Doctor's Note

I touched on paleo diets before in Paleolithic Lessons, and I featured a guest blog on the subject: Will The Real Paleo Diet Please Stand Up?

I wrote a book on low carb diets (now available free full-text online) and touched on it in Atkins Diet: Trouble Keeping It Up and Low Carb Diets and Coronary Blood Flow.

And if you’re thinking, yeah, but what about the size of the cholesterol, small and dense or large and fluffy? Please see my video Does Cholesterol Size Matter?

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.

  • tbatts666

    I think my major concern with the paleo diet is it’s name. It really appeals to people who use evolution as a mental model.

    Can we really be so sure that cavemen ate a certain way?

    It appears to me it is a dangerous oversimplification.

    • Don’t look for logic in Paleo. It is classic “Hear what you want to hear” style ignorance. Say it is 30,000 years ago. We are a small band of noble savages. If we survive long enough to reproduce then it doesn’t really matter what we ate. We find a billion ways to die in the past. I know, I was there. When I was young I couldn’t care less. More brontoburgers please. Now I want to see my grandchildren grow and so I stalk the wild asparagus (and so do they – thanks Mum…and Dr G!)

      • Plantstrongdoc M.D.

        Of course you were there !!
        :-)

        • We just watched “The Man from Earth” :) Pretty cool flic

          • Devra

            That’s one of my favorite movies!

          • “What you’re saying, it offends common sense.

            John Oldman: So does Relativity, Quantum Mechanics, that’s the way nature works.”

            :)

          • Devra

            My favorite line is the one with the talking snake.

            Not posting it here in case there’s an “Edith” around. ;)

          • “We could have a holy war in our living room any day of the week!”

            The funny thing about that movie was we both kinda turned our noses up and then about a week later we realized we were still talking about it. It is so unusual (for us) to find thought-provoking movies that havent been CGI’d to death. And it was GREAT to see Imogene Coca after more years than i can count… Any suggestions welcomed.
            “Coffee and cigarettes” if you want a laugh

          • Devra

            We had the same experience–not realizing the psychological truths in that film until later.

            You might also enjoy “K-Pax.”

          • Thank you! I’ll see if they have it on rental here.

          • Intermedx

            You can watch it free on You Tube.

      • tbatts666

        Sure. I am fairly convinced that the Paleo diet is counterproductive, but it’s widely popular.

        People don’t have the time or initiative to do much research about their diet, and I can attest to that. Dr. G is like my only source of nutrition knowledge.

        In terms of the narrative we make for nutrition mental models are incredibly important. The idea that Paleo is somehow proven through natural selection is appealing. It’s important that public health type people remind us that modern day Paleo is not really historically accurate (This is covered somewhere on Nutritionfacts).

        Is Paleo an unhealthy fad diet? If so we should constantly be reminding people that the Paleo diet is probably not what ancient humans ate.

        • I think you miss my point: I don’t think we should remind people about Paleo probabilities at all. Human nutrition does not depend on what cave folks ate. The whole idea is wacky. But I would never try to convince anyone that I know what the myriad geographically isolated populations of paleolithic humans composed for their various diets. Anyone can believe whatever they choose to believe but anyone wishing to live a long and healthy life needs good nutrition based on good science.

          I hear a lot about narratives these days. and metrics and lots of other neat sounding werds. Called buzzwords right? What is important is getting people to believe that science should work FOR them and to believe that good science is good for them. And to learn to recognize good and bad science.

          All the stories about the Garden and Gandolf and pills and majic potions lead folks down a pretty path to the land of Woo. No offence intended but isn’t scientific nutrition the only proper paradigm for a “nutrition mental model”? All models are wrong, some models are useful.

          • Peter Block

            For more info, pick up the book “Paleofantasy”.

    • Thea

      tbatts666: re: “Can we really be so sure that cavemen ate a certain way?”
      I think you are on the right track as well as are the replies you have gotten. The only thing I would add is a link to the following NutritionFacts blog article. If you haven’t seen this one yet, I highly recommend it in terms of a partial answer to your question:
      http://nutritionfacts.org/2014/09/23/will-the-real-paleo-diet-please-stand-up/

      • DoctorD

        I also highly recommend plantpostivie.com This blogger has outlined in detail, in a format much like the good Doctor G, the science completely debunking paleo and atkins. It is not to be missed for those interested in good health through good-science-based nutrition. As we proceed to the end-game of this nonsense about humans eating animals, expect the witless and emotional-based paleo attacks to increase.

        • Thea

          DoctorD: Thanks for your post. I’m a huge fan of Plant Positive. I recommend him all of the time too. I agree that his work is very high quality.

          re: attacks. Yep. But for the most part, I don’t think it is attacks so much as really misguided people who really believe what they say and thus are passionate. The best way to proceed with such people is gently. (Note to anyone reading this: I’m not talking about anyone in particular or on this threat at all. I’m just making general conversation with DoctorD.)

    • Gus Wehrman

      Indeed. Especially when you consider how inaccurate the term is, since modern foods are hybridized versions of what would have been eaten then. And what might the average lifespan and activity level looked like then?

    • Darryl

      Paleo advocates have some good insights. We should all eat whole foods with minimal processing, avoid added sugars, and pay attention to reducing glycemic loads by choosing lower glycemic index starches (whole grains, legumes & sweet potatoes rather than baked goods and white rice). That said, the modern paleo movement also has a lot of dogma that isn’t supported by the evidence, particularly regarding whole grains, legumes, and curious assertions of which fats are and aren’t healthy. Many advocates have more the character of political or religious extremists than scientists, as anything that doesn’t fit a preconceived worldview is discarded as irrelevant, and some go out of their way to choose diets opposite to the nutrition consensus as a means of “giving the finger to the man”. You won’t have to look far in the ancestral health community to find characters whose diets are full of the decidedly non-“paleo” options of bacon and butter, who then seem surprised that like any lab animal fed these they’ve become insulin resistant and hyperlipidemic.

      As someone who embraces evolutionary models, I’ve no problem with the term “paleo” diet, though I find some willful ignorance among many proproponents. Some scientific problems with modern paleo movement include:1) dogmatic insistence on the Raymond Dart model of “man the hunter”, which has been contested and supplanted in paleoanthropology for decades; 2) ignorance about the speed of evolutionary adaptation, for example our very recent acquisition of lactase persistence and high amylase gene number; 3) focus on the diets of 80-10,000 years ago, dismissing the 40 million years when our lineage were predominantly herbivorous forest dwellers. 4) focus on the diets of remaining hunter gatherers pushed into extreme environments, whereas several contemporary African savannah & forest hunter gatherers eat predominantly plant-based; 5) the unfounded assumption that the same diet that maximizes growth in youth will also maximize healthspan free of chronic disease, which experimental gerontology has resoundingly dismissed.

      • guest

        Yes! This is exactly what I have been told as well! You are so right mr. darryl! We have been apes for far longer than we were cavemen, so it makes no sense to model our diet off of them. You should write a paper on that subject and submit it to them. Maybe that will get them to see reason.

    • Mary

      Paleolithic people did NOT eat that way. Here’s an excellent TED talk which debunks the paleo diet: https://www.youtube.com/watch?v=BMOjVYgYaG8

      • Kyle Laney

        this does NOT debunk the “paleo” diet

      • Viki Thurman

        This person doesn’t know what the paleo diet is. She did not research it and does not understand it. It’s easy to think you’ve “debunked” something that you understand only through gross assumptions.

    • Isabell Sandström

      Maybe low intense and anaerobic training is healthier, no matter the diet?

      • Kyle Laney

        Low intensity is NOT better. Many runners get injured due to chronic cardio.

    • cameron

      I completely agree, why should we base what we believe to be a healthy diet on what our ancestors did 30,000 years ago. Today we have markets filled with foods we never had access to. The paleo diet is good on behalf that it encourages lots of vegetables and fruits, but wrong in the sense that it encourages us to eat more meat. Meat continues to show time after time to have negative effects on human health. Dr. Collin Campbell a pioneer in the plant based revolution brought this to life with his book the China Study, a book i would recommend to anyone who wants to see the research on animal foods and their many affects on our overall health. The paleo diet is coupled with a the fitness industry/crossfit lifestyle. There is a large disconnect between being healthy and looking fit (e.g. skinny/ripped). The fitness industry focuses mainly on physique breaking food down to macronutrients only. They consume protein like like medicine because they are told they need more protein, protein, protein to help them build their muscles. However, 20 grams per meal is really all athletes need to initiate protein synthesis (anabolic muscle growth). Protein can be found a a large number of plant foods including nuts, beans, quinoa, oats, rice and as long as you are consuming a good amount of these foods you should have no issue in building muscle. Their needs to be a collaboration between the fitness industry and what truly being healthy inside the body looks like. The paleo diet will fall as do all fad diets, and the plant based revolution will rise to the top because its benefits to life are endless: weight loss, prevention, longer life, happier life, and overall healthier body.

    • skeptic15

      Paleofantasy is a decent read, imo

  • Merio

    I can’t lose the chance to remember about Plant Positive’s work on the diet issue:

    http://plantpositive.com/

    While talking about paleo diets… i think there were many paleo diets in the past and not only one diet for all the young mankind.

    Probably depending on environment and situations there were populations heavy on meat and fish, and others practically vegetarian and probably a lot of bad periods in wich food was scarce and life was really hard.

    And i don’t know why, it’s only a feeling that i have, but i think that insects play a major role in ancient times for our diet.

    • Jim Felder

      Lots safer hunting insects. They don’t typically turn and try to gore you to death when you have the bad manners to stick a spear into their sides. Even ferocious predators will eat insects when they get a chance. Look at Grizzles. In some places and at certain times in the summer they can get nearly all of their calories eating the insects in mass congregations (army cut worm moth, ladybird beetles, etc). It looks like they are grazing, but in fact are licking up pound after pound of insects. So I would say that it is a very safe bet that paleo humans ate insects any time they got a chance. A rotten log was probably an early version of a smorgasbord board with all of its tasty crawly things and grubs. In fact I think everyone starting a paleo diet should be required to eat a plate of BBQ crickets (something easily found from street vendors in Bangkok) in order to get an idea of what real paleo eating was like.

      • Merio

        I was thinking that if we as mankind were in some way intelligent, probably we would have created a bug meat industry instead of the current animal meat industry.

        I mean it’s really easy (compare to cows, chickens etc) to raise insects than animals.

        • Thule

          As an entomophobic, I am getting sick only imagining. But aren’t most folks entomophics to some degree?

          Evolutionary pays off to keep your distance from the animals that kills more humans than all other species combined.

          Also as a species we are frugivores, that later got more enzymes to digest cereal than the other primates, it is true that primates do eat some lice or similar they might have in their fur, but they don’t go out of their way hunting insects. They go for the fruits. :)

          • Merio

            Yes, fruit is definitely the king of foods out there.

            :-)

          • Wegan

            I remember seeing a study of some primates in some zoo that weren’t thriving because the fruit they gave them didn’t have the requisite bugs in it.

        • Why cook bug meat when you can eat an ExoProtein bar made from cricket flour? That’s Paleo, right?

          • Merio

            But, do not forget parasites !! :-)

          • Not sure processed parasites have the same effect.

          • Merio

            XD

  • Jeneatsplants

    Way off topic, but Dr. Greger, with the holidays around, I am wondering if you partake in “any” amount of spirits. And wondering about others here as well. If one does some reading via google, much has been said that even minimal ounces of alcohol can harm the gut barrier. Heck, maybe even the brain barrier. And I will guess that booze wipes out the natural bacteria in our mouth, throats, all the way down…..

    So wondering here, even after looking through the videos, I do not get a clear picture on a glass or two of organic beer, an organic red wine (4 ounces), as having no chance of causing internal harm. I know that there are benefits to booze, but the benefits are mutual exclusive to the harm.

    • Eva

      I know it is not for me to answer to your concerns but it’s an interesting topic. I don’t think a glass of wine or two around Christmas and New Year is any problem whatsoever. There are countries where some strong alcoholic drinks actually act like garlic – they do kill bad bacteria and I know from personal experience that these people haven’t had a flu throughout their lives, they live up to 90 years of age (and even more) and are lively folk. And, they drink these drinks in very moderate amounts, and only when needed (if they suspect a flu or feel low in energy). And of course, I am talking about home-made grape alcoholic drinks (not only wine). So, again, one-two glasses of wine or a bit of beer isn’t going to destroy your health. Just do it a few times a year. Personally, I avoid alcohol because I don’t need it. I am cheerful without the booze :)))))) and I am not ashamed to say that I will not drink something if I don’t want to no matter the peer pressure.

    • Lawrence

      Spill the wine, eat the grapes.

  • Wegan

    In the conclusion of the Paleo study they mention several studies showing how glucose tolerance is better for Paleo eaters and how wonderful dairy is. Do they even read the studies they cite?
    I looked at one of the Paleo glucose studies by S. Lindeberg et al. ( which may be why Sweden embraces paleo)
    The Mediterranean group ate a lot more low fat dairy and not much less meat than the Paleo folks. What they didn’t even mention in their conclusion is that the Mediterranean group drank a whole lot more juice and sweet beverages (soda?) another worthless study IMO.

  • BenzoSt

    I just finished being >99% vegan for three months, which involved eliminating my regular consumption of fish, fish oil, egg whites, and yogurt. At the end of the experiment, my fasting glucose and HbA1c improved (both lower than at start). But while my total cholesterol also became lower, this was exclusively a result of a lowering in HDL, so (under the assumption that the HDL: total cholesterol ratio is an even stronger indicator for risk of heart disease than total cholesterol alone) it seems being vegan didn’t improve my lipid profile as it did for people in one of these experiments.

    • pbdoc

      Your LDL did not drop?

      HDL is only protective when TC is low. HDL cannot perform its antioxidant efflux function when cholesterol deposition into the intima is high because it too becomes atherogenic and lodged into the intima. Don’t worry too much about HDL.

      • gordotl

        You are assuming all LDL is the same – it isn’t. Type A is beneficial – Type B is not. However, no one does the differential analysis between the two – therefore, your argument is flawed.

    • Eva

      I think it depends very much if you, by switching to a vegan diet, had missed on some important ingredients, nutrients, etc. Being a vegan requires extra attention and knowledge gathering. I’ve been doing this for almost 2 years (veganism) and throughout that time I read lots and lots of studies, watched medical videos, etc, and still keep learning new things, and finding out things that can slip out of the attention of a vegan person. Of course, you may have gathered the info before you began being a vegan, but in my opinion veganism is the perfect lifestyle choice. And the reason why some vegans show bad test results is probably because they have missed something. There is no way anyone can make me believe that eating meat ad dairy is something humans cannot live with and be healthy till the end….

      • Lawrence

        I agree. I have been a Vegan Plus now for about 3 years. When I started this journey, I quickly realised that you can be a vegan and still be unhealthy. Being a vegan is about not eating any animal products but some vegans still consume too much salt, sugar and processed plant based foods such as white bread. So, I decided I needed to be a Vegan Plus and differentiate myself from ordinary vegans. I also gave up alcohol as it was just another processed food and a real poison. That also meant giving up an alcohol based mouthwash. I also gave up toothpaste and now clean my teeth with green tea. My mouth tastes so much better now.

        • How do you clean your teeth with green tea? I’m guessing you grind the green tea into a powder, add some water to make a paste and use that?

        • Eva

          Very nice choices. I also use home-made toothpastes with cosmetic clay and lavender oil extract. Other times we just buy an organic toothpaste from a not well-known danish company that uses only organic products in it. I like the term Vegan Plus :) It really means that you’re not just excluding some foods, but consciously including others and improving your lifestyle even further. Being a vegan requires proactivity, it’s not just a decision to be something and go with the flow. Today it may be tough to be a vegan since all food too contaminated with chemicals and heavy metals… but, that’s it.

    • What is coming to light in recent studies is that it’s not the amount of HDL that counts so much, but it’s ability to function. Unfortunately, HDL functionality is not something that can be tested for in a routine clinical setting.

      Milano Apolipoprotein Targets Atherosclerosis: A Newsmaker Interview With Steven E. Nissen, MD

      http://www.medscape.com/viewarticle/464291

    • BenzoSt

      Here is a much more detailed account of my 3 month vegan trial, which I posted a few days elsewhere on Disquss:

      I have just finished an experiment in which I tried veganism for 3 months. Prior to this experiment, I made a drastic change to my diet in order to drastically reduce my elevated cholesterol (by strictly limiting meat, egg yolks, butter, coconuts, and refined sugar). Since I have in the past changed my dietary habits to achieve a massive reduction in my cholesterol, I was curious how taking the next step and becoming vegan would affect my physiological parameters. Prior to starting this experiment, I was consuming a healthy omnivorous diet. Therefore I didn’t expect veganism to improve my health as profoundly as it would improve the health of someone formerly consuming a typical American diet.

      Basically the changes I made to my previous diet were:

      Eliminated about 3 daily servings of nonfat Greek yogurt, whey protein, and/or egg whites.

      Eliminated about 2-3 weekly servings of sardines and/or canned salmon.

      Eliminated all meat, which I previously ate about once or twice a month.

      Replaced daily triple-strength fish oil capsules with daily Ovega-3 algae capsules.

      Increased consumption of beans, peas, lentils, and potatoes.

      Although it was very easy for me to avoid junk food at the grocery and relatively easy for me to avoid eating junk food at home, I usually failed to resist treats at parties. During this experiment, I did violate veganism on a few occasions at parties by consuming baked goods containing dairy products and eggs. But at least I was completely vegetarian – having consumed absolutely no meat or fish – for 3 months. I’m quite certain that at least 99% of my calories during this experiment were from vegan sources.

      Thus I have been consuming less protein, less saturated fat, and more carbohydrates over the past 3 months. I predicted this would slightly lower my total cholesterol, LDL cholesterol, and (unfortunately) HDL cholesterol, and slightly raise my HbA1c and fasting glucose.

      My starting status as compared to optimal values were:

      Weight 167 148-160
      Height 5′ 9”
      Waist 32”
      Hips 37”

      Triglycerides 72 60
      LDL cholesterol 118 <80
      VLDL cholesterol 14
      Ratio chol/HDL: 2.97015 <2.5

      Blood pressure 108/70 <120/80
      Fasting glucose 90 <90
      Fasting insulin 4 <3
      HbA1c 5.1 <5.8
      hs-CRP 0.2 <1.3
      Homocysteine 8.8 <7.5

      My ending status as compared to optimal values were:

      Blood pressure 112/78 (+2/+8) <120/80
      Fasting glucose 87 (-3) <90
      Fasting insulin unavailable <3
      HbA1c 5.0 (-0.1) <5.8
      hs-CRP unavailable <1.3
      Homocysteine unavailable <7.5

      Weight 161.8 (-5.2) 148-160
      Height 5' 9” (no change)
      Waist 31.5” (-0.5”)
      Hips 37” (no change)

      Triglycerides 69 (-3) 60
      LDL cholesterol 118 (no change) <80
      VLDL cholesterol 14 (no change)
      Ratio chol/HDL: 3.4 (+0.43) <2.5

      My hypothesis that my cholesterol would get slightly better (lower) and that my fasting glucose and HbA1c would get slightly worse (higher) were refuted by this experiment. Although my total cholesterol did indeed decrease, this wasn't a welcome change because the decrease was the result of a reduction in exclusively HDL. The highest my HDL has ever been was about 1.5 years ago when I was consuming lots of saturated fat from coconuts, eggs, and dark chocolate. My prediction that my fasting glucose and HbA1c would increase due to higher carbohydrate consumption was also wrong because these values dropped. So in conclusion, it seems that for me a healthy vegan diet is no better than a healthy omnivorous diet low in saturated animal fat.

      I found a vegan diet pleasurable, although it was an inconvenience when going out to eat with friends and family because vegan options in most restaurants are very scant. At no time during this experiment did I have a craving for meat, eggs, or dairy. Since the end of this experiment, I have eaten animal flesh on three occasions. The first occasion was turkey on Thanksgiving, which was enjoyable but not as thrilling as the mashed sweet potatoes or onions it shared my plate with. The second occasion was a tin of sardines a few days later, which wasn't as pleasurable as the turkey. The third occasion was steak at pop's birthday party, which tasted too greasy. It seems that by avoiding meat, my taste preference has shifted and I enjoy eating legumes and potatoes more and animal flesh less. This a welcome change because I believe these plant foods are healthier and I know they are certainly less expensive. Recently I've been eating home made split-pea soup almost every night and it is always tastes terrific.

      Perhaps coincidentally, I had less heartburn and less involuntary muscle twitching and night cramps in my calves during this experiment. My athletic performance didn't seem to change much during this time. In fact, I achieved a new bench press PR of 180x5x5 and a new deadlift PR of 305x5x3 while being vegan. However, this is the beginning of wintertime, when I deliberately emphasize strength more in my training than cardiovascular endurance in order to avoid becoming vulnerable to the common cold. I predict that decreasing the amount of intense cardiovascular exercise is the main reason for my reduction in HDL.

      Now that the experiment is over, I'm going to make it a point to eat a tin of sardines and a big bar of dark chocolate each week. After the holidays, I'll emphasize intense cardio and HIIT more at the gym, even though it might make me more susceptible to colds. Hopefully these changes will increase my HDL. And I will allow myself to indulge in pancakes once a month. I will continue to strictly limit my consumption of meat, eggs, sugar, and dairy products.

      In conclusion, I'm glad I did this experiment and highly recommend other people try it. For many people it will feel like a drastic change, but I think you will adapt in a few weeks. For those who do try it, it is important to take vitamin B12 because plants don't have this essential vitamin. For those who are into weightlifting, creatine and perhaps beta alanine supplementation become even more beneficial because plants don't contain much of these compounds.

      My staple foods during this experiment:

      “Vegetables”: 5+ servings daily

      Leafy greens, onions, scallions, broccoli, cauliflower, bok choy, cabbage, kale, brussel sprouts, green beans, beets, carrots, celery, eggplant, zucchini, tomato, avocado.

      Fruits: 2-4 serving daily

      Berries, lemons, grapefruit, oranges, apples, bananas, grapes, watermelon, pineapple, mango.

      Legumes: about 2 cups daily

      Lentils, peas, black beans, kidney beans, pinto beans, garbanzo beans, tempeh.

      Starches: about 4 servings daily

      Potatoes, sweet potatoes, squash, quinoa, corn.

      Nuts and seeds: 1-2 oz daily

      Chia seeds, flax seeds, pistachios, pecans, walnuts, almonds, filberts, Brazil nuts.

      Drinks:

      Water, black coffee, tea, herbal tea, cocoa, beer/wine (max 4 per week).

      Spices/vinegar: lots!

      Turmeric, curry powder, garlic, ginger, fenugreek, cayenne, black pepper, chili powder, cumin, sage, basil, oregano, cinnamon, clove, apple cider vinegar, balsamic vinegar, red wine vinegar.

      Supplements:

      B complex, D3 4,000 I.U. (wintertime), Ovega-3 500mg, zinc gluconate 30mg.

      • HereHere

        Thanks for sharing your experiment with us. I found it intriguing and, like yourself, found the cholesterol results surprising. It seems you are on a very healthy path, and at least cholesterol did not increase. I don’t know if you were using oil, it doesn’t sound like you were. But if so, this may be a reason for lack of decrease in LDL cholesterol.

      • drew4021

        BenzoSt thanks for sharing. I did something quite similar from September to Thanksgiving this year and my results were on par with yours –although my cholesterol numbers were better –probably because I also eliminated all refined oils, nuts, caffeine and sugar. I would be curious to hear what your diet consists of now as our statistics are similar and it sounds like we also have similar lifestyle and fitness goals.

        • BenzoSt

          My next annual physical is April 2, so I’ll get another round of bloodwork done on that day. So for the next 3 months, I think I’ll try the strict version of the Ornish Spectrum diet. Despite never having a carotid ultrasound or similar test, I have little doubt that more than three decades of eating a SAD (standard American diet) has left me with a bit of plaque in my arteries, and the Ornish diet is supposed to reverse atherosclerosis. So for the next 3 months, I’ll try limiting fat to about 10% of my calories by cutting back on nuts, seeds, and avocados. I was thinking about going back to eating fish once or twice a week, but since I’ll be cutting back on nuts and hence omega-6, I think I’ll be fine just taking an Ovega-3 and eating 2 tbsp of flax daily. Aside from that, the little fat I will consume will be from a little dark chocolate and a daily Brazil nut.

          As for caffeine, I have learned that UNfiltered coffee elevates cholesterol, but filtered coffee does not. Nevertheless, I’ll try to swap out my daily 1-2 mugs of coffee for green tea, as recommended by Ornish. As was the case for the three months of my vegan experiment, I’ll continue to strictly limit refined sugar, flour, and oil.

          I’ll also be emphasizing cardio more and strength less in the three months to come. Aerobic exercise is supposed to be a little better than weightlifting for fighting anxiety and depression, and January-March are the most dreary and depressing months here in Massachusetts. I suspect this emphasis on cardio will help boost my HDL. And if, come April, my lipid panel isn’t better, I can try eco-Atkins by eating less starch and more nuts, seeds, avocados, and chocolate.

    • Dominic

      I had my blood lipid levels tested in June 2012 and June 2013. My total serum cholesterol levels were 99 mg/dl in 2012 and 119 mg/dl in 2013. (I’ve been eating a WFPB diet since March, 2009)

      My HDL (“good cholesterol”) levels were 29 mg/dl and 31 mg/dl respectively. Each time, the student nurse commended me on my low Total Cholesterol numbers, but then lectured me on ways that I could increase my HDL levels. (ie. increase exercise and eat fish).

      Although the Mayo Clnic and the American Heart Association state that an HDL level under 40 increases the risk of developing coronary artery disease (CAD) in men – I am not concerned.

      One of HDL’s roles is to remove cholesterol from cholesterol-loaded macrophages, the sort that accumulate in arterial plaque. This is known as its cholesterol efflux capacity.

      Dr. Caldwell Esselstyn Jr., (of heart disease reversal fame) sites research that high HDL efflux capacity protects against atherosclerosis and that HDL blood levels are NOT indicative of HDL’s efflux capacity. He also mentions that statins do not increase efflux capacity.1

      HDL’s second role is to modulate inflammation. Epidemiological studies show that HDL-cholesterol levels are inversely correlated with the risk of cardiovascular events. However, many patients who experience a clinical event have normal, or even high, levels of HDL cholesterol.

      Measuring HDL-cholesterol levels provides information about the size of the HDL pool, but does not predict HDL composition or function. The main component of HDL, apolipoprotein A-I (apo A-I), is largely responsible for reverse cholesterol transport. Apo A-I can be damaged by oxidative mechanisms, which render the protein less able to promote cholesterol efflux. HDL also contains a number of other proteins that are affected by the oxidative environment of the acute-phase response. Modification of the protein components of HDL can convert it from an anti-inflammatory to a proinflammatory particle. Small peptides that mimic some of the properties of apo A-I have been shown in preclinical models to improve HDL function and reduce atherosclerosis without altering HDL-cholesterol levels.2 Eating the typical western diet appears to damage apo A-I and renders them proinflammatory and atherogenic.

      In populations where CAD is just about nonexistent, people have both low LDL and HDL levels. These populations follow diets that are higher in whole plant foods and lower in fat and saturated fat than the typical western diet. Studies have shown that it does not appear that low HDL levels provide any vascular risk in individuals who attain very low concentrations of LDL – through diet alone or on extensive statin therapy.3,4.

      In essence, when looking at your lipid profile, it’s best to focus on your Non-HDL number. To calculate your Non – HDL level, just subtract your HDL level from your total level. This will give you a number that represents your cholesterol that is likely to be atherogenic – your LDLs and VLDLs. Strive to keep your Non HDL levels to below 100.

      So if you’ve been following a WFPB diet and both your LDL and HDL levels decline, but your Non HDL number is under 100, don’t be surprised if your physician is unconcerned that your HDL level is under the current guideline.

      1. Khera, AV et al. Cholesterol Efflux Capacity, High-Density Lipoprotein Function, and Atherosclerosis. NEJM 2011; 365: 127- 135

      2. Navab M et al. HDL and Cardiovascular Disease: atherogenic and atheroprotective mechanisms. Nat Rev Cardiology Advanced Publication; Feb 8, 2011

      3. Brinton E et al. A Low-Fat Diet Decreases HDL Cholesterol Levels by Decreasing HDL Apolipoprotein Transport Rates. J. Clin. Inves. January 1990; Volume 85: 144 – 151

      4. Ridker P et al. HDL Cholestrol and Residual Risk of First Cardiovascular events after treatment with potent statin therapy. The Lancet, Volume 376, Issue 9738, Pages 333-339, 31 July 20910

      • BenzoSt

        Looks like you know what you are typing about. In case you didn’t preemptively notice that I posted a more thorough description of my experiment and blood work a little bit further down this page: as a result of switching from semi-vegetarian to vegan, my total cholesterol dropped but this drop was due exclusively to a reduction in HDL(my LDL didn’t decrease at all). My goal is to reduce LDL and improve my HDL:LDL ratio, and a “balanced” macronutrient vegan diet didn’t accomplish that for me. So I am currently trying limiting fat to 10-15% of calories (fewer avocados, fewer nuts and seeds) in favor of more carbs. This is easy during wintertime because I copulating love split-pea soup, bean burritos, kabocha squash, and hot oatmeal with warm berries. I’ll see what comes when I have my annual physical in April.

  • pbdoc

    Boom.

  • JayS

    I have two friends who are paleo. Yes, there are benefit; no processed food, most food made from scratch but I’m don’t think this has to be exclusive to the paleo diet. They eat a lot of vegetables but no fruit because of the sugar content so this video makes especially interesting viewing. As a vegetarian I would also be interested in what Dr Greger makes of this study that was mentioned to me by the same friends.

    http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pone.0088278&representation=PDF

    As it goes against most other research I’ve read, I can only assume there is industry bias behind it.

    • Wegan

      “….. no statements can be made whether the poorer health in vegetarians in our study is caused by their dietary habit or if they consume this form of diet due to their poorer health status.”
      They may be trying to heal themselves with plants.

    • b00mer

      Thank you to JacquieRN the NF Team Member who shared the following response to the Burkert article by Dr. Garth Davis on another video thread. Also fwiw the same research group also published another study using the same data source and came up with the opposite conclusion. Very poorly designed research, meaningless conclusions in both cases.

      From Dr. Garth Davis:
      “Social media, and its infinite viral wisdom, strikes again. A ridiculously bad article was published in an online crappy journal and it is now spreading like wildfire as if it is the truth handed down by God.

      The article states that vegetarians are less healthy than meat eaters. What?! There has never been a study that has been so bold as to state such a fact! They must have something big, right? I mean this goes against the vast majority of recent science. Anytime an article is an outlier it needs to be well understood, and for it to have meaning it should be replicated. So lets take a look.

      This study is from Austria. They looked at over 15,000 people. So since this is a comparative study I would imagine there must be quiet a few vegetarians right? WRONG!!!! 0.2% where vegetarian. That is it. A few measly vegetarians. With such a low amount there is no way that you can do an adequately powered statistical analysis, so the authors didn’t try. Instead they matched the few vegetarians they had with age matched meat eaters. Some of the vegetarians had no age matched counterparts so they were dropped from the study!!!!! Even fewer vegetarians now.

      OK so we are going to take these few vegetarians and compare them with meat eaters and follow them for years and see how the do, right? WRONG!!!!! They just did one interview with them to assess their health and their eating habits. So do we know how long they have been vegetarian? No. Could they have turned vegetarian because they were sick. Of course. Many people facing a diagnosis of heart disease turn to vegetarian diet. In this case the heart disease would have been equated with being vegetarian. This was a 1 day study not a multiple year prospective study like the Adventist Health Study.

      Well at least we should be able to discern exactly what “vegetarian ” means, right? We should at least know that these vegetarians are in fact eating vegetables, right? Wrong! They applied labels on people but never assessed their exact meal plan. There is no mention as to how many fruits and veggies they were eating. In fact, they noted that the vegetarians were less likely to pursue preventative health, which in itself could explain their poor health. What this means is that these people were unlikely vegetarian for health reasons. In predominately meat eating populations when you find very few people abstaining from meat, and not going in for regular doctors visits, it could be that they are “ethical” vegetarians. In other words, they do not eat meat because of the cruelty aspect. Often times these people eat quite a junk food diet. Lots of processed carbs and not much actual fruit and veggies.

      In the end this is just bad science. Their conclusion is not worth the paper this would have been printed on had it actually been printed. Instead this wound up on an online journal known for poor peer review. This was not debated at a large scientific conference. This study would have gotten F had a student turned it into me, regardless of the findings, just based on the poor experimental design. In the end, this study would have been never looked at again, except that social media loves a good controversial study that confirms what everybody wants to believe. Now it is showing up all over the internet as if Harvard had just released the study in The New England Journal of Medicine. And this is why people get so confused!”

      • Colin Wright

        Yes, I also suspect the Austrian sample of vegetarians was biased with people who switched to vegetarianism because they were sick. A recent Dutch study found: “75% of vegetarians with a prevalent cancer at baseline had changed to this diet after diagnosis”

        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220685/

    • HereHere

      Yes, that Austrian article is odd. I didn’t realize the sample of vegetarians was 0.2%. I noticed that obesity is 1/3rd of what it is in the US (http://www.oecd.org/els/health-systems/Obesity-Update-2014.pdf), so their population is likelier healthier overall. Compare their health status to average Americans and we might find opposite conclusions, I don’t know.
      That said, there are so many studies done on vegetarianism that the evidence is overwhelming on the health benefits, although we each have to take personal responsibility to ensure the vegan foods we eat are health promoting. It is easy to slide into junk food veganism. At least that is my experience.

  • Maggie

    Not sure I agree we can make these sweeping statements based on my own personal observations. I have been monitoring my lipid progress for over decade. I was a vegetarian for 5 years (I am a nutritionist so it was a high nutrient density balanced vegetarian diet) and my HDL was low (20’s) and LDL borderline. Then I started eating meat again after I was tested severely nutritionally deficient (apparently all that fiber actually trashed my GI tract). LDL did increase but HDL soared (over 65). I can’t remember what my levels are of all the numbers–just reporting the ones that are important to me. I was even able to get pregnant after being told I would not be able to get pregnant (3 years of infertility treatments) ON and off again, I’d try Meditteranean Diet or go back to vegetarian and inevitably my lipids were NOT behaving the way the studies indicated they should be behaving. (I am also a university professor, with an expertise in obesity). Most recently, I tried the Mediterranean Diet again for 3 years. I gained over 20 pounds. My blood sugar levels soared to 99 and my lipid profile (including LDL and HDL particle sizes) indicated severe heart disease risk, small dense LDL and HDL. After this my doctor put me immediately on a grain free, corn free, sugar free diet. I brought back my coconut oil. I’ve always eaten nuts everyday in my diet (vegetarian or not). I wouldn’t say I ate a tremendous amount of meat, but at least 1 serving a day. My vegetable intake has always been pretty high–much more than 5 servings a day, but I did lower fruit intake to 2 pieces a day. After 2 months, I lost 20 pounds, my cardiovascular lipid profile was markedly better –on many parameters an improvement of over 300%) and completely turned around than it was when I was in my twenties. ON this diet I ate lots of fat: coconut oil, cheese, avocado and was even able to indulge in daily 85% dark chocolate. My HDL rose dramatically, LDL actually changed its profile to being the large fluffy versions (actually switched patterns) and also lowered. Before the diet, my Lp(a) was 55 (limit suggested was 75 on the printout). That was pretty good to begin with. After the grain free diet (which I call a modified Paleo) it was 12. TWELVE! My doctor told me to get out of his office because my heart was disgustingly perfect at age 45 (this was also after having EKG, stress test and echo). I think we need to explore the impact of eating sustainably raised meat vs conventional, grains, sugar load and how fat interacts with sugar/carbs before we make these sweeping recommendations of everyone going vegetarian. Time has proven itself to me that vegetarian and high grain consumption (even if it’s ancient grains), is not the best diet for me. If you go this route, then you’re eating lots of grain–and many people today have issues with their GI tract. They improve dramatically when grain leaves the picture. So for these people, fat or meat isn’t even an issue–they have no choice but NOT include grains. Then there are the people who have been vegetarians their entire lives and are pictures of health–while others have been Paleo for over a decade and are also pictures of health. Maybe I’m just a freak of nature who doesn’t follow textbook case. But I have a feeling if I’m one, then there are others out there. Bottom line, we are individuals and we need to track our own personal outcomes and adjust to a diet that works for US personally. No on disputes the health value of vegetables–I think we can all agree on that one and most people need more of that prescription. But when it comes to proportion of grains/meat etc, we need to follow our own individual lab tests. And place a higher emphasis on sugar–even the type that converts from the complex kind.

    • Brock Leham

      We need to making sweeping statements because we’re talking about the majority of the population, not extreme examples.
      Billions of people have no problems with grains in their diets.
      If you have issues with grains (like people have issues with peanuts, or eggs), then stop eating them. It’s that simple.

    • HungryShrew

      Thanks for sharing, very interesting.

      • I was going to say…grains are great! Nothing wrong with oatmeal, lowers cholesterol and helps remove toxins. Wonderful stuff.

        • Nungiver

          Even the wheat and grains sprayed with Roundup at harvest? When I dropped whole grains and what few sugars I used my
          waist went from 42 to 38. Then I restricted fruit, milk sugar rich milk products and started running and then working
          out the waist is now 33 to 32 inches, For a time my carb intake was quite low and then I added carbs from nuts and
          legumes but no grains worth mentioning. I limit fruit and prefer berries.

          Insulin is useful for building muscle. I can out work, out lift and out run men 40 years younger than me.

          • Toxins

            Nungiver, lets be honest. it probably was not brown rice, oats, whole wheat pasta, and the like you were consuming. These foods are healthy and promote weight loss and control. Refined grains from white bread, white pasta, cakes and cookies, etc. cannot be compared with whole unrefined grains.

          • Nungiver

            It was mostly whole grains that I consumed with any regularity. I did eat the occasional loaf of sourdough bread. I checked my BG after both the bread and other carb sources
            and that was enough for me to drop the grains and many of carbs. The inches dropped
            off and added exercise and more inches dropped off and then the waist kept getting
            smaller and the weight stabilized…..muscles.

          • HereHere

            I emphasize organic when I use grains in my diet. I can’t do it 100% of the time, and I know there may be small amounts of drift if nearby farmers doing areal fogging (spraying), but it will reduce my exposure to pesticides.

    • Michael Boscato, IART Trainer

      When you were vegetarian can you describe what your diet was like? I’m very surprised that your blood work wasn’t better… And I’m not saying that I don’t believe you; please do not mistake me for someone looking to start an argument. We are all here to learn and am grateful that you shared your story.

      Were you lacto-ovo-pesco? or vegan? You mentioned that you included nuts in your diet at all times. Dr. McDougall has taught us that dietary fat paralyzes the effect of insulin on blood sugar forcing the pancreas to secrete many times more insulin (typically resulting in an overshoot) than would otherwise be required…

      What about avocados, olives, coconut, nut butters and oils?

      Could you have been overindulging in fruits? Some people’s triglycerides rise from moderate levels of fructose…

      I’m a personal trainer and for the last decade have been teaching my clients “the truth” about food and haven’t seen any case of someone who, when eating 15% fat or less on a whole foods plant based diet, had anything other than stellar results. But I have seen how the inclusion of even small amounts of rich, fatty foods can curtail results. Did you calculate what % of calories were coming from fat?

      Dr. Greger, if you can provide some insight here it would be a privilege!

      • Matthew Smith

        Congratulations on your health, your child, and your career! I have Dr. Greger many times saying on this site “Calorie restriction” can add to life and be a health benefit, and he is trying to help people get that benefit while not sacrificing calories. I have been drinking tea and eating many less calories. Eat until you’re 8/10 full is an expression among the long lived. Dr. Greger would like everyone to have this benefit, the benefit of starvation. Perhaps it is nuts that give you this benefit. Women have the opposite problem, those who eat well at times in their life can live longer. Perhaps it is the nuts that have made a difference in your life. Perhaps it is the fact that you eat so much less meat than most Americans. I am glad you found a balance that is working for you. Remember if you have a health problem in the future veganism is one of the most effective interventions. It sounds like you have been a vegan for most meals, if not almost all in your life. Please stay well!

      • Matthew Smith

        I am sorry Mr. Boscato, I met that message to go to Maggie.

    • Alan

      Most nutritionists that have went and got a degree do not know anything about true nutrition. The curriculum comes from the mainstream. If a person would eat the diet recommended by Dr McDougall, or Dr. Joel Furhman, Dr. Dean Ornish, Dr Esylsten just to name a few they would prosper in their health. Each of the above disagree on some minor points but basically they recommend a starch based diet with lots of fruits and veggies, especially greens. Some of them recommend nuts and seeds and some none at all and some a few. Esylsten recommends none, but he works with serious heart patients. Those that follow his program do not have any more heart issues after being on his program. It will work for any disease. I personally follow Dr McDougalls plan very close, except i eat a few more nuts and seeds than he recommends, yet not to high. It is a very high carb diet. I do not go for regular checkups to have blood work done, but i feel fins and do not remember the last time i was sick. And i do not take any flu shots and do not get the flu.

    • Nonymouse

      You lost me at “apparently all that fiber actually trashed my GI tract”.

      • Andrea

        Totally agree. How is that even possible unless she was eating wood?

    • Grains are not the enemy… GMO grains and pesticides are. But good old oatmeal? I love it and eat it every morning. Brings only good health and a happy tummy.

      • b00mer

        The only genetically modified “grain” available is corn. Wheat and other grains are not genetically modified.

    • I have heart disease, osteoarthritis, and am borderline diabetic. For the past year I’ve been on a high fat food plan emphasizing meat and vegetables. For nearly a year I ate no grain products or sugars of any kind, and only 1 cup of fruit daily. I began the experiment at 302 lbs; as of this present date I weigh 258. My last blood test showed blood pressure normal, cholesterol levels normal, kidney and liver functions normal. Now, a year later, my weight loss has slowed to a stop, however, so I am experimenting with portion control, have cut out all dairy but Parmesan cheese, and I am seeking to add sustainable exercise to the plan, not because it will help me lose more weight (it won’t at the levels I am able to do it) but to encourage my heart to build new blood vessels. My point is that people’s bodies are unique communities, and different bodies behave in different ways. On the other hand, it is clear that long term damage is possible with such a high fat, high protein eating plan, and that is why I am having myself monitored closely for negative changes.

    • Rosemary Guy

      I wonder if you would get the same results by being a high fat vegan from whole food sources. this would create a better world where we don’t destroy the planet and you might get the same results taking out the grains for you?

  • Elizabeth

    What does the fat and protein in nuts, seeds and avocados do to insulin levels?

    • Stewart

      Elizabeth, you might be interested in my experience. I am type I diabetic. Since I made my diet entirely plant based my insulin usage has dropped about 25%. My understanding is that this is fairly typical. I did not eat much fat before and I do eat a fair amount of nuts, soy and flax seeds so I do get a fair amount of oil though I only occasionally add any to food. Bottom line is; I think my fat intake is almost as high as it has ever been. Still that is only somewhat indicative based on the experience of one individual and not on carefully measured portions.
      You might also check http://plantpositive.com/36-how-to-become-insulin-resis/ for a good analysis of the impact of saturated fats and proteins on insulin. The author of that maintains that both raise insulin resistance and that plants and PUFAs do not. By the way, he also does an exhaustive review and debunking of paleo diet “science”.

      • Matthew Smith

        For Diabetes, this site would recommend alma, beans, flax seed meal, hibiscus tea, cinnamon, and whole grain. The Amla alone was more effective than one kind of pill without the side effects. Good for you eating the nuts, soy, and flax seed. You have been doing what your doctor said you should! What a great improvement, a 25 percent drop in usage. Great job.

        • Stewart

          Just one correction Mathew. Sadly, no I have not been following my doctor’s recommendations on diet. They’ve generally been patronizing and oblivious to diet and only mention exercise as an afterthought if that. My information and experience on insulin sensitivity with low fat, low or no animal protein, and high fiber seems to leave them incredulous. But I keep repeating myself.

          I do still have plaque psoriasis and did have psoriatic arthritis. With my current vegan diet the arthritis has completely disappeared. My dermatologist was incredulous but at least took note. She had never seen psoriatic arthritis do anything but get worse unless controlled with an immune suppressant.

          • Toxins

            The power of pant, that’s amazing. Thanks for sharing. Its too bad that MD’s are not even aware of the research relevant to their field.

    • Julie

      Like Stewart, my daughter is a type 1 diabetic. When she eats a lot of nuts or seeds, insulin needs increase. For her, dairy fat requires the MOST insulin of any food fat, and avocados the least. Overall, on days she eats more than ~50g of fat, she will use significantly more insulin than on days where fat intake is lower. So different from what she’s been taught by endocrinologists and diabetes educators. Nice to see some validation here from Dr. Greger in this video.

      • Matthew Smith

        For Diabetes, this site would recommend alma, beans, flax seed meal, hibiscus tea, cinnamon, and whole grain. I should watch how much fat I eat if it causes insulin spikes. I think this shows that animal fat are every expensive for the body to process. You have said it all, great to find validation. Your frustration and patience make you a great mother.

  • dirtcoach

    If one was to read the study by Smith et al. 2014 “Unrestricted Paleolithic Diet is Associated with Unfavorable
    Changes to Blood Lipids in Healthy Subjects” There were zero controls whatsoever as all subjects all ate Ad libitum (as much or as little as they wanted) within a “Paleo” framework supplements were also not restricted. The exercise was also Ad libitum of the Cross Fit type. The subjects were not in what I would call fit, I would describe as a normal “healthy” average. Men had an average weight of over 200 lbs with 22% body fat the women in the study total weight was over 150 lbs and body fat 26.6% the average VO2 max for all in the study was only 39.82 ml/kg pre and 44.90 post 10 week testing period not obese but IMO all fairly sad. I have had many athletes that I have coached over the years that have came to me with that previously were “over trained” to use a term that most people think they know what it is. I won’t go into the semantics of that as there is no consensus as to what “over trained” actually is. Besides high rates of chronic injury’s, decreased performance one of the results from the blood tests of all of these athletes is that their cholesterol profiles all showed high total cholesterol, high LDL and lower than expected HDL, along with other abnormalities in the blood tests. Of all the athletes I mentioned most were eating a traditional diet. So you see basing any assumption on a highly flawed study is a flawed assumption no mater how qualified the presenter may seem.

    • James Wald

      If the study shows that Paleo is not tolerated by the average non-athlete, that is a great reason for the general public to avoid it.

  • Plantstrongdoc M.D.

    Who cares what our ancestors ate – they ate what was available – their goal was to avoid starving to death – not to prevent degenerative diseases and improve quality of life – heck most of them died before the age of 25 because of accidents, infection, violence, heat, frost or starvation. Arguments based on evolution makes no sense. High protein advocates don’t even know basic biochemistry……

    • Stewart

      I just gotta add to your outstandingly succinct summary: Most on true paleo diets had what would be considered reasonable cholesterol levels but as your comment suggest. This is in spite of the fact that they ate all viscera and organs (ie guts including feces) and were generally calorie restricted and infested with parasites from their raw diet. That’s true of the Inuit as well as the hunter gatherers who might have been closer to vegan. And too the archeological evidences shows clearly the fact that there was atherosclerosis and other chronic health issues that simply did not have time to kill them in their short lives.

      • Plantstrongdoc M.D.

        Stewart,
        Thanks for your comment.
        Evidence suggest health benefits on calorie restriction – even on a diet including meat – but impossible to follow for most people – and they look to skinny to me….
        And again – who cares about cholesterol – its a pseudo marker – hard endpoints count – death, stroke, heart attack, cancer ect.

  • Matthew Smith

    This site has advocated for common themes in diet, medicine, exercise, and lifestyle for long life based in scientific literature shunned by medicine as unprofitable by those who fund research. The paleo diet is the diet before we invented agriculture, I imagine. What would you eat if we were still hunter-gathers? I think this diet acknowledges we’d get meat rarely and should eat nuts, roots, beans, some seeds, and only every now and then the meats and milk from domesticated animals. Some people take this more extreme. What would a hunter gather eat in the Eastern region of America? Or a hunter gather in North America Eastern Region before trade? Would it be tomatoes, blueberries, cranberries, pumpkins, and pecans? Could we live without agriculture or trade? I think that the paleo diet loves whole grains, because we could find some of them. Was agriculture bad for man kind? I actually think it made us live longer, but made us very dependent on grain and grain feed meat. If you had to live in a forest how would you live? You’d eat more roots, nuts, and berries with only some meat. I also think you’d be hungry. Is grain really that unhealthy? Are grasses bad? Whole grains, like oats, were so productive we took them into our homes and used them as wealth. They are a great source of heart health now, and yes, hunter gathers would eat any grass seed that they could find. Perhaps the enemy is in the refinery, not the grower. I think refined product is not paleo, and they are more into whole food. Christ mentioned mill stones. Perhaps grain has to be milled. Is it too milled? Would paleo and vegans agree that we can find a diet for friends, family, and loved ones? Whole grains would be part of a paleo diet and are good for the health. Too much enriched bleached flour would not be in many diets and maybe you’d agree that they shouldn’t be in any diet today. Why, for instance, is it harder to find whole grain parboiled rice (try minute rice brown, very expensive), knowing how much healthier it is, and why is it so much more expensive knowing how much cheaper it is? Thank you for saying whole grain is good for insulin levels, enriched wheat flour drum pasta not so much.

  • Char

    Is it high insulin that is the problem in type two diabetics (insulin dependent in my husbands case) or high blood sugar for which the insulin is ineffective. (Insulin resistance due to excess weight aside) Measuring blood glucose levels after eating seems perhaps better than measuring insulin levels when making/recommending food choices on a daily basis, or are the two essentially the same? Does eating steak increase blood glucose more than pasta?

    • Filipe Coimbra

      both the glicose and the insulin are bad in excess amounts in the blood, however if you look at the basis of the pathophysiology and pathogenesis of type 2 diabetes you will see that was not the excess in glicose consumption that caused the disease, but manly the excess fat and animal protein and the consequence pro-inflamatory factors that this two folks cause in the human body. (sorry for my english, i’m trying to get better)

    • Filipe Coimbra

      and you can cure your’s husband diabetes if he goes on a whole food, plant-based diet. I hope you the best!

    • Matthew Smith

      For diabetes, this site would recommend amla, hibiscus tea, cinnamon, flax seed meal, beans, and whole grain. Yes, according to this video steak increase glucose more than pasta. Whole grain pasta might increase your insulin the least. The Republic of Tea sells a tea that has amla in it, Get Clean PM. It is made mostly of amla, Amla tea is also available from Ron Teaguartener’s Dragon Herbs site. if you can’t find it elsewhere.

  • Devin

    This is your BEST video of the year. I love it, great work. I hope the low-carb insulinophobic camp sees this.

  • Clair et Lipide

    Nice video. Can you debunk Matt Lalonde’s approach or the ADILAN study. Thx.

  • olhg1

    If our bodies had a mechanism to signal, immediately and sense-wise, when we put anything harmful in them, health would be a no-brainer. But we are either shocked by the scientific research or by the impact of painful disease which for some of us comes later in life, hence the “It can never happen to me” lifestyle.

    • Devra

      I believe most people DO have immediate signal mechanisms, but they either ignore them or take a pill instead of addressing the cause. Got indigestion, bloating, heartburn or constipation? Don’t change your diet, just take Tums, Lactaid, Pepto Bismal or Ex-lax. Your child gets hyper and out of control after ingesting candy or soda? He must have a Ritalin deficiency. :(

      • olhg1

        I was thinking of the simile to a “red hot iron on skin” rather than the comfortable transitional form-causing illness gradually-that we have.

        • Devra

          Yes, that would be a great benefit–immediate feedback so extreme it can’t be ignored. Though I suppose that would have been an obstacle to our ancestors’ survival when healthy food sources were unavailable. During the Nazi siege of St. Petersburg, some people survived starvation by ingesting things like linseed oil which was used to restore paintings.

  • Does anyone know the biochemical mechanism for an elevated blood insulin after meat meals? Sugar, insulin and glucagon I “get”. But Beef? not so much

    • Matthew Smith

      I think Dr. Greger said it takes a lot of Insulin Growth Factor 1 to digest meat, because it is a complex and tough food source. The IGF-1 is very damaging to the body, and leaks easily through the intestines. The body has to make a lot of IGF-1 and IGF-2 to make insulin, or rather, that is the ultimate product of making these digestion particles or proteins to dissolve flesh, which can dissolve our own. This is perhaps the mechanism he would suggest as to why meat ages us.. Insulin in itself can not digest meat. Same particles are made by the body to dissolve meat, which is tough and like us, and those same particles can hurt our vascular system over time. A single cup of Green Rooibos tea may have 100 days worth of antioxidants and can help repair this damage at any time.

  • gordotl

    Here is the point (and, I am a Paleo / Primal eater), you assume that we are eating tons of meat – WE AREN’T. By far, the highest amount (by volume) that we eat are vegetables! Nor, do we espouse a high intensity cardio program – far from it. Hard core works outs are difficult on the body. Ancestral man didn’t run long distances (unless chased by a saber tooth) – he DID move though as that was part of the lifestyle.

    Dr. Greger doesn’t seem to provide references to any of the studies, so – I can’t verify (nor negate) any of his findings; but – I will tell you that many nutritional studies have a very poor statistical power – and, the studies in and of themselves are flawed.
    I will continue to enjoy my diet style which is high in vegetables, healthy proteins and fats. Unlike his reported studies – I can say this – my insulin level has decreased substantially, HbA1c is down, triglycerides are down, LDL is down, CRP and homocysteine are down. I lost 23 pounds and my energy is through the roof. So, I question his Nutrition Facts – as they are conventional wisdom and conventional wisdom once thought the earth was flat.

    • Thea

      gordotl: Dr. Greger provides references in the “sources cited” section. Just click to see that data. It is a link to the right of the video. Enjoy.

    • Congratulations on the improvement in your health with your current diet and exercise regimen. It is obviously working better than what you were doing before. One of the advantages to Dr. Greger’s website is that he does provide not only references but abstracts or articles if they are available for free. If you look at box to the right of the video and click on sources cited it will give you the list of articles. In this case 15 by my count. Click on the study and you will get the abstract at least or the full article if it is available for free. The articles are available about 30% of time. This is a tremendous resource for busy professionals as there are over 10,000 peer reviewed articles every year relating to primary and secondary prevention and lifestyle issues (e.g. diet, exercise). For me, both as a clinician and quality improvement expert, it boils down to how much risk do you want to accept and whether you want to challenge your beliefs consider further improvement. I’m not sure what a “healthy” protein is for example. We, of course, need to consume adequate essential amino acids but if you consume adequate calories you can not be protein deficient. The “quality” of protein as measured by the essential amino acid profile is the same in eggs, broccoli and asparagus. Since given adequate calories we all consume excess protein and our bodies don’t store it our livers and kidneys must get rid of it. Studies have shown that higher protein is harmful. You can browse through the 66 videos relating to protein and pick the ones most appropriate to your situation and interests… all are referenced. Outside this website the best articles that I have seen are the three newsletter articles written by Dr. John McDougall… Protein history(12/2003), Protein Sources(04/2007) and Protein Overload (01/2004)… all have cited references but you would need to go through PubMed to read abstracts. So I would disagree that this video deals in conventional wisdom. If you continue your present diet and exercise program I hope you continue in good health but keep tuned to NutritionFacts.org as the science keeps changing.

      • Arjan den Hollander.

        Very happy to see you getting more engaged with the site again.
        While its clear that Dr. Greger is the vanguard, I think it very important the supporting peers especially the ones with a medical degree can sign their contributions with their given name, it just adds so much more value.
        A pseudonym can be dropped at a moments notice, a name shows a preparedness to close ranks when the going gets tough.
        I salute you for that.

  • Trent

    Great presentation.
    Two different studies not quite apples to apples.
    The CrossFit group appeared to be very healthy to start out with as LDL-cholesterol levels were well under 100.
    I’ll need to look at studies but would guess participants healthy fit college students.
    Even with the moderate increase and LDL levels follow the Paleo diet the numbers were still good.
    That doesn’t mean I would advocate bacon butter and other meats as a basis for diet as not good trend.
    The other group in one study cited that followed plant-based diet experienced definite improvement; however, baseline LDL’s quite a bit higher-perhaps an older group that was not as physically active.

  • Rph1978

    When you compare the insulin response to protein in the 1984 article in this video………….
    “F Q Nuttall, A D mooradian, M C Gannon, C Billington, P Krezowski. Effect of protein ingestion on the glucose and insulin response to a standardized oral glucose load. Diabetes Care. 1984 Sep-Oct;7(5):465-70”
    ……….with the response to a high protein low carb diet in the 2004 journal ‘Effect of a high protein low carbohydrate diet on blood glucose control in people with type ii diabetes Diabetes Vol 53 2004…..what you find is that the current article shows that a high protein/low carb diet (30% PRO, 20% CARB) reduces blood glucose and insulin levels compared to a control diet of higher carbs (55% carb, 15% PRO). This is probably because of a rise in glucagon.

    • largelytrue

      Or maybe it’s that the control diet was constructed to be worse than the low carbohydrate diet in ways that wouldn’t occur if the controlled study exchanged dietary protein for dietary carbohydrate in a plausibly healthful manner. Note that the dietary fiber is somehow 50% greater for the test diet in table 2, something that would not happen if you were exchanging calories from meat, eggs, or dairy for calories from whole grains, fruits, vegetables, or legumes. It might be expected to happen, though, in a study that captured funding from the beef industry: “This study was supported by grants from the American Diabetes Association, the Minnesota Beef Council, and the Colorado and
      Nebraska Beef Councils.”

  • Andreas

    These researchers lost me when they started asserting (toward the end of the study) how good dairy is for your health.

  • Lawrence

    Debunking of the Paleo diet from an expert. https://www.youtube.com/watch?v=BMOjVYgYaG8

    • Thanks for that. What an interesting presentation. Because of animal products I’ve had a heart attack, 4ple bypass and years of misery…but I’m gonna give it one more chance! NOT

  • Interestedobserver

    The study: No evidence of insulin resistance in normal weight vegetarian (http://link.springer.com/article/10.1007/s00394-005-0563-x) compares the level of vegetarians to non-vegetarian who consume a traditional “western diet”. I do not see how he can use this as a comparison when looking at people who consume a “paleo diet”. Obviously people who consume a western diet would have worse insulin resistance based on current literature. How ever he some how ties in that study to talking about people on a “paleolithic diet” compared to vegetarians. Does anybody know any studies that would directly compare the “paleolithic and vegetarian/vegan diets, and maybe a group such as “western diet”? That would be a much better way of assessing the situation. Also the study citing insulin (response http://ajcn.nutrition.org/content/66/5/1264.full.pdf+html) shows that beef/pork/meat actually does have a much lower insulin response than white bread, the number he cites as being higher is the ratio of Insulin under curve/ Glucose under curve, but than states that it is directly insulin response. If i made a mistake in appraising this please let me know, how ever it seems as though there may be a good amount of extrapolation from these studies to make these conclusions.

    • Thank you for writing in! I do cite the direct insulin response as I note in the video, not the insulin/glucose ratio. The numbers in the graph come from column 6 in table 4 on page 1269 (available free full-text here), the insulin per gram of serving weight. So for example a large apple weighs about 200 grams, so 20 (pmol)(min)/(L)(g) times 200g = 4000 (pmol)(min)/(L) = 40 (micromol)(min)/daL, which is what I have in the graph. So servings of apples, and oatmeal, and even white flour pasta cause less of an insulin spike than servings of beef and fish (and chicken and pork accordingly).

  • C2

    If insulin is the root of all evil, as mentioned in the Paleo discussion above, then how much is too much if you have cardiovascular disease and are not diabetic or pre-diabetic? I have not found a NutritianFacts discussion on this, and would be interested to see what Dr. Greger can dig-up.

    I am a strict Esselstyn vegan with high normal fasting blood glucose and CVD. I have noticed that my blood sugar spikes to alarming levels if my portion sizes are large, or if I eat reasonable portions of certain types of plant based foods, such as Ezekiel bread, sweet potatos, or grapes. Why not use metformin to control glucose spikes and allow larger portions and greater variety of whole foods?

  • Sodor

    I have just been looking for the best eating life style and the more I look the more I get confused. Lately I have been discussing the Paleo and found it to be more than just a meat fest.
    Recently I found this http://www.phoenixhelix.com/2013/04/08/wahls-veggie-protocol-qa/

    “If you aren’t familiar with Dr. Terry Wahls, check out our interview. She’s a leader in the paleo movement, having reversed her multiple sclerosis through dietary intervention. A cornerstone of her protocol is feeding the mitochondria in our bodies, with 9 cups of vegetables/fruit daily. P.S. If you have people in your life who think paleo is a meat-only diet, feel free to direct them to this article, or any article about Dr. Wahls. Paleo people LOVE their vegetables and often eat more of them than vegans/vegetarians who get a bulk of their calories from grains. – See more at: http://www.phoenixhelix.com/2013/04/08/wahls-veggie-protocol-qa/#sthash.Ao6YuDzp.dpuf
    Any thoughts?

    • Veganrunner

      I have read some of her stuff years ago. Isn’t it truly amazing she was able to go from being in a wheelchair to returning to walking around her office and treating patients? Wonderful outcome from changing her diet. She stopped eating processed foods and begins eating a ton of fresh fruits and veggies. I am not sure we can say that switching to pasture raised meat made a contribution but it is all really interesting. Doesn’t the statement “feeding the mitochondria” sound a bit odd? What do you think that means?

      I really enjoy reading all of the testimonials about patients whose autoimmune diseases have been in remission from Drs Furhman, McDougall, etc recommending diet change to their patients. Fascinating.

    • Darryl

      The focus of this and other health-oriented websites on whole-plant based diets is in effect combining the best of the two, seemingly opposite approaches to nutrition. There are a number of recent paleo-vegan recipe books, and some research on a vegan “Eco-Atkins” diet by the very respected Dr. Jenkins.

    • b00mer

      “Paleo people LOVE their vegetables and often eat more of them than vegans/vegetarians who get a bulk of their calories from grains.”

      Source: a blogger who did a google image search

    • KWD

      There are other discussions that have occurred previously about the topics you’ve posted links to and you’re able to search disqus within the site, I believe, to find them.

      I think it’s great that you’re trying to make changes to your diet to make it “best” for you. It may be less confusing if you simply look at your current diet and pick one thing you know could be better. As an example, focus on more fiber (presuming you need it as you may not), and work on just that item for a period of months. There are lots of resources available on fiber http://nutritionfacts.org/?s=fiber and focusing on just that aspect will help you feel your body respond to the gradual change of incorporating more of that nutrient.

      You might also find Dr. Greger’s “Nutrition Year-in-Review” video series of interest/usefulness in your efforts. If you go to nutritionfacts.org homepage and scroll to the bottom, there are links to each of the three videos. While longer in duration, they are nice high-level summaries of important topics in nutrition and health.

      Also, if you’re serious, I recommend setting up an account at one of the free online nutrition trackers to gauge your baseline of nutrient intake and how it compares to standard recommendations for your demographic. Then, you’ll have a better idea of what you need to focus on.

  • uspijeh zvijezda

    Cavemen live now. Even that word “live” is not appropriate. The word “cave” is connected with the word “stone” so you are maybe able to understand when was in fact that so called cavemen age when our Spiritual Father, God Shiva says these days that now His children have stone intellect and that majority of them are not able to understand anything of His knowledge, He also teaches us that we were pure deities with the pure diet almost 5000 years ago, that we became more and more impure by indulging in vice of lust and other vices so today our stage is such that there are no such degrees of purity in the soul and our intellects became stone-like! In the future golden age perfect human beings, that is deities will eat only fruit, flowers, grains and cow milk and ghee as fat! But surely it wasn’t ghee as we know it today because there all food we ate were fresh and raw. Even vegetables weren’t grow at that time. In eating meat there is so much violence, diseases and sorrow. Majority people of today are not able to understand and realize that eating meat is not their free choice but that bad habit is in fact their punishment!!! They are now like in a circle where they can’t find the way out. This is called by God, a bondage of negative karma. A sensible being who wants happiness for yourself couldn’t eat something such impure, something that truly isn’t food but the product of violence and blindness. It is – Giving and taking of sorrow. Hope at least few of you, my brother souls, will understand this!

    • b00mer

      “In the future golden age perfect human beings, that is deities will eat […] cow milk and ghee as fat!”

      Count me out. If you think dairy does not involve violence and sorrow, you are ignorant of the basics of the female mammalian reproductive system. And if you think it does not involve disease, you haven’t been following this site for very long.

  • Vegg-E

    Thank you! I have been waiting for a video like this for a long time! Way to knock it out of the park again Dr. G!

  • eric

    HIPPOCRATES HEALTH INSTITUTE.

  • disqus_GB8lUuziuG

    I wish this place wasn’t such an echo chamber, far to sudo religious for me, lot’s of great info here but we don’t need the ideology inserted into the argument of diet, it’s confusing enough. Why does this site censor contradictory evidence as well?!

    Love this site!! but I’m not comfortable recommending it to people who don’t have many many hours to devote to reading and investigation in order to sort through the selective bias here =(

    • Toxins

      Dr. Greger often presents contradictory evidence and shows us how this evidence may not be strong or relevant. What exactly do you have issue with? The paleo diet itself is a fad diet and most credible health organizations advocate a diet opposite to what is advocated on a paleo diet. Dr. Greger is simply sharing the studies and facts. Science doesn’t operate on popularity. If what is presented goes against what people perceive to be healthful, this does not equate to “bias”.

      • Matthew Smith

        I am sorry you think this website is a cult! Merry Christmas and Happy Holidays. I think there is some conflicting evidence in health. Milk was thought to be slimming, Dr. Greger here said it’s fattening. Dr. Greger only approves of tomato juice, saying too much of the fruit is lost in processing and filtering, perhaps he would approve of unfiltered grape juice (Trader Joe’s) or Apple Cider, made with more apples. He does not recommend juice and suggests fresh fruit. Dr. Greger believes most of the benefit of Cocoa is from Industry funded bias but 85 percent dark chocolate can reduce your risk of heart disease by half, he does recommend pure cocoa, maybe as a drink or Rooibos tea additive (chocolate has one of the highest ORAC values of any food tested). . Many of the long vegans here believing olive oil to be bad for you or at least neutral, even extra virgin, I think this would make most plant fat sources bad except for raw oil from walnuts. I do not believe it is reasonable to assume all Americans can be vegan for all meals, however, this website says at any sickness, at any point in your life, when ever or where ever you try it, for as long as you do, for as much as you want, it will make your life better. There are other foods that may help too and Dr. Greger wants every American to have the benefit that comes from eating less. Maybe nori, flaxseed meal, white button mushrooms, walnuts, or garlic could help with this..

      • disqus_GB8lUuziuG

        I take issue with his ideological selective bias, it creates an echo chamber on this web site that is more like a religion then science. It should be obvious to anyone taking a remotely unbiased position on nutrition when viewing and reading content/comments here.

        I am not here taking notes about it all so I can argue with people and cause a scene, it’s just an observation. There are some very strong, knowledgeable science backed critiques of his work if you use Google to explore varying sources of information before you make a decision.

        I also find a great deal of amazingly good information here and he is UBER charismatic which certainly helps digest the content. Especially his work with antioxidants, as an example.

        Stating: “most credible health organizations advocate a diet opposite to what is advocated on a paleo diet. ” so as to conclude paleo is all bad is exactly the kind of logical fallacy I’m talking about.

        Just off the top of my head this is a decent example of what I’m talking about,
        https://www.youtube.com/watch?v=eREuZEdMAVo

        The head researcher is a 20 year vegan as well, for what it’s worth.

        • Toxins

          Most of what I find regarding negativity towards Dr. Greger on google are also other paleo proponents who do not appreciate the studies shared on this website. Regardless, other opinions of Dr. Greger do not matter, as I will explain. Yes, Dr. Greger shares a large number of studies showing how beneficial a plant based diet is (there are literally hundreds on this website throughout the videos and the articles). But that is not to say there are an equal amount of studies showing that animal products and the like are also beneficial to health. The opposite is true based on the available evidence. Hence, why I am saying that it doesn’t matter what others say about Dr. Greger as a person, the studies he gathers are peer reviewed, published studies and have applicability and value. It is different if he is making claims with limited or no evidence, (as is the case with many of fad nutrition protocols out there) but every video and article presented here is purely a review of studies. If you pay attention to his word choice, nothing he says is absolutest, qualifiers are often used. Nothing is 100% definitive.

          My negative comments regarding the high fat low carb paleo diet are based on a review of dietary guidelines around the globe in regards to SFA. Most recommend limitations of less than 7-10% of calories. The paleo diets promotion of a high fat diet and promotion of saturated fat as healthy is a damaging message and simply not based on sound science.
          See Table 1
          http://journals.cambridge.org/download.php?file=%2FBJN%2FBJN107_S2%2FS0007114512001444a.pdf&code=b7e130e134f198fe954f7b01a59f9543

          Of course paleo has its positives, limiting refined carbohydrates and processed foods, but to follow a paleo diet to its entirety would be harmful to health.

        • Toxins

          I should add that I have seen every video on this website and actually look through many of the studies he shares. If the comments seem to lean a certain direction, its based on previous knowledge of other studies. Evidence has to be viewed as a whole against other evidence. I am familiar with many other studies that conclude positive health outcomes with animal based foods and they are generally conducted in such a way where it has to be so. Several come to mind, especially in regards to eggs.

          • disqus_GB8lUuziuG

            The same can be said for some of the pro vegan studies listed on this site. I am not trying to denounce a vegan diet, it is healthy and works very well for many but it is obviously not the be all/end all of the dietary discussion like this site proclaims in every video and article.

            The bias is very obvious and that is unfortunate because it undermines trust.

          • Toxins

            Again, the studies are not “pro vegan”. They are not funded by big PITA. They show these conclusions because that is how the human body works. Studies evaluate the natural world, they are not popularity contests, I feel that you are not understanding this concept. Studies that are “pro meat” and “pro saturated fat” are hard to come by and when they do come to these conclusions, the methodology makes it so, and the quality of the studies is not high. The BOLD study is a prime example of this. You will not find a study showing increased whole grain consumption is linked with chronic disease. Inversely, you will not find studies showing those with the highest saturated fat intake have the least chronic disease. These conclusions simply do not exist in the literature. That is not “pro vegan”, that is just a tested and repeatable theory that tends to be true for the human population.

          • Matthew Smith

            I would like to publicly thank you for sharing this medical literature. I do not have access to all the medical journals and you are publishing the results that are subjectated and sequestered by medicine. I have accepted that eating one Brazil nut a week, or rather, four in one day a month, could raise my HDL granting me a better quality of life. Dr. Greger said this review was from a smaller group of people but should be used as there is no evidence that they are bad. I found this empowering. Many people would ask why Germany has better psychiatry than America or Japan a better health care system. It seems they rely more on preventative measures as treatments than American medical pills. Before World War II, it was perfectly acceptable to proscribe a cup of tea or a tincture for a disease. After the actions of Dow Corning and other chemical companies, only pills, and only single compound pills, were the way to treat people. I often think that medical doctors are trying to find the right nutrient or right essential atom to treat a disease, and use a complex mixture instead. This has made a great but complicated medical system. For instance, bones are made up mostly of Phosphorous. Would it make sense to treat a bone disease like Osterperosis with Phosphorus? Maybe, but doctors say Phosphorus is bad for bone density. Yet, Phosphomax, the active treatment for osteoperosis, has Phosphorus in the name. There is lots of phosphorus in diet soda. Would that treat osteoperosus? Would a heavy dose of Phosphorous supplements? I think so. I don’t think the medical literature agrees. Much of medicine is about the placebo effect of a pill. Nobody takes pills, the average prescription being 4 pills with a standard deviation of about 3 pills and almost nobody filling their prescriptions. People might take the Brazil Nuts for Osteoperosis if it was just one a week. I am really grateful you are sharing the gems of medical and nutrition research. They have made a difference in my life. This website has a treatment with nutrition for most illnesses already. The idea is they work, because if they don’t you can’t blame the diet. Here, we can always seem to blame the meat. They say it is always possible to not help the diagnosis. Adding for health, not taking away. Thank you!

          • disqus_GB8lUuziuG

            I think this might be going over your head.

            This site is ideologically pro Vegan and nearly all the commenters as well. We know this because it/they ignore and even censor contradictory evidence. This site and most, not all, it’s supporters do not simply go by the evidence like you say, that is the problem I have with it. I have no problem with the claim that a vegan diet is very healthy, there is sufficient evidence to support that. However to claim that this is the end of the story and the only, or even the most, healthy diet is also a false claim that the evidence does not support.

          • Toxins

            Please share counter evidence, as I have yet to see evidence that a diet high in meat and fat will lower risks of chronic disease. Population studies show just the opposite.

          • disqus_GB8lUuziuG

            When did I say a diet high in meat and fat will lower the risks of chronic disease?

            – I do remember saying that this site ignores contradictory evidence.
            -I do remember saying that this site is like an ideological echo chamber.
            -I do remember saying that I don’t want to start an argument, I have no interest in arguing with ideologically positioned people, it is an utter waste of effort.

            If you wan’t to learn more about diet then this site has to offer all you have to do is use Google, you can find plenty of good information if you can stomach evidence that is contrary to your held beliefs.

            In all the possible respect I can muster, I do not know why you are having such a hard time understanding this. This is simply my experience with this web site, if I am having this experience then you can bet PLENTY of other people are as well, something to consider if you want to be taken serious instead of seen simply as ideologues.

          • Toxins

            Let me explain to you why I am asking for counter evidence, so that this discussion can go somewhere useful.

            I have told you that I have seen counter evidence, and my definition of counter evidence is that saturated fat and cholesterol are negligible. It is also that a low carb diet is more effective in weight loss. If we are using that as counter evidence against a plant based diet, then the evidence to support those arguments is dismal. The evidence for a plant based diet is by far the most vast and clear cut, some misconstrued studies showing otherwise are simply not applicable. There are hundreds of studies showing that the tenants of a paleo diet are simply false, which is why I am asking for counter evidence. Using Google to find blogs is not exactly how we should come to conclusions. I am asking for clear cut studies. A bloggers opinion are negligible, which is why nutritionfacts.org does not operate on opinion or misconstrued studies. The evidence is clear in each “sources cited” section of each video, available for everyone to see for themselves. I encourage you to explore this website further.

          • Thea

            disqus_GB8lUuziuG: re the claim of censoring: I am not aware of any censoring. Quite the opposite. As long as people follow basic courtesy rules, they are welcome to post any contradictory evidence they see fit. It happens all the time. We don’t censor it. We just have knowledgeable people who are able to explain the difference between good studies and bad. We often respond to such posts to help people understand the “evidence” they are presenting. Healthy, respectful debate is encouraged on this site and always has been.

            re: “…over your head.” If this sentence doesn’t break our posting rules, it sure comes close. You can debate ideas, not attack someone’s personal character. Consider this a warning. Here is a link to our rules:
            http://nutritionfacts.org/faq/#sources-cited

            The part of interest is:
            “What are the rules for posting comments on this site?

            The intention of the comment section under each video and blog post is to allow all members to share their stories, questions, and feedback with others in a welcoming, engaging, and respectful environment. Off-topic comments are permitted, in hopes more experienced users may be able to point them to more relevant videos that may answer their questions. Vigorous debate is welcome so long as participants can respectfully disagree.

            To make NutritionFacts.org a place where people feel comfortable posting without feeling attacked, we have no tolerance for ad hominem attacks or comments that are racist, misogynist, homophobic, vulgar, or otherwise inappropriate. We’ve gotten more sensitive to this after a physician who graciously donated his time to answer people’s questions stopped contributing because of negative comments. So please, for everyone’s benefit, help us foster a community of mutual respect. Enforcement of these rules is done to the best of our ability on a case-by-case basis.”

            Thank you for your compliance.

          • disqus_GB8lUuziuG

            I witnessed it happen first hand, a friend of mine made a very well articulated post with supporting evidence and it was removed from the site. Perhaps this was some kind of fluke but that was my first experience with this web site.

            The “over your head” comment was in the same spirit and tone as when Toxic said: “I feel that you are not understanding this concept” are you going to scold him as well or just me because I don’t fall in line with this web sites ideology? I am being respectful.

          • Toxins

            “Studies evaluate the natural world, they are not popularity contests, I feel that you are not understanding this concept.” Is not mean spirited. It highlights the point. I am sorry you found it derogatory, that was not my intention.

          • Thea

            The two statements are very different as far as I’m concerned. It’s not about “spirit”. It’s about conversing.

            Please note that I left your comment up, but just gave you a warning. It has nothing to do with your ideology. If you follow this site very much, you will see that I go after anyone being disrespectful (when I can) regardless of whether I personally agree with that person’s content or not. And I’ll just state again, unless your friend had rude comments in her/his post or the post broke some other rule, it is not the policy on this site to remove posts of different ideologies.

          • disqus_GB8lUuziuG

            I don’t know why half my posts are not being posted but what ever…

            I do not want to argue with anyone, I was just making an observation based on my experience and the experience of other critiques to this site I have come across, if you don’t want to alienate people because of ideology then perhaps what your critiques say might be of some use to you but if people want to reject it that is also fine, it’s your site after all.

            I like to think we are all on the same side here, better health through diet and all that… Anyway I am done with this conversation, peace out.

          • Thea

            re: “I don’t know why half my posts are not being posted…”
            I’m guessing it is a disqus issue. We have seen this before. To my knowledge, any missing posts of yours has nothing to do with any moderator’s actions. We do not preview comments, and we only delete comments which actively break our posting policies. And even that is very rare.

            There have been other times when people were unable to find their posts. And then when they checked back later, the post appeared. Disqus may be one of the best options out there, but it still leaves a lot to be desired. And there isn’t anything we can do about it at the moment. I hope your posts appear.

          • disqus_GB8lUuziuG

            I also forgot to mention that you have completely taken my “pro” comment out of context. I mean “pro” as in the observed results of the study happen to support what we would call a vegan diet. I did NOT mean “pro” as in it’s a popularity contest.

  • IAteBambi

    http://www.humanewatch.org/hsus_doc_exposed_as_schlock/ – If you believe anything this guy posts, step back from your keyboard and go eat a nice grass fed steak as quickly as possible. Your brain obviously needs some nice saturated fat to be able to think again.

    • FLAGGED and REPORTED. geez… Dr G must be doing something right, looky how mad the low-carb paleos are. Keep up the great work Dr G! We are with you 100%! Plant based diets for the win!

      • IAteBambie

        Typical wah wah wah response. Did you read the link, or just press your wittle flagged button? But, hey, keep scarfing on your GMO soy burgers. More meat for those who read both sides. The amount of propaganda coming out of the vegan side of things is adorable.

        Oh, and you don’t have to yell. I can read “flagged and reported,” just as easily if you don’t do the whole, LOOK, I’M IMPORTANT – I USE ALL CAPS thing. From the comments here, it’s obvious that most of the info on Paleo is coming from sources who describe it fairly wrong. Try Chris Kresser or Mark Sisson, for some easy to understand real info. You can even read the PHD diet which uses an apple (those are still plants, right?) for it’s graphic.

        And to the poster who wrote that cooking makes a thing processed – well, we all know that isn’t true in the Veggie community. From all the frozen veggie garbage sold at Whole Foods, it’s quite apparent that “healthy” to some just means no meat. After all, the cow you eat might have grown up to be president. Or a brain surgeon. Does soaking beans also make them processed?

        Lastly, my post wasn’t angry. LOL. No nerve was hit. Logically to me, any eating plan (veganism, though not vegetarianism) that needs to supplement with B12 because it can’t be found in its food is a mistake. Our ancestors didn’t have online supplement purveyors. And just to keep up with your post: !!! <— Exclamation points after every sentence makes you right.

        • Toxins

          IAteBambie, please tone down the caustic nature of your post. You are walking a fine line in terms of posting ethics.

          In regards to your comments, the issues with a paleo diet are vast and numerous. This single video with its few studies is a piece of the larger picture. “Vegan propaganda” is an interesting way of viewing peer reviewed research. This reaction seems like a premature dismissal rather than a critical view of the evidence. In addition, GMO is a non issue in terms of the chronic disease epidemic. It is a bandwagon distraction from the major issues, that being, too much processed foods, a high intake of animal products and a high intake of fat. Please see here on the evidence for and against GMO.
          http://nutritionfacts.org/?s=gmo

          In addition, the harms of animal product consumption extends far beyond associations within populations. Please see here for some biological mechanisms
          http://nutritionfacts.org/video/the-leaky-gut-theory-of-why-animal-products-cause-inflammation/
          http://nutritionfacts.org/video/the-exogenous-endotoxin-theory/
          http://nutritionfacts.org/video/dead-meat-bacteria-endotoxemia/
          http://nutritionfacts.org/index.php?s=igf-1

          As a final note, if you are truly interested in having a complete understanding of the evidence, then you will see the videos I shared and look into the cited research. It is not vegan propaganda, it is peer reviewed research. Because the research points towards a plant based diet does not mean that the research is biased. The premise to assume that would mean that you believe with certainty that animal products are healthful, in which case it would seem like vegan propaganda. But you should be more critical than that. I have seen the evidence for a paleo diet and studied both sides extensively, and frankly, what supports a paleo diet is dismal and the primary claims are unsupported. If you would like to share studies to back up your points then please do, but lets keep it civil.

        • Of coarse I clicked the link Mr Bambi eater (Nice Troll name too BTW). Why do you think I flagged it? You posted a mean-spirited attack link against Dr Greger himself… It was disrespectful and disgusting. I’m all for debating issues based on peer reviewed science, but what you posted was uncalled for and Juvenal. I have great respect for this site and its contributors and if you post another disgusting attack link like that again… I will indeed flag it again. Have a good day.

  • Ray Tajoma

    Paleo diet is against eating “Processed foods”. Isn’t meat processed food ? People don’t eat RAW chicken, RAW bacon, RAW hamburger, etc…They BURN it at extreme high temperature and then eat the burnt meat with vegan spices. Also most meat in USA is full of chemicals and hormones.

  • GodBlessAmerica

    I do not believe that Cholesterol has anything to do with your risk of dying of a heart attack. Could the reason a vegetarian diet is effective in reducing your risk of heart disease be it’s high content of vitamin C? Vitamin C is important in the bodies formation of collagen keeping arterial walls intact. If Cholesterol was the problem, wouldn’t we have plaque everywhere? Yet they use the large arteries in the legs in CABG surgeries because they are clear of plaque. Check out Linus Pauling’s work, he patented the cure for heart disease using large doses of Vitamin C, L-lysine, and L-proline which together reverse plaque and clear arteries. Look it up while we still have a free internet…….

    • But are you willing to risk your life on that doubt? The low-carb paleo folks try to sell ‘doubt’ about the lipid hypothesis same as the tobacco industry did when they claimed cigarette smoke had not been ‘proven’ to cause cancer. I don’t buy into the “doubt’ selling tactics the cholesterol deniers employ…. We’ve seen it before from big tobacco. I’d rather play it safe and keep overt fats and animal products off my plate.

      • Toxins

        Stay tuned, Dr. Greger has an upcoming video regarding Dairy using a similar tactic in regards to saturated fat.

        • Matthew Smith

          Thank you for this heads up! Dr. Greger has said that animal saturated fat is the cause of many diseases in this country and that the vegan diet is maybe too effective at treating many illnesses in America. I would ask, how would you compare Uganda where there is no heart disease at all but the average age of death is 50-55 to America where there is lots of heart disease but the average age of death is 77? Clearly this is a diet attitude that is shared by those who feel meat is an indulgence and plants only can extend health and age. Your site, as advocated for both by name and by shared ideas by Kaiser Permante, the largest Health Group in the nation, says the plant based diet can add years to life and is strongly recommended. This advice can reduce the burden to medicine by tens of billions of dollars a year and can also end endless tears for millions of families.

      • GodBlessAmerica

        While your brain represents about 2-3% of your total body weight, 25%
        of the cholesterol in your body is found in your brain, where it plays
        important roles in such things as membrane function, acts as an
        antioxidant, and serves as the raw material from which we are able to
        make things like progesterone, estrogen, cortisol, testosterone and Vitamin D. Every cell in your body has the ability to make cholesterol.
        What I am saying is it’s not the cause, it’s a symptom that something isn’t right in our bodies.

        In the past, before the huge profits seen by drug companies hypothyroidism was diagnosed by an elevated cholesterol levels and treated with iodine and/or thyroid replacement….cheaply.
        That said, I’m with you on not eating animal products, a plant based diet is the way to go! The hormones, toxins, radiation contamination, herbicides and pesticides, GMO, etc. etc. ……..everything found at the top of the food chain is best avoided. Dr G presents that argument very well and after over 30 years in the food and nutrition profession I am so grateful to have this website as a reference. Thanks for you comments. I really appreciate the discussion.

  • Óscar Picazo

    Lack of control group, lack of dietary control and analysis, combination with high intensity exercise, statistically significant but clinically irrelevant results, title shows bias (no mention of aerobic improvement). Low quality study, not worth the attention.

    • largelytrue

      Are you disputing the idea that it’s well-established that high intensity exercise (of the sort that improves aerobic fitness) tends to improve the lipid profile (raising HDL and lowering LDL)? Do you think that the lipid profile would have been better on transition to the ‘paleo’ diet under study if only the subjects hadn’t exercised so much? What’s your point?

      • Óscar Picazo

        Check the bibliography, it is not always as you mention, sometimes there is a transient worsening of lipid profile. And the study design is full of flaws and uncontrolled, and mixes variables. Check either crossfit or diet, not both. This study does not allow to come to the conclusion the researchers state. What is needed is more studies, but well designed. By now the issue is not solved.

        • largelytrue

          There’s good evidence that these infrequent ‘transient’ worsenings will show up 10 weeks after an intervention such as this one? “Check the bibliography” is a bit too vague for me. Which references about transient worsening do you have in mind?

          • Theodore

            Seems like ye old paleo sour grapes to me.

    • Veganrunner

      Oscar I am not sure you can conclude as you have. It may not be a RCT but it has value. Do you think the researchers were surprised by the increase in aerobic capacity of the subjects?

      “Unrestricted Paleolithic Diet is Associated with Unfavorable Changes to Blood Lipids in Healthy Subjects” you would have liked to see “but showered improvement in VO2 max” added to the title?

      Wouldn’t that have been something if they had participated in an exercise program for that length of time and showed no improvement….I would hang up my shoes!

    • Theodore

      Maybe not the greatest study in the world, but still ten times more scientific than anything coming out of the pro-paleo camp.

      • Óscar Picazo

        Not by far, compared to the design quality of the studies by Lindeberg, Jönsson, Frassetto. There is need for more quality studies, not this sub par design.

        • Theodore

          OK. This from the (3-month / 13-patient) Jonsson study (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724493/): “the Paleolithic diet was lower in total energy [than the Diabetes diet]”. Bingo.

          In the (12 week / 29 patient) Lindeberg study (http://link.springer.com/article/10.1007%2Fs00125-007-0716-y), the paleo people ate less food again and the main composite difference between the two diets was that the paleo diet contained significantly more whole plant foods.

          The Frassetto study only had 9 participants, lasted 10 days and had no control (http://www.nature.com/ejcn/journal/v63/n8/full/ejcn20094a.html).

          So it seems like what we have here is yet another instance of someone wearing the living sheed out of their paleo goggles.

          If you like Frassetto so much, why not get your chops around this study: http://www.ncbi.nlm.nih.gov/pubmed/11034231

          While you’re at it, try and speak to some decent anthroplolgists who don’t have a diet book to sell and ask them what they think paleolithic man actually ate. Because if there’s one thing worse than being stuck in the past, it’s being stuck in a past that never existed in the first place.

  • This is fantastic. I’m forwarding to family and friends who remain stubborn about the dangers of consuming animal products. Thanks Dr. Greger!

  • Gerard

    Double source citing. “S H Holt, J C Miller, P Petocz. An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. Am J Clin Nutr November 1997 vol. 66 no. 5 1264-1276.”

  • john

    In the youtube video about paleo diets the claim is made that meat causes a higher insulin response than oatmeal or pasta. There are even fancy graphics and a chart showing this. I cannot believe that people are dumb enough to believe this nonsense. All a person has to do is look these foods up in any glycemic index to discover that this is absolutely false. Eating protein causes very small increases in insulin and eating fat almost no response.

    • Toxins

      John, have you seen the glycemic index of the said foods? The meats tend to spike insulin as much and more in some cases then most of the carbohydrate containing foods. See for yourself.
      http://ajcn.nutrition.org/content/66/5/1264.full.pdf

      • What good does it do to spike insulin after eating meat, a low starch/sugar food? What is in meat that triggers this response?

        • Toxins

          That I do not know, and as I look through the study, I cannot find a clear explanation for this either.

          • john

            Your “study” is BS. Proteins and fats do are not high glycemic. There are none so decieved as the willingly decieved. You have made up your mind then look for “evidence” to support your view. Dr. Gregor happily provides the false “proof” you need. If you want the truth ask a real doctor without a anti-animal products polital agenda.

          • Veganrunner

            John did you look under sources cited? The studies that Dr G refers to are all listed there. If you click on the link you can read the studies and comment specifically what you found in the study that you think was subpar. But without that insight it makes it difficult to converse.

          • john

            The Dr. is selectively choosing “studies” in order to mislead people into thinking that eating meat has a higher glycemic load than pasta. Anyone who is a real doctor would know that Proteins and Fats have completely different metabolic pathways than Carbohydrates. The role of insulin is quite different for an amino acid than it is for glucose. Paleo and low carb diets focus on insulin as the primary trigger of fat storage. Protein not only increases insulin but also glucagon levels, which actually inverts the role of insulin to raising blood glucose levels and converting protein to glucose. Your Vegan doctor is misleading you into believing that an apples to oranges comparison can lead to a scientific conclusion about diet. He is wrong. The body has a very complex chemical and hormonal balance and it adjusts itself accordingly to food intake. The fact that the body has a predetermined response and meatabolic pathway for proteins and fats by itself proves veganism to be against nature.

            Maybe the word lying is too strong. How about “deliberately misleading by selectively citing information in order to appear as supporting a foregone conclusion”? Is that less offensive?

          • Easy bro…You sure do like to stomp around here calling people liars John. Not cool… Yup…It’s true, beef spikes insulin MORE than white flour pasta. I looked it up on the American Journal of Clinical Nutrition site and the numbers I found were Beef spiked insulin more (51) as opposed to white flour pasta (40). Kinda proves the whole keto diets framework is flawed to begin with. Apperantly you haven’t been introduced to plant positive yet? Have a read though this first to bring yourself up to speed.
            ~~~> http://plantpositive.com/

          • john

            You are a troll of the worst type. Veganism does not benefit from your activity on the internet. Try just sticking with the facts. Eating a steak does not cause insulin induced fat storage as pasta does. Align yourself with facts, rather than attempting to make facts fit your own foregone conclusions.

          • Toxins

            John, I have had to delete one of your comments because it was purely mean spirited. If you would like to prove your point, please use studies. I have already provided you with a study showing clear evidence that yes, meat does raise insulin, and more so in many cases than carbohydrate containing foods. These studies have not been altered in any way and are not “veganism” studies. Please be open minded. If you have conflicting evidence, then please share.

          • john

            Lol@u calling others mean spirited. Do me a favor, delete all my posts. It is obvious there are no objectively minded seekers of truth here anyway. Or if there were, they would be quicklu run off by the troll.

          • Toxins

            Adopt your own statements to your posts John “Eating a steak does not cause insulin induced fat storage as pasta does. Align yourself with facts”. This is simply false, its not zeal, its science. You have yet to provide a reference (studies please).

          • Guest

            Easy John, please try to keep it civil. I’m not insulting you. I’m a proud
            vegan who supports plant based living. This is a vegan site that I like
            to support and comment on. So who is the troll here? You have been
            provided with information about the deleterious effects of meat and you
            simply won’t accept that meat and fat are bad for health and that beef
            spikes insulin more than pasta. The whole paleo low-carb framework is flawed bro-science at best. I wish you would open your mind and read through
            plantpositives.com. It is a great resource to pick you up to speed on
            the the diet/health debate. Have a good day.

          • Please try to keep it civil John. I’m not insulting you. I’m a proud
            vegan who supports plant based living. This is a vegan site that I like
            to support and comment on. So who is the troll here? You have been
            provided with information about the deleterious effects of meat and you
            simply won’t accept that meat and fat are bad for your health and that beef
            spikes insulin more than pasta… Like I said paleo
            diets are a dangerous fad based on misleading bro-science. did you have a chance to read through
            plantpositive.com. It is a great resource to pick you up to speed on
            the the diet/health debate. Have a good day.

          • Toxins

            John, how exactly is that study “bs”? They fed people these foods and did direct measurements. That’s exactly what we are trying to determine isn’t it? Because your favorite paleo doctor Dr. has another “opinion”, does not mean that his opinion is right. Here we have direct evidence that meat indeed raises insulin. If you won’t take that evidence then you are simply blinded by dogma.

    • I just looked up beef vs. white pasta on the American Journal of Clinical Nutrition site and the numbers I found were beef=51, pasta=40. So at least for this comparison, yes… beef spikes insulin more that white flour pasta.

  • john

    It is sad to see the same old lies are still being told about the cause of Dr Atkins death. Someone sent me a link to this video thinking that it would convince me veganism is superior to low carb. After hearing this along with the outright lie that meat causes higher insulin reaponse i cannot see any reason to consider this dr credible at all. If veganism is really superior there would be no need to tell lies to prove it.

    • Toxins

      John, Dr. Greger never claimed that atkins died from these conditions. He showed his medical record which showed that he had experienced these complications. Nothing in this video is a “lie”. It is from peer reviewed research. You can see the sources cited section yourself and find the papers.

    • Hi John, no lies going on about Dr Atkins death. His death report is freely available to the public. You can look it up for yourself. It states very clearly on the report that Dr Atkins suffered from cardiovascular disease and hypertension. No doubt from his high protein and animal based diet… atkinsexposed.org

      • john

        According to his death certificate, the “immediate cause” of Atkins’s death last April was “blunt impact injury of head with epidural hematoma.” He was critically injured when he struck his head in a fall on an icy Manhattan street. Anyone attempting to link his death with his diet is not only guilty of a shameless ad-hominem attack, but is telling an outright lie.

        Dr. Patrick Fratellone treated Dr. Atkins from 1999 until 2002, and also worked with the doctor at the Atkins Center. He says Atkins suffered from cardiomyopathy, a chronic heart weakness. But this condition, he says, was caused by a virus not his diet: “I was his attending cardiologist at that time. And I made the statement… When we did his angiogram, I mean, the doctor who performed it, said it’s pristine for someone that eats his kind of diet… Pristine, meaning these are very clean arteries. I didn’t want people to think that his diet caused his heart muscle – it was definitely a documented viral infection.”

        Now you know the truth. Will you be honest and consider that those with a militant vegan agenda may have stretched the truth a bit?

        • Yes, I believe the truth was stretched, but not by Vegans, rather it was stretched by Atkins wife to protect the Atkins fortune. To really understand what happened you have to go undercover and get the inside scope, as the Atkins camp is very strict on not letting out any negative information to the public.

          In fact Atkins had his first heart attack in 2002 and tried to cover that up as well… When Katie Couric pressed him to talk about it on NBC Atkins became defiant and claimed it was an infection.

          We know now that an infection could not have caused Atkins health problems as told by Dr. Fuhrman here ~~~> QUOTE “Ketogenic diets have been shown in the medical literature to cause a
          pathological enlargement of the heart called cardiomyopathy,” and “The Atkins Corporation denies that Dr. Atkins’ own cardiomyopathy-induced heart attack, hypertension, and blocked arteries had anything to do with his diet. But it is important to counter these ridiculous claims with reality. Atkins had not only cardiomyopathy but high blood pressure and aththerosclerosis according to his medical record. These diseases are not caused by viruses. In fact, even viral-induced cardiomyopathy is thought to be caused by low levels of fruit and vegetables in the diet.

          Now fast forward to 2003 when Atkins had his 2nd heart attack… This is where Dr Fratellone comes into play. A friend and mutual patient of both Atkins and Fuhrman tells this story…

          “April 2003 and Dr. Atkins dies, slips on ice? I see Dr.
          Fratellone about a month later and during the visit, I express my
          sorrow for the death of Dr. Atkins. I said that was some accident,
          slipping on the ice and hitting his head and dying. He looked at me
          with a questionable stare and pointed to his heart. I said, “He had a
          heart attack?” He said no more after that.

          So weather he slipped on ice or had a heart attack that made him slip on ice is irrelevant. His death report states that he was obese, with hypertention and heart disease. The man was a health mess.

          ref ~~~~> http://www.diseaseproof.com/archives/diet-myths-responding-to-comments-about-dr-atkins.html

          • john

            Well I tried to get you to be honest. Your response was to dig up even bigger lies. Sad. You lie about Dr Atkins personally. And you lie about his diet when you presume that it doesnt include vegetables. Lies lies lies.

          • I take offense to being called a lair. That was Juvenal and uncalled for. I have no need to lie, I am interested in the diet/health debate and I do my own research and report my findings. I simply quoted what Dr. Furhman and his patient said in his blog about Atkins. I even provided you with the reference link so you could go read the whole article for yourself. Did you even click the link?

            Maybe you yourself are so blinded by the low-carb dogma that you can’t accept the truth about Atkins yourself. I know a great deal about Bob Atkins, I’ve studied his life… So your attempt to cover up his poor health will not fool me or others ‘in the know’. Some fun facts for you… Did you know ol Bobby Atkins was a resort entertainer and salesman before he made up his crazy diet?

            Read all about it. ~~~~> atkinsexposed.org.

          • john

            Your hatred for Dr Atkins is pretty amazing. If you resent being called a liar, try this: stop lying.

  • john

    It is sad to see the same old lies are still being told about the cause of Dr Atkins death. Someone sent me a link to this video thinking that it would convince me veganism is superior to low carb. After hearing this along with the outright lie that meat causes higher insulin reaponse i cannot see any reason to consider this dr credible at all. If veganism is really superior there would be no need to tell lies to prove it.

  • Tara

    Recently I challenged a paleo blogger to give up his blood test results. Apparently this is where he’s at:

    TC 158 (had tested a few weeks later to get NMR and was 170s),
    LDL-C was in the 70s with LDL-p around 1,100 if I recall.
    HDL was 85 or so.
    hs-CRP was 1.X which was slightly above low into the moderate level.
    Fasting sugar was low 80s with A1C of 5.2.

    I was shocked. Could his results just be an anomaly? However, more people came to the party saying their cholesterol levels were low too. Assuming everyone is telling the truth, could the reasoning here be just that some people are more predisposed to lower cholesterol? These people apparently eat copious amounts of butter, coconut oil, meat, etc… Baffles me. Any thoughts as to why this might be? Recently I dropped my total cholesterol by 27%, my LDL by 37% and my CRP by 54% – in TWO months, simply by going vegan. Was thrilled (and it’s thanks in large part to this website). But I’m just so confused as to how people who eat paleo can claim to have such great blood work? Thanks!

  • BYOL

    Dr. Greger, I’m curious if you were aware of the backlash against this study? Any response either from the authors or from you? http://therussells.crossfit.com/2014/09/08/acsm-fellow-publishes-bad-science-on-crossfit-and-paleo/

    Thanks so much for all of your work!

    • Veganrunner

      BYOL that is a scary website. Those guys are true believers in the crossfit/Paleo craze. They talk about injury from crossfit being untrue and I will tell you in my practice I have treated many people who practice Crossfit. The problem is that a particular exercise is done as many times as possible in a given amount of time. My the end the form is gone and people are injuring themselves to get more reps in. I don’t have a problem with the exercises the program uses just the timed aspect. It encourages injury. I just had a new patient last week who injured her neck.

      As far as the study they should have done a better job getting the people to fill in the food diary instead of abandoning them altogether. Phone calls could have been used to encourage compliance. But the Russells in their claims about what was eaten is as problematic. They ask one guy to retrospectively explain what was eaten during the study. That is ridiculous. If you want to debunk a study you don’t do it with a equally blatant mistake.

    • That site is one of those low-carb Paleo sites Dr. Greger warns to take with a grain of salt. They are ‘doubt’ sellers like the rest. I wouldn’t put to much faith in their personal opinions of the study in question. I’d like to hear what Plant-Positive has to say about it. He usually does a great job dissecting the data for us.

      • BYOL

        Veggie Eric,
        I completely agree, but if what they say is true about the study not actually looking at people following a diet, it’s a bit misleading. The same way many journals attack low fat diets (but they set low-fat at 30% of calories)…

  • Jackie

    This is FANTASTIC NEWS! I’m an animal lover but I was diagnosed 3 years ago as a “borderline diabetic” (I’m insulin restistant) and was told to eat a high-protein, low carb diet. It’s been a difficult emotional struggle for me as my heart tells me to be a vegetarian but my doctor tells me all the carbs will spike my A1C. Just days ago, I finally decided to go with my heart. Coming across this report is the universe’s way of telling me I make the right choice in all aspects. <3

  • TJtruthandjustice

    It’s very easy to cherry-pick studies. The fact is that people don’t all react to carbohydrates equally, and many studies you don’t cite reflect this.

    • Toxins

      Where are these studies? Please do share.

      “Although some of the protein-rich foods may normally be eaten in smaller quantities, fish, beef, cheese, and eggs still had larger insulin responses per gram than did many of the foods consisting predominantly of carbohydrate.”
      http://ajcn.nutrition.org/content/66/5/1264.full.pdf

  • GoldPaintedLemons

    OK, I’ll bite. Have to at least add some alternate perspective to this, hoping it won’t fall in a black hole. A few things:

    1) Paleo isn’t necessarily low carb and I eat more fruits and veggies than some vegetarians I’ve known. No corn is not a veggie :-)

    2) I could be wrong but insulin itself is typically not blamed for health issues other than fat storage (which is good) by most paleo advocates, and we know protein spikes it too. Fat much less so, but that’s not the issue. We blame spikes of the glucose itself, as that is what causes inflammation. Here’s a study: http://content.onlinejacc.org/mobile/article.aspx?articleid=1138298 and a well written article sighting that study asking others http://www.scientificamerican.com/article/carbs-against-cardio/

    3) Picking some recipes “at random” from “a popular site” to get total average nutrition facts is pretty unscientific. I was especially concerned when the author ended up with an 11:1 omega 6:3 fat ratio. That’s not what we strive for. Fish, grass fed beef, pastured eggs… Look it up.

    4) Stop the cholesterol myths. The lipid hypothesis is still completely unproven. Most cholesterol related studies linked lowered cholesterol to reduced heart attacks by way of statins, that’s a classic logical fallacy.

    5) Sight your quotes. I’ll admit some interesting stats were shown here but if I can’t go read the study myself and draw my own conclusions from the methodology of the study, I can’t assume you’re assertions hold water. Typically it’s not the facts/numbers that are wrong, but the conclusions drawn by either faulty/bias logic (such as the cholesterol myths) or via assumptions based on other “facts” ascertained the same way.

    • Toxins

      1) The bulk of the calories come from protein or fat. Veggies are mostly carbohydrates but the total caloric load is low so the overall diet tends to be low carb. I doubt fruit comprises a large percentage of calories. Even so, a high fat, or high protein diet is not healthful, as will be detailed.

      2) Considering that the participants had high saturated fat intakes, low fiber intakes and low folate intake, this does not point towards a healthy diet that even meets the minimum dietary recommendations. The relevance of this study is low.

      Pure glucose alone causes inflammation, yes. But in terms of a healthy diet comprising of whole foods, this is not a realistic scenario. Carbohydrate containing foods tend to be anti inflammatory. Lets look at the research. I apologize for the length in advance.

      Four groups of 12 people that were healthy and of a normal weight were assigned to ingest 300 calories of glucose, orange juice or cream. There was a water control group. The researchers examined the effects of these items on nuclear factor-kB (NF-kB), suppressor of cytokine signaling-3 (SOCS3) and Interleukin 6 (IL-6) in mononuclear cells (MNCs), endotoxin lipopolysaccharide (LPS), and Toll-like receptor-4 expression (TLR-4). All of these factors represent inflammation when present in greater quantities than normal. The measurements were taken at baseline, 1, 3 and 5 hours after intake. It was found that glucose and cream increased all inflammatory factors, except glucose did not increase LPS concentrations nor did it increase TLR-4 expression. It appears the orange juice, a source of carbohydrates, did not increase the inflammatory markers, whereas pure glucose did. The cream increased all inflammatory markers and resulted in endotoxemia. Endotoxemia is an important inflammatory factor that will be discussed further. The fat content of the cream, particularly the saturated fat, is acting as a pathway for bacterial endotoxins to enter the bloodstream and result in an inflammatory response.
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2858203/

      To examine the effect of endotoxemia further, it is necessary to identify what foods result in endotoxemia. An in vitro study examined the effects of various foods on the inflammatory markers characteristic of endotoxemia, including TLR-4 and LPS
      http://www.ncbi.nlm.nih.gov/pubmed/20849668

      The food categories included fruits and vegetables, dairy, meat and processed foods. Of these food groups, in vitro, pork, turkey, and ice cream resulted in the greatest inflammatory response due to the endotoxins. It has been identified that this response is a result of the bacteria that has fermented or colonized the foods, and then subsequently killed and ingested. The dead bacteria leave behind a toxin that the body responds to with an inflammatory response. It appears that in vivo based on the previous study with the cream, saturated fat is necessary to enable the gut permeability and translocation of the endotoxins. Cooking and pH did not have an influence on diminishing these endotoxins, so choosing the right foods is necessary. An in vivo assessment of the inflammatory nature of animal based foods comparing the saturated fat content in varying degrees is in order to determine how significant the effect of saturated fatty acids are on inflammation. A preliminary trial of ten subjects provides some insight into this question. Traditional domesticated meat and kangaroo meat were compared with each other to determine the levels of inflammation.

      The domesticated meat was 25-30% fat and 40% of this was saturated. The kangaroo meat was <4% fat and of this, 400-500 mg/d. People desiring maximal reduction of serum cholesterol by dietary means may have to reduce their dietary cholesterol to minimal level”

      http://ajcn.nutrition.org/content/55/6/1060.full.pdf

      “The saturated fatty acids, in contrast to cis mono or polyunsaturated fatty acids, have a unique property in that they suppress the expression of LDL receptors (Spady et al., 1993). Through this action, dietary saturated fatty acids raise serum LDL cholesterol concentrations (Mustad et al., 1997).”

      http://www.nap.edu/openbook.php?record_id=10490&page=432
      So yes, dietary and cholesterol and saturated fat influence serum cholesterol.

      Here is the link between cholesterol and heart disease that has been proven in hundreds of studies.

      http://jama.jamanetwork.com/article.aspx?articleid=363237

      http://jama.jamanetwork.com/article.aspx?articleid=373603

      “This systematic review and meta-regression analysis of 108 randomised controlled trials using lipid modifying interventions did not show an association between treatment mediated change in high density lipoprotein cholesterol and risk ratios for coronary heart disease events, coronary heart disease deaths, or total deaths whenever change in low density lipoprotein cholesterol was taken into account. We found a statistically significant, substantial association between change in low density lipoprotein cholesterol and risk ratios for coronary heart disease events, coronary heart disease deaths, or total deaths, adjusted for other lipid subfractions and drug class.”
      http://www.bmj.com/content/338/bmj.b92

      In addition to the many other studies showing this link, animal models clearly show this pattern of high fat diets leading to heart disease. Which I can also happily share if need be. A high fat diet has never reversed heart disease. The only diet to ever reverse heart disease is a low fat, plant based diet very high in carbohydrates.
      http://www.jfponline.com/fileadmin/qhi/jfp/pdfs/6307/JFP_06307_Article1.pdf

      5) click “sources cited” next to the video and see the studies yourself. The premise your coming at this with is false. A paleo diet is not based on the available evidence.

      • Merry Winter Holiday, Toxins! Your detailed responses like the one above are such generous and informative gifts to us all! Thank you very, very much. As a psychologist, I am fascinated and seeking to understand the dynamics of a person’s openness or defensiveness to information about diet. Food opinions and information are something like political convictions. The need to be right, the possibility of asserting one’s “rightness” about a complex topic pushes many assert X, Y, or Z is true with inadequate evidence and to experience helpful, but contradictory, information or opinion as an attack. Much as with religious opinions/beliefs. This is a real problem in a democracy, health, and education. Thank you for doing your part and helping us get the facts that ARE available straight.
        I have even noted some of this feeling attacked when an experienced dancer is trying to help beginner ballroom/tango dancers (men). When more experienced men offer to help the new dancer the insecure male responds with defensive hostility! The thought cloud may read: How dare you point out that there is something I do not know or that I am wrong!” Insecure people are sometimes so desperate to show mastery in one or all aspects of living that they can’t be learners from others. Instead, they do their own “research” and reject the help from generous people who are more experienced and who do not claim to be 100% right, just better informed to help one along in his or her search.
        I think one of the cruelest things our society does to men especially, is to give them the expectation that it is manly never to be lacking in mastery, to always be good at things, and well informed. This happens less to women, but to an even grater extent in some other cultures, such as the French one. ( I have taught in Europe and French men have explained this to me in some sad detail.) What a thievery of new learning and new experiences it is to rob one of a sense of dignity, delight, and exuberance in learning new things, sports, arts, new anything! And here, new information that could dramatically improve the quality of one’s life and that of one’s loved ones.

        • Toxins

          Thank you Gayle and Happy Holidays to you too! The information I provided above is available on nutritionfacts.org in several of the videos, I just take some of the studies that are of particular interest to me and synthesize them myself to gain a greater understanding of them.

          What you are observing is very interesting and I would agree. I think food and diet is a sensitive topic and it can be almost religious in dogma. Diet is so personal because it regards our health and what we believe to be good for us. If we find out our diet is harming us, that can be shocking, denying it may be a better alternative. Thanks for sharing your interesting viewpoint.

          • JS Baker

            Hello Toxins and Gayle,

            Happy Holidays to you both. I’m almost 2
            years strictly eating whole foods plant based diet since I began to study
            this wonderful NF website. Once I absorbed enough evidence from Dr.
            Gregor’s incredible video library and could find nothing to seriously
            contradict it (I searched extensively for rebuttals to Dr. Gregor’s
            video presentations as I was vetting this site) I completely cut out all
            animal products overnight. Later as my knowledge increased I dropped
            all refined oils, too.

            I find the scientific evidence
            overwhelmingly compelling that plants promote health and animal products
            degrade health. So why do so many people resist the overwhelming
            evidence pointing to the root causes of poor health in western
            societies? I recently came across the idea of “solution aversion” or
            “motivating reasoning” as a device our human minds use to block
            undesirable solutions. See this fascinating study at Duke University. http://today.duke.edu/2014/11/solutionaversion

            Last year the Cultural Cognition Lab at Yale Law school
            revealed similar conclusions to the recent Duke findings. Yale Law study, entitled “Identity-protective
            Cognition Thesis” (ICT),” treats cultural conflict as disabling the
            faculties that members of the public use to make sense of decision
            relevant science. Find more in their paper here:
            http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2319992

            Given
            your recent comments on this site to which I am responding I thought
            both of you would find these studies of interest as you try to help
            other people improve their health through changes in diet.

            Toxins,
            I also want you to know how grateful I am for your numerous, thoroughly
            researched and even-tempered answers to so many questions on this
            site. You and the others, both NF Team and frequent commenters, help to
            make the entire NF website an incredibly valuable resource for me. Many, many thanks.

  • Andres

    I have noticed a positive change in my life as a “Paleo” eater. Really I don’t care if it is based From our ancestors way of eating but it feels right. Vegetables, some omega 3 fish, fruits and maybe some sort of seeds. I took away rice, Milk, and processed meats. Humans are in fact the only mammals who consume milk as adults, and we are the only specie who drinks milk from another animal. Don’t take me wrong, I also like to have some cheat days, grab a burger, eat some great cheesy pizza, drink a coke. I work out three times a week and eat paleo Monday to Friday. My goal is to live a life of abundance in health, and be able to put good things in my soul and body.

    • Really

      Humans are also the only mammals to cook their food.

  • joselinus

    What I can say, and it is easy to see for everybody without doubt is “veganism” is useless for hair loss :-). See the dr.

  • Adonis Maiquez, MD

    I am a long time supporter, thanks Dr. Greger but I might disagree on part of your video. It is my impression from reading the original paper ( which is also the graph that Dr. Greger showed in the video) that meat/fish increased “insulin to glucose ratio” higher than fruits and other carbs, not the actual insulin level (which was the other way around). Is that right? thanks.

    • largelytrue

      Yes, your interpretation seems to be correct. The numbers for the salmon and the beef seem to come from the numbers for whitefish and beef steak in the paper, rescaled. The values are for the ratio between the insulemic response to the glycemic response. In terms of absolute secretion of insulin per calorie, apples generate a slightly higher insulin response per calorie than beef steak, as can be seen in Fig. 2.

      Hopefully a team member will see.

      • Toxins

        It has been noted, thanks!

      • Please see my response to Dr. Malquez–I used the insulemic response per serving as I said in the video, not the ratio. I appreciate you chiming in–sorry I missed the original post 9 days ago!

        • largelytrue

          Ah, thanks for the clarification! Part of why I missed the obvious here may be that comparing foods by weight is pretty unusual, and as far as I understand, does not meet the paleo argument(s) head on. Any paleo framework that can adapt enough to recognize that beef induces an insulemic response as well as pasta will tend to turn toward the idea of the insulin index: the total insulin spike per calorie of food.

          Simply showing them that the insulemic response per unit weight is greater for meat than for pasta does not immediately suggest that they should be eating meat rather than pasta. After all, the insulin score for meat is lower than for pasta. If they have a Big Idea that insulin spikes disrupt satiety signals and cause people to eat more and more food in general, as they often do, eating more meat would naturally tend to cause people to consume fewer calories and would also reduce the insulin load of the total diet. This citation of the insulin index paper tends to contradict the idea that insulin on a pasta-only diet would be ‘better’ than that of a meat-only diet, as far as a low-carb-paleo framework is concerned.

    • No I do cite the actual insulin level not the ratio–sorry if you were confused! The numbers in the graph come from column 6 in table 4 on page 1269 (available free full-text here), the insulin per gram of serving weight. So for example a large apple weighs about 200 grams, so 20 (pmol)(min)/(L)(g) times 200g = 4000 (pmol)(min)/(L) = 40 (micromol)(min)/daL, which is what I have in the graph. So servings of apples, and oatmeal, and even white flour pasta cause less of an insulin spike than servings of beef and fish (and chicken and pork accordingly).

  • belgianquill .

    The study found these changes in Blood Lipids with “concurrent improvements in body composition and cardiorespiratory fitness”. The Blood Lipid theory is less and less helpful and may be completely obsolete. To date, reduction of Blood Lipid levels has been extremely helpful to the Statin manufacturers and has not reduced Cardiac events.

  • Arpitam

    I saw the paleo video and ask myself, what if the sudden change of a usual diet to paleo or any other diet stresses the body and metabolism so much that insulin and bad cholesterol would go up…how would the numbers be after exercising and eating paleo after 2 month, half a year and one year? Still the same ‘bad’ results? … And I wonder how effective plant based protein powders are in any diet combined with exercise?

  • Mark L

    This was a very interesting video…. but, being the logical thinking person that I am, I have the following question… If Dr. G’s video was correct, then it would follow that the masses of paleo eaters would become diabetics with extremely high cholesterol levels! If this were the case, I think there would be headlines about how terrible the paleo diet is.. causing diabetes and high cholesterol… I haven’t seen these headlines!
    Mark

    • Toxins

      Mark, paleo dieters do indeed have extremely high cholesterol. They do not think that high cholesterol is an issue though, which is one of their primary tenants. I can’t find the link now, but I saw a chart of the paleo advocates leading the movement publicly displaying their cholesterol numbers. LDL was commonly in the 200 range and many went into the 300’s. This is LDL, mind you, not total. Atherosclerosis takes some time to develop. Also, many paleo dieters are into ketogenic diets. On ketosis, your body burns fat over carbohydrates. In this state cells do not require glucose. The cells are still insulin resistant, the pathway for energy is just different. Being in ketosis though is not a sustainable health solution and will indeed lead to a variety of health issues.Please see here
      http://plantpositive.com/35-how-to-become-insulin-resis/
      http://plantpositive.com/36-how-to-become-insulin-resis/
      http://plantpositive.squarespace.com/blog/2012/3/26/tpns-58-61-ketosis-is-natural-natural-is-good.html

      • largelytrue

        Plant Positive cited the Perfect Health Diet’s list of high profile low-carb Paleo people (the good guys, in their view) with high LDL scores. Perhaps this was the sort of thing that you were referring to:

        http://perfecthealthdiet.com/2011/03/low-carb-paleo-and-ldl-is-soaring-%E2%80%93-help/

        • Toxins

          It was, thank you! Im still horrified that people think this is ok.

      • Mark L

        Toxins, thank you very much for these links. Wow, they are deep and very informative and clear up many myths on saturated fat, cholesterol and heart disease. After listening to many of the videos from the links, I am now convinced that meat does cause an increase in diabetes and cholesterol and heart disease..
        I am wondering something that you or anyone reading this may be able to answer for me. I am vegan but eat lots of nuts – about 3 to 4 handfuls a day. Its no secret that nuts have lots of saturated fat. So my question is… does the saturated fat from nut consumption cause the same heart problems that the saturated fat from meat consumption does??? thank you in advance for any insight you have on this.
        Mark

        • Toxins

          I am glad you found plant positive helpful. As I have said before on this website, plant positive is my #2 to nutritionfacts.org. You should explore some of his other videos, they are equally informative and enlightening.

          In regards to your comment on nuts, if your cholesterol is higher than you would like, then reducing nut consumption may be beneficial. Choosing certain nuts/seeds over others may prove beneficial as well. Walnuts and flax, for example , are some of the healthiest nuts you can eat.

          http://nutritionfacts.org/video/walnuts-and-artery-function/

          http://nutritionfacts.org/video/black-versus-english-walnuts/

          http://nutritionfacts.org/?s=flax

          Another possible concern is consuming too much omega 6 rich nuts (peanuts, almonds, brazil) over the omega 3 rich nuts (chia, flax, walnuts). Too much omega 6 does not allow adequate conversion of omega 3 ALA to DHA and EPA. A good ratio is 1:4 or less of omega 3:6.

          • Mark L

            thank you very much for those links Toxins. If I think of other health questions, is there a way to reach you?
            Mark

          • Toxins

            You’re welcome, you can just reply to my comments on this website. I will see it on my Disqus notifications more readily than the moderating dashboard.

  • guest

    Hi Dr Greger, I have been following your nutritional advice for the past year or so and I feel healthy,
    however I have just watched a documentary called ‘Cereal Killers’
    https://www.youtube.com/watch?v=dON-fPp5Hy0

    I have seen Forks over Knives and read the China Study and this documentary seems to contradict much of what I have learned,
    now I’m confused?, are they misrepresenting the data? drawing false conclusions, cherry picking?

    as vegans should we be eating more nuts and seeds, and fewer carbohydrates?

    if you have seen this documentary I would love to hear your take on the information that they put forward

    • Thea

      guest: I haven’t watched “Cereal Killers”, however I would bet that it uses the exact same arguments and “information” that you get from books like Grain Brain and Wheat Belly and any ole paleo or atkins type site. These arguments are not based on the body of evidence – and often twist evidence. And then there are the times that references they use to back up their claims do nothing of the sort.

      I would argue that Dr. Greger has already answered “Cereal Killers” and all of those other arguments with the body of work on this site. You can find videos on this site that show the powerfully healthy effects of eating whole, intact grains and beans.

      But if you are looking for direct counters to those arguments, I suggest you check out Plant Positive’s work. He has put together indepth research in the form of videos where he directly addresses the claims of cholesterol deniers and usually by extension, those that claim that grains and beans (carbohydrates) are bad for us.
      http://plantpositive.com/

      Here is one video from Plant Positive (as part of a big series of videos) which might begin to specifically address your concerns:
      http://plantpositive.com/blog/2012/3/24/tpns-22-23-thin-gruel-on-grains.html

      I understand and sympathize with your confusion. I hope this helps.

  • Giacomo Cariani

    AMAZING!!

  • raz

    Potatos and Baked Beans have a higher insulin index then meat… Another misleading video…

    • nodelord

      more on the study… http://www.mendosa.com/insulin_index.htm
      still no references just hear say.

    • nodelord

      Thanks for your opinion. Can you prove it? oh, and do you mean baked beans with all that tasty brown sugar or just beans?

  • nodelord

    so the paleos say the study was flawed?

    “The insulin index, which first made its appearance in a 1997 American Journal of Clinical Nutrition article, was primarily the creation of Susanne Holt, a graduate student at the time and now a doctor. Interestingly, Holt, her supervisory co-authors, or other researchers haven’t chosen to conduct further research to update the “preliminary” results of their insulin index study since its creation eleven years ago now.

    While Holt and her co-authors found a high correlation between glycemic index and insulin index measurements, they stumbled upon an intriguing exception. High protein, virtually no-carb foods like meat and eggs, while low on the glycemic index, measured high on the insulin index. In other words, while the meat and eggs didn’t cause a spike in blood sugar the way most carbohydrates do, they did result in an unexpectedly significant rise in insulin. (Baked goods, with their high levels of refined carbs, elicited a very high rise in insulin as well. Of course, this comes as less of a surprise.)

    Read more: http://www.marksdailyapple.com/insulin-index/#ixzz3Q9iMPG1l
    The above is from Marks Daily Apple! Is it true? The didn’t offer any references to any retractions. Does anyone have a official update to the study?

  • Jessica

    I remain unconvinced. LDL and HDL counts are not accurate predictors of a person’s risk for heart disease. Using only these as a measure can produce a false positive and/or false negative. A person’s LDL and HDL particle numbers are a more accurate predictor of heart disease risk. A study measuring the participants’ particle numbers would have me more convinced.

  • Ulevo

    Quick question. We know that foods high on the glycemic index are classified as high glycemic foods because of their ability to drastically elevate blood sugar levels. We also know that insulins responds to this spike in blood sugar to calm it down. So if insulin spikes the same when a piece of meat is consumed as when sugar is consumed, would that piece of meat be classified as a high glycemic food? Is our blood sugar spiking when we consume meat products, or is there another reason for the release in insulin?

    • Wade Patton

      See the video http://nutritionfacts.org/video/diabetes-as-a-disease-of-fat-toxicity/
      Also note that GI was developed eating fixed (sometimes unusual) amounts of foods independent of each other, which is NOT how folks usually consume meals. Combining foods generally changes the GI, condiments and drinks will change GI as well. The best practice might be to develop your own GI by composing your meals as you eat them and testing your own blood responses. Or just go WFPB and let the “magic” happen.

  • veganballerina

    This makes a lot of sense. I was put on a high protein “paleo” type diet by my former nutritionist…and gained a ton of weight! Now I’m back to vegan and trying so hard to lose it… but it isn’t coming off through clean eating and daily moderate exercise. (How much damage did that horrible paleo diet do, anyway???)
    I’ve been trying to avoid counting calories. It tends to stress me out and I get overly concerned about it. But now I’m worried I’ll have to go back to calorie-counting since I’m not getting any results. (Even though I eat leafy greens at every single meal and limit the more calorie dense things like beans, grains, and potatoes.) The theory of “calorie density” is that keeping your calories per ounce below 25 should cause weight loss. Mine has been between 14 to 20 every day. I force down large quantities of greens to keep it that way. But the extra fat remains!! It’s becoming so frustrating… any suggestions? Not sure what to do at this point.

    • Thea

      veganballerina: How frustrating! It certainly sounds to me like you are doing everything right. At 25 calories per ounce (400 calories per pound) or less, you would expect to loose weight even without exercise.

      Since you are already eating the way that works for so many, I don’t have too much more to suggest. I wanted to express my sympathies for you. But I also did have one idea. It sounds a bit counter-productive since I too believe in the concept of losing weight by paying attention to calorie density, but Dr. Greger has a video on this site showing how some people actually lose weight when they incorporate 1-2 ounces of nuts into their diet.

      This doesn’t work for everyone. Some people seem to gain weight on any amount of nuts. But since you have already tried paying attention to calorie density and whole plants foods so well, maybe adding some nuts is just what you need?

      I don’t have that NutritionFacts video link at my fingertips. But hopefully it won’t be hard to find. It was part of a series of videos on nuts that was done some time ago.

      I also have one other suggestion. You may already be following this general eating pattern on your own, but maybe Chef AJ’s program will help you tweak your diet just enough to help you start losing? Here is a link to Chef AJ’s program, which is essentially a calorie-density program. But maybe the devil is in the details for you?:
      http://eatunprocessed.com/dvd.html

      I hope you are able to find a system that not only works for weight loss, but is healthy and results in food that you enjoy. Good luck!

  • 1) He lumps low carb and Paleo together in the first sentence, which is bothersome as Paleo has no set macronutrient ratio.

    2) His point that meat raises insulin levels is not necessarily relevant. The context would be looking at which foods raise blood sugar the fastest, causing insulin secretion quickly, followed by a fast drop off. Furthermore, while people eat a bowl of oatmeal by itself, an apple by itself, etc. they rarely eat meat by itself. Meat eaten with vegetables and fat is going to have an even slower effect on blood sugar. And most relevant Paleo people should be proponents of fruit and starch, so this is a false argument.

    3) His insulin sensitivity study has nothing to do with Paleo or real food diets. It compared chinese vegetarians with “omnivores.”http://www.ncbi.nlm.nih.gov/pubmed/14749752 — Who the hell knows what these “omnivores” were eating?

    4) He compares the fasting insulin levels of vegetarians. And since this is a video about Paleo, he leaves you to assume these studies compared vegetarians with real food eaters. But no, all of them compare vegetarians to “meat eaters.” This is a common occurence that presents an exponential amount of confounding variables. Vegetarians tend to be people concerned about their health. A random “meat eater,” probably not so much. They’re basically taking people who are on the SAD and comparing them to vegetarians and touting around the “findings” as something spectacular. So…your diet beat out the standard american diet, congrats!

    5) “Put someone on a plant based diet and you can bring down their fasting insulin levels in 3 weeks.” — Put someone on ANY diet that doesn’t include processed foods and you’ll do EXACTLY the same thing. It’s not a case for vegetarianism, it’s a case AGAINST processed food.

    6) Very low carb diets can cause an increase in the fasting insulin levels as a physiological response to the lack of glucose. It’s a defense mechanism. This is called “physiological insulin resistance” and is in no way related to metabolic insulin resistance of diabetics. His argument against low carb diets for not reducing fasting insulin levels is out of context.

    7) His argument against the rise in LDL cholesterol on low carb diets is also out of context. There’s no information on the particle type and size and there’s also no information on the quality of food consumed. I’m not defending the long-term use of low carb diets, but he’s not adequately arguing against them.

    8) LDL cholesterol levels alone have nothing to do with heart disease.

    9) He argues that a study showed Paleo increased people’s LDL and decreased their HDL. This was a 10 week study in patients “asked to eat Paleo” (no details). The study notes that their weight and body fat percentage decreased. Well…this is problematic as anyone who has done blood testing during significant weight loss knows that it elevates cholesterol, particularly LDL. This is a poor time to test cholesterol as lots of excess fat is being dumped into the blood stream. This study would need to be months long in people whose weight was stable to be relevant.

    10) The entire premise of the main argument in the headline is false based on these issues.

    • arandomanimal

      Fantastic summary Kevin.

  • Martin351

    It all comes down to what part of the world our ancestors lived in. They lived off the land which included meat, veggies, fish (if close to water), and fruit. Colder climates yielded more fatty types of meat from animals.

    The premise of paleo is not eating processed foods which they wouldn’t find however many thousands of years ago. To further simplify it, if you can’t kill it, pull it out of the ground, off a plant, off a tree, or out of the water, you don’t eat it. Grains weren’t included in this as you don’t just pull grains out of the ground and eat them.

    You also have to keep in mind for those saying we evolved to eat grains, no we didn’t. Scientists have already stated it would take millions of years for humans to evolve their diet from a plant/meat style diet to incorporate grains.

    Something I always like to tell people who say were not meant to eat meat. We evolved to have incisors so we can rip and tear at meat. If we weren’t meant to eat meat, we wouldn’t have them :)

  • Bobby5939

    Yet another asinine video.

    Paleo is the staple of crosfitters. Look at them and tell them paleo negates their gains.

    Absolutely stupid. In reality, it’s video like this where the posters should be accountable for jail time for such ridiculous spread of misinformation.

  • Abdelfetah Taopaipai

    But what means the “Unrestricted” in the study is it representative of a real and well-executed paleo diet?

  • Abdelfetah Taopaipai

    But what means the “Unrestricted” in the study is it representative of a real and well-executed paleo diet?

  • Sleepy Dwarf

    Paleolithic man lived to be what…. 30?

  • Orion Antares

    The biggest issue with this study is in this paragraph:
    “Subjects were advised to increase their consumption of lean meat, fish, eggs, nuts, fruit, and vegetables and were instructed to strictly avoid all grains, dairy products, and legumes. All modern, processed foods including any form of processed sugar, soft drinks, and coffees were also excluded from the diets of the subjects. No specific macronutrient recommendations were made, as the study design wanted to closely mimic a real world model that would incorporate food choices made by the average consumer. Intake of specific proportion of food categories (e.g. animal vs. plant foods) was also not given.”

    For someone not being properly advised on this type of diet, the tendency is to go too far into lean meats and not enough into vegetables and fruits to replace the excluded items. They end up doing Atkins instead of Paleo.

  • Wellness Man

    We use diet to categorize what we eat. The original meaning was lifestyle. The food and drink diet is important, few dispute that. Recently, I’ve heard some people toss around percentages of importance: “It’s [health; weight loss; balance; etc.] 80% about diet,” is a common adage. That’s like saying life is 80% about human relationships. It is not a percentage that means anything concrete or testable. Tossing around such percentages may be more of a reaction to the sad health situation in which we find ourselves. People in the modern era have a good understanding, for the most part, about what is healthful and what is detrimental. Most know that coffee is bad for most things but good for a few things–one being temporarily staving off falling asleep at work.

    We are well versed in consuming things through our mouths, eyes, and ears–food, drink, information, music. We are less well versed in the term balance: physical movement, ergonomics, posture, downtime, sleep, fasting. If Paleo diets work for you, you should know by seeing the results. You should have a balanced levels or acidity, blood sugar, triglycerides. Your energy should be good and your sleep sound. Chart your course, you should be able to determine if you are sailing through the seas of life in good health. See my book on this at Amazon: Sedentary Nation. Aloha, Sifu Slim.

  • Frances Lilian Wellington

    I now have my T2 diabetes self managed in the optimal zone (achieved in 6 months since diagnosis). I shed 21kg (from 99kg), 6kg to go. I achieved this through removing all inflammatory and intolerant food choices and focussing upon essential nutrients. I am fully bio individual dietwise and I am thriving. Included in this diaita regime is 2 hrs exercise across all heart rate zones, building muscle mass. My food choices have everything to do with what my body needs… in a calculated preplanned manner… and zero to do with what anyone else did or didn’t do in the past. It is all about a full recovery, and nothing more. My dist is categorised as “very low carb Paleo adjusted for blood type A”. All my health issues (apnea, fatty liver, leaky gut and psychology syndrome, obesity, arthritis, high blood pressure, digestive problems… as well as learning difficulties) are resolved. Mentally I am 100% again for the first time in 40 years (now 51 y/o). I, for one, couldn’t be more delighted. Is this sustainable? I don’t see why not? Heck, it’s got me this far who knows what I can achieve next!

  • Lauta

    I’m looking for information and help with the connection between hyperinsulinemia and tinnitus and Vertigo?

  • Viki Thurman

    This entire video is based on the assumption that one quote illustrates the entire concept of the paleo diet? This lack of research into the thing you are arguing against is the epitome of being unscientific. You also glibly state that Atkins was obese and died of heart disease, which isn’t true. Atkins was not obese and though he did suffer a heart attack it was caused by a viral infection and did not, in fact, kill him. It doesn’t even take any effort to find this out. Your credibility is in question and based on what I’ve seen in your videos, I’m guessing this is all vegan propaganda. It is likely that all your research and supporting “facts” are just as biased as your research into Atkins and Paleo.

  • Aria

    Really appreciate this video! A comment on youtube made me curious about your take on something I hadn’t thought of before: “protein also increases glucagon.” Is this really sufficient to “refute” your cited studies on the effects on insulin? I am truly curious about your thoughts on this, and if anyone else has any published studies or information they would like to highlight I would love to look further into this. Especially because it has made for such a strong argument in my discussions with others considering veganism.

    Thank-you!

  • Vegan

    Dr. Greger, why none of your paleo videos mention some credible peer-reviewed studies that show quite surprising significant benefits of true paleo diet? https://authoritynutrition.com/5-studies-on-the-paleo-diet/ This gives me a feeling that your source selection is biased (although as a vegan myself I have an enormous appreciation of your mission, but I support non-biased thinking).

  • Rami Najjar – NF Moderator

    Authority nutrition is a heavily biased website that includes a lot of misconstrued information. I highly recommend plantpositive.com for paleo myth busting.

  • Thea

    Vegan: I would say the answer is because the studies are not valid and in other cases are not relevant. I started to look at the page you referenced and even the first study she reviews tells us nothing about the healthfulness of the “paleo” diet. They are comparing to a “Mediterranean-like” diet. Here’s how they define that: “a Consensus (Mediterranean-like) diet (n = 15), based on whole grains, low-fat dairy products, vegetables, fruits, fish, oils and margarines.” Yikes: dairy products, oils and margarines! All foods that lead to insulin resistance. So, we have a study comparing an unhealthy diet (Mediterranean-like) to people who might be doing slightly less unhealthy eating (because they are avoiding say sugar and processed foods and maybe even dairy). That study doesn’t tell us anything about the healthfulness of the paleo diet. I didn’t bother looking past that point.
    .
    FYI: Your post provided me with yet one more example of Authority Nutrition’s incorrect reporting. Authority Nutrition is usually not a credible source of information about nutrition.

  • Marty Kendall

    Does the protein or the carbohydrate component of food cause a higher insulin response? http://wp.me/p5VAQF-5u

  • AK

    Paleo isn’t anti carb, it actually has plenty, as sweet potatos and other veggies which are high in carbohydrates are very incouraged there