Doctor's Note

This is one of my favorite videos of the year so far. If you’re not familiar with Dr. Esselstyn’s  work I touch on it in:

And in fact he just released a much larger study. Read it here.

Sadly, medical students learn little about these powerful tools:

If you haven’t heard of Pritikin, I introduce him here: Engineering a Cure

An intro to Dr. Ornish: Convergence of Evidence

Dr. Burkitt: Dr. Burkitt’s F-Word Diet

The Cornell-Oxford-China Study: China Study on Sudden Cardiac Death

And more on Dr. Walter Kempner’s work at Duke coming soon!

If you haven't yet, you can subscribe to my videos for free by clicking here.

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  • Coacervate

    There are none so blind as those who will not see. I think real change to real nutrition can happen only if/when we teach it in schools starting on day 1. The majority of “grown ups”, like the old me, see what they want to see and hear what they wish to hear. I was so much older then…I’m younger than that now.

    • mbglife

      Nutrition won’t be taught in school until enough people agree on what proper nutrition is. And that won’t happen without proof. Carnivore advocates like paleos and the Weston Price Institute, would have a different idea than vegans of what’s nutritious. It’s the old problem of which came first, the sunflower or the seed?

      And forget schools, when will health specialist catch on in hospitals? They don’t seem to relate the affects of real food on patients. When I had surgery and an overnight stay at the largest chain-hospital in northern California last year (which is a company I respect and appreciate) I brought my own foods like oatmeal, lentils, brown rice and fruit. (I could have gotten some fruit from the hospital, but I wanted organic.) But as I recall, while they offered some fruits, they had only refined grains and animal products for breakfast, lunch and dinner. I’m sure I could have had a bologna and mayo on white bread sandwich if I asked for it. The staff was wonderful and very accommodating in helping with my meals, but it was food that I had to bring. How do people recovering get better on the stuff they serve?

      And for a friend who is currently in a county jail serving a 6 mo sentence, almost every lunch is bologna on white, and almost every dinner is low grade animal products and ramon noodles and a small serving of over-cooked canned veggies. Talk about your cruel and inhuman punishments.

      • Karl Young

        Yep, re. amazing hospital food. I worked for quite a while in a medical imaging research lab located at a prominent northern California VA hospital (i.e. in the heart of foodie USA). I was stunned the first time I checked out the cafeteria. Alongside the pepperoni pizza, greasy fires, fried chicken,and mammoth soda dispenser, the only “healthy” alternative was a plastic container full of iceberg lettuce and tasteless tomatoes.

        • mitch

          Same here. I’ve worked in hospital based imaging for over 40 years and the food was atrocious. The last place I worked,though, had an unusual but delicious salad bar, like someone knew what they were serving.
          Sad to say most MD’s are clueless to plant based reversal of heart dz. When I mentioned it to some of the MD’s I worked with their eyes glazed over and got very uncomfortable…If it was not in their “cookbook” of how to treat dz with the Burn Cut or Poison method they were like a fish out of water…

      • 4Baccurate

        If you are talking about Marin General Hospital: Yes, their food planning takes no notice of patient’s nutritional needs— They were incompetent to bring my husband’s blood pressure down from 180 (!!!) after a hemorrhagic stroke (likely pharmaceutical-induced) and it didn’t come down until I got him home, phased him off the cardiology-prescribed drugs— It didn’t even occur to them to try magnesium citrate: a real clown show. Additionally, my husband’s room was not properly sanitized— I swiped one of the bed rails with a paper towel dampened with water and hand sanitizer, turned the towel over and saw an impressive amount of grey matter… They hadn’t even cleaned the bed rails that the patient and others touch. Within 6 days of visiting the hospital, I came down with a respiratory infection that would have killed a less healthy person. You’d expect this kind of hospital in some backwater, like Tuskaloosa, Alabama, not in Marin County— within minutes of UCSF medical center and not that far from Stanford.

    • Blanster

      I just wanted to thank you for reminding me of one of my favorite Bob Dylan lines. :)

    • Jeff

      Good Byrds reference in the last line!

  • Dmitry

    At the autopsy of young soldiers killed in Vietnam, doctors discovered a strong atherosclerosis. It turns cholesterol is not guilty?

    Michael what do you think?

    • mbglife
    • mitch

      In my early career in imaging, I viewed an autopsy of a young gent. The pathologist said the same thing! This was 35 years ago. He said autopsy on WW2 soldiers had very little to no plaque in their hearts. Korean war, more plaque and with vietnam it was exploding, pardon the pun. The pathologist showed me the left coronary artery on this 20 something year old and it had little flecks of white in it. The beginning of Atherosclerotic Heart Disease…
      Kind of parallels the injestion of more meat products, high fructos corn syrup and highly processed food. Hummmmm…..

  • Dmitry

    I had in mind that one of the main causes of atherosclerosis in the young age the stress and no cholesterol.

    • mbglife

      I recall reading something a few years ago that said stress plays a factor because cortisol–produced by the body when it’s under stress–increases how fat and cholesterol collect as plaque around organs, especially the heart.

  • HemoDynamic, M.D.

    Well presented! Thank you again and again and again! I’m glad you have not been blinded by the “science”!
    Reminds me of a song . . . “She Blinded me with science”

  • Plantstrongdoc M.D.

    Great video!
    Maybe a lot of doctors are in denial.
    As Dr Greger points out:
    It takes a big study to show minor results – and who cares?
    It takes a small study to show big results – and nobody cares !!
    Every M.D. know this, so I dont understand why the work of Dr Ornish, Dr Esselstyn and others doesn’t have a huge impact on modern medicine.
    Medicine have throughout its history recommended treatments based on probable evidence, but when we talk about food as a tool to prevent, control, reverse or cure disease the medical establishment demands absolute proof. Talk about bias….

  • brec

    “This is one of my favorite videos of the year so far.” Justifiably so!

    But (of course! :) wouldn’t the intro be helped by mentioning Esselstyn’s recently-published study?

    • Jen Drost, Physician Assi

      Hi Brec! :)) The ECMO example is such a powerful analogy, isn’t it? To answer your question, Dr. Greger and his fab team scripted and recorded this video piece just a few weeks before Dr. Esselstyn’s most recent study was released. But if you look under “Doctor’s Notes” (above these comments, below the video), there’s a link to Dr. Esselstyn’s newest study. So stay tuned, I think Dr. Greger mentioned that he plans to highlight the new Dr. Esselstyn study in an upcoming piece. And if you’re not already, make sure you’re subsrcibed by going to: so you don’t miss it!

      NF community, if you like this piece, please share it with as many people as possible! Or at least with the people you care about living long, healthy lives! :)) Let’s get the word out!

      • Blanster

        I’m frustrated because the people I LOVE in my life who need to take action on this message sadly have not. Despite my best efforts of sharing Dr Greger’s videos. You can lead a horse to water…sigh.

        • Psych MD

          You’re absolutely right. I am a physician working in a hospital and all around me I see colleagues , coworkers, and patients getting fat. I discuss diet and fitness on a daily basis yet, at the end of the day (a phrase I am rapidly tiring of) most people eat what they think tastes good. And it usually comes in a paper bag with a familiar logo on it. Poor eating habits are incredibly ingrained in our society. I always know when a class of nursing students is departing by the telltale pink doughnut boxes left behind as a token of their “appreciation.” You mention the word vegetarian to people and the most common response is, “So all you eat is salad?”

          • mbglife

            When I went vegetarian (later vegan) I told friends having me over for dinner, at the time of invitation, to just serve me everything except the meat. At the dinner, my friend’s wife served me a chicken breast. When I reminded her that I was now veg she replied, “I know, that’s why your piece is smaller.” When I politely declined it she got upset and said, “but you can’t eat NO meat! You have to eat SOMETHING!” They never accepted it.

          • Thea

            mbglife: That may not have been funny at the time, but that’s just so funny now. I can just imagine someone so outraged/confused/bewildered and earnestly saying that.

            I guess it’s both funny and a sad testament to how lacking our education system is. Your friend’s wife no doubt hontestly believes that if you don’t eat meat, that’s tantamount to eating nothing or nothing of value. OK, now I’m sad again.

          • mbglife

            I know. I love how a smaller piece of meat is equal to being vegetarian.

          • RunsWithPoodles

            And fish, don’t forget fish. So many people, when hearing that I am vegan, say, “But you eat fish, right?” Duh.

          • Blair Rollin

            I’ve experienced the exact same response a number of times. When I repeat that I don’t eat any animal products I’ve even had an adult ask me “Is a fish an animal?”.

        • Thea

          Blanster: I can so relate. And you are right, you can’t force people to do what they don’t want to do. What makes it painful is when the stubborn people (horses or another word for donkeys? ) refuse to change.

          If it is any comfort, I can say that I never thought my parents would change. But I kept being patient in terms of sending information and being a good role model without pushing. Eventually both parents went largely vegan (maybe 97% I think). And both have experienced significant health benefits. So, it may not happen fast enough to give you peace, but it *can* still happen.

          You may have done this already, but I highly recommend purchasing a copy of Forks Over Knives. (Or if you have Netflicks, I believe they have it.) And then bribe your loved ones to sit down and watch it with you. I think that movie is powerful. And while it didn’t have an immediate effect on my parents, I believe it was what started to change their thinking. Dr. Greger’s summary videos also helped greatly.

          Good luck!

          • Blanster

            Thanks! My frustration is that so many friends have serious (even life threatening) health issues, yet prefer to take medications and suffer over trying dietary changes that would potentially cure their issues. And I have to worry and listen to them worry in the meantime. :(

          • mbglife

            I just posted this link in a separate post on this page to a Dr Greger video about how vegans die at a higher rate than omnivores unless they are getting vitamins B6, B12, folate and balanced omega-3 to omega-6. The advice can also help omnivores, so you might want to try that info with your no-diet-change friends.

          • RunsWithPoodles

            A friend of mine, who last year told me that he couldn’t live without meat, recently confided to me that he is changing his diet to more veg. Yay! I think recent health issues in his family along with all the delicious pics of my vegan dinners that I post on FB are changing his mind.

          • Thea

            RunsWithPoodles: Nice!!! Good for you. That’s really leading by example.

  • There are 57 countries with a lower prevalence of coronary heart disease than that in the United States:
    What fraction of the diets in these nations is plant-based?

    • Ben

      I can’t speak to every country out there, but Israel has about 1 million vegetarians (with a total population of 8 million), with about 5% of the total population being vegan.

      Sorry about the link being in Hebrew, but Google Translate should do the trick.

    • george

      This is a very informative site. Thank you for the link.

    • Psych MD

      That’s an excellent link, but it initially threw me for a loop. I recalled an earlier video which mentioned that heart disease was virtually unheard of in Uganda, yet according to this chart it is significantly higher than in the U.S. I went back and watched the Uganda video again and realized that the studies were done more than 50 years ago. My how they have progressed.

    • Psych MD

      Wow! I just went through every cause of death on that chart. It’s mindboggling. If you ignore infectious diseases, which obviously predominate in Africa, it’s difficult to see a pattern with the various cancers and other afflictions.

  • Eric O’Grey

    This video is a perfect pairing with your “tomato effect” video, which remains one of my all time favorites: The main point you raise in each video, that scientists need to stop pretending that valid science regarding nutrition doesn’t exist, because it doesn’t fit the current generally accepted view, is perfect. Thank you so much for all of the useful information I get from your site every day.

  • george

    I read Esselstyn’s book, but it was a while ago. As I remember, his subjects took statins while on a strictly plant-based, low-fat diet.

    • brec

      Some of them, perhaps a majority, took/take statins. I take one. But millions of people do. I need both (diet+statin) to get my TC and LDL to what I consider acceptable levels.

    • Darryl

      Dr. Esselstyn added relatively low dose lovastatin and sometimes
      cholesyramine to push total cholesterol below 150 mg/dl, where the Framingham study indicated negligible cardiac risk.

      For most middle-aged, Western patients on low fat Pritikin/Ornish/Esselstyn diets, diet alone achieves cholesterol levels around 170 mg/dl. But achieving lower cholesterol through diet (or genetics) appears to have greater protective effects than through drugs. High-dose statins can reduce event rates by about 26%, whereas traditional low-fat plant based diets reduce events by upwards of 80-90%, and genetically lifetime low LDL reduces rates 3 times as much as pharmaceutical reductions with statins.

      I monitor my own progress with bimonthly blood donations, and indeed, my own levels hovered in the 170 mg/dl range for years after adopting a whole foods plant based diet. I finally had a 147 test result last week, and I suspect an almond binge (with its high levels of phytosterols) during the prior week contributed to the good number.

      • I’m not quibbling with the effect of a WFPB diet on CAD (Joe Crowe’s angiogram in Esselstyn’s slide and first chapter of his book is all the more impressive because he refused statins), but doesn’t the footnote in Esselstyn’s book mention cholestyramine, 4 g twice daily, and lovastatin @ 40 mg to 60 mg/day? Don’t know about cholestrymine, but isn’t 60mg a pretty hefty dose of statins?

        • Darryl

          Statins have varying effectiveness at LDL reduction, this is a useful comparison chart. There are numerous articles in the literature where “aggressive” LDL lowering with 80 mg Lipitor or 20 mg Crestor are used, which appears to be many fold the effective dose used by Esselstyn.

          • Thanks, Darryl. That chart was just what the doctor ordered.

      • Mike Quinoa

        I’m glad to hear that the almonds lent a hand. I need nuts and seeds to maintain a healthy weight. So I eat variously raw (when possible) almonds, walnuts, pumpkin seeds, sunflower seeds, Brazil nuts, hemp seeds, and peanuts (I know, not a nut). I try not to over-do it, as I could easily be eating a “high-fat” diet.

        Darryl, do you have any comment on unsweetened, shredded coconut?

        Superb video, Dr. Greger.

  • Ben

    Thanks for another great video. It always astounds me how much misinformation gets spread through doctors, who most people believe have the best information on nutrition.

  • Darryl

    Dr. Esselstyn has published a new, larger study of zero-added fat whole plant food diets in coronary artery disease:

    Esselstyn, Caldwell et al. (2014). A Way to reverse CAD? J Fam Practice, 63(7), 356-364.

    It will be criticised for not having a randomized control arm, but a 10% (and only 0.6% “recurrent”) adverse event rate in the 177 adherent patients vs 62% in the 21 patients who fell off the wagon deserves a more prominent outlet than J Fam Practice.

  • DB

    I’m still waiting for a meat and dairy sponsored Esselstyn-like study to demonstrate that a high fat low carb diet can reverse heart disease.

    • Thea

      Cute. ;-) Don’t hold your breath, or you’ll turn purple.

      (Or maybe they will come up with something by creating yet another twisted/invalid study. Yikes. Be careful what you joke about…)

    • You would be surprised how many doctors even cardiologists and lipidologists have been persuaded to accept LCHF diets as an alternative to plant-based nutrition. Part of this has to do with the efforts of Gary Taubes & Assoc/NuSI. It’s possible some have been able to lose weight themselves on such a diet, despite risk factors worrsening in many but not all who undertake the diet.

      (Though I have yet to see proof of regression, theoretically it is possible that weight loss alone can induce it. Problem is, no one can lose weight indefinitely, which leaves one eventually with the stark effects of the foods themselves.)

  • Patrick Lamy

    The only way Dr’s will prescribe a good diet over of pills is if pharmaceutical companies can have their own grocery stores where patients HAVE to go and fill out their orders.

  • bobluhrs

    I think the level of difference vs chance should help determine the extent of studies needed to demonstrate efficacy. If 18 out of 18 who complied with Esselstyn’s diet were functionally cured, as it appears they were, then what is the likelihood you’re going to see something different in patient 19? Not much. Certainly low enough to take the chance, especially with the meager results of other things, many of which failed his 18 patients already before they even started on his diet.

    The science demonstrating diet is unknown to the public. I have to say that before I found Esselstyn, Campbell, Ornish, Fuhrman, Greger, Burkitt, Klapper, Barnard, and some others, I had NO IDEA there was any real dietary science being done, that the results were in, and that the miracle cure had been found. It is so cool, yet the public is mostly unaware how powerful all this information actually is, or where exactly to find it amidst all the hype and confusion.

  • Nate justice

    This is an especially important video! Thank you dr. Greger! You and your team rock my world with the latest and greatest in nutrition and all around useful and practical information (almost) every day! Keep up the good work!

  • mbglife

    Dr Greger has a 1hr 15min video on youtube of his presentation in the early 2000s about vegans dying of heart disease, cancer, stroke and Alzheimer’s at rates higher than meat eaters.

    In it he explains the cause was discovered to be that people need to take folate, B6 and B12 to get homocystine levels down, and get their omega-3 and omega-6 levels within a 1 to 4 ratio or better. And the results showed that this was the case regardless of cholesterol being over 200. Good video but loooooooong. I wish he would make a mini version for this site. It was really good. I’ve enjoyed and supported this site for years, but never saw the video until recently. Now I tell my omnivore friends to at least pop a few more pills (the above listed supplements) to protect themselves better. Some are doing it. So it’s a start.

  • NameLass

    I notice there were only a handful of women in Dr Esselstyn’s study of nearly 200 (see link to July, 2014 “A Way to Reverse CAD?” article, under Doctor’s Note, above).

    Thanks, Dr G.

  • 4Baccurate

    So glad you are on the case of current medical practices. Clearly (after all the life-endangering compliance with cardiologists’ “aggressive risk management” in uncritically prescribing the usual trilogy of drugs to anyone over 50—— “evidence-based medicine” is a grotesque misnomer in a profession that operates in the pre-scientific age— relying on a drug-effect reporting system with vast holes and massive evidence suppressed, ignored, unreported, unobserved and beyond the ken and outside the radar in medical settings. “Prescribe and forget” —- e.g., No baseline testing in the first place to see if a patient needs any anti-platelet aggregant, or not! No drug response monitoring— Even when patients go to emergency rooms with life-threatening drug reactions, doctors have no system to notice or even care —-this is obviously off their’ radars— except perhaps for the E.R. doctors whose job it is to administer antidotes. Examples: patient comes in with edema, compromised kidney and pancreatic function, joint pain, gout— in response to cardiology-prescribed drugs. “Oh, you have venous insufficiency!” or, “Did you know you have a heart arrhythmia?” — More drugs to treat drug-induced disorders. A hemorrhagic stroke, sudden hearing loss, anaphylaxis, abducens nerve palsy? Couldn’t be the aspirin or the other aggressive risk management drugs I prescribed which is so good for you! Gotta be Old Age or Patient Non-Compliance!

  • ap

    Is there a vegan alternative to vaccines available for shingles prevention?


    I am looking for guidance on the Gardasil vaccine for me daughter. If she, and our whole family, are vegan and generally practice a healthy lifestyle, will that decrease her chances of getting cervical cancer enough to skip the vaccine? I am quite dubious of the pharmaceutical industry…

    • Jim Felder

      I can understand being a little dubious of the pharmaceutical industry since they haven’t exactly covered themselves in glory with respect to the safety and efficacy of many different drugs. But vaccines are not an area where we should not let that skepticism make us avoid being vaccinated. With regard to not needing the vaccine due to a vegan diet, HPV, the virus that is the target of Gardasil, is a sexually transmitted virus rather than food born. In fact HPV is THE most sexually transmitted virus in the US with nearly all sexually active people being infected at some point in their lives. So being vegan won’t make any difference.

      Vaccines are extraordinarily safe. The only significant negative effect of the HPV vaccine reported in the clinical trial with over 15,000 participants was due to allergic reaction to components of the vaccine. So unless your daughter has specific allergies, the HPV vaccine is about as safe a thing as you can get in medicine. The benefits far, far outweigh the tiny risks. I strongly encourage you to get your daughter vaccinated now because once exposed to the virus it is too late and will dramatically increase the chances that she will develop cervical cancer, as well as a couple other types of cancer, later in her life.

      Oh, and all boys should be vaccinated as well. Men seldom display any symptoms (such as genital warts) of HPV infection, yet can still serve as a disease vector passing the virus along to all sexual partners. Getting rid of HPV will require that all young girls and boys be vaccinated. If even a small fraction go unvaccinated, HPV is so easily transmitted that it will continue to circulate in the population. But the vaccine is extremely effective and so within a matter of years or decades at most, we could completely rid ourselves of this virus (much like we did with small pocks and are on the verge of doing with polio. And while HPV infections is mostly closely associated with cervical cancer in women, men can also develop penile cancer and other cancers as a result of HPV infection. Thus boys being vaccinated isn’t just a bit of altruism on their part so that girls don’t develop cancer.

      Bottom line, everybody needs to be vaccinated before their first sexual encounter.


    Jim, thank you for your thoughtful comments. You certainly give me more to think about. However, I keep reading that the risk of getting cervical cancer from HPV is small. While most of us have the HPV in us, only a few strains of it are linked to cervical cancer and even then, it doesn’t always turn into cervical cancer. Even the American Cancer Society’s website lists eating fruits and vegetables as one way to reduce risk of cervical cancer. I also read that there are risks, as with any vaccine. (For point of reference, our family has taken all our vaccines to date). Gardasil contains aluminum in the vaccine and it does not contain the actual virus. So, I still question the necessity of this vaccine given our family’s healthy vegan lifestyle (and commitment to it). I post, because I am still interested in learning more to convince me one way or another!