Ornish vs Mediterranean Diet, Which is Better

What is the healthiest diet?

 

How can I achieve sustainable weight loss?

 

Is it possible to prevent, reverse or control type 2 diabetes with diet?

 

Those who have been following my blog know that I believe in the following key strategies to live a happy, healthy, healing lifestyle:

 

  • Eat whole foods
  • Exercise
  • Drink plenty of water
  • Get 7-8 hours of sleep per night
  • Control stress and anxiety
  • Spend as much time as possible with your happiness elements

 

This post will focus on the best diet to achieve weight loss and keep your body as healthy as possible.  Our family tried the Whole30 diet in October.  It was challenging for us all, but some major lessons were learned from the experience.  First, it is amazing how good you feel when crappy foods are eliminated from your diet.  Your thoughts are clear, your energy level improves, and you feel better in general.  Secondly, your skin improves, you look healthier, and sugar cravings disappear.  Although this diet is hard to continue indefinitely based on its restrictions, I do recommend trying it to get an idea of how the food you eat effects your life.

 

Let’s look at two different diets that may help you.

Dean Ornish’s Spectrum Diet

Dr. Dean Ornish has created a program which is similar to what I believe will lead to a healthier you.  His program claims to be able to reverse heart disease, diabetes, prostate cancer, and lead to weight loss.  Dr. Ornish believes that foods are neither good nor bad, but some are healthier than others.  He believes eating more of the healthy foods such as

 

  • Fruits
  • Vegetables
  • Whole grains
  • Nonfat dairy
  • Fats that contain omega 3 fatty acids
  • Legumes
  • Soy products
  • Egg whites

 

can have anti-aging, anti-cancer, and anti-heart disease effects.  Like me, Dr. Ornish emphasizes whole foods.  Processed foods should be limited.  He believes eating mostly plants in their natural form will lead to better health.

 

Ornish’s diet does not restrict calories unless weight loss is a goal.  He believes in small frequent meals throughout the day which maintain energy levels and controls hunger.

Carbohydrates

This diet limits the following “bad” carbs

 

  • Sugar
  • Concentrated sweeteners
  • White flour
  • White rice
  • Refined carbohydrates

 

Added sugars such as agave, honey, white or brown sugar, maple syrup and refined carbohydrates are limited to 2 servings per day. 

 

Alcohol can be consumed in limited quantities, but is not encouraged and is limited to one serving per day or

 

  • 5 ounces liquor
  • 4 ounces wine
  • 12 ounces beer

Fats

The Ornish diet recommends 4 grams of good fats daily.  These include

 

  • Fish oil
  • Flax seed oil
  • Nuts
  • Seeds
  • Plankton based omega-3 fatty acids

 

Limit calories from fats to 10% or less.  This diet achieves this by not adding fats, oils, avocados, coconut, or olives to the mostly plant-based diet.  The fat will come naturally from grains, vegetables, soy, fruit, legumes, and beans.

 

Cholesterol is limited to 10 mg or less per day.  Non-fat dairy products are optional but should be limited to 2 servings per day.  Alternatives such as soy milk are preferred as they are rich in healthy nutrients and are cholesterol-free.

 

Since nuts contain large amounts of fat, serving sizes are limited.  Three servings of the following types of nuts are recommended.  These specific types contain antioxidants, phytochemicals, and polyphenols which convey cardiovascular benefits.

 

  • 5 tsp pumpkin seeds
  • 6 peanuts
  • 3 pecan halves
  • 1 whole walnut
  • 5 almonds
  • 9 pistachios
  • 2 cashews
  • 5 tsp flax seeds, ground
  • 2 tsp chia seeds or sunflower seeds

 

Low fat packaged foods are not encouraged, but optional.  Remember, whole foods are preferred.

 

 

Protein

Protein, obtained mostly from plants, is encouraged by the Ornish diet.  Examples include.

  • Beans
  • Legumes
  • Tofu
  • Tempeh
  • Egg Whites
  • Non-fat yogurt
  • Non-fat cheese

Other Recommendations

Flavoring foods with herbs, spices, vinegar, and citrus fruits is preferred over salt.  If you are a coffee drinker, limit coffee to one cup per day, or two cups decaf or black or green tea.  Supplements may be taken as well.  Dr. Ornish recommends a low-dose multivitamin and mineral supplement with vitamin B-12, fish oil, and calcium supplements if directed by a physician.

All information regarding the Ornish diet was obtained directly from his website at:

https://www.ornish.com/proven-program/nutrition/

 

The Mediterranean Diet

The Mediterranean Diet is a way of eating in countries that surround the Mediterranean.  The basic guidelines are as follows.

Foods to eat daily:

  • Whole grains
  • Beans
  • Spices
  • Healthy fats
  • Herbs
  • Fruits
  • Vegetables
  • Nuts

To be consumed twice a week:

  • Fish
  • Seafood

Moderate portions of:

  • Dairy products
  • Eggs
  • Poultry (occasional)

Foods to consume infrequently:

  • Red meats
  • Sweets

There are many websites devoted to a Mediterranean diet and lifestyle.  One of my favorites is http://www.oldwayspt.org

This pyramid is found on that site.  This gives a visual explanation of what I have written above.

Why the Mediterranean Diet?

Studies have shown that this diet achieves better results than other diets in many areas:

  1. A 50% lower risk of type 2 diabetes compared to low fat diets.1

 

  1. Lower blood sugars in type 3 diabetics compared to other diets.2

3

  1. More effective for sustainable weight loss.4

5

  1. Lower rates of cancer, dementia, heart disease, stroke, and overall dementia.6

  1. More favorable cholesterol, blood sugar and inflammation levels compared to low fat diets.

    7

It is important to realize that what you actually eat depends on your situation and what you are trying to achieve.  The above Mediterranean diet pyramid shows what to eat in general. 

Since most are likely reading this because they want to lose weight, here are some pointers.  Remember, if you are at your goal weight, just eat according to the pyramid above.

Try to stop eating and drinking sweet foods and beverages

This includes those with artificial sweeteners.  Even fruit juices should be avoided.  These items are high in empty calories and can spike insulin levels.  If you refrain from eating sweets, your cravings for them will decrease.  I noticed when on the Whole30 diet that fruits will also start to taste much sweeter and become more enjoyable to consume.

Avoid grains, even whole grains. 

If you want to lose weight, or are having trouble controlling blood sugar, avoiding all grains is important.  Grains contain high levels of carbohydrates.  Grains fit into three broad categories.

     Highly-refined grains

Any foods made with white, wheat or enriched flour.  Some examples include bagels, focaccia bread, pizza, pancakes, pastries, donuts, cookies, chips, pretzels etc.  White rice, tortillas, most granola bars, and ready-to-eat breakfast cereals also fit into this category.  Highly refined grains should ALWAYS be avoided.

     Moderately-processed whole grains

These foods are not as processed as the highly refined carbs but contain rapidly-metabolized starches which spike blood sugar levels much like their highly-refined counterparts. Examples in this category include whole grain versions of pastas, crackers, breads, couscous, brown rice cakes, puffed grain cereals, muesli, and granola.  People at goal weight without diabetes, high triglycerides, or insulin resistance can eat moderately-processed whole grains in limited quantities.

     Intact whole grains

These are grain products that have not been processed.  Examples include whole unpearled barley, wheat and rye berries, oat groats, brown rice and millet.  These are the healthiest grains available but, again, should only be eaten by those who are at goal weight, don’t suffer from diabetes, insulin resistance, or high triglyceridemia.

Eat nine servings of whole fruits and vegetables daily but eat the vegetables first

Most frozen vegetables are almost as good as the fresh variety.  Be sure to eat more vegetables than fruit and eat vegetables with every meal, even breakfast.  Eat the vegetables whole instead of juicing them.  Steer away from starchy vegetables such as potatoes.  Keep serving sizes of yams, carrots and sweet potatoes small.

All fruit is not created equal.

The best fruits to eat are apples, pears, berries and citrus fruits.  Dried fruits should be avoided as they contain concentrated sugars.  The only exception is dried prunes which have a lower glycemic load.  Higher sugar fruits such as bananas, pineapple, grapes and mangoes should be consumed in moderation.

Eat beans and legumes regularly

These are best prepared from the dry versions.  Be careful when using canned beans.  Many contain added sugars and fat.  Beans and legumes add vegetable protein to the diet and have less of an impact on weight gain and blood sugar than whole grains.

Try to eat good fat, protein and fiber with each meal and snack

This has a couple of benefits.  First, blood sugar will rise more slowly and increase satisfaction.  Secondly, combining these leads to a longer digestion time which curbs hunger. 

Don’t skip meals. 

I know intermittent fasting is currently popular and I like to practice it myself.  Eating a good breakfast and small, frequent meals has been shown to help with weight loss.

Eat unsweetened cultured dairy products. 

Some studies have shown that eating dairy reduces diabetes and obesity risk.  It is also better to choose whole or 2% milk products instead of the low-fat or non-fat variety.  Eating aged cheeses is preferable to drinking milk.  Kefir and yogurt can be a great source of microorganisms (probiotics), calcium and protein.  It is always best to consume plain yogurt and sweeten it yourself.  I like to use blueberries, raspberries and blackberries for this purpose.

Always read food labels. 

Don’t fall for marketing slogans such as “healthy” or “low-fat.”  Avoid packaged foods that contain added sugar, refined grains and bad fats.  Remember, it is always best to eat whole foods whenever possible.  If it doesn’t come with a label, it is probably much healthier for your body.

Plan ahead. 

Often we make poor choices when in a hurry or when we haven’t purchased the correct ingredients for healthy meals.  Stay away from fast food and limit trips to restaurants. 

Exercise!  

My readers are probably tired of hearing this but it is probably the most important key to health, happiness and weight loss.  Be active, take the stairs, park further from your destination and walk.  There are many ways to get exercise, you don’t necessarily have to live at the gym to accomplish this.

Get enough sleep. 

This is another thing that comes up over and over in my posts.  Lack of sleep puts you at a higher risk for type 2 diabetes.

Let's Compare the Two Diets

Now that we have explored these two diets, we can compare them.  They are actually not that much different.  They both rely on fruits and vegetables as the primary food source and both prefer you eat the “whole” versions of these.  They both restrict refined sugars, processed foods, and unhealthy carbohydrates.

  The Ornish diet allows 2 servings of “bad carbs” daily whereas the Mediterranean diet advocates consuming them as a treat or on special occasions. 

Fat consumption in the Ornish diet is only 10% of the daily caloric intake whereas the Mediteranean diet allows for approximately 29% fat on a daily basis. 

Every physician I have consulted regarding diets has recommended the Mediterranean diet over all others.  The primary reason for this is the large quantity of clinical data available to support it for heart disease, diabetes treatment and prevention as well as the prevention of neurodegenerative disorders such as Parkinson’s disease and Dementia.  The prevention of dementia is of upmost importance to me as I work on a hospital unit that cares for these patients.  This disease is devastating for both the patient as well as the family and care-givers.  Anything I can do to prevent this disease is worth the effort.

U.S. News and World Report ranked 35 diets and ranked the Mediteranean diet #1 and the Ornish diet #9. 

https://health.usnews.com/best-diet/best-diets-overall

This isn’t surprising considering the evidence available.  The main complaint surrounding the Ornish diet was the finding that the fat limitation made the diet hard to adhere to.  Nevertheless, this diet is very good for your heart and is also supported by quality evidence.  I see no problem following this diet if you are able to stick to it.  You will likely lose weight and feel great.  It follows all of my “rules” which are explained at the beginning of this post. 

I plan to stick with the Mediterranean diet for now.  My main reason for this is the evidence supporting its effect on the progression of neurodegenerative diseases.  I have no problem recommending the Ornish diet as well.  I have researched it and find it to be a great alternative for weight loss.  I recommend you take a look at both and make your decision based on what you can maintain.  A diet only works if you are able to stay on it.

As always, if you have any questions or comments positive or negative, please let me know.  I would also love to hear topics you are interested in reading about.  The goal is to keep you informed about anything that supports a happy, healthy, healing lifestyle! 

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Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

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  1. Salas-Salvado, J. et al. Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet.  Diabetes Care 2011;34:14-9. https://care.diabetesjournals.org/content/34/1/14
  2. Shai, I. et al. Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. NEJM 2008;359:229-41.

  3. Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr. 2013 Mar;97(3):505-16. doi: 10.3945/ajcn.112.042457. Epub 2013 Jan 30. Review. PubMed PMID: 23364002.

  4. Shai, I. et al. Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. NEJM 2008;359:229-41.

  5. McManus K, Antinoro L, Sacks F. A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord. 2001. Oct;25(10):1503-11. PubMed PMID: 11673773.

  6. Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review andmeta-analysis. Am J Clin Nutr. 2010 Nov;92(5):1189-96. doi: 10.3945/ajcn.2010.29673. Epub 2010 Sep 1. Review. PubMed PMID: 20810976.

  7. Nordmann AJ, Suter-Zimmermann K, Bucher HC, Shai I, Tuttle KR, Estruch R, Briel M. Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. Am J Med. 2011 Sep;124(9):841-51.e2. doi:10.1016/j.amjmed.2011.04.024. PubMed PMID: 21854893.