Part 4: Reversal is Possible

George Cho, ND

During my time as a young clinic intern, I was assigned to a patient who had type 2 diabetes. I had expressed to this individual that given her current health status, there was scientific evidence to suggest that the disease could potentially be reversed. She could not believe me. She was told before that type 2 diabetes could not be reversed and had resolved to merely manage the disease for the rest of her life. It was only after displaying some of the scientific evidence and also giving her the book: Dr Neal Barnard’s Program for Reversing Diabetes (1), that she actually came to the hope that indeed type 2 diabetes was potentially reversible. 

Interestingly however, it was not only the patient that pushed back on the idea that a chronic disease like type 2 diabetes could be reversed, it was my fellow interns as well. I remember one particular conference session during which I had expressed the idea that type 2 diabetes could be reversed, and one of the interns challenged me on that saying something to the effect of “It can be managed but not reversed.” 


This kind of thinking is not surprising in today’s medicine. Many in the medical community do not believe that chronic diseases can be reversed. Therefore, the preferred term these days is “management” and the main method of managing diseases like heart disease, hypertension, type 2 diabetes, arthritis, etc is through drugs and surgical procedures. As discussed in prior articles in this essay series, because drugs and much of conventional medical care does not address the causes of diseases, it is only left with slowing down a disease from progressing. Thus, “healing” and “reversal” are  often not part of the language used by doctors nor the hope transmitted to patients. 


But change has been coming and indeed is here. Over the past few decades and particularly in the last several years, the scientific evidence has been coming out like a flood that the disease course of many of today’s leading killers can actually be reversed. This is because scientists have explored the potential role of healthy lifestyle changes in the treatment of these chronic diseases. Some examples are listed below:

  • In patients with up to 40% narrowing of the coronary blood vessels, Dr Dean Ornish and colleagues were able to start re-opening these arteries in one-year by putting patients on a  low-fat vegetarian diet, exercise, stress management and smoking cessation program. These patients also experienced a 91% reduction in anginas, 42% reduction in duration of angina, and 28% reduction in the severity of anginas. On the other-hand, most of those on standard medical care continued to have more narrowing in their arteries, 165% increase in anginas, and 39% increase in the severity of anginas (2). 

  • In a follow-up to his original study, Dr Ornish tested his lifestyle program for 5 yrs on patients with coronary vessel narrowing. Again, he found similar results. The lifestyle group saw a re-opening of their arteries whereas those in the control group continued to see their arteries get narrower. The number of cardiac events was two times higher in the control group. The lifestyle group had a 91% reduction in anginas after one year and a  72% reduction in the frequency of anginas after 5 years. But in the control group, they experienced a 186% increase in the frequency of angina after 1 year. After five years, the frequency of anginas went down by 36%  but this was because those experiencing an increase in angina underwent surgery (3). 


  • Dr Neal Barnard and colleagues were able to bring: the average hemoglobin A1c of patients from 8.07% to 6.84%, and drop the fasting plasma glucose from 177.4 mg/dL to 128.2 mg/dL, in just 22 weeks with an intervention of a low-fat vegan diet (4).


  • A group of Korean researchers were able to reduce Hemoglobin A1c in patients with type 2 diabetes from 7.5% to 6.6% by intervening with a vegan diet for only 12-weeks. [Below 6.5% is referred to as pre-diabetes, not type 2 diabetes] (5).


  • Elderly individuals were able to add 1 to 2 years worth of volume to the hippocampus (important brain area for memory) with one year of moderate to high intensity walking, effectively “reversing age-related loss in volume…” This increase in hippocampal volume also translated to improvements in memory tasks (6).


  • In patients with mild to moderate depression, meeting the physical activity guidelines resulted in 46% of patients having a therapeutic response to treatment (50% reduction in depression scores) and 42% of the participants had a remission in symptoms. This rate of remission is comparable to other depression treatments such as medications or cognitive behavioral therapy (7).


These and many other studies are demonstrating the power of lifestyle changes to help people reverse the course of their diseases. 


When we rely only on drugs and surgeries to deal with lifestyle-related medical conditions, we will often be left with merely managing diseases. However, when we bring lifestyle changes such as moderate-to-vigorous physical activity, a whole-foods plant-based diet, stress management, adequate sleep, etc into the picture, the potential of reversing these medical conditions improves greatly. Why? Because you are not just dealing with symptoms, you are actually getting to the root of the problem.


So, you may not hear the words “reversal” coming out from the mouth of many doctors, and that may not be their fault because for a long time “management” was the term dominating the medical field, however, the good news is that a revolution is taking place within the scientific and medical communities. Lifestyle medicine is emerging as the next cutting-edge field of medicine and with it, the hope of potentially reversing chronic diseases is emerging as well. Through lifestyle medicine, “reversal” is back in the conversation.


To learn more about lifestyle medicine, visit the official website of the American College of Lifestyle Medicine (



  1. Dr Neal Barnard’s Program for Reversing Diabetes. 2008 

  2. Ornish D et al. Can lifestyle changes reverse coronary heart disease? The lifestyle heart trial. Lancet 1990; 336:129 – 33

  3. Ornish D et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998; 280: 2001 – 2007 

  4. Barnard N et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care, Vol 29, No 8 , 2006 

  5. Lee, YM et al. Effect of a brown rice based vegan diet and conventional diabetic diet on glycemic control of patients with type 2 diabetes: A 12-week randomized clinical trial  PLoS ONE 11 (6)

  6. Erickson K et al. Exercise training increases size of hippocampus and improves memory. PNAS. Feb 2011. Vol 108. No. 7. 3017 – 3022

  7. Dunn A et al. Exercise treatment for depression. Efficacy and dose response. Am j Prev Med 2005;28(1). 1 – 8 

George Cho