give you glib advice.

So somebody might say, I may look like the perfect dad,

but my kid's on whatever-- some drug.

And instead of someone else saying, oh, well,

why don't you send them to a drug rehab program--

like they hadn't thought of that-- it's like,

what feeling does that evoke in you?

And share it as a feeling.

Oh, I'm really sad to hear that.

Or gosh, my kids have other problems,

or I used to have a drug problem, whatever.

Suddenly, it doesn't fix the problem,

but it fixes the loneliness and the shame and the isolation.

It's the part of my program that most people have the most

apprehension about.

Most people think it's all diet, and it's not.

But also, it's the part that's invariably the most meaningful.

And we have people that were in our study 30 years ago--

they're still meeting.

And they didn't like each other when they first got together.

They just happened to be going to the cath lab

at the same time.

Because that need for connection and community

is a primal, fundamental human need.

And even if you've just scratched the surface of that,

you can create a Facebook or a multibillion-dollar company.

So whatever people out here are doing in the world,

to the degree that you can create

real, authentic connections between people,

it's going to be that much more successful, and ultimately

that much more healing.

JACK: So Dean, let's talk about genetics now.

What's interesting is, again, people often

think of genetics as something hereditary.

I have what my parents gave me, and that's what I'm stuck with.

But what you've shown is that these kinds of lifestyle

changes--

not only, again, the diet and the exercise,

but the stress reduction with meditation, the bonds--

are actually changing the expression of the genes.

And so across 500 genes, both in terms of up-regulating good

ones and down-regulating bad ones--

we'll get to telomeres in a second,

but let's just talk about those kind of studies

that you've been involved with where you've shown--

again, with actual sequencing-- to show

that the genetic expression has changed

with these kinds of changes.

DEAN ORNISH: Well, just that.

I mean, so often, people say to me, oh, I've got bad genes.

What can I do?

In fact, Bill Clinton is a good example.

When his bypasses clogged up, one of his doctors

had a press conference.

He said, oh, it's all in his genes.

His lifestyle had nothing to do with it.

So I sent him a note, and I said, actually,

it has everything to do with it-- not

to blame, but to empower.

Because if it's all in your genes, you're a victim.

What can you do?

I said, you're not a victim.

You're one of the most powerful guys in the world.

And so he began making these changes,

and he's still doing it now, nine years later,

which I think sets a great example, whatever

your politics, when a former president who

was known for not eating particularly healthily

does that.

But we found that, again, it's another example of how dynamic

these mechanisms are.

In just three months, we found over 500 genes were changed.

As you say, up-regulating the healing genes

and down-regulating the--

JACK: So three months of change in lifestyle?

DEAN ORNISH: 501 genes.

JACK: 500 genes.

DEAN ORNISH: And we published this with Craig Venter

in the "Proceedings of the National Academy of Sciences,"

and we particularly down-regulated chronic

inflammation-- genes that cause chronic inflammation--

oxidative stress, and what are called the RAS oncogenes

that promote prostate, breast, and colon cancer--

just like that.

Again, it's amazing how dynamic people

can get better or worse when they make these lifestyle

changes.

JACK: Let's talk about telomeres now.

Talk to us-- you've been interacting with one

of the founders of the whole telomeric medicine--

DEAN ORNISH: Liz Blackburn.

JACK: --science.

Liz Blackburn-- won the Nobel Prize.

Talk to us about what are telomeres, first of all,

for those in the YouTube land who may not know yet?

And what findings did you show in terms

of the impact of these kind of changes

on telomeres themselves?

DEAN ORNISH: Well, telomeres are--

the analogy that Liz Blackburn often gives

is they're like plastic tips on the ends of your shoelace

to keep your shoelace from unraveling.

They keep your DNA from unraveling.

And as we get older, our telomeres tend to get shorter.

And as our telomeres get shorter,

our lives get shorter, and the risk of premature death

from heart disease, diabetes, most forms of cancer,

Alzheimer's, goes up proportionate to that.

Now, she had done an amazing study

with Elissa Epel where they found that women who

are under chronic emotional stress

because they were caregivers of either parents

with Alzheimer's or kids with autism--

the more stress they felt and the longer

they felt that way, the shorter their telomeres were.

And they calculated that the difference

between the high and low-stress women

was nine years in terms of-- excuse me, 17 years in terms

of longevity.

But what was even more interesting to me

is that it wasn't an external cause.

It was how the women were reacting

to it that determined its effect on their telomeres.

In other words, even if you're in a bad situation,

you can mitigate and modulate that by doing

the kinds of things we're talking-- by meditating,

by eating healthily, by exercising,

by having social support.

And so I thought, well, OK, if bad things

make your genes shorter--

I mean, your telomeres shorter-- maybe

good things make them longer.

So we did a study together, and we found that

after just three months, the telomerase--

which we published in "The Lancet Oncology"--

increased by 30%.

And after five years, the telomeres

got 10% longer, whereas they got shorter in the control group.

It's still the only control study

showing that any intervention can actually

make your telomeres longer.

And when "The Lancet" sent out a press release,

they called it "Reversing Aging at a Cellular Level,"

which I think is true.

And so many of these things that we think are in our genes,

we really have a lot more control over.

Again, not to blame, but to empower.

JACK: So let's talk about the medical establishment itself.

You've had a deep engagement there.

What's great is that you went through med school.

You went to Harvard for fellowship, Mass General.

And so you're deeply familiar with the core establishment.

And in fact, you've been invited, now--

over the past number of years, particularly--

to some of the key establishments to give

rounds, to actually describe your science.

So no longer is it something like,

what is Dean doing over there?

You're now inside the Cleveland Clinic.

You're inside Mass General.

You're inside these areas.

Yet, if you look at the curriculum of med school,

if you ask most doctors till today how they were trained

and how they're being trained, we

don't see enough of the kind of science

that you're talking about.

Again, not just feel-good stuff, but core science and impact.

What will it take, or what do you recommend

as a prescription, as it were, to the med schools--

as you talk to deans of med schools around the country--

what do we need to do?

DEAN ORNISH: Well, it's a really good question.

I used to think if we just had good science that would change

medical practice and education.

And to some degree it did, but not nearly as much

as I thought.

What I finally learned-- and I learned this the hard way

when--

I started a nonprofit institute called The Preventive Medicine

Research Institute, and we've been

training hospitals and clinics and physician groups

around the country and doing research and so on.

And so through that, in the early '90s,

we trained 53 hospitals around the country.

We got bigger changes in lifestyle,

better clinical outcomes, bigger cost savings, and better

adherence than anyone's ever shown, and a number of them

closed down because we didn't have the reimbursement.

So the painful lesson is-- if it's not reimbursable,

it's not sustainable.

JACK: So you went on a quest-- an odyssey.

DEAN ORNISH: So I went on a quest.

JACK: And it took you what, just a few months?

Joke.

DEAN ORNISH: Yeah, right.

It took 16 years, actually.

Because I'd been working with the Clintons since '93,

and when he was president, I also

was working with Newt Gingrich's daughter,

who had had some health issues.

And so we had the President of the United States,

the Speaker of the House, 20 members of the Senate,

30 members of the House-- they all said, this is a great idea.

And they still took 16 years to get Medicare to cover it.

But they did, and I'm really grateful that they finally did.

JACK: Just to clarify that-- so when people now want to do

these lifestyle changes of the diet, the exercise,

the stress reduction, and the bonding--

that program, now, is now covered?

Even though-- again, highly unusual situation,

because typically, most insurance companies want

to cover a pharmaceutical intervention, a drug,

a surgical intervention--

DEAN ORNISH: Or a device.

JACK: --but now they're going to cover--

they're covering something, now, that is not that?

DEAN ORNISH: That's what took 16 years.

And they're covering it as a Dr. Dean Ornish

program, which is great.

So we partnered with a company called Sharecare which is--

excuse me-- Jeff Arnold, who started WebMD, and Mehmet Oz--

Dr. Oz-- and Don Whaley and others, and we're

training hospitals, physician groups, health systems,

and clinics around the country.

And again, we're getting the same thing-- bigger changes

in lifestyle, better clinical outcomes, bigger cost savings,

better [INAUDIBLE].

We're also doing these 12-day retreats where

people can come from anywhere.

And Medicare is paying for it, and most insurance companies

are paying for it, too.

And so what I'm learning is that when you change reimbursement,

you change medical practice, and even medical education.

And it is changing.

It's slower than I would like.

It's been 40 years I've been doing this work.

The president of the American College

of Cardiology, last year--

Dr. Kim Williams-- found that his own LDL cholesterol

was really high.

Didn't want to go on statins the rest of his life.

Did a literature review.

Came across my work.

Went on my program.

His LDL came down 50%.

Wrote about it in all the medical literature.

And at the American College of--

JACK: This is the head of the American College

of Cardiology himself--

DEAN ORNISH: That's right.

JACK: OK.

DEAN ORNISH: And he headed a six-hour seminar

on lifestyle medicine.

And lifestyle medicine is using lifestyle to reverse disease

and to treat it, not just to prevent it,

which I think is the most exciting trend in medicine

today.

And we did a seminar on lifestyle medicine,

and over 1,000 cardiologists came.

That wouldn't have happened five or 10 years ago.

So things are changing, and it makes me really happy

to see them.

JACK: So we talked about cardiology.

We talked about diabetes.

Let's talk about cancer.

You've now shown-- you did a series of studies on prostate

cancer to begin with, and now, I believe, maybe

on some other cancers-- showing that, again, these kinds

of non-pharmaceutical interventions

did have a powerful effect, for example, in prostate.

Talk about that study.

DEAN ORNISH: Well, prostate cancer

is the number one cancer in men other than skin cancer.

And there was a major study that came out a year ago

that looked at a 10-year study of randomized trial--

in "The New England Journal of Medicine."

And what they found is that men who had the conventional

treatments-- which were surgery or radiation--

didn't live any longer than men who

did nothing who had biopsy-proven early-stage

prostate cancer.

And yet, the complications of the treatments

tend to maim guys in the most horrible and personal ways.

You're wearing diapers because you're incontinent,

and you can't have sex because you're impotent, in many cases,

for no benefit at huge economic cost.

So I did a collaborative study with Dr. Peter Carroll,

who's the Chair of Urology at UCSF, and the late Dr. Peter

Carroll--

excuse me, Bill Fair-- who, at the time,

was the Chair of Urology at Memorial Sloan Kettering Cancer

Center.

When you're doing something disruptive,

it's good to work with the most respected people,

because it's easier to get things published.

People believe it.

And we did a randomized trial, and we found that these same

lifestyle changes could slow, stop,

or reverse the progression of men who have early-stage

prostate cancer--

just the lifestyle changes alone.

So if a guy has a biopsy--

their PSA goes up, gets a biopsy.

The doctor will invariably say, you've got prostate cancer--

if they have it-- and you need to have it taken out,

or you need to have radiation.

But most guys don't want to do that,

but they don't want to, quote, "do nothing."

This idea of watchful waiting--

waiting for something bad to happen--

is like sitting under a sort of Damocles,

waiting for the other shoe to drop.

People don't want to do that.

They say, I've got this cancer growing.

I've got to do something about it.

So we give people a third alternative.

An aggressive-- if you want to put it in more macho terms--

nonsurgical, non-pharmacologic intervention.

And then Dr. Carroll has developed these algorithms

where they can monitor people very carefully and find out,

who is that 1 out of 50 people who really would benefit

from surgery or radiation?

And the others can do this.

And unlike most things, the only side effects are good ones.

JACK: That's great.

So what is next?

You've done, now, cardiac, diabetes, cancer.

Now you're thinking about Alzheimer's as well.

DEAN ORNISH: And by the way, before I

forget, if it's true for prostate cancer,

it'd almost certainly be true for breast cancer.

And Dr. Laura Esserman, who runs the Buck Breast Cancer

Center at UCSF, and I have been talking

about doing a study for a long time to show that.

And I'm quite sure that'll be the case as well.

JACK: For breast cancer as well?

DEAN ORNISH: For breast cancer as well.

JACK: Great.

DEAN ORNISH: So what we did-- we just

began the first randomized trial to see if we can

reverse Alzheimer's disease.

People are more afraid of Alzheimer's than anything.

In fact, James Watson-- you know, Watson and Crick--

when he had his genome first sequenced, he said,

I want to know about everything except the APOE4 gene,

which is the one that increases your risk of Alzheimer's.

Because why would I want to know if I can't do anything

about it?

So we think you actually can do something about it.

I think we're at a place with respect to Alzheimer's very

much like we were 40 years ago when I first started doing

research on heart disease.

There's every reason to think it'll work.

There are animal studies, epidemiological studies,

anecdotal case reports, randomized trials

where they use less intensive lifestyle interventions

that could slow or stop the progression.

I think a more intensive lifestyle intervention

can actually reverse it.

So we're doing a collaboration with Dr. Bruce Miller and Joel

Kaplan at the Memory and Aging Center at UCSF, who run that.

And we're going to take 100 men and women who

have early-to-moderate Alzheimer's, randomize them

into two groups, put half on the program and not the other,

and compare them using PET to look at amyloid

and MRI to look at hippocampal volume

and looking at cognitive function testing and biomarkers

and so on.

And we've raised most of the money that we need to do this,

so we've already started it.

We just got our IRB approval last week,

and we're ready to begin.

And I'm cautiously optimistic.

You never know, but I'm pretty sure this is going to work.

And it runs in my family, too, so I have

a personal interest in this.

And if we could show that we can reverse

the progression of early-to-moderate Alzheimer's

by changing lifestyle, that would really

give millions of people new hope and new choices.

Because when you lose your memories, you lose everything.

JACK: Particularly as-- in society, our demographic's

getting older.

[INTERPOSING VOICES]

JACK: People age--

DEAN ORNISH: Exactly.

JACK: --and live longer, this is going to be more prevalent.

So before we turn to audience questions,

let me just ask a very practical question for folks here,

and also watching on YouTube.

In terms of the kinds of things that people should

do, in addition to the diet, the lifestyle,

meditation, stress reduction, and the social bonding,

are there certain--

in terms of the diet that we get-- the nutrition we get,

I want to use-- the word nutrition may

be even better than diet.

People sometimes confuse diet for a diet--

some kind of--

DEAN ORNISH: A way of eating.

JACK: --bizarre regimen.

But the kind of supplements that people

should think about using or not thinking about using--

fish oil supplements, good or bad?

Mushrooms?

I don't mean shrooms.

I mean mushrooms.

[LAUGHTER]

JACK: What are the kinds of things--

DEAN ORNISH: Actually, there's some good studies on shrooms,

as well.

JACK: What are the kinds of things that people

should or should not consider?

DEAN ORNISH: Before I answer that,

let me say one thing that I forgot to mention,

which is that with all this interest in personalized

medicine, it's the same lifestyle program that we found

could do all of these things.

It can down-regulate all these mechanisms

that could reverse all these different conditions.

And I think it's because they share

certain common underlying biological pathways,

although we tend to silo them as being different diseases,

they really may be more different manifestations

of the same kind of underlying processes.

Now, if you're trying to do a targeted immunotherapy

for melanoma-- like you so brilliantly--

I mean, I don't know if you know Jack's dad-- is

it OK to talk about your dad?

JACK: Sure.

DEAN ORNISH: Jack's dad developed melanoma.

Now, most people, when their dad develops melanoma,

they go, oh, that's so bad.

I'm so scared.

Jack, who's not an oncologist, decided

he would learn everything he could about melanoma, developed

a treatment-- an immunotherapy-- and his dad is cured.

So that's Jack.

JACK: I didn't develop it myself.

We supported other people's work.

DEAN ORNISH: Yeah, but you were the one

who actually directed that.

It wasn't just giving them money.

It was actually saying, let's study this.

Let's see what happens.

It was really your work that they put into practice.

So if you're doing something like that,

I think a targeted immunotherapy or whatever is brilliant.

But for the vast majority of chronic diseases,

it's these same lifestyle changes that

can prevent and reverse them.

And it's not all or nothing.

I wrote a book called "The Spectrum," which

was based on the finding that in all of our studies,

the more you change, the more you improve in every way

we can measure.

So if you have a life-threatening illness,

that's more of the pound of cure.

You really do have to make big changes.

That's why we were the first to proe that,

because most people didn't go far enough.

But if you're otherwise healthy, if you indulge yourself one

day, eat healthier the next.

If you don't have time to exercise one day,

do a little more the next.

You get the idea.

In terms of supplements, the ones that I take--

I take fish oil every day.

I think in general, it's better to get your nutrients from

food, but I think Omega-3s may be an exception to that

if you're going to eat fish, because--

JACK: I guess that's my question.

In other words, it's obviously better to get it from food,

but what is available to us in the average--

even organic-- grocery, what do you

feel is missing from that general availability

that we may want to think about [INAUDIBLE]??

DEAN ORNISH: I think the Omega-3s and fish

oil are really worth doing, because there

are no clean fish.

All fish are contaminated with either mercury, dioxin, PCBs--

bad stuff in varying degrees.

But when you take the fish oil, if you take certain brands,

they remove all the bad stuff so you just

have the pure [INAUDIBLE].

Or you can take the plankton-based Omega-3s,

which are vegan, which is really where the fish get it from

anyway--from eating the plankton.

And then you don't get the bad stuff, either.

So I think three grams of fish oil or flaxseed oil

or a plankton-based Omega-3s a day are a really good idea.

I think that depending on--

I think the probiotics, actually-- there's a lot of--

we're actually also doing some studies on the microbiome.

JACK: The microbiome.

Let's talk about the microbiome a second.

Just describe that.

DEAN ORNISH: Well, you know, there

are trillions of cells in our body

that we exist in a homeostasis with,

and we're just realizing how powerful those

are-- and again, how dynamic you can change your microbiome.

We did a pilot study.

We found in just three days, we could show significant changes

in the microbiome in healing directions.

So I think for most people, if you're not

eating a particularly healthy diet, taking

one of the microbiome supplements

can be a good thing.

The Omega-3s we've talked about.

I think most people don't get enough vitamin

C in their diets, so taking 500 or 1,000 milligrams of that

is a good idea.

The turmeric-- I know you like to drink turmeric tea,

which we share--

[INTERPOSING VOICES]

JACK: Right here.

Here it is.

DEAN ORNISH: Turmeric is a very powerful anti-inflammatory.

This is one of the reasons why it's

been linked with reducing Alzheimer's, but also

other conditions.

Most people aren't going to drink enough turmeric tea

or eat it in their diet-- or curcumin--

so I take a supplement.

It doesn't make you smell like curry, and those were good.

So those are the things that I think

most people can benefit from.

JACK: Cool.

Let's turn to the audience.

Is there questions from the audience?

Why don't we start?

You have a question?

Yeah, let's use the microphone.

Make sure the microphone's on so our YouTube audience can hear.

AUDIENCE: I guess it's on.

JACK: Yes.

Tell us your name and what your question is.

Let's keep your questions short, because we want

to get a lot of questions in.

Go ahead.

AUDIENCE: My name is [INAUDIBLE]..

Thanks for coming and giving us this excellent talk.

DEAN ORNISH: Thank you.

AUDIENCE: My question is about-- so my dad--

so I'm an Indian, and my dad lives in India

and he's having heart disease.

So my question is, how are your diets mapping to Indian food?

Because food, as you said, is a major part of the plan.

But if the food is--

so Indian food is typically pretty [INAUDIBLE]..

But if we move into a different kind of diet,

then he will not like it and he'll probably reject it.

So how is that going?

DEAN ORNISH: There are a couple of doctors in India

that are offering my program there.

And it's working really well.

They have thousands and thousands

of people who have gone through.

But you're right, the traditional Indian diet,

even if it's vegetarian, is generally high in fat

with all the oils and so on, and also

generally high in ghee and butter and things like that,

and saturated fat and so on.

So there's a lot of room for improvement.

And for whatever reason, people of Indian descent

are usually more predisposed particularly

to type II diabetes, and often to heart disease.

So these lifestyle changes are even more important.

And unfortunately, what's happening

in India is happening in China, is

happening in most of the developing world--

is that they're starting to eat like us and live like us,

and all too often die like us.

And 50 or 60 years ago, heart disease and diabetes

were really pretty rare in India and in China.

And now they're by far the number one causes of death.

And it's diverting a lot of precious resources

from things that really do require drugs, like AIDS, TB,

and malaria--

the things that can be largely prevented, or even reversed,

by changing lifestyle.

So copy our successes, but not our mistakes.

JACK: Thank you.

Other questions, please.

AUDIENCE: So I have two questions.

JACK: Your name and then question, please.

AUDIENCE: My name is [INAUDIBLE]..

Two questions.

So is there some effort to develop the recipe books for,

let's say, different parts of the world?

So I suppose you'll need like 20 different recipe books

for different parts of India.

DEAN ORNISH: Can you say it just a little slower?

AUDIENCE: Sure.

[CHUCKLES] So are there some efforts

to develop recipe books for the different parts of the world?

JACK: Recipe books?

AUDIENCE: Yeah.

JACK: Yeah.

AUDIENCE: Customized to the spices and ingredients

found in different parts of India, for example?

The second question is, do you have books or something

for teenage kids?

So what are we doing about teenage kids in USA?

JACK: Teenage kids, yeah.

DEAN ORNISH: Yeah, yeah, well, we

don't have anything that's specific to India for spices.

But I'd love it if you or someone like that could--

JACK: We have some recipe books.

But I don't think--

DEAN ORNISH: Oh, we have [INAUDIBLE]..

Yeah, there are hundreds of recipes in all of my books

but nothing specific to Indian food.

JACK: So maybe a new collaboration, I think.

DEAN ORNISH: Yeah, maybe so.

That would be great if you could do that.

JACK: How about teenage--

DEAN ORNISH: I've got a 17-year-old son

and he was vegetarian until he hit about 14 or 15.

And he said, look, Dad, it's either meat or heroin.

What do you think?

So I said, meat, good choice.

[CHUCKLES] He had to rebel in some way.

But when he was younger, I learned that even

more than being healthy, whether you're six or 60,

people want to feel free and in control.

And he's a pretty strong-willed kid.

And Jack has been mentoring him, which we're very grateful for.

And I knew that if I told him he couldn't have certain foods,

he'd want them.

And he'd probably develop an eating disorder.

So I said, look, the rule in our family is nobody can tell you

what to eat, not even me, and I'm your dad,

and I know more about food than a lot of people,

because it's your body.

You control it.

This is why we eat what we eat.

But you decide what you want to have.

And so we taught him how to read labels.

So he'd go into a store and say, oh, that has too much of this.

Or I don't think I should have that.

Now that all shifted when he went through puberty.

But I think that the idea of empowering your kids

and teaching them and if you can help

them grow food and actually see where it comes from

or visit a farm if you don't want to do it yourself,

it's magic to them.

And they get their taste when they're

younger, their taste preferences,

which are really malleable.

So if you tend to feed them healthy food

from the beginning, they begin to actually prefer

those kinds of foods.

So I haven't read a book yet like that, but I'd like to.

But Bill Sears has written some good books about that.

JACK: Bill Sears?

DEAN ORNISH: Yeah.

JACK: Yeah.

I think it's so challenging, because particularly here

in the US, there's so much packaged food and even, quote,

"healthy" packaged food.

It does make it easier for a very busy parent.

You're a busy parent.

You have lots of kids.

You're feeding things like that, and you just

get a lot of packaged food.

But it is disconnecting us from the source of the food

and where things are from.

DEAN ORNISH: It's true.

JACK: It's something that unfortunately

is a major challenge that--

DEAN ORNISH: Well, to the extent at least the meal kits

or whatever can be used to--

the meal kits are different than the frozen foods, and so on,

because you're actually making dinner.

But they just have done the hard part.

So it makes it easier.

And there are studies that show that just when the family sits

down together to have a meal together, just the sitting down

together, there's better academic performance, lower

truancy, lower illness, all the kind of things that you want.

Again, it goes back to the social factors and the power

of community and family.

JACK: Great.

Other questions, please.

Your name?

AUDIENCE: Hi, my name is [INAUDIBLE]..

My question is about what are the things

we can adopt and encourage that can help build a stronger

immunity against diseases.

JACK: Stronger immunity, yeah.

DEAN ORNISH: Well, one of the most powerful things you can do

is to actually have more love in your life, believe it or not.

There was a study that was done by Sheldon Cohen that

was in the "Journal of the American Medical Association."

And I don't know how he got this through the Institutional

Review Board, but he got volunteers.

And he dripped rhinovirus that causes colds in their noses.

100% of them got infected.

But not everybody that got infected actually got sick.

And they found that the more social contacts

they had-- the more friends visiting them,

the more phone calls, the more love

that they had-- they had four times fewer signs

and symptoms of a cold, even though they were all infected.

So [INAUDIBLE] is we have this idea that the bacteria

or the germ causes the disease.

But it's a necessary but not always sufficient

factor, even with people who are--

Margaret Chesney did a study at UCSF where she found that men

and women who were HIV-positive who were lonely and depressed

were more than twice as likely to develop AIDS and die from it

than those who weren't.

So diet is important.

Exercise is important.

These all affect our immunity, but probably more

than anything, these social factors.

And we tend to think that the time we spend with our friends

and family is a luxury that we do after we've

done the important stuff.

And to me, the value of the science

is that it increases awareness.

So we understand just how powerful those things are,

and that the time that we spend with our friends and family

is not the stuff we do after we've done the important stuff,

that it is the important stuff.

JACK: And that's also a message for employers.

I mean, obviously, here we put a lot of emphasis on that.

People are encouraged to take their vacations,

go home, be with their families, things like that.

So it's a real message around if you want your employees to be

healthy, that it's just not a nice-to-have, it's a must-have.

DEAN ORNISH: And it's unfortunate

that the startup tech world is often the mythical

let's stay up all night and eat pizzas and really run ourselves

into the ground.

And yet, you can do that for a short time.

But if you really want to keep your creativity at its maximum,

as you know, taking care of yourself

makes you smarter and makes you work more effectively.

JACK: Great.

Other questions.

Please, right here in the front, and then-- oh, good, good.

There, and then the front.

We have two mics?

OK.

There-- yeah.

AUDIENCE: So my name is [INAUDIBLE],,

and my question is regarding caffeine.

There's a lot of confusion regarding whether it's good or,

if so, how much.

I would love to hear your thoughts.

DEAN ORNISH: Why do you want to know?

[LAUGHTER]

That's what I'm like when I have too much caffeine.

I'm very caffeine-sensitive.

If I even have decaf, it's like, hurry up!

Can't you go any faster?

[CHUCKLES] It's really-- it makes me very aggressive.

And I've learned to avoid caffeine in all of its forms.

But my wife can drink three cups of coffee and go to bed.

So there is a lot of individual variation around that.

The problem with caffeine is that for some people like me,

it makes your fuse shorter.

It can potentially add stress.

It makes you more likely to be stressed out.

For other people, it doesn't do that.

And there are other things that are

in coffee besides caffeine--

the polyphenols, and so on--

that actually may be protective against some of the more

common chronic diseases.

So you decide.

If you find that you don't have those negative side

effects from doing caffeine, then that

is probably good for you, up to a point.

JACK: This one right in front here,

and then we'll go to the back.

DEAN ORNISH: I'm like Robin Williams on speed

if I have caffeine.

[LAUGHTER]

AUDIENCE: So thanks for the really interesting talk.

I'm [INAUDIBLE].

JACK: Sorry, is the mic on?

Just make sure it's on.

AUDIENCE: Oh, sorry.

JACK: Good.

AUDIENCE: I'm [INAUDIBLE].

And so my question is on--

so a lot of the improvements you describe,

they're these very human lifestyle improvements.

So I was curious about whether there's any sort of technology

that's emerging that you're excited about that might also

effect these improvements in people's lives.

DEAN ORNISH: Yes, technology is a powerful force.

I don't have to say that here at Google.

But it can be used to bring us closer together.

It can isolate us more, as we talked about earlier.

If you look at other people's Facebook profile,

it makes you separate.

But on the other hand, we found that support groups

are so powerful.

And after they finished their Medicare--

and most insurance companies are paying for 72 hours

of the people meet twice a week for 9 weeks,

or a 12-day immersion retreat--

and afterwards, we found that because they've developed

a sense of trust already--

and trust is really everything, because you can only

be intimate to the degree you can open your heart

and be vulnerable.

And you can only do that to the degree you feel trusting.

And so that's why trust is really fundamental to healing.

And so once you develop that sense of trust with a group

of people, we then meet-- instead of having them come

in a central place which we found was hard,

and particularly if they came for a tour or retreat from

different parts of the country, they can all use--

we use Zoom as a technology.

But we could use Google or anything to say, OK, between--

they pick a day, like Thursdays, from 5:00 to 6:00,

we're going to have our support group.

It's 15 people.

And they all chime in.

I like Zoom, because whoever is talking immediately

fills the screen.

Except for people who are not very tech-savvy,

it's an easy way to do that.

And so that's just one example of how technology can really

be healing in a powerful way.

AUDIENCE: One really quick follow-up question,

what about machine learning?

So this is something I work on, so I was just curious as to--

JACK: Artificial intelligence, machine learning.

DEAN ORNISH: Yeah, well, you're talking to the man here.

He's having a conference here for the next three

days on that.

What particular aspect of that are you asking about?

AUDIENCE: So one thing people are excited about in machine

learning at least, in health applications,

is trying to take image data and try and spot

sort of the progression of diseases, for example.

So-- yeah.

DEAN ORNISH: Well, certainly, we're

already seeing things in pathology

that artificial intelligence can actually diagnose cancers

more accurately and sooner than even the most

experienced radiologists.

But I defer that question to you, Jack.

JACK: Sure.

Yeah, I would say, it's a very exciting field.

I think we're just at the beginning.

If you look at medical imaging as an example,

and there are several projects across this campus

and other startups and lots of people beginning down

this road, the good news is I started my career

in medical imaging at NIH.

And it's one of the fields that has been most digitized.

So the good news is, coming out of most major scanners--

Phillips, GE, so on and so forth, Siemens--

you get a digital file.

Unfortunately, most of those files

get stored away in some data center.

And no one ever looks at them again.

We're beginning now as a technology community

to begin to tap into that and then hook that up

with the electronic medical records, which again can

be our ground truth as to what did, in fact,

happen to this person?

What were they diagnosed as based on the medical imaging?

And then what was the ground truth over the next five,

six years of what actually developed?

And that becomes a rich source of supervised learning

possibility for neural networks or other models

that we can use.

So I do expect this kind of technology

to really enhance the role, say, for example,

of the radiologists, where the radiologist now

is not just popping something up on a screen.

I literally still visit hospitals today

where people are printing out films.

And so it's still happening today,

where rather than looking at it in a high-resolution monitor,

they're still printing out film.

So that is changing.

There are other parts--

there are still a lot of records that are not electronic yet.

There is a lot of movement to make that happen.

And even when they are electronic,

we have to be very, very careful.

It's clear now that we have to be--

as we're ingesting this data for the role

of supervised learning, there's often

errors in terms of the labeling.

And we have to be careful about what we're training,

what we're not training.

We also to make sure that we have a diversity in terms

of the demographics that we're ingesting into these AIs.

And so if we're going to do this,

we want to make sure that we have population pools that

are drawn from a wide gamut of society

so that we haven't inadvertently trained the AI to do

a great job on this part of the demographic

when their medical image is taken in,

but not that part of the demographic.

And I also think it's important to do this on a global scale.

There are some initiatives in other countries

to begin to add to this database.

But it's really just beginning.

So my biggest concern right now is about diversity,

is about making sure that as we're going through this,

we have a real wide diversity of patients that

are coming into this thing.

But yeah, go ahead.

DEAN ORNISH: Let me say one more thing.

There's a company called Lark that Julia Hu organized

with a group of MIT people that actually

does AI text-based messaging.

So it feels like there's a health coach on the other end,

but there's not.

And actually, you can scale that for virtually nothing,

because you don't have to have a coach on the other end.

And so it's actually getting increasingly

effective at motivating people to make behavioral changes that

can be scaled at virtually no cost.

JACK: Yeah.

The one real-world example I would also point people to

in the UK is something called Babylon Health.

People in the audience and viewing this

can check out that company.

That company has not just created a fun app

which you can use to engage on your health issues

and also triage--

the National Health Service of England, of the UK,

uses it to actually officially triage

1.5 million citizens in the UK.

And so it's actually an official part.

DEAN ORNISH: Yeah, it's beautiful.

JACK: It's one of the first examples

that I've seen of a health service incorporating

this technology in an official capacity.

DEAN ORNISH: And by the way, TRICARE

is using the AI in their app as well.

So I think we're seeing this more and more.

And I think it's really the wave of the future.

JACK: Yeah.

I think we had a question back here.

Yeah, please, your name and-- go ahead.

AUDIENCE: Hi.

My name is [INAUDIBLE].

I'm interested to know that most people coming from India

suffer from vitamin D deficiency.

And so we've been prescribed by the doctors

to take it as a supplement.

What are the precautions actually needed

to mix it [INAUDIBLE]?

And there are some articles that I read online

that you shouldn't take it with this supplement.

You shouldn't take calcium supplements along with iron.

There are so many confusing things

about taking supplements.

Can you clarify it?

DEAN ORNISH: Well, it's not just people from India.

Most people in this country are vitamin D3 deficient.

And so I think that I would add that to my list of supplements

for most people is take 1,000 units of vitamin D every day.

And I wouldn't worry so much.

Vitamin D is a pretty innocuous thing about combining that

with other supplements.

I'm not aware that that's really going

to create any major problems for most people.

JACK: Cool.

Question here in the front, we have a--

great.

AUDIENCE: Hi, this is Alexis [INAUDIBLE]..

Thank you so much, Dean.

I have a question around sleep.

We haven't touched on that.

And I think all of us would agree that it's

increasingly important.

And it's, in fact, one of the most important.

So what are your thoughts?

DEAN ORNISH: Well, sleep is one of the ways

that your brain detoxifies itself.

And so there are a lot of people who think,

I don't need much sleep, and so on.

But Bill Clinton famously said that the worst decisions

he ever made were when he was sleep-deprived.

And I think Arianna Huffington has done a of work

in raising the awareness about the importance of that.

So I think if you want to really be creative and innovative,

as opposed to imitative, try to get more sleep.

It can really make a big difference.

JACK: Yeah, I think what's interesting about sleep

also is that we don't fully know the science yet

of how sleep is helping us.

And so I think a lot of times, we're

willing to cut corners on sleep, because we

don't have that immediate knowledge about what

is actually happening in the brain during the sleep.

But obviously, it's now come out.

And it's very clear from many studies.

DEAN ORNISH: Well, I think, even from an evolutionary

standpoint, why would we evolve to do something that's

going to make us use up so much of our life,

make us completely vulnerable to predators while we're sleeping,

unless it was really important.

And I think that's part of why when

I'm in the middle of the night and wanting

to get up and do work, I have to remind myself of these things.

[CHUCKLES]

JACK: Exactly, great.

We have one more question back here.

AUDIENCE: Hi, my name is [INAUDIBLE]..

My question is about the prescription, the four pillars

which you mentioned.

Does that change based on the ethnicity or the underlying

problem which a person is trying to treat,

like obesity or heart disease or cancer or those things?

Or is it all [INAUDIBLE]?

DEAN ORNISH: Not really so much.

I mean, we fine-tune a little bit.

Some people can metabolize refined carbohydrates or gluten

or things like that better than others.

But for the vast majority of it, it's really the same.

And when I started doing this work, I predicted--

incorrectly, as it turns out--

that the younger people who had less severe disease

would do better.

And what we found, it wasn't a function

of age or disease severity.

It was simply a function of the more you change your diet

and lifestyle in these areas, the more you

improve in every metric we looked at

and every disease we studied.

Now, there may be ways of fine-tuning this

as we learn more.

But what I'm still so struck by is

that these same lifestyle changes,

the more diseases we study and the more biological mechanisms

we research, the more reasons we have

to explain why they are so powerful.

And it's so hard for a lot of people to believe,

like, you mean talking about my feelings

is going to help me live longer?

Are you kidding me?

[CHUCKLES] Is that the best you can do?

It's like, yeah, as a matter of fact, it is.

I mean, David Spiegel did a landmark study

at Stanford years ago, where he took women

with metastatic breast cancer, randomized them

into two groups.

Both groups were getting the same chemo

and radiation and surgery.

But one group had a support group once a week

for an hour and a half for a year,

in the same way as we were talking about.

And then they stopped.

Five years later, he told me he almost fell off his chair

when he looked at the data.

Those women lived twice as long.

So these simple things can really

make a powerful difference.

JACK: Great.

With that, thank you very much for coming.

Thank you to our YouTube audience.

Thank you, Dean Ornish.

DEAN ORNISH: Thank you.

[APPLAUSE]

JACK: Let me just mention that if folks want more information,

I believe your website is ornish.com?

DEAN ORNISH: Yep.

JACK: Your nonprofit is PMRI.org.

DEAN ORNISH: Yep.

JACK: And the general website is ornish.com

for people to get more info.

DEAN ORNISH: That's it.

Thank you.

JACK: Thank you, Dean.

DEAN ORNISH: Thank you, Jack.

JACK: Thank you.

[APPLAUSE]

The Description of Dean Ornish: "Transforming Lives and Healthcare" | Talks at Google