Doctor's Note

To which other reports might the principal investigator be referring? I profiled similar pathology reports in What’s in a Burger? and What Is Really in Hot Dogs?.

More on fecal contamination from chicken in Fecal Bacteria Survey, fish in Fecal Contamination of Sushi, and pigs in Yersinia in Pork. How can that be legal? See Salmonella in Chicken & Turkey: Deadly But Not Illegal.

More on the preservatives in chicken in Phosphate Additives in Meat Purge and Cola and antibiotic contamination in Drug Residues in Meat. Estrogenic Cooked Meat Carcinogens also build up in poultry in particular, something the Physicians Committee also tested for previously: Fast Food Tested for Carcinogens.

If we’re going to eat something chickenish that isn’t chicken meat, why not truly boneless chicken: Chicken vs. Veggie Chicken.

For more context, check out my associated blog post: What is Actually in Chicken Nuggets?

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  • natural skeptic

    Clearly no nutritional expert in their right mind would advocate eating commercially bought “chicken nuggets”. But while a diet rich in plant foods can be quite healthy, taken to excess, it can lead to certain harms. For example, a total absence of animal foods deprives one of vitamin B12, riboflavin, essential fatty acids like DHA, iodine, vitamin D, etc; it also extremely low on other important micronutrients like bioavailable iron, calcium, riboflavin, tryptophan, choline, carnitine and taurine. Conversely, many members of the population (at least a third) have, for good reason, evolved a “supertaster” gene preference to avoid bitter green leafy vegetables for the very reason that many plants and their products (seeds, etc) contain natural pesticides and other relatively toxic compounds, including phytates, oxalate, lectins, and goitrogens; not to mention large quantities of omega-6 fatty acids in many seeds and nuts. Eaten to excess, these moieties could cause severe problems including mineral deficiency, hypothyroidism, and uncontrolled inflammation.

    It is probably the case that the best of both worlds combines a diet rich in plants with a diet containing adequate amounts of oily species of fish, preferably those tested to be low in contaminants such as mercury, PCBs and furans like dioxin. This explains why pesco-vegetarians had the most optimal pattern of disease-free outcomes in the recent Adventist Health Study II, published this past spring in JAMA Internal Medicine. Finally, any diet that requires taking a fistful of supplements is probably not a very healthy or nutritionally intact diet.

    • Phil

      Pretty much everything you said is incorrect. Greger already talked about all of this in his other videos, backed by hundreds of scientific study.

      • Dave

        DHA should be supplemented in a vegetarian diet. That part is accurate but otherwise it’s completely off course. Riboflavin and B12 not in any vegetarian diet? Try looking into that again.

        • donmatesz

          Humans do not need dietary DHA, it is not an essential fatty acid. Humans only requires ALA, found in plants. This is the position of the Food and Nutrition Board of the National Academies of Science.

          • Markus

            Sorry, this is still in debate as the conversion rate is very different, depending on age, sex, fat intake, fat types and genetic.

            A diet including 2-3 portions of fatty fish per week, which corresponds to the intake of 1.25 g EPA (20:5n-3) + DHA (22:6n-3) per day has been officially recommended on the basis of epidemiological findings showing a beneficial role of these n-3 long-chain PUFA in the prevention of cardiovascular and inflammatory diseases. The parent fatty acid ALA (18:3n-3), found in vegetable oils such as flaxseed or rapeseed oil, is used by the human organism partly as a source of energy, partly as a precursor of the metabolites, but the degree of conversion appears to be unreliable and restricted. More specifically, most studies in humans have shown that whereas a certain, though restricted, conversion of high doses of ALA to EPA occurs, conversion to DHA is severely restricted.

            The use of ALA labelled with radioisotopes suggested that with a background diet high in saturated fat conversion to long-chain metabolites is ∼6% for EPA and 3.8% for DHA.

            With a diet rich in n-6 PUFA, conversion is reduced by 40 to 50%. It is thus reasonable to observe an n-6/n-3 PUFA ratio not exceeding 4-6. Restricted conversion to DHA may be critical since evidence has been increasing that this long-chain metabolite has an autonomous function, e. g. in the brain, retina and spermatozoa where it is the most prominent fatty acid. In neonates deficiency is associated with visual impairment. abnormalities in the electroretinogram and delayed cognitive development. In adults the potential role of DHA in neurological function still needs to be investigated in depth. Regarding cardiovascular risk factors DHA has been shown to reduce triglyceride concentrations. These findings indicate that future attention will have to focus on the adequate provision of DHA which can reliably be achieved only with the supply of the preformed long-chain metabolite.


            Human beings are poor DHA synthesizers, possibly because of their LC(n-3)P-abundant ancient diet. Dietary changes in the past century have lowered the (n-3) status to a current state of subclinical deficiency that is epidemiologically related to CVD, inflammatory disorders, mental and psychiatric diseases and suboptimal neurodevelopment. The strongest evidence comes from randomized controlled trials with LC(n-3)P, showing reduced mortality from CVD, improved neonatal neurodevelopment, and lower
            blood pressure in later life. With these studies as evidence, we conclude that DHA is likely to be essential.


            My proposal: go for an Omega 3 blood panel of your red blood cell’s membranes. If your index is >8% you have it well done, if it more or less <6% you are in the same range as Joe Sixpack on his SAD…I would not messa round with this as a healthy brain should consist 30-40% of DHA!

          • DH

            This is my understanding too. That’s why I continue to consume 250 mg of DHA as a vegetarian supplement. In some brain tissues (e.g. gray matter), DHA concentration exceeds 50%. There is significant evidence that our early hominid ancestors in the Rift valley system had broad access to fish species rich in DHA, and that this may have promoted frontal cortex development onto a path allowing for the development of language and other “higher order” functions. See: Broadhurst CL, Cunnane SC & Crawford MA (1998) Rift Valley lake fish and shellfish provided brain-specific nutrition for early Homo. British Journal of Nutrition 79, 3–21.

            There are numerous studies of vegetarians and vegans who do not consume fish and have very low DHA levels. One except is the EPIC study, but this has been heavily criticized (see Jack Norris’s commentary on this study on at ). So if we can’t make DHA in sufficient quantities from ALA, and what production we can afford is subject to high background rates of linoleic acid intake present in most plant-based diets, it only makes sense to supplement with DHA. The only downside is cost.

          • Toxins

            “Interest in the cardiovascular protective effects of n–3 (omega-3) fatty acids has continued to evolve during the past 35 y since the original research describing the low cardiovascular event rate in Greenland Inuit was published by Dyerberg et al. Numerous in vitro experiments have shown that n–3 fatty acids may confer this benefit by several mechanisms: they are antiinflammatory, antithrombotic, and antiarrhythmic. The n–3 fatty acids that have received the most attention are those that are derived from a fish source; namely the longer-chain n–3 fatty acids eicosapentaenoic acid (EPA; 20:5n–3) and docosahexaenoic acid (DHA; 22:6n–3). More limited data are available on the cardiovascular effects of n–3 fatty acids derived from plants such as a-linolenic acid (ALA; 18:3n–3). Observational data suggest that diets rich in EPA, DHA, or ALA do reduce cardiovascular events, including myocardial infarction and sudden cardiac death; however, randomized controlled trial data are somewhat less clear. Several recent meta-analyses have suggested that dietary supplementation with EPA and DHA does not provide additive cardiovascular protection beyond standard care, but the heterogeneity of included studies may reduce the validity of their conclusions. No data exist on the potential therapeutic benefit of EPA, DHA, or ALA supplementation on those individuals who already consume a vegetarian diet. Overall, there is insufficient evidence to recommend n–3 fatty acid supplementation for the purposes of cardiovascular protection; however, ongoing studies such as the Alpha Omega Trial may provide further information.

            Combined with the lack of convincing clinical data in favor of n–3 fatty acid supplementation for cardiovascular endpoints and the lack of data in those that consume a vegetarian diet, it is difficult to make the recommendation that vegetarians should consume fish to optimize their cardiovascular mortality.”


            “Comparison of the PLLC n23 PUFAs:DALA ratio between dietary-habit groups showed that it was 209% higher in vegan men and 184% higher in vegan women than in fish-eaters, was 14% higher in vegetarian men and 6% higher in vegetarian women than in fish-eaters, and was 17% and 18% higher in male and female meat-eaters, respectively, than in fish-eaters This suggests that the statistically estimated conversion may be higher in non-fish-eaters than in fish-eaters.”


            In addition, another study showed that despite this “theoretical” low conversion rate, there is no evidence of any harm so, the problem may not be in the conversion rate, but in the assumption that it is low.

            “There is no evidence of adverse effects on health or cognitive function with lower DHA intake in vegetarians”

            “In the absence of convincing evidence for the deleterious effects resulting from the lack of DHA from the diet of vegetarians, it must be concluded that needs for omega-3 fatty acids can be met by dietary ALA. ”


          • VegAtHeart

            Thank you Toxins for a great post!

          • DH

            Jack Norris RD had some interesting comments about the EPIC Norfolk DHA findings (see ):

            “Vegans and vegetarians have been shown in many studies to have lower levels of long chain omega-3 fatty acids (EPA and DHA) than meat eaters. Table 4 shows the results of some of these studies. The general trend is that lacto-ovo vegetarians and vegans have lower levels of EPA and DHA in their blood. One exception is the 5 vegan women in the 2010 UK study who had, on average, higher DHA levels than even the fish-eaters. This is probably an anomaly for a few reasons. First, “vegan” was simply defined as someone who did not list eating animal products in their 7-day diet diaries. These vegans might have only been vegan for one week. Second, there were only 5 vegan women in the study making the finding unlikely to be statistically significant. Third, the standard deviation for the DHA levels of the vegan women was very high at 211 µmol/l. That means that one or two of the vegan women had very high levels of DHA but some had very low levels.”

            Also, a follow-up letter-to-the-editor strongly criticized their methodology and findings:

            So it is important to get the full context on these cited papers.

          • DanielFaster

            Dr. G recommends an algae oil supplement, so I have started taking 250 mg DHA, also comes with a tiny bit of omega 6.

          • VegAtHeart

            A couple of years ago Dr. G also recommended taking 4000 IU / day of vitamin D and then reduced this recommendation by a factor of two the following year. No doubt the dude is a genius, but that doesn’t make him infallible. He may or may not be right about the DHA/EPA issue, but the issue seems unsettled as you can tell from this discussion.
            Here’s a summary of the 2009 position of the American dieticians:

            “Vegetarians should include good sources of
            ALA in their diet, such as flaxseed, walnuts, canola oil, and soy. Those with increased requirements of n-3 fatty acids, such as pregnant and lactating women, may benefit from DHA-rich microalgae”

          • donmatesz

            The conversion rate is adequate for all age groups. There are literally millions of vegetarian people around the world (Jains, Buddhists, Taoists, Seventh Day Advenists) who produce and maintain normal brains throughout life and have low risk of vascular disease without consuming preformed EPA or DHA in the amounts that you suggest, and “there is no evidence to suggest that the capacity for DHA synthesis in vegetarians is limited.”


            All studies showing limited conversion are done on men, who have very low DHA needs, probably because they don’t bear costs of child-bearing and ~97% of neural DHA is recycled. Long term vegan men have stable long-chain n-3 fatty acid levels.

            Women of child bearing age have an ongoing conversion rate more than 200 times greater than men, as needed for pregnancy and lactation, and they store it in their adipose for use during pregnancy and lactation. Numerous buffer systems protect both mother and child from DHA insufficiency during the child-bearing years, regardless of DHA intake.

            Ingestion of both excess n-6 and DHA suppresses conversion of ALA to DHA, confounding studies such as you have cited, since omnivores have DHA intake, this suppresses the conversion. In other words, studies of ominvores eating fish or animals regularly will show lower rates of conversion because the body regulates the amount of DHA by negative feedback…high dietary intake suppresses conversion.

            Infants also convert ALA to DHA so long as n-6 intakes are low.

            We also have evidence that dietary EPA and DHA may have deleterious effects on embryo development, which would explain why the body attempts to regulate DHA conversion (produce only small amounts as needed, particularly in individuals without high requirements). Eating DHA bypasses the regulation step, leading to potential toxic accumulations. http://Maternal%20supply%20of%20omega-3%20polyunsaturaed%20fatty%20acids%20alter%20mechanisms%20involved%20in%20oocyte%20and%20early%20embryo%20development%20in%20the%20mouse

            The studies I cited post-date the article wherein Muskiet et al argue partly on the basis of a hypothetical ancient diet that humans require dietary DHA. The idea has been a boon to those who sell fish and fish oil, but humans have no dietary requirement for fish or fish oils. Period.

          • Thea

            donmatesz: Thanks for taking the time to write out this information. I found it to be very helpful and well worded. Thanks.

          • VegAtHeart

            Very educational post! Your last link doesn’t work. I am interested in reading this study please.

      • David

        Yes, but Greger has an answer for literally everything. He and his sponsors have an ideology and science can be cherry picked. I think there is a lot of good information here and it seems likely that minimizing animal foods in the diet is the best for health, but I question the wisdom of going 100% vegan for health reasons.

        • David

          Also, is it really a problem that chicken nuggets are 50% muscle but also contain other chicken parts. Aren’t those parts ultimately either protein or fat? They’ll either be digested and used or passed. What’s the big deal?

          • DH

            “Also, is it really a problem that chicken nuggets are 50% muscle but also contain other chicken parts. ”

            It is if, as in this case, the “nuggets” contain things like intestinal lining (which they shouldn’t). Have you heard of campylobacter, E. coli, salmonella, listeria and shigella? These are all present in chicken fecal material. I, for one, would prefer not to eat chicken feces or intestines.

        • Steve

          Who are Dr. Greger’s sponsors? I can’t find any advertisers on his website.

          • Thea

            Steve: The only “sponsors” are those everyday people who respect the quality of the work on this site. It’s people who understand that Dr. Greger carefully reviews the “body of evidence” (all studies), not just one or two studies, and then keeps us informed by sharing the relevant individual ones. In other words: People like you and me who donate our own money to keep this site going for the benefit of all. That’s it as far as I know – after the initial grant money got used.

        • Rich

          I think respondents here would do well to explain their points rather than just say “Dr Gregor says…”

    • BillyRadd

      “many members of the population (at least a third) have, for good reason, evolved a “supertaster” gene . . . ” Ha, ha. That’s rich. I have evolved an automatic BS meter and the needle is going off the chart with your post.

    • Chessie

      I would love to meet the person who eats way too many bitter leafy greens…and shake their hand.

      • Thea

        Chessie: Hee, hee. Me too! I need to hang out with these super people. Good habits might rub off on me.

    • SecularAnimist

      This comment is full of inaccuracies, exaggerations and outright falsehoods. To start with, the various claims about a “total absence” of certain nutrients in a vegan (a.k.a. “plant based”) diet are just plain false.

      Vitamin B12? WRONG. B12 is produced by bacteria, and the exact same bacteria that produce B12 in the gut of an animal can produce the exact same B12 in a culture dish. If you think that’s unnatural, then don’t EVER eat ANY food produced by fermentation, including yogurt and bread.

      Riboflavin (B2)? WRONG. B2 is plentiful in legumes, peas, nuts and seeds as well as green vegetables including broccoli and collards.

      Iodine? WRONG. Kelp is an excellent source of iodine.

      Essential fatty acids? WRONG. Hemp oil and flax oil are rich in essential fatty acids. (I notice that you condemn a vegan diet for lacking essential fatty acids, and then contradict yourself by condemning seeds and nuts for containing “large quantities” of omega-6 fatty acids, which suggests to me that you are really ignorant about this issue, and worse, didn’t even read your own post).

      Vitamin D? WRONG. The main and best way to obtain vitamin D is through exposure to sunlight, which enables our own bodies to produce vitamin D. Most of the vitamin D consumed from animal foods comes from “fortified” foods which have Vitamin D added (e.g. milk), and similarly fortified vegetarian alternatives (soy milk, rice milk) are just as good.

      The rest of your babble about plant foods being “extremely low on important micronutrients” is just more equally ignorant and blatantly false rubbish, as are your ridiculous suggestions that green leafy vegetables should be avoided because they contain “toxic compounds”.

      Look, if it’s your job or something to spread anti-vegetarian propaganda, you need to up your game, because this is REALLY, REALLY bogus, lame, laughable stuff, as anyone who takes 10 seconds to consult some basic nutritional references will immediately realize.

      • d1stewart

        You’re right, the post was full of information, but its one correct point was on B12. Unless you take a supplement of B12, you won’t get any on an all-plant diet. You won’t have any problem getting B12 on an animal food diet, though of course you’ll get the rest of the load of detrimental substances too.

        • p

          B12 deficiency has been detected in meat eaters, too.

      • Johann

        Comment appreciated. The body consists only of cells and the cells recognize their nutritional needs. Enzymes are required to enable nutrients to access the cells and if there is a lack of enzymes the nutrients will be wasted. Enzymes are manufactured by the body and you can read more about that in books such as that written by Lita, Lee and Goldberg. (“The enzyme cure – How plant enzymes can help you relieve 36 health problems”). Some people have an enzyme shortage whilst in any case our bodies manufacture less the older we get. The best source of enzymes would be fruit and live green veggies. The enzymes start dying off at temperatures exceeding 118 degrees F. So eating dead cooked food might still have some surviving nutrients but they still have to be piggy-backed on enzymes to get to the cells. So, the more dead food the bigger strain on the body’s metabolism to get its engine working optimally.

        My spouse is 85 and I am a youngster of only 77. We have been following a vegan diet for the last 14 years and use some supplements which are considered to be live food. We are not evangelical about it but in general would stay away from animal proteien. This works for us and the only regret which we have is that we did not make an earlierstart on this journey. Our choice was health driven.

    • laurieangel64 .

      obviously you havent done a whole lot of research on an all plant b ased do not need meat and dairy or “oily”fish to get all the nutrients you are talking about.i have been on the forks over knives/engine2 diet for a few months now and my blood levels have improved drastically in a short period of time,and i take NO supplements.if you know WHAT to eat,you can get it all and prevent cancer,diabetes,heart disease and animal abuse all in one shot with a plant strong diet.its all in there.

  • mark

    Isn’t it illegal to name a product by anything other than the main ingredient?

    • Phil

      it’s just a product name, they can call it whatever they want, think about it, there’s no milk in soy milk or almond milk, there’s no apple nor pine in pineapple, there’s no egg in eggplant, there’s no ham in hamburger and the list just goes on.

      • d1stewart

        Ha. I think you should keep the list going on. It’s kinda funny.

    • Phil

      There’s no law on this, you can name thing as you like. Think about it, there’s no milk in either soy milk or almond milk, there is no apple nor pine in pineapple, there is no egg in eggplant nor ham in hamburger and the list just goes on.

      • David

        That’s not true. There are laws concerning some product names. It’s not legal to call cheese-like substances cheese for example. Look at a pack of Velveeta or Kraft Singles (“American cheese”) and you will not see “cheese” on the package. You could see “cheese food” or “american pasteurized cheese product” but they can’t just call it a cheese. Certain kinds of alcohol are regulated closely in various countries.

  • Carl Newmeyer

    Yup….and what about the added chemicals–like simethicone, a type of silicone oil. –Also an antiflatulent drug.

  • Derrek

    What are some natural sources of good bacteria? Is kombucha good for you?

    • Thea


      Dr. Greger has a video about kombucha. I highly recommend watching that video before consuming any.

      I have an idea for you: I have been making a home-made probiotic called “rejuvalac”. I make mine from quinoa, which goes very fast. I use it as an ingredient in vegan nut cheese, but I know that some people drink it. It doesn’t taste awesome by itself, but it doesn’t taste bad either. And you could put it in juice or something. Perhaps you might want to research rejuvalac?

      FYI: The instructions for making it looked intimidating to me at first, but after I did it the first time, I decided it is super-easy. You just have to be willing to wait a couple days for the finished product. If you are interested, I am willing to write out how I make it.

      The other thing you might want to research is “water kefir”.

      I don’t know how much either of these products is likely to have the type of bacteria that you are looking for, but it seems worth investigating to me. It would be something that is fresh and vegan. And it might help???

      Hope that helps!

      • Derrek

        Could you provide the recipe for it? Also, how do you ferment veggies and fruit without adding a bunch of junk llke sugar and etc.?

        • Thea

          Rejuvalac: Part 1 – Intro Text

          Derrek: I’m sorry, but I have no idea about fermenting fruits and veggies.

          I also thought I would mention my own personal situation: when I went to a whole plant food diet, I didn’t any change in frequency of gas. But I did notice that the odor decreased significantly. Others I have read about noticed similar change. So, while I have no idea what might actually be wrong with you, I do agree that something isn’t right. I hope you are able to figure it out. I have no idea if rejuvalac would fix your problem, but it seems worth trying.

          The following directions for rejuvalac are modified from the book Artisan Vegan Cheese by Miyoko Schinner. The modifications are what works for me, including knowledge I had picked up from reading a couple books on sprouting. I found that if I use the quinoa for the grain, both the sprouting phase and the culturing phase take the smallest amount of time given the expected time ranges listed below. Though time also depends on temperature. Some day I want to try different grains to see if they taste different.

          The following makes about 6-8 cups of rejuvalac. I don’t know how much you should drink a day to meet your needs. But suppose that you make 7 cups and you drink a cup a day? (Say 1/2 cup two times a day???) Then the following recipe would cost you the price of a cup of quinoa or other whole grain each week. I would think that would cost less than buying the pills. FYI: I use organic quinoa that I store in my freezer with the idea of keeping it super-fresh and free of as much bad bacteria as I can. (That’s just a theory on my part.)

          Best of luck to you!!!

        • Thea

          Rejuvalac: Part 2 – The Instructions

          > 1 cup whole grains (quinoa, brown rice, kamut, millet, oat, rye wheat or a combo)
          >6-8 cups filtered water

          If you can find one of the giant sprouting jars (Half gallon size – Whole Foods sells one), then you can use that single container for all steps. Otherwise:
          >One quart jar with lid /cover for soaking and sprouting phases listed below – a one quart canning jar with steel screen or cheese cloth bound with a rubber band works well. Here is a place to get the screen:

          >Glass container for culturing – big enough to hold 6-8 cups water (or can use 2 jars of a size of a quart or do what I did and get a single big glass container with a lid)

          >Soaking Phase: Put grains in a sprouting jar and cover with regular water to a couple inches above the grain. Let soak 8 to 12 hours. Drain off water. (Note: I do not use filtered water for this step or the next one. However, I live in a place that has excellent quality tap water.)

          >Sprouting Phase: Rinse grains several times with fresh water. Then drain thoroughly. (Some people prop the jar on it’s side or at an angle downward. Be sure there is plenty of air circulation, though through the lid/cover. In other words, don’t store completely upside down. I shake the jar until the quinoa is spread out on the side of the jar as it rests on it’s side.) From this point on, you want grains constantly damp, but not sitting in any standing water. Rinse and drain 2-4 times per day until you see tails on the grains. (Tails = grains have begun to sprout.) This step takes 1-3 days depending on grains and temperature. (I have had quinoa take 12 hours on a summer day.)

          >Culturing Phase: Put sprouted grains in the culturing jar(s). If you are using two jars, then split up grains between the jars. Fill with the *filtered* water. Using filtered water is important at this step. If you do not have filtered water, try what I did the for a while – just boil and cool the tap water overnight first. Loosely cover and place in a warm place out of direct sunlight for 1 to 3 days until done. It’s done when the water turns cloudy/white/yellowish. It should taste a bit tart, a little bit like a watered down lemon juice – but more complex/different.

          >Wrap Up: Strain the liquid into a clean jar. Cover tight and store in the refrigerator for up to 4 weeks.

          I sure hope this helps! Please let me know if you try this, how it works out for you.

  • d1stewart

    I don’t know… if the bone, nerve, cartilage, epithelium, are all from chicken, how is “chicken nugget” a misnomer? It’s still chicken.

    Personally, I don’t see why any of those parts, or other non-muscle parts, are any different from the muscle, with respect to eating them. It’s all eating chickens. Don’t eat chickens.

  • Ruby

    It’s shameful the 2 food establishments were not sited. I know to us it doesn’t matter but it’s the point and principal of the matter surely. Shameful.

  • Eddie

    Hi Dr. Greger, love your videos, first time commenting! Whilst I would never consume either of the “nugget” products from your video, it got me thinking about articles I’ve read previously about a tendency of native cultures across the planet preferring eating the non-skeletal muscle portions of animals – I even recall reading about one culture in which the lean meat of carcasses was used to feed animals instead of humans.

    As I am finding more and more there are often good reasons for why ancient peoples did certain things and so I’m wondering what the science says about consumption of parts of animals less consumed in Western culture, and if the type of composition of these “nuggets” could be considered healthful if it came from well tended organic poultry?