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If You Are Seriously Obese...

If you already have heart disease, or hypertension, diabetes, obesity, or a fat-related cancer, or a history of thrombotic stroke or its precursor, mini-strokes called transient ischemic attacks (TIAs), an evolutionary approach may not trim enough fat from your diet to prevent health disaster. You may need the kind of revolutionary diet changes Dean Ornish, M.D., has used to reverse heart disease. The Ornish diet is similar to the one Nathan Pritikin developed in the mid-1970s to combat heart disease. (Pritikin died in 1985, but several Pritikin Longevity Centers continue to promote his program, and most supermarket diet sections stock ultra-low-fat Pritikin items.) Both the Ornish and Pritikin diets derive only 10 percent of calories from fat. Dr. Ornish divides foods into three groups:

Anytime. You may eat these foods whenever you feel hungry and until you feel full: fruits, vegetables (except high-fat avocados and olives), beans, and grains.

Sometimes: You may eat these foods in moderation: nonfat dairy products (skim milk, egg whites, nonfat yogurt, sour cream, and cheeses); nonfat or very low-fat commercially prepared foods (whole grain cereals, nonfat salad dressings, egg substitutes, Pritikin soups, Entenmann's fat-free baked goods, Health Valley nonfat soups and chili, and Life Choice frozen dinners, which use recipes from Dr. Ornish's program).

Beware. These foods should be avoided as much as possible: Meats (including chicken and fish), oils (all kinds, including margarine, and most salad dressings), nuts and seeds, dairy products that are not nonfat, alcohol, sugar (which often comes laced with fat), and any commercially prepared item with more than 2 grams of fat per serving.

The Ornish diet may sound rigorous (even impossible), but just as some smokers quit cold turkey rather than slowly cutting back on cigarettes, many people prefer it to less stringent changes.


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