Doctor's Note

I’ve previously discussed how drug-centric approaches to evidence-based medicine may neglect some of the most convincing data: Evidence-Based Medicine or Evidence-Biased?

A sampling of some of my recent Alzheimer’s videos:

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  • durianmangosteen

    Great video Doctor!!! When is that one on fruit coming??

    • If you were subscribed you would have seen it in my newsletter yesterday!

      • Arjan den Hollander.

        Hi Dr. Greger, this question is really going to sound strange.
        But have you ever seen studies done on human feelings of motivation and nutrition?
        I’ve been seeing a kind of inability and in my mother to accept and confront the link between food and exercise and deterioration of the body and mind. It is not depression persee, but more the inflexibility that comes with older age, but with that rigidity comes inability to effect changes it seems. I do not think a doctor would be able to pick up the change as problematic yet, but every few months or so I see her and I am beginning to notice something like old age AD(-H)D.

        Have you come across studies were maybe smells or foods help reconditioning habits and thought patterns?
        Making thinking of healthy foods/habit akin to smelling roses might be enough to slowly settle in a new pattern and change course before deterioration to the point of disability.

        I’m aware this is a very strange question, one for which there might not even be an answer, if so thanks anyway.

        • Your question is a good one but somewhat difficult to answer. As we age our cognitive abilities change. Current evidence suggests that Alzheimer’s disease is related to factors such as saturated fat, simple carbohydrates, cholesterol, some metals (i.e. iron, aluminum, zinc, copper) and sleep. Of course having very small strokes over time can lead to another form of cognitive decline (i.e. multi-stroke dementia). This poses challenges as both of these conditions which account for most cases of dementia are difficult to diagnose. Of course we have a pretty good handle on how to avoid strokes of which there are three types (i.e. ischemic, hemorrhagic, embolic)

        • HereHere

          There is some research into aromatherapy you may want to look in to. In school, we were told that lavender helps with memory, and I believe most people find the smell of cinnamon to be uplifting and possibly nostalgic. I would look into evidence-based sources on aromatherapy, rather than ones that are just a regurgitation or based on folk wisdom. I think back to Pavlov’s dog, where the sound of a bell would stimulate salivation. Same thing can be done with nearly any stimulus. Good luck with your mom, I can see you love her a great deal.

          • Arjan den Hollander.

            Thanks for replying, I was kind of avoiding mentioning Pavlov though, so thank you for that.
            In all seriousness though, she can enjoy the joke in this as much as we can :)

            While familiar with Pavlov, it was actually a smell that triggered a pictorial of a past scene in my mind and subsequently an emotion set that made me think damn this might actually be cascading askew through otherwise quite linear unfolding thoughts, memories and details. # Kind of like a hash tag.
            If memories from different senses travel the same pattern but cascade at a different angle that might explain some of the weird memory effects we sometimes experience.

        • HereHere

          There is some research into aromatherapy you may want to look in to. In school, we were told that lavender helps with memory, and I believe most people find the smell of cinnamon to be uplifting and possibly nostalgic. I would look into evidence-based sources on aromatherapy, rather than ones that are just a regurgitation or based on folk wisdom. I think back to Pavlov’s dog, where the sound of a bell would stimulate salivation. Same thing can be done with nearly any stimulus. Good luck with your mom, I can see you love her a great deal.

  • Bravo.

  • fred

    Not to mention that for someone my age…about 1/2 of the people of the same age will be dead in 15 years. Though I’d really like to wait for those double-blind studies…well maybe not? I try to take the best available info from a variety of sources…and APPLY IT. Problem is that there is a wide variety of recommendations…but then again most distill down to diet (mostly veggies)…exercise for sure…avoiding pollutants where possible…some supplements or not….and avoiding getting hit by a bus. Also try to stay interested in things…even when some around you are the walking dead…or work for the walking dead. May they rest in peace.

  • Veganrunner

    The Modest Proposal For Longitudinal…..editorial is in full text in the link above. It is great and I have sent it out to a couple of friends who always remind me about the need for a RCT in regards to consumption of fats. Great find Dr. Greger.

  • elsie blanche

    Well spoken, Dr. Greger.

  • Jane’s Addiction

    Another great video. I had to laugh this morning when I saw the health news: now they’re saying that it’s okay for pregnant women to eat fish because the omega-3s prevent the mercury from causing fetal developmental damage. I’m thinking, “Dr. Greger has already COVERED this! Why not just take the omega-3s and skip the mercury with a good algae-based DHA/EPA supplement?”

  • patrick

    how does youtube manage to minimize the slow jerky buffering/downloading of videos but nutritionfacts.org (and many other websites ) can’t do it?

    • dogulas

      This particular one is Vimeo, if viewing from this site. Google must have magic.

    • KWD

      patrick, not sure why you’re experiencing buffering problems. It doesn’t seem to be a problem we’re having reported from other users, at least not that I’ve seen. I’ve had occasional buffering problems myself in the past using google chrome, but it’s because I have multiple browser windows open simultaneously and am often streaming music from youtube – that tends to create buffering issues for me. I’ve always figured it’s a result of having opted for the cheapest data package my ISP provides.

      • jj

        I’ve always had buffering issues with vimeo no matter if I use – AOL, Internet Explorer or Google Chrome. Less so with Google Chrome.

        • KWD

          Hoping this link might be helpful…dealing with playback issues from vimeo: http://vimeo.com/help/faq/watching-videos/playback-issues

        • Charzie

          I also have issues with vimeo and my probably antiquated system, no matter what I do, but not with youtube. Not only buffering, but stutter, and other odd delays I don’t experience non-vimeo. Not to say I never experience delays on youtube, they are just more frequent and more varied with vimeo and my system. Just the nature of the beasties I guess! Until I can afford an upgrade, I guess I will just be grateful to connect at all!

  • Tom

    This video should be shown to every new medical student on the first day of classes.

    • val

      I think EVERY SINGLE video of Dr. Greger’s should be shown to med students, period! Holy heck…his work is tremendous!

  • charles grashow

    http://www.sciencedaily.com/releases/2013/02/130205131629.htm

    Vitamin D, omega-3 may help clear amyloid plaques found in Alzheimer’s

  • Lin

    Hi Dr. Greger!
    Your video was interesting and as always, advocating a healthy, plant-based diet and exercise.
    I have worked in Alzheimer’s research and clinical trials, both big pharma and NIH – sponsored, for many years, and follow the ongoing research, of which there is not a lot of. Sadly, AD research does not seem to be a priority these days, with dwindling funds and a much larger emphasis on other diseases. All of us baby boomers (and our kids!) are going to be in big trouble in the next 15-20 years.
    There is NO cure and there is NO prevention known to date for the plaques and tangles that are the hallmarks of this devastating disease. Yes, staying healthy with a plant-based diet, exercise, and social interaction is crucial for so many reasons and for so many other diseases and afflictions, even NORMAL brain aging and memory issues (senior moments!). But Alzheimer’s disease is different. Its onset is slow and insidious, and it strikes even the most active and engaged and healthy. It is truly the saddest affliction to humanity, for it takes away our memory and our mind.
    It is a disease that I hope will begin to get the attention it deserves in my lifetime. But a plant-based diet won’t help with this one.
    Regards,
    Lin

    • dogulas

      How do you know that someone who consumes no added oil, no added sugar, gets plenty of sunshine, eats zero animal products throughout their life, eats whole plant foods, and is active…can eliminate their potential for Alzheimer’s. Those studies have not been done. Is it too much of a stretch to wonder if the same thing that can prevent heart disease can prevent Alzheimer’s? Even though heart disease is reversible to an extent and plaques and tangles in the brain are not reversable, it does not mean that Alzheimer’s cannot be prevented. No normal person eats and lives that way. Normal is not optimal or even close to it, most of the time.

      • Jocelyn

        Yes! It has been amazing to me (though really when you think about it, not all that surprising!) that a diet filled with whole plant foods pretty much fixes everything! Thanks Dr. G! Our bodies truly are amazing when we treat them right.

    • Jocelyn

      Only one way to find out! As you say yourself, their is such limited research in the field….
      And since there are no negative side effects of a whole foods plant based diet, and actually there are myriad other benefits to look forward to, it only makes sense to me to give it a shot!

    • KWD

      Lin, Thanks for posting. Given your stated research experience, it would be interesting to learn why you feel strongly that “a plant-based diet won’t help with this one.” Dr. Greger has published a number of videos on the subject of Alzheimers disease and dementia, presenting compelling considerations that seem to point towards non-genetic factors that may very well be influenced by dietary choices.

      Besides the sampling list of videos Dr. Greger added in his commentary for today’s video, I find this one to be interesting also: http://nutritionfacts.org/video/alzheimers-disease-grain-brain-or-meathead/

      And in Dr. Greger’s yearly summary presentation he talks about AD and dementia broadly but nevertheless, it’s worth a listen – the relevant commentary begins at 18:30: http://nutritionfacts.org/video/from-table-to-able/

    • Lin

      Hi Jocelyn!
      I am not suggesting that a whole foods plant based diet isn’t the way to go – it is!!!
      But sadly, the numbers of Alzheimer’s victims are going to skyrocket in the coming years. There are a LOT of claims out there based on unsubstantiated research and heresay about how to prevent AD (omega-3 fatty acids, crossword puzzles, avoidance of aluminum, a MILLION other things) that I believe are reckless and give false hope. And many other things can mimic AD. For example, a deficiency of Vitamin D, urinary tract infections, and even some statin drugs prescribed for high cholesterol can cause dementia-like memory problems, but this is NOT the same as AD!
      Sorry – I get upset about this. For sure, eat right – it can only help not hurt. And advocate for greater awareness and research on Alzheimer’s!
      Lin

      • Veganrunner

        What is your opinion on why “going to skyrocket in the coming years?” To make a statement like that you must have an opinion why that would be true.

        Interesting.

    • VegCoach

      Lin, I recommend that you read Neal Barnard’s book, Power Foods for the Brain – http://www.nealbarnard.org/books/brain/ Following the practices he recommends goes a long way toward preventing AD. He’s got a couple videos on You tube. The presentation at UNE Center for Global Humanities is a good one. https://www.youtube.com/watch?v=sxtRilvU5s0
      Thanks again for the great video today Dr. Greger!

    • Theodore

      Seems like doubt is Lin’s product.

  • dogulas

    This was hilarious :) And a great point. I especially loved the placebo head injury!

  • GaryS

    A very small study out of UCLA is offering a glimmer of hope for those with what is often a hopeless diagnosis. Nine out of the 10 patients involved in the study, who were in various stages of dementia, “say” their symptoms were reversed after they participated in a rigorous program. The program included things like optimizing Vitamin D levels in the blood, using DHA supplements to bridge broken connections in the brain, optimizing gut health, and strategic fasting to normalize insulin levels.

    Full article,

    http://www.cnn.com/2014/12/08/health/alzheimers-reversal/

    • Matthew Smith

      Dr. Abram Hoffer, who is announced as “discredited” by Wikipedia, has successfully been treating patients with pyschosis for 50 years with vitamin B3, Niacin, which was successful in pyschitry’s first placebo control double blind study. Taking 3,000mg or more of Vitamin B3, together with a very large dose of vitamin C, seem to clear patient’s heads, reduce suicide risk, reduce hospital stays, and put people back to work. http://www.altmedrev.com/publications/13/4/287.pdf This might be a miracle or break through for people who have had to deal with so much less. He, now dead, has known about it for years and even proposes a mechanism of action, the inactivation of oxidated endorphins, but modern pyschitry does not believe in supplements turning to more expensive pills. Niacin, or NAD, is the fuel of mitochondria, the power house of the cell, and can stir the soul or what our life force is. If it can do this even in the mitochondria in the brain, maybe, in my opinion, it could help those with Alzheimer’s. Thank you for your reservations.

  • Matthew Smith

    Webmd has made a list of brain smart foods. http://www.webmd.com/diet/features/eat-smart-healthier-brain It includes blueberries, wild salmon, nuts and seeds, avocados, whole grains, beans, pomegrante juice, freshly brewed tea, and dark chocolate. All of these foods are believed to be good for the brain. Do any of these foods reduce the risk of Alzheimer’s? With the addition of dark leafy greens here, if these foods have any benefit on the brain, it could be worth while to eat them to help the brain if it gets Alzheimer’s.

  • Peter Westphal

    Thanks for putting some focus on the tyranny of RCT`s. Touted to be the golden standard of proof in medicine, it does exclude things like nutrition in science. Most medical and surgical procedures has not been subjects to RCT`s anyways. While being a brilliant concept, it`s foremost the brilliant for Bigpharma in excluding anything that is not a drug in being researched for its potential health benefits.

  • Am

    I miss the subtitles.

    • Charzie

      Me too Am. Watching on Youtube somehow isn’t the same. :( Kind of like having to go out to a movie when you just want to stay home and watch something good with your family!

    • HereHere

      I really miss the 2x speed feature. Now, it takes me twice as long to listen to one of these mini-lectures, so I listen to about half as many.

      • Tommasina

        Sorry it’s taken us so long, but SUBTITLES ARE BACK!! :) We think we got them all, so please email me at tommasina[at]nutritionfacts.org if you spy a video without the CC button at the bottom of the screen. As for the 2x speed feature, we’re seeing what we can do. Thanks for the feedback!

  • Bruce Cropley

    Off topic: My (very limited) understanding is that flax seed is a good source of Omega 3 fatty acids. However, your optimum nutrition recommendations include “250 mg daily of pollutant free (yeast- or algae-derived) long-chain omega-3′s (EPA/DHA)”. Do we need to take an EPA or DHA supplement daily, or is a heaped tablespoon of ground flax seed enough? TIA :)

  • Derrek

    Is maple sugar derived from maple syrup ok? Its a sugar like date sugar.

    • No

    • b00mer

      Hi Derrek, date sugar usually means the entire date dried and ground. So date sugar, while a high-sugar food, also has the same amount of nutrition as the whole fruit – vitamins, minerals, other phytonutrients, and fiber. Maple syrup is not considered a whole food to begin with. Both the original substance and the dried form would both be considered refined sugars. Most whole foods plant based advocates recommend limiting refined sugars in the diet.

    • Derrek

      So Dr. Greger doesn’t recommend maple sugar because it isn’t a whole food? It is organic and someone bought it for me.

      • Charzie

        None of my business I guess, but if I had it, I would use it in small quantities, the same way I sometimes use even white sugar. I know, gasp! But I use it so rarely and in small amounts to sweeten the very occasional dessert or decadent tea. I have tested my blood sugar levels afterwards, (formerly diabetic) and the increase is negligible, so I don’t stress about it. Sometimes I wonder if the stress we cause ourselves worrying about every perceived “offense” isn’t more damaging than what we are ingesting! Don’t get me wrong, I am a strong proponent of a WFPB diet and am also vegan… my diet has been, and will always be, a life saver, so I don’t advocate for unhealthy habits!

        • jj

          Charzie, “stress we cause ourselves…..more damaging than what we are ingesting ”
          There is something to that. I’ve heard it talked about by a researcher. Don’t remember which lecture of his but it was very interesting.

      • b00mer

        Hi Derek, I would second Charzie’s response. You won’t find any WFPB diet advocates actually *recommending* the consumption of any type of refined sugar. I believe most would classify it in the “use sparingly” category, but not necessarily something that needs to be banned from your diet completely for the rest of your life. Personally I don’t think a small amount in the context of an overwhelmingly healthy whole foods diet is going to make too much of a difference in overall health for the average person. My personal philosophy to refined sugars is similar to Charzie’s I think: I limit it to the extent that the differences between e.g. maple syrup, brown rice syrup, corn syrup, beet sugar, sugarcane sugar, etc, become negligible and are really just nuance. I think that if a person is eating so much sugar that the mineral content in maple syrup vs table sugar becomes meaningful, then they’ve got bigger issues to deal with, first and foremost, reducing the sugar.

  • brit

    I completely agree that fruits and veggies help our brain and our health. However, my husband who has always eaten plenty of fruits and veggies (we are vegetarian) seldom ate anything with sugars and ended up with dementia last year. His blood work showed low Vit D and B12 so we should all be aware of the danger of being low on these nutrients as this may be more important

    • GaryS

      Good point about low vit D levels. I read somewhere that low vit D ups your risk of dementia or AD by 50% to 125%.
      I got my first blood work done at age 59 a yr ago and my vit D was the only thing that was out of range and low at 18.8. Range is 30-100.
      So now I take a supplement and eat 2 or 3 cans of sardines in the Louisiana hot sauce a week. (the only kind I like on a bed of rice)
      I should get another test done to see if there has been any improvements.

    • VegCoach

      Brit, you say you are vegetarian? Does that mean you are ovo-lacto eaters? Eggs and Dairy? You did not say vegan – or, Whole food plant based. Cutting out the high fat and cholesterol animal products will make a positive difference. They say, “What’s good for the heart, is good for the Brain”.

  • Maree

    It seems that greens are the medicine that we all should be consuming but is it possible to eat too many green veggies? I would say that about 70 – 80% of the food I eat is green leafy veg. Is this too much? I feel great, a little extra gas but I don’t mind because I want to keep my mind :)

    • HereHere

      Yikes! That does sound like too much! It may be fine, but I would worry about kidney stone formation (oxalates). I’m not an expert in the area of greens, but keep doing your research, and perhaps consider increasing the variety of whole foods you eat (beans, nuts, seeds, vegetables of other colors, berries, mushrooms, etc.).

    • Julie Cornelius

      Hi Maree,

      As Dr. Greger says in the video Overdosing on Greens, “you can overdo anything.” You may also be missing out on important nutrients that come from other types of food. Try eating other plant foods to add some variety to your diet.

  • Maree

    Can you have a diet too high in leafy greens? I eat a lot of greens.

  • vegank

    Vitamin K2 is supposed to be quite important too I have heard, difficult to find any plant based source but apparently Natto (Japanese fermented soy beans) has the Vitamin. Not sure how this would apply to the male population with the theories about soy and cognitive decline in males over 65.

  • Hermes Liberty

    I laughed in my grave!

    Jonathan Swift

  • MarthaLA

    About a month ago, I ceased putting 2 Tablespoons of flaxseed meal in my morning oatmeal because of having been on a weight plateau for about a year now. I need to lose about 50 lbs. more, so have been plugging my food into cronometer.com fairly consistently and found the flaxseed meal is one of a few high-fat components. I’m still including 2 T of walnuts, though – also high-fat. I know I also need to exercise, but somehow never quite get to it with any consistency. In any case, although I’ve got lots of information, much of it garnered here, there’s been no budging more than a pound or two with rebound not long after. Maybe I’ve been taking Dr. McDougall’s “eat all you want” of the right stuff too literally? I really would like to get back to thinking about other things than food! (Just venting.)

    • Thea

      MarthaLA: I don’t have a definitive answer, but when it comes to weight loss, I highly recommend taking a look at the free talk from Dr. Lisle: How To Lose Weight Without Losing Your Mind. It is a really great help in figuring out how to tweak your diet so that you don’t have to worry about portion control and are still eating healthy and can still lose weight. If nothing else, it is very educational and entertaining.
      https://www.youtube.com/watch?v=xAdqLB6bTuQ

      If the talk interests you and you want to get an even more thorough grounding in the concept, then I highly recommend Jeff Novick’s DVD on Calorie Density:
      http://www.amazon.com/Calorie-Density-More-Weigh-Less/dp/B003ASP6JE/ref=sr_1_1?ie=UTF8&qid=1423085081&sr=8-1&keywords=calorie+density+how+to+eat+more+weigh+less

      It’s a bummer that you are going through a frustrating time. I hope you are able to figure it out without too much more pain.

      • MarthaLA

        Thanks, Thea. In re calorie density, I have read Jeff’s posts on the McDougall forum and/or watched clips on You Tube. Have not yet watched the Dr. Lisle video. Thing is, I am nearing the end of the 5-year recovery after breast and uterine cancer surgery. AND after chemotherapy and radiation therapy. I was a lot healthier going into surgery than I have been after treatment. So, I was more interested in anything that would help improve health (you know, like flax seed, cinnamond and cloves per Nutrition Facts, etc.) and more minorly interested in weight loss (though needed). I did lose 42 pounds early on, and then weight loss seemed to stop dead, though I’m pleased to say that I no longer feel like I am or have been dragging an elephant around, but have some energy, and pain from osteoarthritis and cervical spondylosis attacks has eased off, due, I think to the general plant-based diet. So now, reluctantly, I’m trying to reduce those higher fat plant foods (flax seed, walnuts, avocado, darn it!). It’s amazing how much percentage of fat calories chronometer.com shows me when I enter my meals. I hope to get there eventually, but am, indeed, rather frustrated. But not in the least hopeless. Ciao.

        • Thea

          MarthaLA: My heart goes out to you. I do recommend the Dr. Lisle video, but it sounds like you have a good handle on things and have been dealing with a lot very well. Glad you are not feeling hopeless, because it is definitely not that!! Ciao. :-)

    • daisy

      has the deleting of your 2 T ground flaxseed daily resulted in weight loss?

  • Maree

    Is it possible to eat too many leafy greens. I have 4/5 big smoothies of mixed greens everyday to help prevent Alzheimer’s. I also eat green soups and steamed greens at meal times. My husband jokes that I will turn green like people do when they eat too many carrots.

  • Joy

    Is age related dementia have the same risk factors and causes as Alzheimer’s?

  • Dina Powers

    I read that saffron helps with memory for Alzheimer’s patients. How much saffron do I use in one day? Can you crush saffron and eat it like medicine or do you have to put it into a recipe?

  • Carol Fenwick

    Hi Dr. Greger, Your videos are awesome! I have a question about the 6th leading cause of death or maybe I misunderstood what you said. What I thought you said is FDA approved pharmaceuticals cause many deaths and that death by medications is the 6th leading cause of death. Would you please explain?

    • Cody

      Hi Carol, I am a volunteer for Dr. Greger. Thanks so much for your question! The side effects from prescribed pharmaceutical drugs given in hospitals do indeed kill approximately 106,000 Americans every year. That makes it the 6th leading killer already. That doesn’t even include the thousands that die from receiving the wrong medication by mistake, 20,000 that die from other hospital errors, the nearly 100,000 deaths/year from hospital-acquired infections and 12,000 deaths from complications due to surgeries that weren’t even necessary. This totals about 225,000 deaths/year, making it the 3rd leading cause of death in America. Finally, these statistics only include deaths that occur from complications and drug side effects that occur in hospitals. Side effects from drugs given outside of hospitals may cause an additional 199,000 deaths/year. I encourage you to watch the video below for Dr. Greger’s specific analysis of this horrific situation. I hope this helps!

      http://nutritionfacts.org/video/why-prevention-is-worth-a-ton-of-cure/

  • mangot

    Could you make a video explaining if is true or not that cooking in aluminium pots causes alzheimer or neurological damage? Also with aspartame? and what about cooking in teflon as ir seems to release toxic cancirogen gases? and about cooking in microwave and about the radiation that the oven emits and the molecular change of the food? I think those are important topics to inform the people of the elements to avoid using in the kitchen, as well as copper metals, etc… I think in addition of a plant based diet we should take care of those things…