An Excerpt From Dr. Dean Ornish's The Spectrum

For over 32 years, Dr. Ornish has been an integral member of medicine's clinical research community. He is a pioneer who demonstrated for the first time that lifestyle changes could reverse even severe coronary heart disease. To purchase your copy of The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health, click here.

An Excerpt From Dr. Dean Ornish's The Spectrum

Dr. Dean Ornish is the author of 6 best-selling books, including "Dr. Dean Ornish's Program for Reversing Heart Disease"; "Eat More, Weigh Less"; and now, his most recent book, "The Spectrum." Read chapter 2 of "The Spectrum" now, and learn the basics of a program proven to help you lose weight, live longer and gain health.

"The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health"

By Dean Ornish, MD, Founder and President, Preventive Medicine Research Institute and Clinical Professor of Medicine, University of California, San Francisco


"Listen, here's what I think. I think we can't go around measuring our goodness by what we don't do. By what we deny ourselves. What we resist, and who we exclude. I think we've got to measure goodness by what we embrace, what we create, and who we include."

~From the movie, Chocolat

Like most things in life, the longer you do something and the more experience and practice you have, the more successful and skillful you become at doing it.

During the past three decades of conducting research on the powerful effects of making comprehensive lifestyle changes, my colleagues and I at the Preventive Medicine Research Institute have learned a lot about what really works to motivate people to make and maintain lasting changes in diet and lifestyle. A lot of what we once thought was true turned out to be wrong. We have made many mistakes and learned from them, so you don't have to make the same mistakes--you can make new ones!

Here's a summary of what we have learned so far.


When people make the diet and lifestyle changes I recommend in this book, most of them find that they feel so much better so quickly that it reframes the reason for changing from fear of dying to joy of living. Joy and love are powerful, sustainable motivators, but fear and deprivation are not.

1. You have a full spectrum of nutrition and lifestyle choices.

As I mentioned in chapter 1, it's not all or nothing. To the degree that you move in a healthful direction along this spectrum, you're likely to look better, feel better, lose weight, and gain health. You're likely also to smell better and taste better, because your body excretes wastes via your breath and perspiration.

People have different needs, goals, and preferences. What matters most is your overall way of eating and living. If you indulge yourself one day, you can eat more healthfully the next. If you're a couch potato one day, you can exercise a little more the next. If you don't have time to meditate for twenty minutes, you can do it for one minute--consistency is more important than duration. Then you're less likely to feel restricted. Studies have shown that the people who eat the most healthfully overall are those who allow themselves some indulgences.

If you're trying to reverse heart disease or prevent the recurrence of cancer, you may need the "pound of cure"--that is, bigger changes in diet and lifestyle than someone who just wants to lower his or her cholesterol level a few points or lose a few pounds. If you have a strong family history, or if genetic testing shows you to be at higher risk, this information can be a powerful motivator to make bigger changes in diet and lifestyle than you might otherwise have made. Also, it may be possible to tailor pharmacologic interventions more effectively and efficiently.

If you're like me, basically healthy, you can thrive on the "ounce of prevention." And if you're somewhere in between--if you have some worrisome risk factors for heart disease (high cholesterol, high blood pressure)--you can begin by making moderate changes in diet and lifestyle, progressively more intensive as needed. If that's enough to achieve your goals, great; if not, you may want to consider making bigger changes.

For example, most people in this country have elevated cholesterol levels. They are initially advised to follow a diet based on the National Cholesterol Education Program or American Heart Association guidelines--less red meat, more skinless chicken, and so on. For some people, that's sufficient to lower their cholesterol levels enough, but not for most. Many are then told, "Sorry, it looks like diet didn't work for you" or "You failed diet." Then they are usually prescribed cholesterol-lowering drugs, which they are told they will need to take for the rest of their lives.

In reality, most people can make progressively bigger changes in nutrition and lifestyle to achieve their goals--often without medication. If moderate changes in diet and lifestyle aren't sufficient to lower your cholesterol sufficiently, bigger changes in diet and lifestyle usually are.

How much you want to change is up to you; I just want to make sure you know what your options are so you can choose intelligently and wisely. In this book, I'll show you how.

If you don't have a serious illness such as coronary heart disease, it usually doesn't matter if you indulge yourself on occasion. However, if you do have heart disease, even a single meal that's high in saturated fat may cause acute changes in how stickily your blood clots and how constricted your arteries may become, both of which may increase the risk of chest pain or even a heart attack.

2. Even more than feeling healthy, most people want to feel free and in control.

The food police are counterproductive. "Doctor's orders" don't work, at least not for long. If I tell people, "Eat this and don't eat that" or "Don't smoke," they immediately want to do the opposite. It's just human nature, and it goes back to the very first dietary intervention that failed--"Don't eat the apple"--and that was God talking, so we're not likely to do better than that! And if that person's wife or husband says, "Honey, you know you're not supposed to be eating that," people sometimes start to feel a little violent.

Nobody wants to feel controlled or treated like a child. Even my child, Lucas, doesn't like to be treated like a child. I said to him, "No one can tell you what to eat, not even me. You don't ever have to eat anything you don't want. However, you can't have dessert unless you've first eaten your dinner; part of my job is to make sure that you grow up to be big and strong, and if you fill up with dessert first, there won't be room for the nutritious foods."

One day, Lucas drank a box of sweetened lemonade on an empty stomach. He started bouncing around the room in a sugar rush, then found himself lying lethargically on our kitchen floor. So I used this as a teaching moment.

"This is what too much sugar does. It makes your blood sugar zoom up, and you get a little crazy and overexcited; then your blood sugar goes way down and you crash, and you don't have much energy, like in the movie Over the Hedge."

"How much sugar is too much?"

"Well, it depends. Whenever you buy a package of food, you can read the label and it will tell you how much sugar it contains." And I showed him the label on the carton of lemonade. "This one has thirty grams of sugar per serving, which is a lot. Better to find something that has no more than six to eight grams of sugar per serving, unless it's a treat."

So, at the age of six, he loves to read labels. Whenever we buy food, he checks out the label--"Oh, Daddy, that has too much sugar. Let's get something different."

The point is that he feels empowered and in control, and he also feels regarded and respected, so he feels free to make healthful choices that are sustainable. He understands the reasons for eating this way, which is better than me telling him "Because I said so!"

Kids develop their taste preferences for foods when they're young. The noted pediatrician Dr. William Sears refers to this as "shaping young kids' tastes." They also tend to copy what their parents eat.

So in our home, we serve mostly healthful foods. As a result, Lucas enjoys eating mostly fruits, vegetables, whole grains, legumes, soy products, some cheese, eggs, and a little fish. And, like his dad, he likes to eat a little chocolate most days.

If he wants a treat or some dessert and he's eaten his meal, then he gets it. But since there isn't a charge around it, it's not a "forbidden fruit," so he doesn't feel compelled to pig out. For example:

"Can I have some dessert?"

"Sure, what would you like?"

"Some M&Ms."

"Okay, how many?"


So he has five M&Ms and feels very happy. He doesn't feel the need to eat the whole package because there's nothing forbidden.

Whether you're six or sixty, if you go on a diet and lifestyle program and feel constrained, you're likely to go off it sooner or later. Offering a spectrum of choices is much more effective; then, you feel free. If you see your food and lifestyle choices each day as part of a spectrum, as a way of living, you are more likely to feel empowered and to be successful.

Just to digress--I was with Lucas and my wife, Anne, in our kitchen recently. It was one of those beautiful spring days when I felt lucky to be alive and enjoying the day together with them.

I said, "I just feel so happy, maybe I should pinch myself to make sure I'm not dreaming."

Lucas replied, "Daddy, never pinch yourself when you're happy."

3. Eating bad food does not make you a bad person.

The language of behavioral modification often has a moralistic quality to it that turns off a lot of people (like "cheating" on a diet). It's a small step from thinking of foods as "good" or "bad" to seeing yourself as a "good person" or a "bad person" if you eat them, and this creates downward spirals in a vicious cycle. You flog yourself, saying that gluttony is one of the seven deadly sins. For example, once you feel as if you're a bad person for eating some ice cream, it's all too easy to say, "Well, I blew it, so I might as well finish the entire pint." In reality, although we often project moral qualities onto it, food is just food.

Also, the term "patient compliance" has a fascist, creepy quality to it, sounding like one person manipulating or bending a patient's will to his or her own. In the short run, I may be able to pressure you into changing your diet, but sooner or later (usually sooner), some part of you will rebel. That's why I said earlier that I'm not trying to get you to do anything; in this book, I'm just sharing information that you can use to make informed and intelligent choices.

4. How you eat is as important as what you eat.

When I eat mindlessly, I have more calories and less pleasure. When I eat mindfully, I have more pleasure with fewer calories.

If I eat mindlessly while watching television, reading, or talking with someone else, I can go through an entire meal without tasting the food, without even noticing that I've been eating. The plate is empty, but I didn't enjoy the food--I've had all of the calories and none of the pleasure. Instead, if I eat mindfully, paying attention to what I'm eating, smaller portions of food can be exquisitely satisfying.

Also, when you pay attention to what you're eating, you notice how different foods affect you, for better and for worse. More-healthful foods make you feel good--light, clear, energetic. Less-healthful foods make you feel bad--heavy, dull, sluggish. Then it comes out of your own experience, not because some doctor or book or friend told you.

To paraphrase Gertrude Stein, a calorie is a calorie is a calorie in terms of its effect on your weight but not in terms of how much pleasure it provides. Later in this book, I'll show you how to meditate on your favorite foods. Then you will have all the pleasure and a lot fewer calories.

5. Joy of living is a much better motivator than fear of dying.

Trying to scare people into changing doesn't work very well. Telling someone that he's likely to have a heart attack if he eats too many unhealthful foods or that she may get lung cancer if she doesn't quit smoking doesn't work very well, at least not for long. Efforts to motivate people to change based on fear of getting sick or dying prematurely are generally unsuccessful.

Why? It's too scary. We all know we're going to die one day--the mortality rate is still 100 percent, one per person--but who wants to think about it? Even someone who has had a heart attack usually changes for only a few weeks before he goes back to his old patterns of living and eating.

For the same reasons, talking about "prevention" or "risk factor reduction" is boring to most people. Telling people that they're going to live to be eighty-six instead of eighty-five is not very motivating--even when they're eighty-five--for who wants to live longer if they're not enjoying life?

Sometimes, people say, "I don't care if I die early--I want to enjoy my life." Well, so do I. That's a false choice--is it fun for me, or is it good for me? Why not both? It's fun for you and good for you to look good, feel good, have more energy, think more clearly, need less sleep, taste better, smell better, and perform better athletically--and sexually.

Ironically, some of the behaviors that many people think are fun and sexy--like smoking cigarettes, overeating, abusing alcohol and other substances, and being superbusy and stressed out--are the same ones that leave them feeling lethargic, depressed, and impotent. How fun is that?

The latest studies show how much more dynamic our bodies are than had previously been believed. For example, there are minute-to-minute changes in how much blood flow different parts of your body receive. What you eat and what you do can increase or decrease this blood flow very quickly, with powerful effects--for better and for worse.

A meal high in fat, sugar, and calories causes your arteries to constrict, so blood flow is reduced. So does chronic stress. So does nicotine in cigarettes. So do stimulants such as caffeine, cocaine, and amphetamines. So does a lack of exercise.

How do you feel after you've just finished a holiday feast? Sleepy, as if you want to take a nap. Why? Because your brain is receiving less blood flow and oxygen. So is your skin, so you look older. So is your heart, so you may have less stamina. So are your sexual organs, and this interferes with your sexual potency.

When you eat a healthier diet, quit smoking, exercise, meditate, and have more love in your life, your brain receives more blood and oxygen, so you think more clearly, have more energy, and need less sleep. Your face gets more blood flow, so your skin glows more and wrinkles less. Your heart gets more blood flow, so you have more stamina and can even begin to reverse heart disease. Your sexual organs receive more blood flow, so you may become more potent--the same way that drugs like Viagra work (without troubling side effects such as going blind). For many people, these are choices worth making--not just to live longer but also to live better.

Life is to be fully enjoyed. One of the most effective antismoking campaigns was conducted in California by the Department of Health Services. It dressed up an actor like the Marlboro Man in full cowboy regalia, and put his photograph on billboards and in magazines everywhere with a limp cigarette hanging out of his mouth. The large headline was impotence, not a warning about lung cancer, heart disease, or emphysema.

This approach was brilliant because it went to the heart (no pun intended) of how smoking is marketed: smoking is sexy. But studies show that half of men who smoke are impotent--how sexy is that?

Nicotine makes your arteries constrict--which reduces blood flow to your sexual organs, causing impotence. Nicotine also diminishes blood flow to your brain (which may cause a stroke) and reduces blood flow to your heart (which may cause a heart attack). In fact, studies have shown that men who are impotent have a higher risk of having a heart attack, because if your penis is not receiving enough blood flow, chances are that your heart isn't, either.

Another effective antismoking campaign was, "Smoking Is Ugly." It featured supermodel Christy Turlington, whose father died of lung cancer. She talked about how smoking accelerates aging because it decreases blood flow to your face and makes it wrinkle prematurely (which is why smokers look about ten years older than they really are and often have that gray pallor). Another campaign asked, "Do you want to taste like an ashtray when your lover kisses you?" That brings it into the here and now: joy of living, not fear of dying.

So, to the degree that you move in a healthy direction on the Spectrum, you're likely to look better, feel better, lose weight, and gain health, as well as smell better, taste better, and love better.

6. It's important to address the deeper issues that underlie our behaviors.

Information is important but not usually sufficient to motivate lasting changes in diet and lifestyle. If it were, no one would smoke. Everyone who smokes knows it's not good for them--the surgeon general's warning is on every package of cigarettes, at least in this country. Yet lots of smart people still smoke--30 percent of Americans still smoke and, in some parts of Asia, more than 80 percent of people still do so. We need to work at a deeper level.

In our studies, I spent a lot of time with the participants over a period of several years. We got to know each other very well, and a powerful trust emerged.

I asked them, "Teach me something. Why do you smoke? Overeat? Drink too much? Work too hard? Abuse substances? Watch too much television? Spend too much time on the Internet? These behaviors seem so maladaptive to me."

They replied, "Dean, you just don't get it. These behaviors aren't maladaptive, they're very adaptive--because they help us get through the day."

Loneliness, anxiety, and depression are epidemic in our culture. If we address these deeper issues, it becomes easier for people to make lasting changes in their behaviors.

Hey, I don't want to be the first to break the news to you, but you're going to die. One day. So will I. So will everyone.

Of course, we already know this, but do we really know this? Once we really internalize this, once we accept fully that we're going to die one day, 100 percent certain, we can start to ask, "How can I live more fully?" As Frank Sinatra once said, "Live every day like it's your last, and one day you'll be right."

For some people, it's easy to get into a place of nihilism: It's all in my genes. Who cares? So what? Big deal. Nothing matters. Why bother? I'll eat and do whatever I want; what difference does it make?

I understand nihilism and depression, and I wrote about my experiences with these in two of my earlier books, Dr. Dean Ornish's Program for Reversing Heart Disease and Love and Survival. They were my catalyst and doorway for transforming my life.

On the other hand, if I focus on what brings real joy and meaning into my life, it makes it much easier to make more of my choices each day on the healthier end of the Spectrum.

Medicine today focuses primarily on drugs and surgery, genes and germs, microbes and molecules. Yet love and intimacy are at the root of what makes us sick and what makes us well. If a new medication had the same impact, failure to prescribe it would be malpractice.

Connections with other people affect not only the quality of our lives but also the quantity of our lives--that is, our survival. Many well-conducted studies throughout the world have shown that people who feel lonely, depressed, and isolated are many times more likely to die prematurely from virtually all causes than those who have a strong sense of love and intimacy, connection, and community. I'm not aware of any other factor in medicine--not diet, not smoking, not exercise, not genetics, not drugs, not surgery--that has a greater impact on our quality of life, incidence of illness, and premature death.

In part, this is because people who are lonely are more likely to engage in self-destructive behaviors. Telling someone who's lonely and depressed that he's going to live longer if he changes his diet and lifestyle is not very motivating--I mean, who wants to live longer when he's unhappy?

A patient once said to me, "I watch TV and see all the people whose lives seem so much happier than mine, and I say to myself, 'I don't think this is much fun.' I don't want to kill myself, but I'd rather put more energy into numbing the pain than trying to find joy. Because I don't think joy's out there. So I'm just going to keep distracting myself as quickly and as often as I can and fill in the gaps with ways to deaden myself and my pain."

Getting through the day becomes more important than living a long life when you have nothing to live for. As one patient told me, "You know, I've got twenty friends in this pack of cigarettes. They're always there for me, and no one else is. You want to take away my twenty friends? What are you going to give me instead?"

Other patients take refuge in food. As one said to me, "When I feel lonely, I eat a lot of fat--it coats my nerves and numbs the pain. I can fill the void with food." There's a reason why fatty foods are often referred to as "comfort foods." Or people may numb their pain with too much alcohol or other drugs, too much television, too much time on the Internet, or working too hard. We have many ways of numbing, bypassing, and distracting ourselves from pain.

Our experience was confirmed by a recent study published in the Journal of Marketing about the connection between people's moods and the type and quantity of food they eat. Researchers found that people who are feeling unhappy eat larger amounts of foods they consider tasty but unhealthy than do happy people.

In this study, test subjects were asked to watch the movie Love Story, the maudlin 1970 romance in which the heroine dies at the end (I hope I didn't spoil it for you). They ate, on average, almost 125 grams of buttered, salty popcorn (the amount found in a medium-size bag at the movies)--about 28 percent more than did those watching Sweet Home Alabama, the 2002 romantic comedy about a fashion designer going home to the rural South, even though the movies are about the same length.

In another study described in the same journal, college students reading about the deaths of seven children in a fire ate more than four times as many M&Ms as raisins from nearby bowls of snacks. In contrast, students reading about four old friends having an evening together after a chance reunion ate more raisins than M&Ms.

Change isn't easy. But if you're in enough pain, the idea of making changes may start to seem more attractive. I often hear, "Boy, I'm in so much pain, I'm ready to try just about anything."

Awareness is the first step in healing. Part of the benefit of pain is to get our attention, to help us make the connection between when we suffer and why so we can make choices that are a lot more fun and healthful.

The experience of emotional pain and unhappiness can be a powerful catalyst for transforming not only behaviors such as diet and exercise but also for dealing with the deeper issues that really motivate us. We are most successful when we also address the emotional and spiritual dimensions that most influence what we choose to do or not do.

It's very hard to motivate most people to make even simple changes in their behavior such as altering their diet or exercising when they feel depressed, lonely, or fearful, which are epidemic in our culture these days. It is only when the deeper issues of pain, self-esteem, apathy, and purposelessness are addressed that people become willing to make lifestyle choices that are life-enhancing rather than ones that are self-destructive.

7. Make small, gradual changes or big, rapid changes to create sustainable transformations in your diet and lifestyle.

In my experience, there are two basic strategies that work to make and maintain changes in diet and lifestyle.

The first approach is to make small, gradual changes. The barriers to change are low, so they don't seem too intimidating or overwhelming. This approach is seen in organizations like America on the Move, whose approach is "Keep it simple." They ask people to get a pedometer, walk 2,000 extra steps per day, and eat 100 calories (about one cookie) fewer per day. Over time, small changes add up and are often sustainable.

The second approach is to make comprehensive lifestyle changes all at once. This seems a little strange to many people, especially physicians, who often say, "I can't even get my patients to take their pills. How do you expect them to change their diet, start exercising and meditating, and spend more time with their friends and family? No way!"

In my experience, paradoxically, it's sometimes easier to make big changes than small ones. Why? When you make big changes, you experience big improvements--and quickly. Most people find that they feel so much better so quickly that it reframes the experience from fear of dying (which is too scary) or risk-factor modification (which is too boring) to joy of living. And it comes out of their own experience, not because some doctor or book or authority told them to do so.

Another reason that making big changes can be easier than making small ones is that when you make big transformations in your diet, your taste preferences often change. Have you ever switched from drinking whole milk to low-fat or skim milk? At first, the milk often tastes like water, not very satisfying. After awhile, it begins to taste fine; then, if you go out to dinner and have whole milk, it tastes like cream--too fatty, too greasy, too rich. Of course, the cow didn't change, but your palate adjusted. However, if you were always drinking both whole milk and some skim milk, then your palate would never have a chance to adapt.

This book is all about freedom of choice. Depending where you want and need to be on your spectrum, you can make small or big changes. The more you move to the healthy end of the Spectrum, and the faster, the greater the benefits and the more quickly they occur. The choice is yours, and yours alone.

8. There's no point in giving up something you enjoy unless you get something back that's even better--and quickly.

We're always making choices. In my experience, most people are not afraid to make even big changes in their lives if they understand the benefits and how quickly they may occur.

When I lecture, I'll sometimes ask the audience, "How many of you have at least one child?" Many people raise their hands.

"Was that a big change in your lifestyle?"

"Oh, yes."

"Was it harder than you thought?"

"Definitely. All those sleepless nights, putting money away for college instead of going to Hawaii..."

"How many of you have more than one kid?"

Again, many people raise their hands.

"Did you forget? Or were you just careless? Or because it was worth it?"

"It was so worth it."

And that's the point--many people aren't afraid to make big changes in their lifestyle--even monumental ones like having and raising a child. It's not as though you can return your kid to the store if it's too hard or it doesn't turn out the way you planned. But lots of people every day do it--and often more than once.

The most important factor in motivating you to make and maintain big changes in your diet and lifestyle is understanding how powerful the benefits are and how quickly they may occur.

The foods I now eat are very different from what I ate growing up in Texas, eating lots of chili con carne, cheeseburgers, and chalupas (deep-fried burritos). So it was a big change in my diet and lifestyle when I began eating and living more healthfully at age nineteen.

I've been eating and living that way for most of my life since then. It wasn't easy to make those diet changes. But I felt motivated when I experienced immediate benefits. My childhood allergies and asthma disappeared. My cholesterol has remained below 150 mg/dl. And I take no medications. I'm six feet tall and weigh 175 pounds, my blood pressure is 110/70, and I have no chronic diseases. I had a heart scan to determine if I had any calcification in my coronary arteries, and my calcium score was zero, meaning I have no significant calcified coronary artery disease.

9. If it's fun, it's sustainable.

If we view changing our diet and lifestyle as deprivation and sacrifice, well, forget about it. You might be able to force yourself to make some changes for a limited period of time. However, in my experience, trying to motivate yourself to maintain these changes from the intention of deprivation and sacrifice is not sustainable.

Instead, if we understand that what we gain is so much more than what we give up, it doesn't feel like a sacrifice. We can see lifestyle choices as opportunities to transform our lives in ways that make us feel more joyful.

For example, I'm sitting at my desk writing this book instead of spending the day in the park because it brings meaning and joy into my life knowing that this book may be helpful to many people. This attitude transforms work into joy, deprivation into abundance.

As I wrote earlier in this chapter, having a child can be viewed as a sacrifice or as a joy. I choose to eat foods mostly from the healthy end of the Spectrum because they make me feel so much better, not because someone told me to do so.

How we approach food is how we approach life. Why have any limitations if you don't have to? Why not eat and do everything you want if you can afford it and no one is watching?

Choosing not to do something that we otherwise could do helps define who we are, reminds us that we have free will, freedom of choice. Only when we can say "no" are we free to say "yes."

For example, almost all religions have dietary restrictions, but they differ from one another. Whatever the intrinsic benefit in eating or avoiding certain foods, just the act of choosing not to eat or not to do something that we otherwise might choose helps to make our lives more sacred, more special, more disciplined, more meaningful. More fun.

In this context, what we choose to eat--and not eat--can nourish our soul as well as our body. Each meal reminds us that our lives can be much more than they are. We may choose to follow the restrictions of our own religion or tradition not simply to please God but rather to experience God. We can begin to heal our separation from God and from one another at a time when our world is becoming increasingly fragmented and cynical.

It doesn't have to be spiritual. Any time we can make what we do more special and meaningful, it becomes more fun. Otherwise, life can get pretty boring and meaningless.

When we consciously choose to limit what we're doing, it liberates us. Discipline can be liberating if it's freely chosen rather than imposed, because it enables us to do things and to express ourselves in ways that we otherwise might not be able to do. For example, musicians practicing scales may feel that it's a little tedious at times, but it enables them to express themselves more freely by being able to play beautiful music.

Many people think that we have to choose between living a moral, spiritual life that's dry and boring or an immoral, secular life that's exciting and interesting. Fortunately, that isn't the choice.

Living a moral life can be fun, although it's not usually taught that way. A lot of repression occurs in the name of morality, and it's been politicized by the "Moral Majority."

When we consciously choose not to do things that we otherwise could do, it makes them sacred. When I was a teenager, I thought "sacred" meant "boring"--something dry and old, gathering mold and dust. Definitely not fun.

Now I understand that "sacred" is just another way of describing what is the most special and therefore the most fun, the most meaningful, the most intimate, the most erotic, the most exciting, the most powerful, the most ecstatic, the most joyful, the most playful, the most friendly.

That's what the most enlightened spiritual teachers have taught through the millennia: how to live a joyful life, right here and now.

Ultimately, spiritual leaders teach about ways of living in the world that make it a lot more fun and happy. Not just for some external rewards--going to heaven, getting a gold star or an award, or good karma--rather, these are approaches to living that bring happiness and help us avoid suffering. "My religion is happiness," said the Dalai Lama.

We can go through the world any way we want to; there is free will. Some approaches lead to health and joy; others lead to illness and suffering. We have a spectrum of choices in all aspects of our lives.

People are always making choices, sacrifices. The word "sacrifice" has an austere, depriving connotation. But people don't usually think about that when they put their money aside for their kids' college or wedding, and so they don't buy a new car when they could. These choices--what not to do as well as what to do--bring meaning into our lives.

In this context, choosing to eat and live differently can be a joyful spiritual practice rather than one leaving you feeling deprived or depressed. You can enjoy life more fully by making these conscious choices. Instead of resolving to make changes in diet and lifestyle out of a sense of austerity, deprivation, and asceticism, I find it much more effective--and fun--to be motivated by feelings of love, joy, and ecstasy.

Growing up in the sixties, the common belief then was that morality is booooooooooorinnnnnggg. The "Playboy Philosophy" and others preached that it's liberating to have many sexual partners and boring to be monogamous, but, in my experience, the opposite has been true. From my perspective, it's not that having sex with many people is wrong, just as eating unhealthy foods all the time isn't wrong; it's just not as much fun as making other choices.

If what you gain is more than what you give up, it's sustainable. Abundance is sustainable; deprivation is not. Joy is sustainable; repression is not. "It's good for me" is not sustainable; "it's fun for me" is.

A fully committed relationship allows both people to feel complete trust in each other. Trust allows us to feel safe. When we feel safe, we can open our heart to the other person and be completely naked and vulnerable to them--physically, emotionally, and spiritually. When our hearts are fully open and vulnerable, we can experience profound levels of intimacy that are healing, joyful, powerful, creative, and intensely ecstatic. We can surrender to each other out of strength and wisdom, not out of fear, weakness, and submission.

When Anne and I are having a romantic date, we have complete trust in each other, so we can be open to all possibilities. We never know what's going to happen, so all degrees of freedom are preserved. We're not trying to get to a preconceived place or to replicate a prior experience, so we can more fully enjoy the infinite possibilities contained in each present moment.

Instead of having similar superficial experiences with different people, we continue to have romantic experiences only with each other that are unlike anything either of us has ever had or even imagined. And if we had imagined it, that preconception might have limited our ability to experience something totally new and surprising.

Our experiences are ever-changing, yet always the same. Yet again, like never before. Now and forever.

Preconceptions limit perceptions. Seeing is believing, but we often see only what we believe. Studies show that we are continually filtering our perceptions of how we believe the world is. While this helps provide a sense of order, it also limits our experiences. Preconceptions can lead to boredom because they limit our experiences so significantly.

Great artists and scientists are able to see the world without filtering it through the veil of their preconceptions and paradigms. They literally see and experience the world in a new way, and then they can share their vision with others, helping transform the world we experience.

In summary, when we understand that what we gain is so much more than what we give up, our choices become joyful and meaningful. If it's fun, it's sustainable.

10. The most powerful motivating force in the universe is love.

One evening recently, I was putting my son, Lucas, to bed. I was talking with him about the importance of trust and honesty, and how important these are in any meaningful relationship. He thought about it for a few minutes, and then he said, "Daddy, even if you lied to me a thousand times, I would still believe you."

That degree of unconditional love and trust becomes self-fulfilling. We create what we most love, as well as what we most fear. Knowing how much Lucas trusts me motivates me to be completely worthy of that trust. And when I act in impeccable ways, it allows me to respect and love myself more, which, in turn, gives me that much more love to give others. We can't give what we don't have.

I'd throw myself in front of a train if I thought it would help my son. Almost any parent would. Love is even more powerful than survival.

Whatever their political beliefs, all parents want their kids to be happy and healthy. These are profoundly human issues, ones that defy categorization. At a time when our country is more divided than ever--red states, blue states, Democrats, Republicans, liberals, conservatives--it's heartening (in every sense of the word) when people come together around a common goal.

So it was a double dose of good news when Democrat Bill Clinton and Republican Mike Huckabee, the governor of Arkansas, along with the American Heart Association, announced that they had brokered an agreement with the country's three top soft drink companies (PepsiCo, Coca-Cola, and Cadbury Schweppes and their bottlers) to provide healthier beverages in school vending machines and cafeterias. In addition to the nutritional benefits, they showed that our love for our children can help us overcome our barriers. Republicans, Democrats, companies, and NGOs can choose to transcend their significant differences for the love of our kids. In this case, they did.

Under these new guidelines, elementary schools will sell only bottled water, 100 percent juice, and low-fat and nonfat milk in servings no larger than 8 ounces. Middle schools will do the same but with portion sizes increased to 10 ounces. High schools will also allow diet and unsweetened teas, diet sodas, fitness water, low-calorie sports drinks, flavored water, light juices, and sports drinks in servings up to 12 ounces. At least half of available beverages in high schools will be water and no-calorie and low-calorie selections.

A few months later, PepsiCo and four other companies joined with the American Heart Association and Clinton Foundation to establish voluntary guidelines for healthier foods, including snacks, desserts, and treats sold in schools.

"Ensuring that children have healthier food choices at school is another critical step in the fight against childhood obesity," said President Clinton. "I'm proud of these five companies for making an important statement about this health challenge and an even more important commitment to doing something about it. What we are setting in motion with these guidelines will dramatically change the kind of food that children have access to at school. It will take time, but through coalitions like this of industry and the nonprofit sector, we are going to make a real difference in the lives of millions of children by helping them eat healthier and live healthier."

Now, I think this is one of the best things that's happened in public health in a while. As chair of PepsiCo's health and wellness advisory board (which advises the company on making healthful foods and beverages), we collaborated with company executives in meetings with the American Heart Association and the Clinton Foundation.

Beyond the potential health benefits, this collaboration among Democrats and Republicans, nonprofit and for-profit organizations, and private and public corporations is a model for what others can accomplish when they have a shared vision and determination to make a meaningful difference in the world for the sake of our children. Many people will do things for their children that they won't do for themselves, and these shared goals allow us to transcend our differences.

The epidemics of obesity and diabetes affect children throughout the country, in red states and blue states alike. Awareness is the first step in healing, both individually and nationally. When enough people began to realize that these epidemics may cause our children's generation to be the first to have a shorter life span than their parents, a tipping point was reached.

Concern for our children helps overcome significant differences to achieve a desirable outcome. Appealing to fear and greed can, at least temporarily, be seductive, but I truly believe that love is more powerful than fear, at least in the long run, and enables us to make sustainable changes in our lives.

This primal need to help our children can be harnessed to achieve other goals that affect our kids, such as motivating people to change their diet and lifestyle. If I say to parents, "Consider quitting smoking because it will reduce your risk of getting a stroke, a heart attack, or lung cancer," they often reply, "It's not going to happen to me."

But if I say, "You might consider quitting smoking in order to set a good example for your children so they won't start" or ". . . so they won't have their growth stunted" or " they won't get asthma from breathing your smoke," they're much more likely to give up cigarettes. One of the most effective antismoking strategies has been for schools to educate children about the harmful health consequences of smoking, causing many of them to go home and say, "Mommy, Daddy, please don't smoke. I love you so much, and I don't want you to die."

We can view our choices in diet and lifestyle as austere sacrifice and deprivation--I can't eat this food or enjoy this indulgence--but it is much more effective and sustainable to reframe our choices as acts of love.

Love made manifest.

For example, I'm not one of those people who loves to exercise. It takes effort for me to motivate myself to work out on a regular basis. What motivates me to do so is love:

  • I want to live a long, healthy, and happy life with Anne, and look attractive to her.
  • I want to be around to watch my son (and future children) grow up.
  • I want to see them graduate and fall in love and dance at their weddings.
  • I want to remain healthy enough to play vigorously with them.

Sacrifice is not sustainable. Love is.

As I mentioned earlier, the word "sacrifice" conjures up austerity, deprivation, abnegation, self-immolation, and other awful terms. Sustainable choices come from joy and openness, ones that nourish and delight our hearts, rather than from a place of fear and restriction. Maybe it's time we reframe the concept for what it really is: an act of love, the most powerful force in the universe.

Excerpted from "The Spectrum" by Dean Ornish, M.D. Copyright (c) 2007 by Dean Ornish, M.D.. Excerpted by permission of Ballantine Group, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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