Some scientific studies suggest that very low fat vegetarian diets may be advantageous in treating some patients with heart disease. They have not been accepted as standards for all heart disease patients because of the significant lifestyle change and the difficulty that most people find in following them. Hospital and clinic programs have been established to provide medically supervised treatment, education and support for those who wish to implement a very low fat vegetarian diet and accompanying lifestyle. (Nutritional risks and possible undesirable blood lipid effects can be of concern.) To learn more, refer to several books written about very low fat vegetarian diets listed in the References section.

When taking on a very low fat diet, you’ll probably want to boost your vitamin and supplement regimen under control of your doctor. If you and your doctor determine that you should add an iron supplement to guard agains iron deficiency anemia, so you may have to experiment with a few different formulations to find the right one for you.

A very low fat vegetarian diet emphasizes whole, unprocessed foods rich in complex carbohydrates such as whole grain breads, cereals, cooked grains, fruits and vegetables. The diet is high in heart healthy fiber, vitamins, minerals, antioxidants, and phytochmeicals. No added fats, oils or foods high in fat (avocado, olives, nuts or seeds) are allowed. All animal meat, fish, and poultry is eliminated. Protein in the diet comes from plant foods (beans, soy and tofu) as well as nonfat dairy items such as egg whites and fat free milk or yogurt.

When well planned, this diet can provide adequate calories, protein, vitamins and minerals for good nutrition. Poorly planned, there are risks for nutrient deficiencies. Specifically, low intakes of Vitamin B12, calcium, iron and protein are of concern. While there is no limit placed on the amount of food from any of the permitted food groups, calories will tend to be lower because of the very low fat and low animal food pattern. Weight should be monitored, and dietary corrections made to adjust calories if undesirable weight gain or weight loss occurs. Consultation with a registered dietitian is recommended.

It is important to consult with your physician or heathcare professional before adopting this diet. In some cases, undesirable changes in blood lipid levels can occur, specifically higher triglycerides and lower HDL cholesterol. And remember, the diet has only been shown effective when it used in combination with a total lifestyle approach.

Several different very low fat vegetarian diet programs exist, each with slightly different dietary recommendations. The dietary guidelines below are used by those who follow Dr. Dean Ornish's Heart Disease Reversal Program.

Dietary Component	Recommended Amount	Comments
Fat	10% or less of total calories	Source: Naturally-occurring in grains and legumes. Supplement with very small amount of ground flax seed or flax seed oil. Avoid: Added fats, oils, avocados, olives, seeds, peanut butter and nuts.
Carbohydrate	75 % of total calories	Source: Whole grains, beans, legumes, vegetables, fruit and juices. Avoid: Commercial grain and prepared products with fat, oil, nuts or seeds.
Protein	15% of total calories	Source: Whole grains, beans, legumes, vegetables, fruit and juices. Avoid: Commercial grain and prepared products with fat, oil, nuts or seeds.

Food Group	Minimum Servings	Serving Size
Fat Free Dairy Products	2	8 oz of fat free milk or yogurt, 1/2 cup fat free cottage cheese, l oz of fat free cheese
Protein	2	4 oz of reduced fat tofu, 4 oz of dried beans, 1/2 cup of egg whites
Vegetables	5	1 cup raw vegetables, 1/2 cup cooked vegetables
Fruits	2	Medium whole fruit, 1 cup sliced fruit, 1/2 cup juice
Whole Grains, Cereals & Breads	6	1 oz of whole wheat bread, 1/2 cup of cooked brown rice, 1/2 cup of whole wheat pasta, 1/2 cup cooked cereal, 3/4 cup dry whole grain cereal
No caffeine containing beverages or medications. Sodium is restricted if a specific disease warrant's it (hypertension, congestive heart failure, or kidney failure). Alcohol, if used, is limited to 2 serving a day. Sugar is allowed in moderation. Vitamin, mineral and essential fatty acid supplementation individually recommended.