Dean of the Low-Fat Diets

How much fat is too much? The American Heart Association says 30% of a day's calories. That may sound strict, but it doesn't go nearly far enough to satisfy Dr. Dean Ornish, a University of California cardiologist and dean of the eat-right-for-a-healthy-heart school of medicine. Ornish has long maintained that changes in diet and lifestyle can treat heart disease as effectively as drugs and surgery--perhaps even more so. But modest reductions in fat intake, he says, usually do your heart no good at all.

Ornish puts his heart patients on a strict vegetarian diet allowing for--at most--a third of the fat of the A.H.A. diet. (Patients also take part in an exercise and stretching regimen, plus meditation and group therapy to reduce stress.) Result: according to a five-year study published in 1998, patients on the Ornish regimen had lower cholesterol levels and fewer angina episodes, and in many cases they were able to avoid bypass surgery and angioplasty.

Even Ornish acknowledges that his diet isn't for everyone. A third of the patients in his study dropped out, and critics wonder whether it's really necessary to cut that much fat--and fun--out of life. But Ornish scoffs at the skeptics. "Rather than literally or figuratively bypassing the problem," he says, "my treatment addresses the cause."