She is an employee of Highmark Blue Cross Blue Shield, which is both an insurance payer for Ornish as well as a program administrator. She says that the switch to a lowfat, vegetarian diet with virtually no oil is the most challenging part of the initial work. Ornish recommends no meat, fish, or fowl with one exception, fish oil. (Vegetarians entering this program may want to discuss alternatives with the program’s staff.) The program provides aggressive support for dietary change.