Doctor's Note

This is the second of a three-part video series on the latest discoveries about fighting inflammation with plant foods. See Anti-Inflammatory Effects of Purple Potatoes for part one, and Dietary Treatment of Crohn’s Disease for part three. Other recent videos on nuts include Eating Healthy on the CheapHarvard’s Meat and Mortality Studies; and Plant-Based Atkins Diet, whereas industrial pollutants present in fish oil supplements may even increase inflammation in the body (see Is Distilled Fish Oil Toxin-Free?). The anti-inflammatory nature of plant foods may explain why those eating plant-based diets have less diabetes (Preventing Macular Degeneration With Diet); fewer allergies (Preventing Allergies in Adulthood); less heart disease (China Study on Sudden Cardiac Death); better moods (Improving Mood Through Diet); and fewer chronic diseases in general (Say No to Drugs by Saying Yes to More Plants). Be sure to check out my many other videos on plant-based diets.

We know plant-based diets can help prevent inflammatory disease. But to see if plant-based diets can be used to treat it, you’ve got to put them to the test. Check out Dietary Treatment of Crohn’s Disease.

For more context, see my associated blog posts: How Does Meat Cause Inflammation?Treating Crohn’s Disease With DietThe True Shelf Life of Cooking OilsCholesterol Lowering in a Nut ShellTop 10 Most Popular Videos of the YearBiblical Daniel Fast TestedLead Poisoning Risk From VenisonPlant-Based Diets for Rheumatoid Arthritis; and Mushrooms and Immunity.

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

To post comments or questions into our discussion board, first log into Disqus with your account or with one of the accepted social media logins. Click on Login to choose a login method. Click here for help.

  • Michael Greger M.D.

    This is the second of a three-part series on the latest discoveries about fighting inflammation with plant foods. See Friday’s video-of-the-day Anti-Inflammatory Effects of Purple Potatoes for part one. Other recent videos on nuts include Eating Healthy on the Cheap, Harvard’s Meat and Mortality Studies, and Plant-Based Atkins Diet, whereas industrial pollutants present in fish oil supplements may even increase inflammation in the body—see Is Distilled Fish Oil Toxin-Free?. The anti-inflammatory nature of plant foods may explain why those eating plant-based diets have less diabetes (Preventing Macular Degeneration With Diet), fewer allergies (Preventing Allergies in Adulthood), less heart disease (China Study on Sudden Cardiac Death), better moods (Improving Mood Through Diet), and fewer chronic diseases in general (Say No to Drugs by Saying Yes to More Plants). There are over a hundred videos on plant-based diets alone, along with videos on a thousand other topics.

    We know plant-based diets can help prevent inflammatory disease, but to see if plant-based diets can be used to treat it, you’ve got to put it to the test. Stay tuned for tomorrow’s video-of-the-day Achieving Remission of Crohn’s Disease.

    • HemoDynamic, M.D.

      Have an anti-inflammatory day, during this  in-flame-atory week.
      Happy Independence Day to all.

      Oh, OK go ahead and make it a anti-inflammatory week as well.  Splurge and eat a half a walnut a day.   ~;-}

      • HemoDynamic, M.D.

        Lunch:  It’s Anti-Inflammatory and Fun!!

  • April Lillie

    What kind of nuts dud they study? Do cashews have the same effects too?

  • Valnaples

    Gosh, I’ve become a nutritionfacts junkie!!! Thanks for another great video!

    • HemoDynamic, M.D.

      Are you saying you’re going ‘Nuts’ over ;)

      • Thea

         I’ve gone bananas over this site.  ;-)

        •  Are you saying you’re fruit loopy? :^)

          • Thea

             Gasp!  Fruit loops?  I wouldn’t touch them!  That title is fraud I say.  Fraud!  If there a single bit of fruit in those loopies, I’ll eat my entire organic bannana bunch.

          • HemoDynamic, M.D.

            CooCoo over Coconuts?  ;-}

  • Paulc

     What about the carcinogen, propylene oxide that they sometimes use to pasteurize almonds with? Better stick to organic almonds

  • Slim_Langer

    I’m not from Tennessee and evidently you’re not from Tennessee — but the last cynical swipe strikes me as really petty, and uncalled for. If we’re following a WFPB vegan diet, we’re all human and we’ve all taken some social knocks for it, but it allows us to be on the high road in terms of both moral philosophy/ humane issues AND health science. What call is there for this? It doesn’t help to be negative.  All the best.

  • daisy

    would flaxseed -1 Tablespoon daily provide the same effect as the 1/2 a walnut?

    • Toxins

      No, because flaxseed has much more omega 3 then walnuts as well as potent anticancer lignans that walnuts lack.

  • Greg

    The serum marker used to detect inflammation is commonly c-reactive protein (CRP). The plant based diet appears to effectively reduce inflammation according to CRP. How would one approach reducing IGG sub class 4 (IGG4) blood markers level if CRP is within normal limits?

  • Gauchomatero

    Dr in the video you say one almond a day (or so I heard) and in text half a walnut. Are they equivalent?
    Also, how many nuts/day can we eat without increasing fat too much?

    • Toxins

      English walnuts are indeed healthier due to the fact that they contain much higher levels of omega 3. Almonds contain much more omega 6 which is inflammatory if ones diet lacks omega 3.

      Eating a 1/4 cup of walnuts and two tablespoons of ground flaxseed would be ideal.

      • Toxins,
        Would you mind clarifying whether or not nuts and seeds need to be soaked and/or sprouted (assuming they can be sprouted)? The internet is full of folks claiming you need to do that to deactivate enzyme inhibitors and/or phytates, but WH Foods says there’s no scientific evidence. Please weigh in.

        • Toxins

          Nuts do have some phytates, but that isn’t necessarily a bad thing. Phytate doubles as a potent antioxidant and including nuts in your diet will not cause you to become calcium or zinc deficient.

          Sprouting does increase the antioxidant content of nuts and seeds significantly. For example, sprouted flax seeds contains 10 times the antioxidants when sprouted then before.

          In perspective though for day to day life, including phytate in your diet is a non issue. I wouldn’t worry about it.

  • Jan Carrie Steven

    I wonder if this would work with phlebitis too!?

  • John Theobald

    This doesn’t seem to agree with this and other studies.

    Low Carb Diet Reduces Pain and Inflammation


    A team of Trinity College
    researchers has found that three weeks on a low carbohydrate
    “ketogenic” diet can lower pain and inflammation in juvenile and
    adult animals, offering hope that metabolic, diet-based therapies could have
    broad implications for helping people. The study is published in the
    open-access journal PLoS ONE.

    A ketogenic diet is not unlike a strict version of the popular Atkins diet,
    where low carbohydrate content results in low glucose and forces the body to
    burn ketones for cell metabolism. People who adhere to such diets are
    restricted from eating foods such as bread, pasta, fruit and candy, but are
    allowed to eat green leafy vegetables, meat, fish and some dairy products.

    Clinically, ketogenic diets have proven effective in treating pediatric
    epilepsy and type II diabetes, and recent studies provide evidence that
    ketogenic strategies could reduce brain injury. Ketones are used by the body
    during fasting, and the diet was developed initially based on the observation
    that people with epilepsy experienced a reduction in their seizures when they
    did not eat.

    The Trinity research, which took almost a year to complete, focused on the pain
    sensitivity and anti-inflammatory effects of a ketogenic diet on juvenile and
    adult rats. The work was performed in the laboratory of Susan A. Masino,
    Charles A. Dana Research Associate Professor of Psychology and Neuroscience and
    Director of the Neuroscience Program, along with David N. Ruskin, Research
    Assistant Professor, and Masahito Kawamura, a visiting researcher from Jikei
    University in Japan.

    Ruskin, the lead author, noted that the effect of the diet did not depend on
    any special feeding schedule or limits, and pain and inflammation were reduced
    significantly in both young and adult rats.

    “All the animals ate as much as they wanted,” said Ruskin. “The
    younger animals gained less weight on the ketogenic diet, but the adults were
    not different.”

    The rats’ response to pain was measured by placing them on a warm surface and
    removing them immediately when they lifted up their hind paw, similar to a
    person walking barefoot on warm pavement. A control group of rats was fed
    standard rodent chow. Each rat was tested for six consecutive days at one
    temperature between 46 and 51 degrees Centigrade. How long each rat tolerated
    the warm surface on each day was the measure of his response to pain.

    “The ketogenic diet seemed to have reduced their sensitivity to
    pain,” said Masino.

    In a separate series of experiments, an irritating substance was injected into
    the rats’ paws. The research team found that the swelling and thus the
    inflammation were reduced significantly in rats fed the ketogenic diet
    regardless of age.

    One reason why the findings are hugely important is that pain and inflammation
    are hallmarks of diverse acute and chronic diseases. Indeed, chronic pain is
    one of the most common health-related factors leading to poor quality of life.
    Across all cultures, patients with chronic pain experience among the lowest
    reported quality-of-life scores of any medical condition.

    Moreover, dietary therapy has long been coveted as a strategy to treat a
    variety of clinical conditions, including pain and inflammation.

    The researchers cautioned that the diet formulation used in this initial study
    was more restrictive than the ketogenic diet used by people under medical

    A next step would be to identify the key mechanisms underlying the reduced pain
    and inflammation. Understanding these specific mechanisms could also help
    people with epilepsy by leading to the development of medications that address
    all of these conditions. Without question, said the researchers, a great unmet
    public health need exists for safe, effective and non-addictive strategies to
    reduce pain and inflammation.

    “Our goal is to understand this at the cellular level, which could yield
    new pharmacological treatments and/or less restrictive diet-based
    strategies,” said Masino. “This is a first exciting step, as
    effective and non-addictive new therapies for pain and inflammation are
    urgently needed and could help so many people.”

    In conclusion, the research team said, the data suggest that ketogenic diets
    offer promising therapeutic potential for diverse inflammatory or painful
    conditions across age groups without the added difficulty of maintaining
    caloric restriction. Based on these results and clinical experience with
    diet-based therapies for pediatric epilepsy, a novel anti-inflammatory and
    analgesic application of ketogenic diet therapy would be effective,
    non-addictive and relatively free of major side effects.

    • Toxins

      Please present studies rather than random quotes. Ketogenic diets (very low carb, high fat) have been shown to be helpful with children with epilepsy for the short term. All other aspects of the diet for the short term show ill health effects. Its not something you want to put your body through. I will share the SHORT TERM evidence below. The long term evidence is also damning, but here is short term data.

      “Cognitive Effects of Ketogenic Weight-Reducing Diets,” researchers randomized people to either a ketogenic or a nonketogenic weight loss diet. Although both groups lost the same amount of weight, those on the ketogenic diet suffered a significant drop in cognitive performance.After one week in ketosis, higher order mental processing and mental flexibility significantly worsened into what the researcher called a “modest neuropsychological impairment.”

      A review over low carb diets revealed that “Complications such as heart arrhythmias, cardiac contractile function impairment, sudden death, osteoporosis, kidney damage, increased cancer risk, impairment of physical activity and lipid abnormalities can all be linked to long-term restriction of carbohydrates in the diet.”

      Low-Fat Versus Low-Carbohydrate Weight Reduction Diets

      Effects on Weight Loss, Insulin Resistance, and Cardiovascular Risk: A Randomized Control Trial

      This study looked at 24 people who were overweight/obese and divided them into 2 groups. One group was low carb, high fat and the other high carb, low fat.

      High carb group: 20% calories from fat/60% calories from carbs

      Low carb group: 60% calories from fat/20% calories from carbs

      In addition, the study was designed so that participants would lose 1 pound per week, so calories were reduced by 500 per day.

      Volunteers were given pre weighed foods given as daily portions and were assessed by a dietician to make sure that they were adhering to the diet. After 8 weeks, this is what was found to be significant between the two groups. The low carb, high fat group experienced arterial stiffness which basically means impaired arterial function. What this means is that the people on this diet experienced low grade inflammation which can lead to the growth of atherosclerotic lesions and can become heart disease. “It is possible that the high fat content of a low-carbohydrate diet exerts detrimental effects on endothelial function, which raises concerns regarding the long-term safety and efficacy of low-carbohydrate diets…Currently, supported by evidence from long-term trials, we believe that a low-fat diet should remain the preferred diet for diabetes prevention.”

      Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity

      20 subjects participated in this study. “The [low carb] diet provided 20 g of carbohydrates daily, supplemented with protein and fat content according to the Atkins’ diet recommendation.19 The [low fat] diet provided 30% of the calories as fat, modeled after an American Heart Association diet.” I wouldn’t exactly call the low fat diet “low fat”, but regardless, its far less fat then the low carb diet. Both groups were given 750 calories less with pre made meals so they would stick with the protocol.

      After 6 weeks, there were significant differences between the low carb and the low fat group. The researchers performed a brachial artery test which basically tests to see if arterial function is impaired or not. Typically, the arm is cut off from circulation for about 5 min., then they release the arm, and measure how dilated the blood vessels are. If the blood vessels are constricted, it represents arterial impairment whereas dilation indicates good arterial health.

      On week 2 of the diet, both low carb and low fat groups had poor arterial health and were not significantly different, but by week 6, those on the low carb diet had far worse arterial health then before, and those eating low fat had far better.

      (See figure 1: )

      This again shows that this type of diet is promoting heart disease risk.

      Low carbohydrate, high fat diet increases C-reactive protein during weight loss.

      Unfortunately, I was unable to find the full text of this study so it is difficult for me to view the details and all I can do is base my conclusions of the study based on the abstract which is not something I like to do. Regardless, the study revealed a very interesting finding. It showed that when subjects of the study went on a low carb, high protein diet for 4 weeks, they had a 25% increase in C-reactive protein. C-reactive protein is a marker of inflammation which basically means that this group of people were promoting the development of a chronic disease. In contrast, the high carbohydrate subjects decreased their levels of C-reactive protein by 48%.

      Comparative Effects of Three Popular Diets on Lipids, Endothelial Function, and C-Reactive Protein during Weight Maintenance

      This study is quite interesting. It examined 18 adults aged 20 or over for 6 months. The aim of the study was to examine their health when on 3 diets, the Atkins diet (high fat, low carb), the South beach diet (Mediterranean) and the Ornish diet (low fat, high carb). They found no significant differences between the 3 diets in terms of calories consumed. The results are interesting as seen in table 1 of the study.

      They found higher LDL in the Atkins diet and lower LDL in the low fat Ornish diet. They also found significantly higher levels of C-reactive protein in the atkins diet as opposed to the Ornish diet. What was also found was that the atkins diet had poor results for the Brachial Artery test which again shows impaired arterial function. “High saturated fat intake may adversely impact lipids and endothelial function during weight maintenance. As such, popular diets such as Atkins may be less advantageous for CHD risk reduction when compared to the Ornish and South Beach diets”

      • Tom Goff

        Great post. As you note, the long term effects of ketogneic and other low carb diets are really scary. We know for example that low carb diets do not just increase risk, they increase actual mortality. This effect, however, seems mainly confined to low carb diets based on animal fats and proteins. Low carb diets based on vegetable fats and proteins are apparently much less dangerous. Early death sounds like a pretty undesirable side effect of ketogenic diets to me..

        This is only observational evidence. Nevertheless, experimental studies with animals underline the dangers of ketogenic and other low carb diets:
        “C57BL/6J mice were fed with a HF diet (60% kcal/fat) or control diets (15% kcal/fat) for 27 months. One-half of the mice on the HF diet developed obesity (diet-induced obese (DIO) mice), whereas the remaining mice were diet resistant (DR). At 8 months of age, both DIO and DR groups had increased hyperglycemic response during a glucose tolerance test, which was normalized in 16-month-old mice. At this latter time point, all groups presented similar performance in cognitive tests (Morris water maze and inhibitory avoidance). The survival curves of the HF and control diet groups started to diverge at 15 months of age and, after 27 months, the survival rate of mice in the DIO and DR groups was 40%, whereas in the control diet group it was 75%.”

        Source: “High saturated fat and low carbohydrate diet decreases lifespan independent of body weight in mice

        There was another interesting mouse study published in 2014:
        ‘The team put mice on 25 different diets, altering the proportions of protein, carbohydrates and fat. The mice were allowed to eat as much food as they wanted to more closely replicate the food choices humans make.

        “The healthiest diets were the ones that had the lowest protein, 5 to 10 to 15 per cent protein, the highest amount of carbohydrate, so 60, 70, 75 per cent carbohydrate, and a reasonably low fat content, so less than 20 per cent,” Professor Le Couteur said.

        “They were also the diets that had the highest energy content.”
        “We found that diluting the diets to reduce the energy intake actually made the animals die more quickly.”
        The mice that ate a high-carbohydrate, low-protein diet lived about 50 per cent longer than those on the low-carb diet.”

  • Marie

    Dear Dr. Greger,
    Is there a nutritional quality difference between raw and roasted nuts? What about sprouted ones (soaked overnight)?

  • Ilana

    What about the claim that nuts are too high in saturated fats and should be avoided?

    • Quiana

      If saturated fat in nuts were a problem, we wouldn’t see these positive effects from them. That said, nuts aren’t high in saturated fat. They’re high in mono-unsaturated fat.