Doctor's Note

Check out these videos on meat and cardiovascular disease:
Flax Seeds for Hypertension
How to Prevent a Stroke
Why Was Heart Disease Rare in the Mediterranean?
Cholesterol Crystals May Tear Though Our Artery Lining

And check out my other videos on cholesterol

For more context, also see my associated blog posts: Soy milk: shake it up! and Stool Size and Breast Cancer Risk.

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  • VeganNP

    The citation provided does not appear to match this presentation, and it sounds as if more than one article is cited. Is there a citation for the low-fat vs. whole foods vegan diet?
    Thank you.

    • Michael Greger M.D.

      You are my savior! Thank you so much for pointing that out. You deserve a prize for finding the first error on the site! In fact if you want to email me your mailing address I’ll send you a copy of my new DVD as a token of my gratitude. I have corrected the citation source (thanks to you!). A group of my interns uploaded the source citations and one of them must have made a mistake. Please help me root out any other errors on the site (and I’ll send you even more free stuff :).

  • VeganNP

    I’m also curious about the low-fat vegan diet vs. the whole food vegan diet that included nuts. How low was the low-fat diet?
    Thank you.

    • Michael Greger M.D.

      That is such a great question. Too often “low-fat” diets are anything but! In this systematic review, though, some of the diets really did dip down into the 10% of calories from fat range, which is low-fat by pretty much anyone’s standards.

      • Steve

        any added benefit to having a RAW whole food vegan diet?

  • Toxins

    Should’nt we be heart attack “proof” as Caldwell Essylsten puts it on a whole foods plant based diet??

    • SArmstrong

      I think Dr. Esselstyn would assert you are heart attack “proof” if your LDL cholesterol is under 80 mg/dL.

  • shaadoe

    So what is the optimal fat percentage in a whole food plant based diet.


      Hi Shaadoe,
      What is “low fat”? Many a confusing conclusions from faulty clinical studies have caused many well-meaning dieters to lose faith in low-fat studies. The American Heart Association says 25-30% fat is low enough, but is it? In comes Dr. T. Colin Campbell’s to the rescue with his immensely important book: “The China Study”. His findings from rural China showed that only when dietary fat was reduced from 24% to 6% was there a clear association seen with lower breast cancer risk. But the reduction must not only be of dietary fat “but more importantly of animal-based food.” Judging from his” plant fat/ breast cancer death” chart, we may become heart-attack and breast-cancer proof with a 10-12% fat vegan diet which includes a handful of nuts/day. Get the book; there’s more goodies!

  • working at it

    great questions……looking forward to more discussion. I ate an Esslestyn diet for a couple of years, and never did manage to get my cholesterol under 150. I briefly managed to get under 150 on a Fuhrman diet, but still have not been successful long term. Would REALLY like to know how to be successful with this. Perhaps stress plays a role in keeping cholesterol high? Looking for answers……

    • Toxins

      Hello working at it,
      If you are eating whole foods plant based and avoiding all animal products and processed foods while focusing on the most nutrient dense of those foods than your cholesterol should drop since your not taking in any outside sources of cholesterol. Cholesterol can only be produced by animals. Also, exercising at least an hour a day and eating ONLY when your hungry will significantly aid in lowering cholesterol levels and stress. Maybe do some rock climbing at a gym near by? I hate working out with the weights so all I do is rock climb, its great fun and it works your body hard!

    • Michele Keane

      We produce cholesterol whether we eat animals or not. Cholesterol that we produce is very important for many functions. Each person produces the amount your body needs. If you are not taking in dietary cholesterol, than you shouldn’t worry about it. There is a reason why your body produces 150 and that’s healthy for you. Statins lower your body’s natural cholesterol, cholesterol that your body needs, recognizes and has a purpose. Perhaps the damage statins do is because the body is now not producing the cholesterol needed for neurological functions, muscle contractions, etc. Cholesterol is not the problem if your body produces it. The cholesterol we take in is the problem.

  • working at it

    Thank you, Toxins, for your suggestions on ways to lower cholesterol! Yes, am fanatical about eating only whole unprocessed plant foods. Sometimes too many fruits, and Dr. McDougall says this can raise cholesterol….I do like sweet things (like dates!). Sometimes “stress eating” is an issue, and could always get more exercise. When I was younger I LOVED to rock climb; it’s definitely a good way to focus energy, especially when on the sharp end of the rope.


    Do you have any outlines to eating a wholefoods vegan diet? i have been doing the lowfat mcdoughall diet and weight watchers simple filling technie?? Maybe some websites to give me a new durection in weightloss??

    • Toxins

      The McDougall diet is really good. Id stick with that!

      • DrDons

        I would agree that the McDougall diet is a great way to go. However the devil is always in the details. Two resources that I recommend for those looking to loose weight is Jeff Novick’s DVD, Calorie Density, which can be ordered off his website, Jeff ties Calorie Density(much more important than calories) to exercise which is very important to understand. By adding more low calorie dense foods like vegetables and some fruits you will have more success at “fat” loss. I would also recommend John McDougall’s newsletter article, The Fat Vegan, it can be found in his December 2008 issue available on his website. Those resources should give you some ideas on how to proceed. Best wishes.

  • GreenSmoothie

    For a clear understanding and how to immplement a plant based diet with good fats check out Dr Fuhrman’s nutritarian diet

  • Michael Greger M.D.

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

  • Lily

    Hi Dr. Gregor. I would love for you to address the claims of the “cholesterol myth” crowd and those researchers who say having high cholesterol is healthy. They cite studies such as this:

    Another website I read said here are at least 11 studies showing that high cholesterol is not associate with coronary heart disease, 11 more studies show high cholesterol didn’t predict likelihood of death.

    I think it’s important that you address these research studies, which conflicts with what we are being told as vegans. Thank you!

    • Toxins

      It is very well established that cholesterol is lined with heart disease. From the national academy of science, “Given the capability of all tissues to synthesize sufficient
      cholesterol for their metabolic and structural needs, there is no
      evidence for a biological requirement for dietary cholesterol.”…”a tolerable upper intake has not been set for cholesterol because any incremental increase in cholesterol increases [cardiovascular disease] risk”

      I highly recommend this video, and very rarely do i ever link to youtube.

      As well as some of these nutritionfacts videos.

  • LittleQ

    then why are nuts not included in the reversal of heart disease….???

  • Kevin McLaughlin

    Doctors such as John McDougall MD, Caldwell Esselstyn, Dean Ornish, T. Colin Campbell, and Neal D. Barnard all recommend a low fat vegan diet (between 10-12% fat) and also have significant research on that. Can you please address this? I’m now very concerned about which path is most beneficial. Thank you for your help and all that you do!

  • Dr. Margaret

    I eat nonfat plain fortified yogurt as a partial means of getting the 1500mg calcium recommended after an osteoporosis diagnosis. I know that Dr. Greger recommends zero dairy, but I just don’t know any other means of getting sufficient calcium. All of the high calcium foods seem to be fortified. Which is the greater problem- nonfat dairy or undertreated osteoporosis?

    • Thea

      Dr. Margaret: I’m sorry it took me so long to reply and so sorry to hear about your osteoporosis diagnosis. I’m not a doctor, but I have carefully read a book called, “Building Bone Vitality: A Revolutionary Diet Plan To Prevent Bone Loss and Reverse Osteoporosis” by Dr. Amy Lanou and Michael Castleman.

      It is an excellent book. They reviewed over 1,200 studies and make a compelling case on what type of diet (and exercise!) will help prevent bone loss and possibly reverse osteoporosis. Following their plan is very do-able on a healthy plant based diet. They explain exactly how to do it, including providing some meal plans and a few recipes to give you the idea of how to proceed. This way the osteoporosis is *not* under-treated. It is just treated appropriately.

      Calcium is just one element to consider when dealing with bone health. Throwing massive amounts of calcium at a bone problem without considering 16 other vital bone related nutrients, AND without considering their proportions, AND not addressing the “bone bullies” (substances which take away from bone health – a term I picked up from the excellent reference book for nutrients: Becoming Vegan – Express Edition by RDs Brenda Davis and Vesanto Melina) is not likely to help the bone problem. My understanding is that only upping calcium is very likely to hurt the problem.

      Bottom line is that I *highly* recommend that you read that book. Also, if you want to use fortified foods to get to 1,500mg calcium a day, I recommend using a non-dairy yogurt. You would have to read the labels, but those non-dairy yogurts typically have just as much calcium as the dairy counter-parts – and if you get the right brand, are just as tasty. (The book explains why non-diary is better than dairy – better than I could.) Best of luck to you.

  • Annette

    Hi, I’d just like to mention that Dr Campbell in his latest Whole addresses these questions, quote: “relax”. As long as you eat whole, vegan foods, you’ll be all right. It helps me to relax, I was actually getting paranoid about eating a couple of nuts and fat content in edamame…

  • I am a massive fan of, and Dr. Greger. I cannnot say enough good things about the quality of information provided at this site. THANK YOU!!!. One question though- I don’t understand the conclusions of this video. I realize that at this point this is now an older video, but even by 2010 Dr. Esselstyn had published his first clinical study. Since then his 2014 study showed amazing results arresting and even reversing heart disease with a low fat, whole food, ‘no nuts’ diet. Esselstyn is staunchly anti-nuts and yet has the most impressive clinical studies on heart disease management (and reversal) published. It seems to me that Esselstyn’s results are even more impressive than Ornish’s, and Ornish has done a lot for heart disease reversal and awareness. Esselstyn has achieved these amazing cardiac results by looking at all dietary fats, even those from whole food sources.

    • Joseph Gonzales R.D.

      Everyone has their own take on the research and the doctors you mention are paving the way for heart disease prevention! ​They are doing amazing, life-saving work. Still, the research on nuts seems to be positive. Here is a great video by Dr. Greger that explains the research between nut intake and body weight. Make sure to checkout the bottom of the video’s “Doctors Note” to see more links and info. Lastly, a follow-up to that video is solving the mystery of the missing calories, which may also help.​

  • Eoin Kenny

    So a balanced diet of whole “real” foods wins, 80/10/10 is so stupid IMO. Nuts and seeds are fantastic, especially flax and chia and almonds.

  • Brandon Maryland

    What percentage of fat did the whole foods group consume?

  • AnnieVanCookie

    I would like to know what % of fat is ok. I am always like 15%, some days a bit less, some days a bit more. I don’t eat nuts everyday because of their price so I wonder if I should add more seeds the days I don’t have nuts. Is 15% (35g) of 2000 calories ok?