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Eliminating the #1 Cause of Death

How to essentially eliminate the great scourge of the Western world.

February 17, 2011 |
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Eliminating the #1 Cause of Death, 4.7 out of 5 based on 6 ratings

Sources Cited

W. C. Roberts. The cause of atherosclerosis. Nutr Clin Pract, 23(5):464-467, 2008.

Acknowledgements

Image thanks to chriswong4238.

Transcript

The number one cause of death in the United States, however, is heart disease. Late last year a landmark review was published on the cause of our number one killer, by a Dr. William Clifford Roberts.
First of all, who is this joker? The head of Baylor’s Cardiovascular Institute, he’s authored a mere 1,387 scientific publications, written more than a dozen textbooks on cardiology, and has been the editor-in-chief of the American Journal of Cardiology for 25 years.
Well then, what is the cause of atherosclerosis? Well, first of all, doesn’t he mean causes, though? I mean there’s lots of things that increase our risk of heart disease—hypertension, diabetes, obesity, inactivity, cigarette smoking. None of that matters, he says—unless, you have high cholesterol. All those things can speed the buildup of plaque in our arteries, but if our cholesterol level is low enough, there’s nothing our body can build the plaque with.
According to Dr. Roberts, atherosclerosis simply does not occur if elevated cholesterol is not present, regardless of how high our blood pressure is, our blood sugars, no matter how obese, how inactive, or how many cigarettes we smoke. The plaque that builds up in our arteries choking off blood flow to our heart, to our brain, to the other arteries in our body is made out of cholesterol. If you don’t have enough bricks and mortar to build a dam choking off a river, the dam will not be built. Unless we have elevated cholesterol levels, there simply isn’t enough substrate to form these plaques throughout our arteries to trigger strokes, heart attacks, kill us, make us impotent (though, not necessarily in that order).
If cholesterol is the cause of atherosclerosis, how low does our cholesterol have to be to be heart-attack proof? Ideally, our bad cholesterol—LDL—should be under 70. “If such a goal was created, the great scourge of the Western world would be essentially eliminated.” There are only two ways, he says, to get it down that low: put a hundred million people on a lifetime of high dose statin drugs starting in one’s twenties or be what he calls a “pure vegetarian fruit eater,” which is just what he calls those eating whole foods vegan diets.
Now if we put everyone on drugs, then thousands of people would suffer side-effects, so “Of course a [vegan] diet is the least expensive and safest means of achieving the plaque-preventing LDL goal, but few in the Western world are willing to live on the herbivore diet.” In his words in a recent interview: “The best way to prevent heart disease is to be a… nonflesh-eater, a non-saturated fat eater.” “Because humans get atherosclerosis, and atherosclerosis is a disease only of herbivores,” he reasons, “humans also must be herbivores.”
The cause of our number one killer is elevated cholesterol. According to the most renowned cardiovascular pathologist in the world, that means the cause of our number one killer is: not eating vegan.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out theother videos on heart disease. Also, there are 1,449 other subjects covered in the rest of my videos--please feel free to explore them as well!

Also, be sure to check out my associated blog posts for more context: Soymilk: shake it up!, The last heart attack, Watermelon For Erectile Dysfunction, Stool Size and Breast Cancer Risk, Cholesterol Lowering in a Nut Shell, and Generic Lipitor is not the answer to our heart disease epidemic.

  • http://nutritionfacts.org/members/mgreger/ Michael Greger M.D.

    Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out the other videos on heart disease. Also, there are 1,449 other subjects covered in the rest of my videos–please feel free to explore them as well!

  • http://nutritionfacts.org/members/louisef/ LouiseF

    Why aren’t more doctors shouting this from the rooftops?!!
    Thank goodness for Dr. Greger and some others that will not rest until the whole world knows about this!

  • http://nutritionfacts.org/members/RobertEdmands/ Robert Edmands

    I’ve never been vegan or even vegetarian, but have always understood the value of eating a varied diet.

    Since the obesity epidemic exploded beginning around 1980, I must have missed this massive dietary change at that time. I was 18 in 1980 and my major exercise career was just starting. My theory is that a combination of sedentary lifestyle and worsening diet,i.e. the decline of the family farm and a huge shift to more sedentary employment combined to give this terrifying epidemic its horrible power. My tomato plants are really coming into their own! Can’t go wrong with Heirloom Tomatoes!

    • http://nutritionfacts.org/members/JenniferEldred/ Jennifer Eldred

      Don’t forget high fructose corn syrup too. I was born in 74′ and I even remember my dad hauling it as a truck driver to faygo all the time. We even used it in out koolaid. Sad, but true.

  • http://nutritionfacts.org/members/veggiecarrie/ cpgraettinger

    The video mentions eliminate saturated fats to reduce cholesterol. So we should not eat nuts?

    • http://nutritionfacts.org/members/mgreger/ Michael Greger M.D.

      Nuts actually appear to dramatically lower heart disease risk! See: Halving Heart Attack Risk

    • http://nutritionfacts.org/members/drdons/ DrDons

      Hi Veggiecarrie, Good question. Nuts do contain saturated fats but studies have shown that eating nuts can reduce our risk of heart attacks see Dr. Gregers video http://nutritionfacts.org/videos/halving-heart-attack-risk/. Of course nuts are a concentrated source of calories(about 2800 cal/#) so if your goal is to lower your bodies fat content you might want to go easy on the nuts. I am unaware of a specific study that looks at cholesterol and nut consumption. Whole plant products like nuts also contain beneficial fats, minerals and antioxidants. So the science at this time suggests that unless you are allergic or don’t tolerate nuts then enjoy in moderation of about 1 ounce per day. Hope this helps.

  • http://nutritionfacts.org/members/mike-quinoa/ Mike Quinoa
  • Maxim Fetissenko

    Recently I heard from several vegan friends whose LDL cholesterol numbers were refusing to go down, and in one case had gone up form 102 to 108 in one year. (That particular person had been a vegan for almost 2 years by the time of the test showing LDL level of 102 mg/dL.) I remember hearing that about 10% of people do not see any significant drops in LDL levels after adopting a vegan diet. If so, what does this mean for their risk of heart disease and for Dr. Roberts’s claim (also made by other prominent researchers) that we could eliminate heart disease through vegan nutrition?

    • Toxins

      Vegan is not enough to reduce cholesterol sometimes, for optimum health, they must eliminate all processed foods, all free oils (olive oil, canola and flax oil too) and if they are having issues with cholesterol, try reducing nut consumption by at most a 1/4 cup a day of walnuts. The other side of the coin is exercise, which is almost equally as important as diet. For optimum health, 2 hours a day of rigorous exercise may be necessary.

      • http://www.facebook.com/banananinja2013 Rock AndRaw

        I eat 3000 calories a day,low fat,low protein,high carb,mostly fruit,and hardly ever exercise.Maybe walk my dog.My blood work is perfect, and my cholesterol is under 100. I feel great,and maintain a 7% body fat year round.Movement is great,but you don’t have to kill your sellf in the gym.Diet. cholesterol..fat intake is the #1 problem.The fat you eat,is the fat you wear.

    • http://www.facebook.com/banananinja2013 Rock AndRaw

      You would have to see what they are eating?Just because your Vegan,doesn’t mean your cholesterol will go down.Most Vegans eat 60-70-% of their calories from fat,because they think carbs are the bad guy.Check out 80/10/10,or Mcdougal diet,or Dr.Essylstein from the world famous Cleveland heart clinic.Most DR’s are recommending heart healthy oils,wich are vegan,but pure fat..Lower your fat intake,and I guarantee you your cholesterol will go down.I eat a high carb ,low fat,low protein vegan diet,blood work is perfect across the board,I eat more calories,than an 18 year old(48),and I maintain a 7% body fat year round,and hardly exercise,maybe walk my dog.Never have had a problem with diabetes,because I keep to a low fat diet.Also you will lose weight,because the fat you eat,is the fat you wear.

  • LynnCS

    I eat vegan and love it.  My big downfall is exercise.  I like my projects, but nothiong really active.  I have pulled the old treadmill out from behind the junk in the garage and notice that I still resist.  I don’t want to get some bad diagnosis and hear, “If only you’d exercised more.”  Maybe saying this out loud will shame me enough.  Thanks for all your info.  So helpful.

    • http://www.facebook.com/profile.php?id=670735069 Tan Truong

       Lynn,

      The treadmill will burn calories, but not as efficiently as a hard workout, and that’s IF you actually get on it. Personally, I don’t know anyone that owns a treadmill and is actually thin and fit.

      You can burn calories while gaining muscle and increasing cardiovascular, rather than simply running on a treadmill. If you’re not into traditional weight lifting, then I would suggest you consider workouts like the “Spartacus” series by Funk Roberts:

      You do various weight training (dumbbells and kettlebells) and calisthenics exersizes at the same time, in timed intervals. This increases strength and cardio., while burning calories. Theoretically, you’re so oxygen “deprived” that your body continues to burn fat while you’re not working out, and does it does a lot better than simply running.

      http://www.spartacusworkout.com/program.html#week1

      Ideally, one would do this at a gym because of the equipment and the motivation (the hardest part about working out is the motivation part). Try to find a treadmill from anyone you know that’s not dusty.

      Side note: I did a self experiment to test my cardio from this type of workout. I don’t run too often, but this summer, without any warm up runs, I went straight to a 11.5K run, and found no cardio issues. I did feel really sore in my legs though.

      Well, you’re “saying this out loud” so I gave you a reply. :)

      • http://www.facebook.com/banananinja2013 Rock AndRaw

        Most Vegans eat way to much fat,nuts,seeds,avocados.Veggie and fruit fat is still fat.Low fat is the key!!

    • http://www.facebook.com/banananinja2013 Rock AndRaw

      Try less fat,and walking.I have seen it work a 1000 times.Low fat,would be 10% of calories,not 30% like most dieticians would recommend.

      • LynnCS

        I agree. I’m eating no overt fat, nuts or seeds right now. I am a procrasonator when it comes to getting consistent with the walking, tho. I don’t run so, I think it’s the same walking on the tmill or outdoors. Probably safer on the tmill. Anything is better than nothing. lol! Yes I like doing a little weight lifting too. Thanks all for the encouragement.

  • Valnaples

    Yay…my LDL (okay, last year) was 68.3; I had to go dig out my report. My doc specializes in lipids and told me to keep doing what I’m doing. And, I still eat cold water fatty fish 3 or 4 times a week…but switched to almond milk a few months ago.
    Yes, thank you for another interesting video, Doc! 

    • http://www.facebook.com/gurnani.sunny Sunny Gurnani

      Fish is not Good for you. See this Video again you will find doctor talking about Vegan diet (No Animal Products)

  • Michael Greger M.D.

    Also be sure to check out my associated blog post Soymilk: shake it up!

  • Glenn Harry

    I eat meat regularly and my LDL’s are below 70mg/dL!

    • LynnCS

      It doesn’t mean you aren’t damaging your epithelium!

      Check out Dr Esselstyne’s talks.

  • ladybug

    Dr. Greger, thanks so much for your informative, science based videos.  My family and I really enjoy them.  I have a question that I am having trouble answering to my friends who think I am making a mistake by eating so low fat.  What about HDL?  They are concerned that my HDL will be too low, and although it doesn’t make sense to me that it need be high if my LDL is low.  What data are out there to help clarify this when it comes up in conversation.  I try to not even discuss the way we eat at all just to avoid confrontation.  It’s too bad, because I want to share this information, but I don’t want to be backed in a corner, so to speak.  Thanks!

    • Toxins

       Check out this video regarding cholesterol being low.
      http://nutritionfacts.org/videos/can-cholesterol-be-too-low/

      The only fat your body needs is omega 3 and omega 6. A plant based diet is abundant in both these fats. There is no dietary need to consume monounsaturated fats, saturated fats or cholesterol.

  • Dylan

    Dear Doctor Gregor,

    Thank you for the videos, I love all the great info.

    I have a friend that is getting into the paleo diet and he referred me to the video
    http://www.youtube.com/watch?v=vRe9z32NZHY&feature=share
    where they claim exactly the opposite…quoting a study

    KM Anderson, WP Castelli, D Levy, “Cholesterol and Mortality: 30 years of follow up from the Framingham Study.”  JAMA 1987; 257; 2176-2180

    where they claim increased death associated with lower cholesterol.  

    I am a devout vegan but all of this information is terribly confusing, I know everyone has there ulterior motives.  Any help would be much appreciated.

    Thank you!

    • Toxins

       Dylan, low cholesterol causing increased death is an old theory.
      http://nutritionfacts.org/videos/can-cholesterol-be-too-low/

      We should also note that the population with the most centenarians per capita were the Okinawans. Here is there diet.

      Back in the 1950′s the Japanese rural Okinawan group of people
      had the most centenarians per capita. How did they live so long? Here is
      their diet

       

      Caloric Restriction, the Traditional

      Okinawan Diet, and Healthy Aging

      The Diet of the World’s Longest-Lived People and Its Potential Impact on Morbidity and Life Span

      Ann. N.Y. Acad. Sci. 1114: 434–455 (2007).

       

      TABLE 1. Traditional dietary intake of Okinawans and other Japanese circa 1950

       
      Total calories 1785

      Total weight (grams) 1262

      Caloric density (calories/gram) 1.4

      Total protein in grams (% total calories) 39 (9)

      Total carbohydrate in grams (% total calories) 382 (85)

      Total fat in grams (% total calories) 12 (6)

      Saturated fatty acid 3.7

      Monounsaturated fatty acid 3.6

      Polyunsaturated fatty acid 4.8

      Total fiber (grams) 23

       

      Food group Weight in grams (% total calories)

       
      Grains

      Rice 154 (12)

      Wheat, barley, and other grains 38 (7)

      Nuts, seeds Less than 1 (less than 1)

       
      Sugars 3 (less than 11)

      Oils 3 (2)

      Legumes (e.g., soy and other beans) 71 (6)

      Fish 15 (1)

      Meat (including poultry) 3 (less than 1)

      Eggs 1 (less than 1)

      Dairy less than 1 (less than 1)

       

      Vegetables

      Sweet potatoes 849 (69)

      Other potatoes 2 (less than1)

      Other vegetables 114 (3)

      Fruit less than 1 (less than 1)

      Seaweed 1 (less than 1)

      Pickled vegetables 0 (0)

      Foods: flavors & alcohol 7 (less than 1)

       

       

       

      Data derived from analysis of U.S. National Archives, archived food records, 1949 and based on survey of 2279 persons.

       

      Some points

       

      Their diet was 85% carb, and 6% fat. Sweet potatoes (a Japanese
      sweet potato) made up almost 70% of their calories. Nuts were less than
      1% of calories (the equivalent of 1/10 of an ounce a day) Oil was
      less than 2% of calories (which is about 1 tsp a day) and sugars were
      less than 1% of calories (less than a tsp a day)

       

      The total animal products including fish was less than 4% of
      calories which is less then 70 calories a day. That is the equivalent
      of around 2 oz of animal products or less a day.

      Looking at the prized Inuits of the paleolithic diet, their diet is comprised of almost all protein and fat. They live 10 years less then the average American. Is this something anyone would idolize? I doubt it.

      Dr. Greger covers the paleo diet here in his free ebook showing short term/long term side affects.
      http://www.atkinsexposed.org/

  • Nooch190

    I believe from all that I have read, that inflammation is the cause of most chronic health problems. Perhaps a vegan diet may help to decrease inflammation but there are other ways of doing this.

    • http://www.facebook.com/banananinja2013 Rock AndRaw

      Inflammation,doesn’t kill 750k people a year.Coronary Heart disease does.

  • Laura

    Would love your advice regarding this article that someone just sent me trying to disprove that a plant based diet will reduce our risk of heart disease, cancer, diabetes, etc. My husband and I have been eating vegan for 5 months now, and he’s lost 35 pounds (I lost none, and don’t need to lose a pound). We both feel great and love the food. Been following Dr. Fuhrman’s eating plan. http://www.sciencebasedmedicine.org/index.php/the-china-study-revisited/

  • Karen Gray

    What is the relationship between elevated cholesterol and the cholesterol that your body makes naturally? I know vegans with elevated LDLs and assume they have a genetic cause that their body makes high cholesterol. I am a pescatarian, only eating seafood a couple of times a week, no dairy, and still have a total cholesterol of 200 and an LDL of 128. I hope my next test show an improvement on these numbers.

    • Karen Gray

      I also eat a mainly whole food fruit and vegetable diet. Juicing once or twice a day and limit processed food to an absolute minimum.

  • http://www.facebook.com/tara.janet.5 Tara Janet

    Isn’t cholesterol the main ingredient that makes up our cells? I have heard from Dr. Coldwell that people can be absolutely healthy even with high levels of cholesterol. I am a healthy ovovegetarian and consume 2 pastured eggs a day as well as exercise daily (my levels are extremely healthy btw) http://drleonardcoldwell.com/

  • Sally

    Can irregular menstruation with excessive bleeding and non-cessation be caused by albinism in the family history? I had to be on birth control pills most of my life from 19-50 but no one made the possible connection to albinism. I also had astigmatism and low thyroid. My sister and dad (who had albinism in the famIly) had astigmatism also. My dad’s father and mother had 7 children, 3 of them albinos. I recently read on the Internet there are some connections to diseases I never imagined. Also, is thereafter connection between albinism and pulmonary fibrosis. My daughter’s husband died of p/f and I am worried about my 16 y/o granddaughter.

  • http://www.facebook.com/gurnani.sunny Sunny Gurnani

    I turned to Vegan and now my LDL is 60. Before turning Vegan my LDL was 115 (I was Lacto Vegetarian at that time)
    I am 5-11 and weight 164. Age 27

  • Linda Howson

    I have been vegan, but recently found a source for raw milk from grass-fed, traditionally raised cows. I know that dairy is supposed to be highly carcinogenic as per “Forks Over Knives” and “The China Study” but wonder if that pertains to this high quality milk and yogurt that I make myself at home. I do not heat the milk over 112 degrees and consume the milk fresh with all its enzymes. Thank you for allowing us to ask questions!

    • Toxins

      The raw milk fad is something that should not be viewed as healthful. the issue with milk has nothing to do whether is is pasteurized or not, but what inherent nutrients exist. Here is an excerpt of a write up I have done on dairy.

      The concern with dairy and hormone dependent cancer is something to think about as well. It has been shown that consuming dairy significantly increases circulating steroid hormones in woman and that vegetarians have far less of this hormone. “In conclusion, greater consumption of red meat and dairy products might influence circulating concentrations of SHBG and estradiol, respectively. Given the well-established role of steroid hormones in breast cancer etiology for postmenopausal women, these findings may have important health implications” Tumor growth from these hormone imbalances is also evident “A dramatic increase in estrogen-dependent malignant diseases, such as ovarian, corpus uteri, breast, testicular and prostate cancers has been recognized. Ganmaa et al. investigated the incidence and mortality of testicular and prostate cancers in relation to dietary practices. Among various food items, cow’s milk and cheese had the highest correlation with incidence and mortality rate of these cancers” Children are at high risk “Among the exposure of humans, especially prepubertal children, to exogenous estrogens, we are particularly concerned with” These xenoestrogens from lactating preganant cattle (the majority of commercial cattle used for milk) significantly raised estrogen levels in male adults and reduced testosterone levels and did even more so in children. This is significant since these estrogens have mutagenic affects “Toxicological and epidemiological studies have indicated that E2 could be categorized as a carcinogen. Milk is considered to be a rich source of estrogens. Indeed, E2 concentration is higher in mammary drainage than in the peripheral circulation in high yielding cows.”

      http://www.ncbi.nlm.nih.gov/pubmed/20211044

      http://www.ncbi.nlm.nih.gov/pubmed/19904296

      http://www.ncbi.nlm.nih.gov/pubmed/19496976

    • http://www.facebook.com/banananinja2013 Rock AndRaw

      200000000 species on the planet,they all eat the same foods,but humans.Humans,are the only species to drink another species milk.

  • Frederick Krewson

    Many of these postings are talking about how much exercise people are doing and working out at the gym and doing “2 hours of vigorous physical exercise every day”…??? The video and the article explain that a person’s cholesterol level is CRITICAL (and that this is determined by diet!!!!). Lifting weights or walking or doing a stairclimber or treadmill (or whatever) are all good…but the net effect on your cholesterol level is very minimal.

    Eat a whole-foods, plant-based diet and your cholesterol level will drop like a rock.

  • tree

    please address the issue of the so called cholestrol myth claiming we do not absorb cholestrol we eat into our blood thanks

  • http://www.facebook.com/arkadiusz.szary.5 Arkadiusz Szary

    very interesting video. It gives to think a lot of!

    http://softfinder.com/

  • LynnCS

    “non flesh eater” is a good start, but to go a bit further, shouldn’t we be telling people not to eat eggs and cheese etc. All animal foods?

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