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.

  • 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…

    • 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: http://bit.ly/nutritionfactsupdates 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.

        • 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. https://www.youtube.com/watch?v=q7KeRwdIH04

  • http://www.ronaldwgumbs.com ronaldwgumbs

    There are 57 countries with a lower prevalence of coronary heart disease than that in the United States: http://www.worldlifeexpectancy.com/cause-of-death/coronary-heart-disease/by-country/
    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.

      http://www.globes.co.il/news/article.aspx?did=1000906210#fromelement=hp_folders_821

      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: http://nutritionfacts.org/video/the-tomato-effect/ 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.

      • http://macsmiley.tumblr.com/ MacSmiley

        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.

          • http://macsmiley.tumblr.com/ MacSmiley

            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…)

    • http://macsmiley.tumblr.com/ MacSmiley

      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. https://www.youtube.com/watch?v=q7KeRwdIH04

    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.