By Lauran Neergaard, Kentucky Connect and the Lexington Herald-Leader
WASHINGTON -- Medicare will pay for up to 1,800 elderly Americans with severe heart disease to try Dr. Dean Ornish's famous but radical ultra low-fat diet, to see if it could be an alternative to heart surgery.
Under the pilot project, announced yesterday, Medicare patients who have been told they will soon need bypass surgery or an angioplasty to clear clogged heart arteries can instead try the intensive diet-and-lifestyle program.
Medicare will study the patients to see if the Ornish program is medically effective and if it can save some of the more than $6 billion a year now spent on heart surgery by the nation's health care program for the elderly.
Heart disease is the nation's No. 1 killer.
The diet doctor's regimen is very strict: Patients become vegetarians and limit dietary fat to no more than 10 percent of total calories, eating mostly fruits, vegetables and whole grains. They exercise regularly, learn stress-management techniques such as yoga and attend support meetings.
Ornish contends the program can help heal heart disease without surgery. In a study published in the Journal of the American Medical Association last winter, Ornish reported that 28 patients who followed his program for five years suffered half the rate of heart problems as patients who ate a moderately low-fat diet and used cholesterol-lowering drugs.
``Not everyone is interested in changing lifestyle, and some people with extremely severe disease need surgery,'' acknowledged Ornish, who runs the Preventive Medicine Research Institute in Sausalito, Calif. But Medicare access ``empowers the individual (and) may immediately and substantially reduce health care costs.''
Medicare was urged to try the program by, among others, Ornish patient Rep. Charles Rangel, D-N.Y.
But many heart experts are skeptical, because Ornish's studies involved small numbers of patients and some other scientists have been unable to duplicate his findings, said American Heart Association nutrition specialist Terry Bazzarre.
Some research even suggests that cutting too much fat out of the diet may be detrimental.
So the Medicare project could provide much-needed information, particularly if 1,800 people stick with the Ornish diet for four years, Bazzarre said.
