Doctor's Note

Unfortunately there’s an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet is that fruits and vegetables may actually improve cancer survival:

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 NutritionFacts.org account or with one of the accepted social media logins. Click on Login to choose a login method. Click here for help.

  • HemoDynamic, MD – NF Volunteer

    That IS what nutrition facts is for! Surprise, surprise, surprise!
    As Johnny Carson used to say, “I did not know that.” Did you know that Ed?. Ed: “yes oh great one.”

    • Plantstrongdoc M.D.

      It is “Got NutritionFacts.org?” and NOT “Got Milk?”
      :-)

      • Coolcat

        Milk, hydrogenated, trans fatted, and pasteurized, heated up destroying all nutrients. And loaded with hormones and cow puss. Mmmm delicious.

    • Coolcat

      Good one. “When I die, lying on my bed, a Twinkie by my side, a Big Mac by my head.” Junk Food junkie.

  • HemoDynamic, MD – NF Volunteer

    I just wanted to add that trying to edit these comments or type in a comment off an iPad or an iPhone seems to become more difficult. I don’t knowIf I have to upgrade my iOS or I need to buy a new iPad. I just know it’s become really frustrating for me to try to leave a comment and add edits. Is anybody else else having this issue?

    • Veganrunner

      Good morning Dr. Hemo. What’s cooking?
      Me too! Darn iPad. I can see it now. We both wake up, pick up that iPad and go to Nutrition Facts. Org.

      • HemoDynamic, MD – NF Volunteer

        There is no better resource! I’m glad you enjoy this website as much as I do. Cheers.

      • lilyroza

        Hmm, never a problem on my Samsung Galaxy Note 8, either with or without the bluetooth keyboard if I decide to get really wordy.

    • Bruce Cropley

      I’ve got a related question for anyone – how can I maximise the screen of the videos using the keyboard? I can start and stop it once it is full screen and running?

      • HemoDynamic, MD – NF Volunteer

        I do not know but it is a good question. I’ll try to figure it out.

        • Bruce Cropley

          Thanks :) I’ve had a bit of a try myself already. And just now I’ve figured it out :D
          1. Click anywhere in the video to select it and start it playing.
          2. Press ‘F’ or ‘f’ to go full screen.
          OK it isn’t only using the keyboard, but it’s a lot easier than what I was doing – clicking right on the play button then on the expand to full window in the lower right corner.
          Enjoy :)

    • http://twitter.com/MacSmiley MacSmiley

      Speculation: Might have something to do with the Zendesk thingie now visible on the website?

      I’m running iOS 8.3 on an iPhone 5. No problems I haven’t seen before now.

      • HemoDynamic, MD – NF Volunteer

        Hmmmm! Thanks for the input.

  • Veganrunner

    Ok. That is just scary stuff. Medical doctors not practicing evidence based practice. Yikes! Stay clear of those old timers.

    • Plantstrongdoc M.D.

      Doctors scream for evidence when introduced to ideas that is going against their beliefs, and ignore lack of evidence when an idea fit into their mindset.

      • Thea

        Plantstrongdoc: To be fair, your statement just shows that doctors are human. My take is: We all know intellectually that doctors are human, but it is disheartening when the detailed implications are considered. We all want there to be a profession of people (doctors) who really are evidence-based and fully educated regarding human health. And many of us grew up believing/being told that doctors as a whole/group really fit that description.

        It was interesting to me that I saw your and Veganrunner’s comment just after reading the following article. Here’s a related quote from the article: “Scientific meta-analyses show that we are more likely to be persuaded when requests are congruent with our values, self-image, and future goals. In other words, people are easily persuaded of that which they wanted to do in the first place. …In short, effective persuasion highlights the irrationality of human thinking. We may be living in a data-driven world, but that does not make people more logical.” If doctors are human too, then this applies to doctors too.
        https://hbr.org/2015/06/persuasion-depends-mostly-on-the-audience?ncid=newsltushpmg00000003

        Of course, medical practices and common beliefs do change over time. Non-doctors like me can take heart that there are doctors like you and the others on this website who are leading the change. From the article above: “This is why the same people may regard an idea as absurd one day, and amazing the next. As Arthur Schopenhauer noted: “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.””

        • Plantstrongdoc M.D.

          Thea,
          Thanks for your intelligent and interesting reply! No doubt I listen more if what I am told fit in to my belief system.

          • Kim

            Just finished reading Anatomy of an Epidemic, by Robert Whitaker, and this conversation made me think to plug it here, under ideas that doctors don’t consider. The author makes the case that long-term outcomes are worse for mentally ill patients treated with psychiatric medications as opposed to those treated without, and that there is zero evidence that mental illnesses are caused by chemical imbalances in the brain. It’s a view that supports the sale of pharmaceutical drugs, and as such is aggressively promoted, but evidence is lacking.

            Hopefully Dr. Greger will post more videos on mental health! His video on the ineffectiveness of antidepressants compared to placebo was interesting. The slight (clinically insignificant) increase in benefit in those receiving antidepressants vs. those receiving placebo disappears entirely when active placebos are used. Why is it not considered criminal that doctors are still prescribing these medications?

          • Thea

            Kim, *Very* interesting info/ideas. Thanks for sharing! I agree that it would be great for Dr. Greger to cover this topic some more in the future.

          • http://twitter.com/MacSmiley MacSmiley

            It is my understanding that anti-depressants are not more effective than placebo for mild depression. That’s not the same thing as saying psychoactive drugs are completely useless. I hope you are not suggesting that the use of such medications be abandoned. Or that anybody taking such medications should suddenly discontinue them.

          • Kim

            Please read the book I recommended. There are others on the subject as well.

            Although, no, medications should certainly not be suddenly discontinued. For those seeking to get off of them, they should gradually reduce their dosage, gradually wean themselves off medication and unless one’s issues are mild, help should be sought in doing so. There is no question that medications alter the way the brain works, and suddenly discontinuing medications can be dangerous.

          • HemoDynamic, MD – NF Volunteer

            Why is it not considered criminal that doctors are still prescribing these medications?
            Because that is what the system upholds (Don’t bite the hand that feeds you). Drugs first, everything else second! That is how the system makes money (eg. supports itself). There is no money in supporting eating healthy! My pharmacy only makes money when I prescribe medications for patients. It does not make money when I prescribe a plant based diet for patients. It really is simple math.

          • Rob

            i believe mental illnesses are caused by: vaccinations and then accidents and irregular exposures To chemicals. Then I think mental diseases are caused by an imbalance in the gut flora which is caused by an unhealthy diet. After that, a lack of sleep, mixed with stress, and a poor diet can cause any person to go bonkers. Also, beIng helD prisoner in isolation for a few weeks will also make any normal person hear and see things that are not there.

      • Coolcat

        Brainwashed by Big Pharma and the FDA.

    • Coolcat

      Take your drugs and shut up! Don’t you know we were born with drug deficiencies? LOL.

  • BB

    Fortunately for my mother-in-law who is suffering with the aggressive treatment of her stage-4 ovarian cancer, the doctors have said nothing about limiting fruits and vegetables. That is because they have said nothing about nutrition at all except to get her to eat more protein. So….. when she does eat it is dairy yogurt with (thank goodness) some fruit. She has no feeling in her hands, swollen feet, is bald, congested, very weak and she is going in for another chemo this week. Makes no sense!

    • Gia

      Please give her nanogreens 10…it’s the closest to fresh fruits and vegs.

    • Joseph Gonzales R.D.

      Hi BB. Has her doctor mentioned seeing a dietitian? I would highly recommend it. I can help you find a qualified oncology dietitian if interested. Best to you and your mom-in-law and family and friends during this tough time.

      • BB

        Her doctors (and she has several) are not concerned about nutrition at all. They just want her to eat something and recommend more protein which I would guess is low because she can’t eat much. She ate everything before and was very obese which is logically what caused her present condition. The whole family is very resistant to changing their diets and are all suffering with obesity and/or diabetes. At this stage and with the doctors continuing to recommend aggressive treatment, I am not sure even the best nutrition would make a difference. It is difficult especially when the rest of the family are in declining health solely because of their diet and weight issues. Thank you for your kind words!

        • Joseph Gonzales R.D.

          Understandable. To be honest sometimes in late stages of the disease a complete overhaul on diet can be more stressful for the patient and the family. Treatment is very individualized. Some wish to transition slowly, right away, or not at all. There is really no “right” way to go. They are pushing more protein to prevent muscle wasting, but the downside to that is some proteins come with unwanted fat and cholesterol so choosing the right balance is recommended. This is why I like dietitians because they can see the lab values, meet the patient, see what they are willing to do and what they want and then make an individualized dietary plan from there. I so wish I could help more. Thanks again for sharing your personal stories.

          Warm thoughts,
          Joseph

          • BB

            Thanks again! So happy to have your input on NutritionFacts.org.

        • Gemma Montilla

          Hello BB. Have you come across The Truth About Cancer hosted by Ty Bollinger? I suggest you take time to view it because it is really an eye opener when it comes to cancer-related issues. God bless.

      • Vegan31

        Dr. Gonzales, can you recommend an oncologist or doctor in the Boston area who would monitor me. I have breast cancer and have chosen not to go the conventional route-including no surgery to remove the tumor.
        I desperately want to do all I can to avoid metastasis. Diagnosed in 2013. Suggestions from anyone would be appreciated.

        • Joseph Gonzales R.D.

          Hey Vegan31. I am not familiar with the Boston area. Have you checked out Dr. McDougall’s list? I found some practitioners in MA, but not sure they are qualified for oncology? You could check with them! Here is the list. I can also ask the Oncology Nutrition group I am a part of if you’d like? Unfortunately I am not sure what is the best route is for you since I am not familiar with your cancer stage or history, and of course I cannot give medical advice here. I can certainly look into finding a good team of health professional that could help. In the meantime there is no need to wait to start building a healthful diet. Go at a pace right for you. I suggest watching and reading all the info we have here on breast cancer. Dr. Greger has worked tirelessly to produce the videos and resources for consumers! Please utilize them! You may also want to check out the American Institute for Cancer Research. Let me know if you want me to dig deeper about an oncologist in Boston though my group. Not an easy time for you :-( I also feel that social support, moving your body, “mindfulness”, and diet will all help you overcome this ever frustrating disease!

          Warm wishes,
          Joseph

        • Jeffrey Baker

          Hi Vegan 31. I’m sorry you have breast cancer. I live in the Boston area and found only one MD who promotes WFPB nutrition, Dr. Mona Sigal in Peabody. Check out her website. http://nourishhealthforlife.com/ or call: 978-717-5804. I’ve communicated with her via email and she is very responsive, friendly, and helpful. She is board certified in emergency medicine but she may know oncologists in our area who are tuned into nutrition. I wish you the best.

      • Treacle234

        So glad you mentioned that she see a dietitian. B/c it sounds like she needs help diet wise.

    • Coolcat

      Stop the chemo at once, and get her some apricot seeds. The B17 will kill the cancer cells. The Chemo will kill her.

    • SeedyCharacter

      Here’s an article posted last week on increased survival for women with ovarian cancer with high vitamin D levels:
      http://www.vitamindcouncil.org/blog/new-study-suggests-vitamin-d-status-is-a-predictor-of-survival-among-women-with-ovarian-cancer/

      The Vitamin D Council website is a good one for staying current on vitamin D research.

      Sending healing blessings to your mother-in-law . . .

  • http://www.DonForresterMD.com/ Don Forrester MD -NF Volunteer

    You can add this to the long list of medical practices that need to be changed as the science comes along. Unfortunately taking the science and implementing the required change within medical organizations is challenging. It would seem that a change as easy as changing the diet on the physician order sheet would be straightforward. Anyone who has been involved in creating change in organizations realizes the difficulties involved. Unfortunately bringing new science into practice is not the norm in medical organizations in my experience. I believe that there are many reasons for this failure. At its core is a lack of non clinical skills on the part of health care professionals and failure of leadership within medical organizations. Unfortunately in the medical industry this lack of ability leads to higher cost, more preventable errors plus earlier death and greater disability and suffering for patients. Hopefully by staying tuned to NutritionFacts.org and following the proper diet you will lower your risk and avoid altogether the question of the type of diet needed during chemotherapy.

    • Coolcat

      Chemo kills the good cells as well as the cancer cells. The patient would live longer without it. The “cure” is worst than the disease. The only “solution” to cancer according to convential medicine is Cut, Burn or Poison.

  • Suviva1

    I was advised to eat a balanced diet and to make sure that all fruit and vegetables were washed thoroughly, and to avoid takeaway food as it might not be entirely fresh and I had no control over the conditions in which it had been cooked. I was also given a lot of advice pre-chemo by a friend who had been fighting cancer for several years. She told me to eat plenty of fruit and vegetables to boost my immune system, eat 2 raw carrots every day and take twice the recommended dose of vitamin C. I also ate pineapple every day to avoid mouth ulcers, and later took zinc and copper tablets whilst on CMF chemo, which caused horrendous ulcers. In addition, I took a multivitamin and vitamin B, and the iron tablets I was already prescribed before my cancer diagnosis. My oncologist’s registrar used to laugh when I went for my regular check-ups, because instead of going down, my blood results went up; she said my blood was better than hers! It seems ridiculous to me that any cancer patient should be advised to avoid the very foods that would help to keep their immune system strong!

    • Joseph Gonzales R.D.

      Kudos for finding a healthful diet and taking steps to protect yourself during chemotherapy! I would say that not all cancer patients are advised to follow such a diet. The Academy of Nutrition and Dietetics has a practice group in Oncology Nutrition and our members are well aware of the lack of research. This is why I always suggest seeing a dietitian in combination with the oncologist. I think open communication and a multi-disciplinary approach can only better help the patient.

  • Panchito

    A while back people thought that eating fruit would feed cancer cells 18x. Thus, fruit could increase the size of a tumor. Some internet marketing doctors like Dr. Mercola still hold this belief. I once saw a video of an American based clinic that treated cancer patients with this philosophy but they got bad results and closed. The main idea was avoid carbs so that the cancer cells would starve to death and hopefully live longer. It turned out to be wrong. People were sucked in by a good sounding story.

    • Joseph Gonzales R.D.

      Frustrating to hear such erroneous information! AICR has a great write-up titled: Does Sugar Feed Tumors? Thanks for bringing this up, Panchito.

  • Corsair4

    I just read an article on Forks over Knives about the latest research on Vitamin D

    Posted on May 14, 2015 “Vitamin D Supplements are Harmful-Sinshine and Food Determine Health. by John McDougall MD.

    http://www.forksoverknives.com/vitamin-d-supplements-are-harmful-sunshine-and-food-determine-health/

    Is this the latest information, and is it right? Should we all stop taking Vitamin D supplements?

    Please let us know. I have been taking vitamin D3 for 5 years now.

    • Joseph Gonzales R.D.

      Seems this article has been making the rounds. Thanks for sharing. There will be many more vitamin D videos from Dr. Greger to come so stay tuned…

      Here is Dr. Greger’s take on vitamin D. Perhaps there is more to vitamin D beyond bone health? Dr. Greger mentions if vitamin D supplements are necessary in this video and whether we should obtain vitamin D from sunshine, mushrooms or supplements here. You can also see his video on cancerous tanning beds. Please choose what you feel is best based on the research and your doctor’s suggestions.

      • Kim

        I’m not particularly convinced by Dr. Greger’s video on vitamin D vs. tanning beds. First off, he comments on UVA-emitting beds, but what about those emitting UVB? These are the ones that would be useful for increasing vitamin D levels. Secondly, yes, tanning beds raise cancer risk, but so does sun exposure. Is there any evidence to indicate that we should seek out sunshine but avoid tanning bed use? Or would the takeaway message be to avoid both? I don’t believe avoiding sunshine is healthy (just take measures not to burn – limit your exposure), and while sunshine exposure would be best, for those of us who can’t count on that year-round, UVB exposure from tanning beds, allowing our bodies to make their own vitamin D, seems like the second-best option.

        I’m aware that sun and tanning bed exposure are both linked to increased cancer risk, but we have to bear in mind that most of the time, people using both of these are not paying particular attention to their health. People that enjoy “tanning” often eat very poor diets and smoke at a higher rate than the general population. They don’t responsibly monitor their sun exposure or tanning bed use. So is the assessment of the risk involved relevant to those of us who eat healthy, plant-based diets and are careful not to burn our skin (whether with sun exposure or tanning bed / sun lamp use)?

        • Joseph Gonzales R.D.

          Glad you are conscious of your exposure be it a tanning bed or sunshine. Great points! I think sunshine exposure is fine and does not cause skin cancer, but sunburns and over exposure certainly does. Dr. Greger mentions obtaining 15-30 minutes of sunshine per day in his Optimal Nutrition Recommendations. So that is not much and definitely not enough time to cause a sunburn for most folks. The tanning bed thing just seem so unnatural to me and based on this study Dr. Greger refers to in his video tanning beds warrant caution.

          • Kim

            Thanks for the link to the study. I’ll give that a read. I completely agree on tanning beds being unnatural, but at the same time, I don’t think living in Canada as I do is optimal in terms of the amount of UV exposure we get up here! So my options in winter are to do nothing, supplement vitamin D, or use tanning beds/sun lamps (which I’ve actually never done yet, but we’re considering it). So I’m left to decide, which is more natural and/or optimal, popping pills or UVB lamps? At least with the lamp, my body can go about producing its own D the way it’s meant to. If there’s reason to think it more dangerous than sun exposure, though, we’ll definitely consider the pills.

          • Joseph Gonzales R.D.

            Did you see the video/blog on mushrooms? Light up the mushrooms! ;-0 Not sure what is more “natural” but I would suggest supplements over tanning beds based on his videos and research.

          • Raisa Jari

            I also have never heard any argument that implicates tanning beds except for overexposure to UV rays just like overexposure to the sun. Although I think in Dr. Greger’s video which I did not rewatch today, he may have said something about the concentration of the rays in the tanning beds. But I am not sure if the concentration is a problem vs the same amount of exposure with the regular sun which just takes longer to get. I also live in Canada and using a tanning bed makes me feel much better in the winter, like when I have been exposed to sun. Also, I like to go to Florida once a year and I burn like crazy without building up a base with the tanning bed, just being exposed to the sun down there, not doing any extra tanning. I think a little tanning (I don’t do a lot) is better than a bad burn. I am also open to hearing a good argument against it, but so far, nothing has convinced me.

          • Kim

            Dr. Greger points out that most tanning beds use UVA, which won’t help us make vitamin D (or not enough of it, not sure). That’s good to know, but it says nothing about machines designed to put out UVB. I would be interested in more info regarding the strength of the rays put out by the machines vs. the sun, and whether more or less exposure to these is required to make adequate D but not burn our skin. Wish I could afford a trip to the tropics in winter, too! That’s a great way to boost your levels. :)

  • http://www.radiance-solutions.co.uk Julia Woodman

    Never heard of a neutropenic diet before – I’m neutropenic and eat loads of fresh fruit and veg, and I’m healthy, out here, working in the world to help others.

  • Coolcat

    Try several spoonfuls of Extra Virgin Coconut Oil per day. Anti- cancer benefits.

  • http://jenishares.blogspot.com Jennie McCluskey

    Sounds like if you eat that way, it’s sure to kill you. Hope Dr.’s have stopped recommending their patients this diet plan.

  • luckssj

    I think everyone should read Killing Cancer not People by Mr. Right

  • J. O’Day

    So I’m hoping MD Anderson’s website needs updating? http://www.mdanderson.org/publications/conquest/issues/2012-spring/nutrition-diet-and-cancer.html Still says some patients require no fresh fruits or vegetables. :( All of these changes take time; still grateful they are moving in the right direction! Thanks again Dr. Greger for an excellent video.

  • lilyroza

    I would like to see how the infecyion rate compares to a group that only eats in a vegan kitchen, food prepared by vegans who also only eat food from a vegan kitchen. Because isn’t the preperation of animal products most likely to introduce harmful bacteria into the food and living space?

  • Ray Tajoma

    Doctors KNOW and prescribe it INTENTIONALLY & MALICIOUSLY because it is NOT good for their patients so that they get ill and they can charge 10 times more. Ignorance is good for their wallet.