Dean Ornish M.D.
Newsweek Web Exclusive

What really works to make sustainable changes in diet and lifestyle? It’s probably not what you think. In over 30 years of conducting clinical research, I’ve learned that the real keys are pleasure, joy and freedom, not willpower, deprivation and austerity. Joy of living is sustainable; fear of dying is not.

Why? Because life is to be enjoyed. There’s no point in giving up something you enjoy unless you get something back that’s even better, and quickly. When people eat more healthfully, exercise, quit smoking, manage stress better, and love more, they find that they feel so much better, so quickly, it reframes the reason for making these changes from fear of dying (too scary) or risk-factor modification (too boring) to joy of living. Fortunately, the latest studies show how dynamic and powerful are the mechanisms that control our health and well-being. When you exercise and eat right:

  • Your brain receives more blood flow and oxygen, so you become smarter, think more clearly, have more energy, and need less sleep. Two studies showed that just walking for three hours per week for only three months caused so many new neurons to grow that it actually increased the size of people’s brains!
  • Your face receives more blood flow, so your skin glows more and wrinkles less. You look younger and more attractive. In contrast, an unhealthy diet, chronic emotional stress and smoking reduce blood flow to your face so you age more quickly. Smoking accelerates aging because nicotine causes your arteries to constrict, which decreases blood flow to your face and makes it wrinkle prematurely. This is why smokers look years older than they really are and often have a gray pallor. Supermodel Christy Turlington, whose father died of lung cancer, has a wonderful Web site, which is a powerful antidote to the idea that smoking is beautiful.
  • Your sexual organs receive more blood, so you become more potent—this is how drugs like Viagra and Levitra work—but without the costs and side effects. In contrast, unhealthy lifestyle choices often lead to impotence. For example, half of men who smoke are impotent. Cigarettes are marketed in ways that make it seem as though you’ll be sexy and beautiful, but they really make you ugly and impotent—how sexy is that?
  • Your genes change. In May, my colleagues and I at the nonprofit Preventive Medicine Research Institute and the University of California, San Francisco, published a study in the Proceedings of the National Academy of Sciences showing that changing your lifestyle changes your genes. Really. After only three months of following the lifestyle program described in my book, “The Spectrum,” the expression of over 500 genes changed in men with early-stage prostate cancer. We found that genes associated with cancer, heart disease and inflammation were downregulated or “turned off” whereas protective genes were upregulated or “turned on.” Craig Venter’s pioneering work showed that one way to change your genes is to synthesize new ones. Our research is showing that another way to change your genes is to change your lifestyle.
  • Your telomeres get longer. Telomeres are the ends of our chromosomes that control how long we live. As telomeres become shorter, then cells age and die more quickly. In simple terms, as your telomeres get shorter, your life gets shorter.


Chronic emotional stress shortens your telomeres. My colleagues, Elissa Epel and Elizabeth Blackburn of the University of California, San Francisco, conducted a pioneering study of mothers who were caring for a child with a chronic illness. They found that the more stress the women reported experiencing, the shorter their telomeres. Women with the highest levels of perceived stress had telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low-stress women.

One of the most interesting findings in this study was that the mothers’ perceptions of stress were more important than what was objectively occurring in their lives. The researchers gave the women a questionnaire and asked them to rate on a three-point scale how stressed they felt each day, and how out of control their lives felt to them. The women who perceived that they were under heavy stress had significantly shortened and damaged telomeres compared with those who felt more relaxed. Conversely, some of the women who felt relaxed despite raising a disabled child had more normalappearing telomeres.

In other words, if you feel stressed, you are stressed.

I wondered: if chronic stress can decrease telomerase (an enzyme that repairs and lengthens telomeres) and cause telomeres to age more quickly, could healthy lifestyle changes prevent this from occurring? It did. A few months ago, my colleagues and I (including Blackburn) published a study in The Lancet Oncology showing that the telomerase enzyme increased by almost one-third after only three months of making comprehensive lifestyle changes. This was the first study showing that any intervention, even drugs, can increase telomerase and, thus, telomere length. If a new drugs were shown to do this, it would be worth a billion dollars, but you can accomplish this benefit virtually for free, and in only three months, simply by changing your lifestyle.