Doctor's Note

Anyone can lose weight in the short term on nearly any diet, but diets don’t work in the long term almost by definition. We don’t need a diet; we need a new way of eating that we can comfortably stick with throughout our lives. If that’s the case, then we better choose to eat in a way that will most healthfully sustain us. That’s why a plant-based diet may offer the best of both worlds. It’s the only diet shown to reverse heart disease, our number one killer, in the majority of patients. See for example Eliminating the #1 Cause of Death.

There are a number of theories offered as to why those eating plant-based are so much slimmer on average. See, for example:

For more context, check out my associated blog post: The Healthiest Diet for Weight Control.

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  • Adrien

    What could be more nutrient dense than a vegetarian diet ? … a vegan nutritarian diet (fuhrman/greger vegetable-based style) ? With added B12, Sunshine, Flax (and maybe DHA). With the addition of regular exercices. ;)

    • http://nutritionfacts.org/ Michael Greger M.D.

      Good answer! :)

      • Adrien

        I’ve done my homework :) did I won a DVD ? :D

        • William Wallace

          Flax ? DHA ? Why Add this ?

          • val

            Flax gives us awesome Omega 3’s in ADDITION to fiber, lignans, and other vital nutrients…that’s my 2 cents!

          • William Wallace

            ok thanks :)

          • Pele

            I agree. Flax is for the birds. Healthy fats are present in avocado and nuts. Flax can be toxic. Highly perishable and tastes gross anyway. Who can or wants to eat flax seeds by hand? No as good as hemp seed hearts!

    • Theresa

      Vitamin D adequacy with supplementation. Also zinc. Yes on the B-12. 1 TB Ground Flax each day, yes, G-Bombs don’t forget!
      Yes, on the exercise…I agree!

      • goturnumba

        Theresa: WHAT is a ‘G-bomb’?? I’m following you here and need to know!

        Also, there are credentialed people who have YouTube presentations that are very convincing regarding the Paleo or modified Paleo diet. One series is by Mark Sisson, another is by Dr. Eric Westman, Duke University, Director of the Lifestyle Medicine Clinic there. Westman sites research findings over 20 years that a modified Atkins type diet, with moderate protein from meat, high fat (especially saturated fat!) yields excellent numbers for blood work ups. His video presentation on YouTube is very compelling to many, I’d guess, especially in view of the fact that many find a Vegan diet is hard to do, or at least very hard to stay with, long term. Your thoughts?
        Anyone else, also?
        I have T2 Diabetes, I think, don’t take meds, want to follow a diet that will normalize my numbers and halt any further indications for good.

        Many thanks!

        • Kristin

          G-BOMBS is Dr. Fuhrman’s acronym to remind you what to eat every day, Greens, Beans, Onions, Mushrooms, Berries, and Seeds. http://www.drfuhrman.com/library/gbombs.aspx

          • goturnumba

            oh! Very cool! I like it. Thanks for the help!
            Actually, I keep wondering if beans/legumes contain too much carbohydrate for a T2 diabetic who is trying to reverse that.

          • Veganrunner

            Kristin you should watch the videos regarding diabetics on this website. Go up to top and browse topics. That is a great place to start.

          • http://www.naturallifeenergy.com/ Aqiyl Aniys

            A high carb, low starch, low fat, low protein diet that incorporates blending vegetables and fruit juices, and drinking plenty of water. Also using herbs occasionally to strengthen and clean the organs. I haven’t been sick since I adopted a plant based diet, lost and have kept of 25lbs, and always super-energized.

          • Veganrunner

            Aqiyl I couldn’t agree more! Because I run/exercise a lot I do best with purple, red potatoes, quinoa, etc in my diet. I crave them! Last thing I want is a hunk of cow. The more I run the more I want a big chunk of squash.

          • http://www.naturallifeenergy.com/ Aqiyl Aniys

            LOL Vegan runner! A hunk of cow. LOL!

          • Plantstrongdoc M.D.

            YES. ” I want a big chunk of squash”. That is what makes our engine running! Not meat, not dairy, especially not eggs…..
            see more1

          • vegangranny

            Get yourself a copy of Food for Life by Dr. Neal Barnard, a copy of Prevent and Reverse Heart Disease by Dr. Caldwell Esselstyn, and Eat to Live by Dr. Joel Fuhrman. Then you’ll find your answers on what you can do to reverse your diabetes….

          • Sadie

            Thanks for clarifying. I thought you were making a joke about gas! (My adolescent mind at play! )

        • Toxins

          please see Dr. Gregers note on diabetes. A whole foods plant based diet with some exercise can reverse diabetes and bring your bloodwork to a good range without the ill health affects of an atkins style diet.
          http://nutritionfacts.org/topics/diabetes/

        • Abe

          Hello everyone, I have been T2 diabetes for about 5y now. For the past 14 months or so, I have been totally vegan (with SOME exceptions here and there) – i.e. sushi once every three months . Haven’t reversed the diabetes, haven’t lost any weight. Yes, my body has changed, but on the scale, nothing…
          I do yoga twice a week and run, train at the gym… Is it the dark chocolate I have every day 90% cocoa?
          I need advice!

          • Thea

            Abe: Good for you for trying to do what you can to improve your health through diet. I have some thoughts for you that may be of interest.

            1) Not yet reversed diabetes nor lost weight.

            That’s got to be a serious bummer. However, as Dr. Greger says, when you eat healthy, even if it doesn’t fix a particular problem, at least the side effects are nothing but good. I would suggest that it is possible that because of your diet changes, even if it hasn’t reversed your T2, it has probably helped to control both your T2 and weight issues. Plus, at least with your mostly vegan diet, you aren’t contributing to cancer, etc. It’s a great start.

            2) reversing diabetes and chocolate.

            The book that I recommend the most for people with diabetes is “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs”

            In that book, you will learn how to fine-tune your diet to have an effect on the T2. One of the things you will learn is that T2 diabetes is largely a “too much fat” problem. So, that 90% chocolate? It may be low in sugar, but sugars are not your biggest problem. Fat is. So assuming you meant chocolate (and not no-fat cocoa powder), that 90% chocolate is definitely a problem. (re: Chocolate problem is one that you and I share! So, I get it.) You will also want to stay away from oils. Which would also help with weight loss.

            3) Weight loss. – Dr. Dons who often comments on this site recommends two sources for weight loss and I think both are excellent. One is the following free video, How To Lose Weight Without Losing Your Mind:

            http://www.youtube.com/watch?v=xAdqLB6bTuQ

            The other source is to get Jeff Novick’s DVD on Fast Food. Great info, easy, fast, yummy, super-healthy, and no-fat recipes!

            Hope you found this helpful.

          • Nita

            I’ve been vegetarian and mostly vegan the past 14 month and also had not lost any weight……..until…..3 weeks ago when I seriously cut back (not out) my fat consumption. Since then I have lost 5 lbs. I’m very pleased.

          • Thea

            Nita: That’s truly awesome!! Good for you! It’s that calorie density concept. Fat is just so calorie dense. Makes so much sense. Thanks for sharing your story. That will help others too.

          • Toxins

            Going vegan is a good step, but we need to get as whole foods plant based as possible. This means eliminating all processed foods, like white flour, oils mock meats, etc. I would advise going as low fat as possible. The McDougall approach works the best for this, which is essentially a diet based on complex starches.
            http://nutritionfacts.org/video/how-to-treat-diabetes/
            http://www.drmcdougall.com/misc/2009nl/dec/diabetes.htm

          • Sadie

            Abe, congratulations! You are going in the right direction for sure. As Thea and Toxins said, reducing fats is key. And I think the closer to raw vegan you can get is best. That will automatically eliminate all processed foods, which even when vegan are not healthy and contain hidden ingredients your body will have trouble eliminating. I also eat dark chocolate every day, but just have a one inch square of a 70% bar. I also make wonderful cocoa with dry cocoa powder, stevia, and almond, flax, or coconut milk. Add a little cinnamon, ginger powder, and cayenne pepper for a kick in the pants! Namaste.

        • Sadie

          I’m 74.
          I went cold “tofurkey” 2 yrs ago to vegan diet. No problem transitioning! Lost 20 pounds, all medical tests are excellent! Now I’m transisitioning to raw (90% maybe). Set your mind to YES and just do it. Namaste.

        • Andi

          goturnumba: I would highly recommend watching plant positive’s primitive nutrition series on youtube.

          • JacquieRN

            I would also recommend PlantPositive.com for anyone that wants to get deeper into research concerning Paleo claims.

      • http://www.earthreview.eu/ Ann

        I wouldnt supplement zinc when not necessary. Ive been vegan 8 years, vegetarian for 4 and I had my zinc levels tested last year and they were high

  • BeetsBeansButts

    Nice Video, thanks Dr. Greger!

    Really any diet could beat out the S.A.D.

    I guess it is appropriate to mention here….

    B12…(supplement),
    vitamin D…(soymilk and supplement),
    omega 3’s … (flax seed),
    and iodine … (seaweed or supplement).

    It is pretty easy for plant based people to get those nutrients, but not all do and not all are aware.

  • Richard Schwab

    Dear Dr. Greger, I’m a fellow physician and a vegan. I saw a segment on the Oz show a couple of days ago with Dr. David Perlmutter, author of Grain Brain. Dr. Perlmutter says all carbs are bad
    for our brain health and the worst are the ones that come from grains (including whole grains) and veggies that grow under
    the ground like potatoes, sweet potatoes and beets. Perlmutter also
    says grapes, bananas, and pineapple are also very bad for us. He advocates for a diet high in fat, including saturated fat. His theory seem to be the opposite of Dr. Neal Barnard (Power Foods For The Brain; bananas and sweet potatoes right on the cover!). Is there science to support a causal relationship between (healthy) carb intake and the incidence of Alzheimer’s disease, as Perlmutter suggests?

    • Toxins

      I will share with you what I just shared with another concerned user. Basically what is being advocated for is a low carb, high fat/protein diet. This would essentially be a ketogenic diet.

      Ketogenic diets 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.”

      http://www.ncbi.nlm.nih.gov/pubmed/8589783

      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.”

      http://www.ncbi.nlm.nih.gov/pubmed/14672862

      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.”

      http://diabetes.diabetesjournals.org/content/58/12/2741.long

      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: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702133/figure/F1/ )

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

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702133/

      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%.

      http://www.ncbi.nlm.nih.gov/pubmed/17536128

      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”

      http://engine2diet.com/usrfiles/files/publishedstudies/obesity/comparative-effects-of-3-diets.pdf

      • annie D.

        My husband and myself have been following Dr. Esselstyn’s Whole Food diet (and the Engine2) for 6 weeks now; we’ve never felt better; he lost 20 pounds and I did lose 15 pounds. We have much more energy and we also have a lot of fun creating new exciting and delicious recipes. And the results are just amazing! After more than 20 years trying to lower his blood pressure below the dangerous 150/90 mark it is now at a perfect 121/80 and his blood sugar fell from 8 to 6.3… We do eat a little bit of fats from nuts, seeds, avocado and, very rarely, 1 tsp of olive oil in hummus, for instance. That’s the only difference with the plan Dr. Esselstyn is proposing… But no added fats 99 % of the time…
        Now I have a question for you about the best way to adjust his diet to help him go through some new medical challenges in his life. A few days ago, he had to start a 48-week treatment to cure chronic Hepatitis C (with Interferon and other drugs); his genotype is of type 1, the most common and, apparently, the most difficult to cure; on top of that, he had surgery 4 years ago to remove his prostate due to an aggressive cancer, followed by some radiotherapy treatments in 2010. Now his PSA is starting to slowly go up again; we don’t eat any dairies nor meat of any kind anymore since we’ve learned about their terrible effects on men with prostate cancer; what else could he eat to help him face those two difficult challenges he’s dealing with at this time? We have added flax seed in our daily diet as well. Thanks so much for your help! This ressource is fantastic!

      • Cara

        Q. to Toxins- I wonder if there are any studies in regard to what is beneficial, a vegan higher fat diet (since Atkins is animal fat) vs. a vegan higher carb diet ?

        • Toxins

          The only studies that show that heart disease is reversable is on a low fat vegan diet that is high in complex carbohydrates. A high fat vegan diet is more healthful compared with a high fat animal based diet
          http://nutritionfacts.org/video/plant-based-atkins-diet/
          http://nutritionfacts.org/video/atkins-diet-trouble-keeping-it-up/

          But i find it questionable that a high fat vegan diet would be protective against cardiovascular disease compared to a high carb vegan diet when the carbohydrates comes from whole food sources.
          http://nutritionfacts.org/video/china-study-on-sudden-cardiac-death/
          http://nutritionfacts.org/video/trans-fat-saturated-fat-and-cholesterol-tolerable-upper-intake-of-zero/
          http://nutritionfacts.org/video/our-number-one-killer-can-be-stopped/

          It may be difficult to maintain adequate cholesterol numbers on a high fat plant based diet.

          • Cara

            Thank you! yes that is what I was thinking how could the whole food carbs be harmful, from a laypersons intuitive point of view I would think it would turn out that the best proportions in a vegan diet would mimic the composition of carb to fats in the actual whole foods, adding it up in a large variety of whole foods. To eat a proportionately high fat vegan it would probably include eating extracted oils and other non whole foods? or too many high calorie foods but I didn’t see the Dr. Oz show.

          • Toxins

            The majority of the calories would have to come from nuts if from whole foods. Nuts are fine, but when the bulk of our calories come from nuts we may
            1. Get too much saturated fat
            2. Get too much omega 6

            Nuts are very rich sources of omega 6, which can off balance the omega 3. An adeuqate ratio is 4:1 of omega 6:3.
            Peanuts have a ratio of 5230: 1
            Almonds have a ratio of 2010: 1
            Brazil nuts have a ratio of 1142: 1

            Walnuts, chia and flax seem to have the best ratio.

          • http://www.naturallifeenergy.com/ Aqiyl Aniys

            Yeah to walnuts and almonds. I know that almonds has a high omega-6 content so there are concerns about inflammation, but studies show that almonds have an anti-inflammatory reaction in teh body due to its phytonutrients. Chia and Flax seed are awesome. I am experimenting with black seed right now. A whole-food plant based diet, high carb (from fruits), low starch, low fat, low protein, and plenty of water have done wonders for me. Lost and kept off 25lbs, always energized, always have a clear mind now, and I haven’t been sick in over two year, not even a headache, flu, or even the pesky cold.

          • Toxins

            Indeed, almonds are health promoting. My caution is simply for moderation.

          • http://www.naturallifeenergy.com/ Aqiyl Aniys

            I used to eat a lot of almonds everyday and closely monitored myself and health. When I first adopted a plant based diet I ate 8oz a day a least a year, never got sick, lost 25lbs, and my energy level was and is still incredible. I cut down on the amount of nuts I eat now because I eat a lot more fruits and eat a high carb diet, and the carbs are mainly from fruit. I lost a lot of weight eating the large amount of almonds, but I lost more going to the high carb – low fat route.

          • Kate Scott

            Those ratios for peanuts, almonds and brazil nuts, although correct, are misleading. You have to look at the omega 6:3 balance in the diet as a whole. As long as you eat some chia or flax as well as the other nuts and seeds, and minimise other sources of omega 6 (through oils or animal foods), then your omega 6:3 ratio will be fine. If you adopt a low fat vegan diet with only flax or chia and no other nuts or seeds, you could run the risk of your 6:3 ratio being too low.

          • Toxins

            Exactly my point, being that these nuts can offset your diet. Eating a serving of peanuts does not automatically make your ratio 5230:1. It is difficult to get too low unless you supplement omega 3.

      • http://www.earthreview.eu/ Ann

        awesome post. Ive featured it on my Vegann page :) https://www.facebook.com/pages/VegAnn/633821396708452

    • Bris Vegas

      Dr Perlmutter also thinks that walking about in bare feet ‘earths’ the body and neutralises free radicals. The guy has zero scientific credibility.

  • Lucy

    Hi Dr. Grieger, Because we talk so much about plant based diets, I want to bring your attention to a NPR article you may be interested in…”When Edible Plants Turn Their Defenses On Us”

    http://www.npr.org/blogs/thesalt/2013/10/01/228221063/when-edible-plants-turn-their-defenses-on-us?ft=1&f=1

  • Lucy
    • Thea

      Lucy: Nice article. Thanks for sharing.

      Personally, I really like the free Meatless Monday e-mails. They are fun to get.

  • Edith Spencer

    As an experiment, I started eating mostly vegan this summer and will be continuing into the fall. No weight loss- but I have shrunk a size or two ( from an 8-10 to about 6-8) and I find that I have the energy to get through the day and my workouts. I am finding that I am more muscular- and i am not supplementing with vegan protein. If I want to really get the scale moving down, should I reduce oil? Nuts? Seeds? Sweet potatoes?!?

    • Thea

      Edith: Good for you for trying this experiment!

      I had a thought for you: You say that you haven’t lost weight. But I presume you haven’t gained weight because you would have said so. Plus you say that you are more muscular and that you have lost a size or two. All that suggests that you have put on more muscle while loosing fat. I’m guessing it is not your goal to “loose weight”, but really to loose fat. And you have probably done so!

      If you want to loose more fat, I think you would be interested in the most excellent talk from one of the Forks Over Knives guys, Doug Lisle, Ph.D. He does an amazing job in the following talk explaining the science behind losing weight and which foods will help you do so. See what you think:

      http://www.youtube.com/watch?v=xAdqLB6bTuQ

      Hope you find that helpful.

    • Thea

      Oh. And I had one more thought. I don’t your situation, so have no idea what would be healthy for you. But I would think that a size 6-8 is pretty good. Do you really need a goal of, “really get the scale moving down”? Some fine tuning maybe, but massive changes??? Just something to think about.

      • Edith Spencer

        I am not sure, to tell you the truth! I have not gained any additional weight- and being at the size is good for someone of my height (5’5) but my weight is a bit high for my height (148).

    • Toxins

      Avoiding oil is one of the best things you can do for yourself after going vegan, the key is to get as whole foods plant based as possible, avoiding all processed foods and white flours, including oil.

  • Dan

    I followed an Atkins diet for 5 or 6 months, but stayed in the induction phase for the entire time. While I saw dramatic improvements in my HbA1c, body weight, blood pressure, inflammatory markers, HDL and triglycerides, on the other hand, my homocysteine, total cholesterol, LDL cholesterol, direct LDL cholesterol, and apoB went up to levels as high as patients with heterozygous familial hypercholesterolemia. Perhaps I am a cholesterol hyperabsorber or just sensitive to saturated fat overkill. The data suggest I would have killed myself on this diet, given time.

    I am now on a vegan diet. There are deficiencies that need to be considered, such as B12, iodine, vitamin D3 and perhaps DHA (although the jury is still out on this latter one), and some people can develop significant iron deficiency, zinc deficiency and choline deficiency on pure vegan diets (although the significance of these states is arguable). Vitamin A can be obtained from beta carotene and vitamin K2, if it’s even important, can be synthesized from gut microbiota. It’s important not to overdo linoleic acid intake.

    I think a supplemented, carefully well-rounded vegan diet is far better for health than a sloppy omnivorous farm factory animal-based diet with a couple of greens and fruits tossed out.

    Actually, I still restrict my carbohydrate intake, eating very few free carbs as possible, as I have a tendency (genetic) towards metabolic syndrome. My brother, mother and several uncles all show this. And lots of vascular disease in the family.

    Thanks,
    Dan

    • Toxins

      Whole foods plant based vegans rarely develop iron, zinc, and especially do not develop choline deficiencies. These compounds are abundant in the plant kingdom. The only supplements you need are b12 and vitamin d, and the vitamin d would be needed by everyone, not just vegans. Please see Dr. Greger’s note on supplements here.
      http://nutritionfacts.org/topics/supplements/

      • Dan

        Thank you for that. I do think that iron deficiency, particularly in premenopausal women who are extremely physically active and are vegan may be commoner than you might think. It is certainly well reported on the web and there are some pubmed papers – don’t have the citations off the top of my head.

        The only other thing I would point out is that an ultra low fat vegan diet is unnecessary and difficult for many people to adhere to in the long term. There are no randomized data suggesting that an optimal omega-6:omega-3 ratio should be 4:1; all of the data come from observational studies, not trials. On the other hand, we have excellent data from PREDIMED that high nut consumption prevents stroke; in addition, there are 5 or 6 observational studies suggesting associations with lower rates of sudden cardiac death and coronary artery endpoints (e.g. myocardial infarction). Thus I would not knock nuts. I’m not saying this because I eat a lot of them (although I do) – I believe high nut consumption to be protective, even though it refutes the omega-6:omega-3 hypothesis.

        A meta-analysis of omega-6 supplementation trials showed no increase in inflammatory markers. This is cited on Jack Norris’s website veganhealth.org.

        As for multivitamins being unhealthy – I don’t take them – but a very large trial (PHS II) found a statistically significant reduction in total cancers (about an 8% relative risk reduction) and a nearly significant reduction in fatal cancers. This was a large double-blind randomized trial. I believe they used Centrum Silver or 50+ (or some such).

        • Toxins

          The issue with omega 6 and 3 is more from a biochemistry standpoint and not necessarily something you would find in an interventional study.

          Omega 3 and 6 from plant sources are involved with competitive enzymes. If there is more omega 6, there will be less omega 3. This is simply a matter of fact. Omega 6 is more abundant then omega 3, so this can be a problem when a diet is heavily based on nuts.

          Nuts are healthy, but they should not be the base of ones diet, as they are extremely rich in omega 6.

          As for iron deficiency, again it is more of an issue for someone that does not follow a healthful diet, as even a vegan diet can be based on white bread, French fries, and candy and still be considered “vegan”. You can put your food intake into chronometer and see for yourself how much iron you consume. Just from whole plant foods, I typically exceed the recommended daily intake every day.
          http://cronometer.com/

          Also, my reference to supplements was with vitamin supplements, not multivitamins specifically. Please view the link I previously provided.

          • b00mer

            My personal history as a pre-menopausal woman:

            Prior to vegan, but still eating a “healthy” omnivorous diet (still ate plenty of beans, veggies, fruits, grains), I was diagnosed as borderline anemic with Hb = 11.8-11.9. I was told this was actually pretty normal for pre-menopausal women and I should maybe try to eat a little more meat but not to really worry about it.

            Now vegan, my Hb = 13.7, which is considered very good. When I track on cronometer, I nearly always get exactly 18 mg iron/day, the recommended amount for my age/gender. I make no special effort to get this amount either. I just make sure to eat enough food, and eat a variety of veggies, fruits, grains, beans, and a few seeds.

            I’ve heard it said kind of offhand that vegans (women at least) should get double the recommended amount due to heme vs non-heme iron. I never took that recommendation seriously, since I never saw a legitimate basis for it, and also since meat is 60% non-heme iron anyway. Also doesn’t take into account the higher vitamin C intake of plant eaters.

            So, this is all anecdotal, n=1 stuff, but I just wanted to present a story in which going vegan resulted in better iron levels.

          • Toxins

            Thanks for sharing! Thats the kind of thinking I advocate. A very relaxed approach to diet, and not thinking too much “am I getting enough iron, calcium, b vitmains, etc,” but just eating whole unrefined plant foods to meat caloric needs.

          • M85

            Really interesting B00mer, actually i’ve heard of quite a few women improving their iron levels when going vegan: paradoxically lots of meat eating women are actually quite anemic! You’ve definitely got the right approach to being vegan. Thanks for sharing.

          • Thea

            b00mer: I wanted to add my voice to thanking you for this post. Yes, it is n=1, but those kinds of personal stories make the science real for many people. And your story with those details is so interesting. It helps to address the fears that some people have around a vegan diet and being anemic. Well done.

          • Dan

            My comment about multivitamins was based on the synopsis of supplementation that you linked to. In general, multivitamins are discouraged on this site, even though PHS-2 showed a statistically significant decrease in cancer (by about 8%) in healthy men randomized to multivits. As with you, I am against most high-dose isolated supplements, unless someone has documented deficiency. For example, I discourage the use of supplemental vitamin E, vitamin A, folic acid, iron (for willy-nilly unmonitored use), vitamin C, Zinc, lecithin, coconut oil tabs, omega-3 supplements, etc.

            The omega6:omega3 ratio is more controversial than you make it out to be. Yes there is no question there is competitive inhibition of the production of EPA by omega-6, but there appears to be a growing consensus, based on meta-analyses and more recent feeding trials, that omega-6 is not pro-inflammatory (unlike saturated and trans fatty acids). In the Sydney Heart Trial that you referenced from the BMJ – a very impressive study – there was no control for trans fat intake in the margarine they used, and they had no way of detecting it at the time.

            Canola and olive oil both have positive evidence for cancer, diabetes and cardiovascular prevention in large randomized trials (Lyon Heart and PREDIMED).

            When I need a cooking oil, my go-to option is high oleic (HO) safflower oil, because it does not have readily degradable omega-3’s and has a significantly higher smoke point than most seed oils.

            People who eat lots of fish, eggs, dairy and meat have no problem achieving the so-called optimum omega-6:omega-3 ratio of 4:1. Yet they may drop dead from coronary disease, stroke, or AAA rupture. Vegans typically have ratios of 15:1 or higher (mine is about 10:1). I suppose it’s possible to eliminate all omega-6 from your diet by eliminating most nuts and nut butters (except walnuts), most seeds, seed butters and seed oils (except flax, chia), grains, and legumes including soyfoods. But then what is there left to eat? Vegans are already far ahead of omnivores in terms of ideal health but to further insist on optimizing the omega-6:omega-3 ratio just causes unnecessary headaches in my view. It is like the difference between 99% and 100%. You have already done tremendous work to get to 99%, but do you want to avoid all the wonderful foods that contain omega-6 fatty acids just to get to that 100%?

          • Kate Scott

            I agree with your reading of the literature Dan, but you might like to read the rapid responses to the Sydney Diet Heart Trial posted on the BMJ website. There are 2 there that I found of particular interest – the one by Ram Singh, and the one by one of the study authors C Ramsden. The latter explicitly addresses (and largely discounts) the possibility that transfats in the intervention group margerine could have explained the results. I think the evidence for the healthy, anti-inflammatory effects of nuts is overwhelming and I imagine that had the participants in the Sydney trial been led to increase their omega 6 levels to the same extent with nuts rather than margerine, the results would have been the opposite.

            Anyway, my real point is that you don’t need to eliminate nuts and seeds in order to reduce your omega 6:3 ratio down to around 4:1. I eat close to 3 oz of nuts and seeds per day, including 1 rounded tablespoon of flaxseed, and I use 1-2 tablespoons of olive oil in salad dressings and cooking (I avoid frying at high temps). Within the context of a vegan diet that brings my omega 6:3 ratio to around 4:1, often lower depending on the nuts or seeds eaten that day. So if you substitute olive oil for the safflower you are using, you would presumably find the same thing.

          • Dan

            Hi Kate,
            I did read those replies and I even corresponded with the PI. Though his explanations are convincing, unless he can develop a time machine to go back in time to the 1960’s/1970’s, there is absolutely no way to exclude the possibility that trans fatty acids were responsible for this trial’s results. Another possibility is that dietary worsening in other components in the active treatment group – a kind of carte blanche to eat what you want – may account for their findings. It was not a blinded study after all.

            I was using olive oil to cook but my understanding is that this is a bad idea because olive oil has a relatively low smoke point and in particular in extra virgin olive oil, heat rapidly oxidizes its key constituents.

            HO safflower actually contains a lot of MUFA, as with olive oil. I use about a teaspoon per week. I do not think it is a big deal.

            By the way, Ram Singh is the PI of the retracted Indo-Mediterranean trial, which was most likely a fraud (at least according to The Lancet, for what do I know?).

          • Kate Scott

            I didn’t know that about Ram Singh, or that that trial was retracted – do you happen to have the Lancet ref for that? Interesting!

            I agree that olive oil is not suitable for high heat cooking and you can water-saute and then add some oil at the end if you want the oil. Mostly I use it in salad dressings.

          • Dan

            I do not know the references off-hand. There were a slew of articles published on Ram Singh and the Indo-Med trial in 2005 in both the BMJ and The Lancet – the results of several investigations of his work by both journals. Richard Smith, the editor-in-chief of BMJ, had one such article.

            As to olive oil, I do not use it in my diet. For salad dressings, I use tahini, which is crushed roasted sesame paste. Huge amounts of linoleic acid – about 10 g per 4 tbsp of the stuff. But rich in sesamin and very good cholesterol-lowering effect. Also very delicious when admixed with lemon juice as a salad dressing.

          • Toxins

            Thanks for your input, I agree that nuts are healthful, and I have never advocated to eliminate them.

          • Toxins

            My goal is not to eliminate omega 6, it is an essential fat. My point was to moderate its use, as omega 3 is more scarce. Those on an omnivorous diet tend to get far more preformed arachidonic acid, so no omega 6 processing necessary. Regardless of this, I doubt that they reach this ratio to begin with. The American diet is rich in omega 6.
            http://nutritionfacts.org/video/inflammatory-remarks-about-arachidonic-acid/

            Including oil in your diet is not something that is advocated for on this site, as it is empty calories and it further contributes to the omega 6 in your diet. Have you measured out your ratio or are you making assumptions? Without measuring it, you would be surprised how off you could be. I would also be cautious lumping vegans together in one category, as a simple vegan diet is not what is advocated for here, but one that is whole foods plant based.

            Also, I should add that nuts and nut butters are not the base of my diet, but complex starches are. A low fat vegan diet is the only diet thus far proven to reverse heart disease.
            http://nutritionfacts.org/video/china-study-on-sudden-cardiac-death/

          • Dan

            Toxins, I have measured my OM6:OM3 ratio on peacounter. At one point, I was quite concerned about it because of all the negative publicity one reads on internet blogs. However, after exhaustively investigating the topic by reading full text articles on PubMed, including randomized feeding trials and meta-analyses, I am no longer much concerned about my OM6:OM3 ratio.

            I put it this way: say that a nutritional scientist were to study the adverse effects of the standard American diet, and as part of her investigations, she went through their household garbage. She noticed that people with worse health have a higher proportion of plastic and tinfoil candy wrappers, styrofoam containers from take-out restaurant food, discarded burger wrappers, and empty plastic bottles of condiments like ketchup, mustard and relish. She then publishes a paper stating that “In our research, plastic and tinfoil wrappers, styrofoam containers, burger wrappers and empty plastic bottles, were strongly associated with adverse health outcomes. We believe that people should reduce their intake of these containers and wrappers.” Ridiculous, right?

            I believe the same thing is happening with OM6:OM3. In other words, it’s an epiphenomenon. OM6 is abundant in junk food diets, whereas OM3 is abundant in fish, flax, walnuts, canola oil, chia – very healthy foods. These things are travelling along with the really detrimental or healthful exposures, respectively. In other words, it is not the wrappers and squeeze bottles and styrofoam takeout containers that are worsening health, but the foods once contained therein and (now) consumed. OM6 is added to foods which are extremely high in refined carbohydrates, saturated fat, trans fats, other artificial (non-natural) additives and preservatives, food colorants, etc. Think of all those cookies with soybean oil. So using the OM6:OM3 of the SAD (standard American diet) to indict its role in health is exactly like using candy wrappers as a scapegoat when we should really be blaming the candy!

            The Sydney Diet Heart Trial is intriguing and impressive but – the numbers (especially for the accompanying meta-analysis) are barely statistically significant and there was no control for trans fat intake in the industrial margarine that was used.

            And if I recall correctly, a randomized study using corn oil at a Veterans center in Los Angeles in the 1960’s showed a halving of the rate of coronary events – half the participants got corn oil to replace saturated fat in their diet. You can’t get much more omega-6 than corn oil, which is particularly rich in LA.

      • b00mer

        Zinc was the one mineral which I considered supplementing with, thinking that I must be deficient since I don’t eat pumpkin seeds every day (since of course if you look up “sources of zinc”, you get 1) calf’s liver, 2) fortified cereal, and 3) pumpkin seeds).

        Lo and behold, I actually start tracking on cronometer, and turns out I get plenty of zinc!

        It made me realize even more than I already knew how reductionist our society’s nutritional thinking is: “Food X is a source of Y nutrient. No other foods contain Y, and X has nothing else in it”. What I’ve taken away from cronometer is the huge variety of nutrients that are in all plant foods.

        Same with omega-3. I do eat flax daily, which usually gets me about a 1:1 ratio of 6:3, but even without the flax, I usually have a 2:1 ratio (and >100% rda for omega 3). Yet we tend to be inundated with the idea that if we don’t eat either fish or flax, we will have zero omega 3 intake.

        • Toxins

          Exactly so! We don’t need the flax for the omega 3, its just helpful. And because beans are high in protein doesn’t mean every other plant food will not provide us with protein. Well said!

          • b00mer

            I always cringe a little when I see blogger/fb posts about “vegan sources of protein”. ;)

    • DrBarbaraHoldeman

      Most of the vascular and metabolic (sugar metabolism) disorders are caused from to much fat in the diet and not caused by whole food sources of carbohydrates. Keeping the overt fats to approximately 10% of calories will help greatly in blood glucose levels and inflammation of the epithelial lining of the vascular system. Keep in mind that most fats cause inflammation. Omega 3 fatty acids reduce inflammation – keep them in whole food form and not oils and the fiber and constituent nutrients are intact and beneficial as well.

  • jed

    I am concerned. My friend is a vegan who consumes nothing but fruit – 2500 + calories per day -, he claims. And a few hundred calories of kale and romaine and a few seeds and nuts. Is this detrimental to the liver or pancreas organs? He easily eats 20 medjool dates a day, ten bananas, lots of apples, grapes, and melons. He takes B12, so OK there, but the sugar/fructose overload worries some of us. Are homo sapiens designed to handle this degree of fruit sugar? I would think long term it might screw up his hormones. I’ve seen other fruitarians and a lot of them look too thin and unhealthy.

    • Toxins

      The fruitarian diet has its appeals, but its not sustainable. It is the only diet that cannot provide enough protein simply because your not consuming the proper foods in the correct caloric amount. You can put the data into cronometer and see what is missing. I did a test for you.

      It is nearly impossible to consume as much kale as you are saying, as that would call for 10 cups or more of chopped kale, so I did 3 cups chopped. I did 20 dates, 10 bananas, 5 wedges of melon, and 3 cups of grapes as well as a half cup of almonds. The results?

      About 3500 calories. We have enough protein, but we made it with 3500 calories mainly due to the 3 cups of kale and .5 cups of almonds.

      This person is achieving all micronutrient goals, but there is a cause for concern with the amount of calories needed to reach these goals. It sounds like this individual must eat ALL day to remain satiated and satisfied. There is no evidence showing that a fruitarian diet is more healthful compared with a whole foods plant based vegan diet. I would say based on these results, we can conclude that a fruitarian diet is not sustainable.
      http://cronometer.com/

      • jed

        But is the excessive fruit sugar harmful even if it was 2500 calories of fruit? I’ve been telling him all along that huge loads of fruit on a daily basis can’t be great especially when it is derived from high fructose fruits like dates. He does eat well above 3 cups of kale. I’ve seen him eat the whole head and also blend a whole head of romaine into a smoothie with lots of bananas and dates and drink that throughout the day throughout the morning.

  • Plantstrongdoc M.D.

    Back in the early 90s Michael Klaper M.D. said: “There is absolutely no nutrient, no protein, no vitamin, no mineral that cant be obtained from plant-based foods.”

  • Plantstrongdoc M.D.

    This means that a well planned plant based diet has inborn calorierestriction with optimum nutrition, which probably can explain some of the health benefits from a plantbased diet.

  • Lawrence

    Hi Dr Greger. Big fan of you and watch your posts every day. I have recently noticed that you are placing a picture of yourself in the lower left hand corner as a way to entice viewers to subscribe. Whilst you are a handsome fellow, just like me, your wonderful picture covers part of the video which I want to see. Please remove it. Thanks.

    • Thea

      Lawrence: That picture bothers me too. One saving grace: If you hover your mouse over the picture, you will see that more stuff pops up to cover even more of the video, but on the plus side, there is a small “x”. If you click that small “x” the whole shebang disappears. I do that every time. It’s an annoyance, but you can get rid of it pretty easily.

      Does that help?

  • Karen

    I can appreciate all the work to prove what our ancestors ate, or how we evolved to eat up to this point in our evolution, it seems to help some of the population get oriented and feel alright making adjustments. What I think really matters is the cause and effect of what people eat today. I don’t think I have seen any studies or evidence in vegans and meat eaters that refute anything at all put forth by Dr. Greger. In my experience: One gal who was vegan and felt very ill, and after exhaustive medical tests showed no illness or deficiency, and she felt better after putting in a small amount of meat back into her diet. On the other hand my 72 year old mother who was raised in the South, is 1/4 Native American, was never vegetarian and has had numerous health and weight issues, recently eliminated animal intake and her blood pressure is better than it has ever been and her colesterol is, after decades of worry, way different. She had been gradually eliminating meat eggs and dairy and felt better all the time, and now she is a new woman. I am vegan 4 years and never get a cold or flu, and feel better than I did eating animals.
    My conviction is that humans and all species are spontaneously adaptable, and we humans have an understanding of the way our personal choices work to change our lives; and there is science now that supports the idea that each individual’s choices evolves him or her instantly. To some scientists we may have the appearance of herbivores and the mechanisms to be omnivorous, but it goes deeper, we are adaptable. What do you think of this idea: Health is more than diet (and exercise), but has to do with our relationship to our environment and each other-mind body and spirit. We are in an age where with the click of a button we can see what is happening and how we are making it happen. If we are to evolve health we will only do it evolving peace. I think many of us understand that and many more have that information subconsciously. That may be why the dangers of eating animals are mounting. We more and more understand the potential for peace, Are we perhaps adapting to only accept, on a cellular level, peaceful solutions to our needs and desires?

  • JR

    Can you comment on some of the studies mentioned in this article? Especially those regarding eggs, meat and gluten. THANKS. Much of the contradictory information hurts my brain :). http://www.businessinsider.com/13-nutrition-lies-that-made-the-world-sick-and-fat-2013-10?op=1

    • Toxins

      Dont worry about what you may hear on articles or blogs, because this is typically from misconstrued data or simply contains false information. The key is to look and exam studies which Dr. Greger does. Please see Dr. Greger on eggs, meat and wheat here.
      http://nutritionfacts.org/topics/eggs/
      http://nutritionfacts.org/topics/meat/
      http://nutritionfacts.org/topics/wheat/

    • guest

      Avoid gluten for six months and your life will most likely change for
      the better, even if you do not have celiac. It is nothing short of amazing. Dr. McDougall has written about the harmful aspects of gluten (although his comments might not apply to everyone. Other doctors from esteemed staffs at US hospitals have spoken out as well. Going gluten-free is amazing. It is so hard for people to understand this because most have never gone an extensive amount of time 100 percent gluten-free. Most in the US have had some form of gluten in their everyday since birth. Go for it. No one else can do this for you but yourself.

      • Thea

        guest: For someone for whom gluten is a problem, I have no doubt that going gluten-free would be very helpful – in the same way that a person with a peanut allergy would experience great benefits by going peanut-free. But how much of a problem is gluten for the general population? I think your opinion may not match the data. I’m not interested in doing in-depth research myself, but I was able to follow up a bit on your Dr. McDougall reference.

        re: “Dr. McDougall has written about the harmful aspects of gluten…”

        I’m not sure what writings you are talking about. However, there is a free recording available of a McDougall talk that happened just last month. If you skip to the end of the talk where Dr. McDougall takes questions from the audience, you will see that he addresses the gluten issue. It doesn’t sound to me like he thinks gluten is much of a problem. (Maybe 3% of the population according to the numbers he pulled out of his hat to make his point about his opinion.) So, whatever he has written in the past, I don’t think he considers it a big deal now.

        If you are interested, go to the following page and play the talk with the following title:

        “John McDougall, MD: September 20, 2013
        Autoimmune Disease and the Impact of Diet
        presented at Enhancing Health with Plant-Based Nutrition Medical Conference 2013.”

        http://nwveg.org/presentations

        Hope you find that helpful.

  • Geoffrey Levens, L.Ac.

    I have been eating a whole foods plant based (low cal high nutrient) diet for about 5 years now. How do I square your comment about higher metabolism with the fact that I am consistently colder all the time, and more to the point, need about 1/2 the calories to maintain my weight as I did when eating a lot of meat, cheese, etc? I have always thought that a CRON type diet would decrease metabolic rate. No?

    • guest

      I too am often cold on a plant based diet. I wonder if this is due to the body having no idea to warm itself up – create a slight fever? – to deal with the meat and dairy bacteria. Are there any studies that look at why vegans often complain of feeling cold?

    • guest

      I meant to type “i wonder if this is due to the body having NO NEED to warm itself up when not eating meat, dairy, egg.

      Thinking that eating meat dairy egg causes the body to feel warm….the body has a slight fever to deal with the bacteria of the meats dairy?

      I am freezing in the wintertime when eating plant based.

  • Max

    Dear Dr,

    I read an article elsewhere about 5 brain nutrients that cannot be obtained from plant based diets and one of them was carnosine. Could this nutrient potentially benefit people with diabetes/pre. Are there risks/side effects and what are the best sources to get this nutrient

    thank you !

    Max

    • Toxins

      All essential nutrients (except b12) can be found in plants, the rest are synthesized by the body.

  • France

    About the % of the recommended daily intake appearing on a label–does it represent the % of the intake recommended to avoid deficiency or that to allow optimum health?

    Thanks

    • Toxins

      It is used to avoid deficiency. The recommendation for vitamin c is just enough to avoid scurvy. You can find this trend through out all the nutrients. Calcium seems to be an exception though.

      Calcium needs for humans are not as high as the DRI may recommend, and if we consumed a low sodium diet low in animal protein, our calcium needs can be as low as 450 mg per day as discussed more extensively in this article from the Food and Agriculture Organization of the UN. As represented in the figure below, and citing from the article “In a western-style diet, absorbed calcium matches urinary and skin calcium at an intake of 840 mg as in Figure 14. Reducing animal protein intakes by 40 g reduces the intercept [calcium balance] value and requirement to 600 mg. Reducing both sodium and protein reduces the intercept value to 450 mg.”

      http://www.fao.org/docrep/004/Y2809E/y2809e0h.htm#bm17

  • Ronald Chavin

    In this video, Dr. Greger mentioned many of the nutrients that vegans have no trouble getting enough of. However, Dr. Greger forgot to mention the critical nutrients that vegans tend to be deficient in: Methylcobalamin (vitamin B12), niacin (vitamin B3), vitamin D, vitamin K2/MK-7, docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), eicosapentaenoic acid (EPA), selenium (antioxidant), zinc (antioxidant), iodine (antioxidant), phosphatidylserine, lysine, and methionine.

    The most shocking information in this video, however, is that real populations of “vegetarians” are eating mostly only white noodles, white bread, white rice, and white potatoes and not eating that much of the healthiest plant-source foods. No wonder “vegetarians” don’t live much longer than meat eaters in scientific studies.

  • Lauren

    Been following your nutritional advice for ten months now, and rather than losing weight I have GAINED thirty pounds! In ten months! After being at a stable weight for 3 years! Of course this is a health concern so I went to the doctor hoping for help. After all blood tests came back normal the only thing the doctor could offer me is a weight loss pill. Ugh.

    Dr. Greger, please tell me you have some research up your sleeve concerning vegans who mysteriously gain weight!

    • Thea

      Lauren: What a serious bummer. For the most part, people loose weight when they eat a whole plant based diet. However, I have heard of people who are in your situation. I’ve become a big fan of the resources that Dr. Forrester points people to:

      Check out Jeff Novick’s DVD series on Fast Food and Lighten Up. I personally have seen (and tasted recipes from) the first two Fast Food DVDs and think very highly of them! Example:

      http://www.amazon.com/Jeff-Novicks-Fast-Food-1/dp/B00466DP42/ref=sr_1_1?ie=UTF8&qid=1387583608&sr=8-1&keywords=jeff+novick+fast+food

      The above DVD gives you recipes that really are all of the following: fast!, cheap!, nutrient-dense without being calorie dense!, yummy!

      Also, here is a free lecture on How To Lose Weight Without Losing Your Mind. I hope you will find it helpful.
      http://www.youtube.com/watch?v=xAdqLB6bTuQ

    • http://www.DonForresterMD.com/ Don Forrester MD

      Hi Lauren, Congratulations on your efforts so far. If fat loss is your goal it is all about calorie density and exercise. Mainly calorie density as if you get it low enough you can lose weight on a couch with a remote. Given the value of regular exercise I don’t recommend the sitting on the couch approach. Definitely no weight loss pills. I would recommend Jeff Novick’s DVD, Calorie Density; Eat More, Weigh Less and Live Longer. I agree with Thea that the free online lecture by Dr. Lisle on how to lose weight without losing your mind gives useful insights which are helpful. Dr. McDougall’s website is a valuable resource especially his newsletter article, The Fat Vegan, which was published in his December 2008 newsletter. You might also watch Dr. McDougall’s free online lecture, The Starch Solution, which goes along way to freeing folks from their misunderstanding about carbohydrates. His website also comes with many recipes from the unsung heroine of the McDougall team… his wife Mary. You can reasonably expect to lose 1/2 to 2# per week depending on your diet’s calorie density and exercise. On the other hand cutting out alot of the unhealthy foods you were eating has benefited many not so obvious parts of your anatomy and physiology. Truth in advertising… I have the pleasure of working with Dr. McDougall, Jeff Novick and Doug Lisle but honestly after 35 years as a Family Medicine doctor the science is in and just keeps reinforcing the best path. Good luck.

    • dogulas

      You made this comment ten months ago. How have the second ten months gone? Have you eliminated add oils?

      • Lauren

        I got pregnant shortly after posting this and now have a newborn. Ate mostly plants while pregnant and was healthy enough, but of course no weight loss. My typical diet is oatmeal with chia and soy milk for breakfast, salad for lunch, and vegetable/whole grain dinners, with seaweed, nuts, and fruit as snacks. Blood tests during pregnancy only found a vitamin D deficiency, so my weight gain still seems a mystery. Gonna try the weight loss medication after I am done nursing, I guess.

        • Toxins

          Track your food intake through https://cronometer.com/

          You might be surprised what foods are contributing most to your caloric load. Oils and fats can really wrack up the calorie count.

        • dogulas

          I hope you don’t need to go for the weight loss medication. The only thing I would suggest is of course take a vitamin D supplement, and maybe, just maybe try using fruit and other things in your breakfast cereal instead of the soy milk. Best of success to you! Trust the principles, and make sure you’re sticking with whole foods and filling up to satisfaction on starches and vegetables and fruits like you’re doing! Last resort, maybe see how much and what types of nuts you’re snacking on, although according to Greger’s findings, nut consumption is not at all associated with weight gain. Although whole food plant based diet advocates besides Greger mostly encourage a definite avoidance of many nuts at all besides chia/flax. Walks are a great way to increase metabolism too :) You’ll do it, just stick with the principles and maybe replace some nuts with more grains and veggies instead.

  • Poonam Sharma

    Hi ! One of my client is suffering from sarcodiosis. Please guide what kind of diet and supplements I can suggest him. He is fond of eating non veg

  • Caterina

    I find interesting and necessary to consider the genetic background of each individual, as showed in this two articles, it could be determining in the development of obesity and other metabolic diseases with a heavier contribution than diet or physical activity according to their findings:
    “Genetic Studies of Body Mass Index Yield New Insights for Obesity Biology”. Joel N. Hirschhorn, Ruth J. F. Loos,
    Elizabeth K. Speliotes, et. al., Nature 518, 197–206 (February 2015)

    “New Genetic Loci Link Adipose and Insulin Biology to Body Fat Distribution”. Cecilia M. Lindgren, Karen L MohlkeNature et al., 518, 187–196 (February 2015)

  • Wade Patton

    Took me all of TWO days to start feeling better, weight continues to fall away after 3 months, but the rate has slowed. So easy to continue eating this way, somebody should tell the sick people. 8-p

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  • Cheryl Hugle

    Has anyone done a comparison of people who keep the weight off on a vegan diet vs those not on a vegan diet? Because the ratio of non vegans keeping the weight off is staggeringly low.

  • Hannah

    After learning so much about eating more plants and nutrient dense food over the past year, I have migrated from a vegetarian diet to mostly plant based. While I eat until I’m full, always eat when I’m hungry, and only exercise moderately almost every day of the week, I have lost 15 lbs without trying. The problem is that I don’t have excess weight to lose and am now underweight with a even lower body fat percentage. Do you have any suggestions as to how to maintain weight on a healthy, plant-based diet?

    Thank you for your time!

  • Pat

    I have switched to vegan for 5 months now. I have noticed weight gain? I gained about 10 pounds. I keep up with exercise but can’t explain the weight gain. Is there something i should look at or certain foods I should avoid?

    • Thea

      Pat: Going vegan helps most people to lose weight, but the devil is in the details. What is needed is not just a vegan diet, but a whole plant food based diet that has low calorie density. The key is understanding the concept of calorie density and how to apply it to weight loss so that you don’t get hungry and you still get all the nutrients you need.
      .
      Dr. Greger covers calorie density, but not in enough detail in my opinion for someone who wants to apply it for the first time. I believe that Doug Lisle is one of the experts in the Forks Over Knives documentary, and he gives a great ‘calorie density 101’ talk officially called: How To Lose Weight Without Losing Your Mind. I have watched the following talk from Doug Lisle several times and think very highly of it. And it’s free!!! And it’s entertaining! https://www.youtube.com/watch?v=xAdqLB6bTuQ
      .
      As good as Doug Lisle’s talk is, it pretty much just gives you a solid understanding of the concept, but not enough practical information in my opinion. For starting to get the practical information, I recommend a talk from Jeff Novick,Calorie Density: “How to Eat More, Weigh Less, and Live Longer,” which is no longer for sale. Argh! (I mention it just in case you can get your hands on a copy. Happily, there is a very good second best source for that information: an article that Jeff wrote that you can get here:
      http://www.forksoverknives.com/the-calorie-density-approach-to-nutrition-and-lifelong-weight-management/
      Be sure to pay attention to the charts.
      .
      Chef AJ tells people who want to lose weight to eat “left of the red line”, where I believe the red line is on a diagram of hers representing is 600 calories per pound. And “left of the red line” is all the whole plant foods which are below 600 calories per pound. The above article from Jeff Novick gives you a good sense of which foods are “left of the red line” by food category. But if you want to look up the calorie density of specific foods, you can find many foods on the following site: http://nutritiondata.self.com/ Most foods on that site have the option of choose an ‘ounce’ as a size. Then you can multiply by 16 to get the calories per pound.
      .
      It would be perfectly respectable if you are one of those people who are just not interested in the theory. You just want to dive right in and want straight how-to information. If you would rather not think about any of that (or start with the theory and then move onto this step), I have one more suggestion that Dr. Greger also recommends in his book, How Not To Die. Consider going through the free program from PCRM (Physician’s Committee For Responsible Medicine) called 21 Day Kickstart. The program will “hold your hand” for 21 days, including meal plans, recipes, videos, inspirational messages, and a forum (moderated by a very respected RD) where you can ask questions.
      http://www.pcrm.org/kickstartHome/
      (Click the green “Register Now” button.)
      At the end of the program, you will have a very good practical knowledge about how to eat with healthy and “low” (normal for most people) calorie density.
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      Another recommendation that Dr. Greger and I share is to get Jeff Novick’s Fast Food videos for tasty, affordable, fast and healthy calorie density recipes. Also, on-line and free is a YouTube series of recipes/cooking shows called something like Chef AJ and The Dietician. I know that Chef AJ will not steer you wrong in terms of weight loss and providing accurate nutrition information.
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      How’s that for some tips? If you give these ideas a try, please report back and let us know how it went.