Doctor's Note

I’ve previously addressed how doctors tend to know less than they think they do about nutrition. No surprise, given most medical schools in the United States fail to provide even a bare minimum of nutrition training, with mainstream medical associations actively lobbying against additional nutrition training.

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  • guest

    Lots of people do not know this but Acai berry contains theobromine, the same stimulant in chocolate. This might not be a good thing for people who do not react well to stimulants.

  • HemoDynamic, MD – NF Volunteer

    This video is not anything new or stuff that I didn’t know (thanks to Dr. Gregor, Dr. McDougall, Dr. Bernard, Dr. Ornish, Dr. Esselstyn, Etc.) but what makes it so powerful is the platform it’s presented at–Nutrition Facts.org! As far as I am concerned it is the first and last word in nutrition education. Keep up the fantastic work to all of you at Nutrition Facts.org.

    • BB

      I agree! This website is powerful. All medical students should be required to spend 3 hours a week viewing the videos. No test required!

  • guest

    Organic chemistry is irrelevant to nutrition? I respectfully disagree. To understand biochemistry, one needs to understand organic chemistry, and to understand nutrition, one needs to understand biochemistry. For example, Dr. Greger talks a lot about antioxidants. How can one understand how they function if one doesn’t understand free radicals? And how can one understand free radicals without learning organic chemistry?

    • UCBAlum

      He said organic chemistry is irrelevant to the practice of medicine, not nutrition, and that courses in organic chemistry are required as “weeder classes” for medical school. On the other hand, nutrition classes are not required but maybe should be because most deaths are related to improper diet and poor nutrition.

      • guest

        UCBAlum: Thank you for responding to my comment. When I wrote “Organic chemistry is irrelevant to nutrition?”, this was my logic: I believe organic chemistry is relevant to nutrition, and Dr. Greger believes – and I wholeheartedly agree – that nutrition is relevant to medicine, so organic chemistry is relevant to medicine. (I gave one example, and Julie above gave more.) Thanks.

    • Julie

      Absolutely! The Krebs cycle, glycolysis, liver detoxification, enzymatic reactions (many of which require vitamins and minerals), are areas of nutrition that are biochemistry, and thus require knowledge in organic chemistry.

      • Sidney

        Not really. You don’t need to understand organic chemistry to understand all those reactions you mentioned. I went back to medical school 10 years after I took organic chemistry and had completely forgot it. I did just fine in biochemistry. You don’t need to know how the actual reactions work (e.g., this is nucleophilic substitution etc.) to understand the biochemistry.

    • Joseph Gonzales R.D.

      I would agree. Biochemistry is useful for understanding many reactions that involve nutrients, but the idea is doctors taking actual nutrition classes not just a science class.

      • Filipe Coimbra

        Hello Joseph! I wanna ask you a question. What Nutrition textbook do you recommend? I know that Jeff Novick R.D. recommend the textbook “Modern Nutrition in Health and Disease” from lippincott williams & wilkins publishers and I’m really enjoying this one, but I wanna know your opinion. Thanks in advance

    • Sidney

      He said organic chemistry is irrelevant to medical school. Which it is. I haven’t used a shred of organic chemistry or physics. I’m doing 3rd year clinical rotations now.

      • guest

        Hello Sidney: That is because of the flawed design of the medical school curriculum, not because organic chemistry is irrelevant. Thalidomide is back in the market, right? If a doctor doesn’t know the difference between enantiomers, how can he know the difference between (R) and (S) thalidomide? And where did he learn about enantiomers? in ochem classes.

  • Plantstrongdoc M.D.

    Great video! The problem exist on many different levels. Sadly I think that many (most?) become doctors due to money and prestige (I know – no prestige here on NF! :-) ). Open heart surgery, procedures and prescribing potent (no pun intended) medication is perceived as sexy, whereas talking about broccoli and beans probably is perceived as a lot less sexy. And the broccoli association probably wont invite you to their annual meeting in Las Vegas!

    • Joseph Gonzales R.D.

      You didn’t get the invite? It was in the “Cruciferous NOW” newsletter ;-) Sorry we’ll miss you this yr.

      • Plantstrongdoc M.D.

        Bummer – missed that issue……. :-)

  • Debra

    Is heart disease really the world’s biggest killer? I thought most people on the planet are still dying of starvation ( another byproduct of our gluttony). Maybe I’m wrong?
    Loved the video, though. At my hospital, the cardiologists are the most ill informed: one preaches the Atkins diet. Keeps ’em coming back for more, right?

    • Joseph Gonzales R.D.

      Here are some statistics by WHO. Yes, still the biggest killer. Hunger and poor nutrition is certainly a problem, perhaps the worst in my opinion, accounting for roughly 3.1 million deaths per year in children up to five, according to the World Food Program. Sobering statistics. And very disenchanting to hear cardiac doctors prescribe Atkins diets. Hopefully the times are changing…

  • Dave G

    Why have you not done a TED Talk?

    • Joseph Gonzales R.D.

      Hopefully soon!

  • fwalker8

    While not many physicians have adequate nutrition education, the same can be said of patients. I doubt that any public school teaches children the optimum diet for having a long, healthy life. A basic course on healthy nutrition should be available to every student, but politics and big food manufacturers prevent that from happening.

    • broken1

      Of couse not. Parents what there kids to grow up to be doctors. Lol

    • Jocelyn

      And I’ll up you one further! I think along with mandatory nutrition classes should be food preparation classes. It is astounding how many people can not prepare fresh foods. My food prep class in high school was where I developed my interest in healthy eating and whole/fresh food preparation.

    • Marilyn

      I spent 2 years trying to implement nutrition education in grade schools. Just so much red tape just to keep the students uneducated, drinking cokes and eating ding-dongs and fruit dupes, to keep big corp in big biz—and of course no nutrition education means a lowly existence without brain food, and there’s no critical thinking, which in turn keeps the dumbed down society in a vicious loop….’fruit loop’.

      I did get good success with the private schools since they are not govt controlled with nutrition education, so what does that tell you? Yes, big Food, big Pharma, and big Ag are all controlling the ‘red tape’ – that keeps the $ coming in and the people too dumb to even ask ‘what anti-nutrients are in processed ‘phood’ or what’s in a ding-dong’? Kids too ‘dumb’ to even ask – keeps the System going. Of course, there’s exceptions to some rely smart kids and I am thankful they can rise above it.

  • plsteiner

    Doesn’t most of what medical students DO learn in med school about nutrition come from material provided by the Department of Agriculture which gets its information from poultry, dairy, and meat industry associations? And WHO is teaching nutrition in medical schools? Do medical students ever hear the words plant-based? I don’t doubt that even that little bit of information young doctors ARE coming away with is MISinformation.

    • Joseph Gonzales R.D.

      USDA doesn’t necessarily advertise this information, but they do have information on plant-based diets and a useful resources pdf. I think Dr. McDougall has made strides to push medical schools to offer nutritional classes.

    • Plantstrongdoc M.D.

      The only plant-based I heard about in med school was wine and beer!

  • Robert Haile

    As a physician, first, I avoided eating hospital food myself. Second, I frequently consulted nutritionists to educate patients and myself, so that I could support their message intelligently. Third, I subscribed to nutrition letters, read books and literature on nutrition, and have watched your videos. I think our true understanding of nutrition is still in its infancy stage, and,to a large part, as you note, because it has been ignored mostly by the medical establishment and bowled over by the lies of ‘Big Agro,’ just as the fossil fuel industry is doing with environmental science. Thank you for your efforts.

    • Joseph Gonzales R.D.

      Thank you! Takes a humble doctor with integrity to admit when they are not familiar in a specific area. The fact you even consider consulting a dietitian speaks volumes! We love when doctors appreciate the work of dietitians and understand the importance of nutrition. Without that multidisciplinary team (doctors, nurse, dietitian, PT, etc) and communication our patients may suffer.

    • Mac

      A while back I was looking for a doctor who is knowledgeable in nutrition in my area… could not find one and gave up. It can be
      hard to find this quality because it’s not mentioned anywhere with the credentials.

      Regarding “nutrition is still in its infancy stage”, this type of diet has been taught for thousands of years from the spiritual perspective. From the Christian perspective it’s found in several places, one being the 1st page of Genesis where we are told what our diet is to include, Mohamed ate meat twice in his entire life, the Buddha mentions avoidance of meat and the Hindus have been almost totally vegetarian until this past century. Man is meant to live in harmony with nature and his younger brother the animal, not to torment them, which he does at present – see “Meet your Meat”. Some would call all this disease and sickness karma, an eye for an eye, as you sow so shall you reap. If you want to see the effects of our diet on
      nature, “The Cow Conspiracy” is an eye opener. On health see “Super Juice Me!”, it’s an incredible documentary!

      Physical laws are based on spiritual laws, and bound by law we live for a short time on this earth.

      • Veganrunner

        The Cowspiracy documentary is scary stuff and a must see. I just watched it this last weekend.

    • Want to get a Certification in Clinical Nutrition? Or just come for really good nutrition CME symposium Dr Greger is speaking! http://iaacn.org

    • elsie blanche

      You’ve mentioned in the past the diet of the locals where you live down in Costa Rica. I am wondering how much/what percentage of the locals’ diet consists of fresh raw fruit? There seems to be an abundance of melons, bananas, pineapples, avocados, and many other fresh fruits in C.R. – I get the feeling that it is mostly rice and beans for the locals in your area, a known for life expectancy, but am wondering what role fruit eating plays in this.

      Also, how much fresh raw fruit is a part of your diet, Robert?

      Thank you.

  • Veggie Eric

    Another great video Dr. G! So true… Nutritional education needs to be moved to the forefront in modern medicine. Huge respect to Kaiser for being and early example.

    • Joseph Gonzales R.D.

      Agreed! For anyone interested, here is a great video explaining the work of Kaiser Permanente – the largest U.S. managed care organization that publishes patient education materials. Kaiser has established a very healthful meal plan that could help doctors and their patients! Thanks Veggie Eric

  • Catherine J Frompovich

    Applause, applause, applause! I congratulate Doctor for having the courage to say this to the medical educational system. Doctor’s remarks have been mine since the early 1980s after I finished matriculation in “natural nutrition,” which was nowhere on medicine’s radar screens. I even had an MD who was head of a pediatric facility say to me in the 1980s, “If there were anything to nutrition, don’t you think we would know about it?” That remark tells the sad story of MDs and nutrition. How YOU, dear Dr. Greger, came to such higher consciousness about nutrition truly is amazing considering Med school, and thank you for the courage to buck medicine’s ‘consensus science’ about it.
    Personally, I think your remark in the above video regarding the will to put it [nutrition] into practice, quite frankly, will do away with the need for much of Big Pharma’s products: patented Rx pharmaceuticals–the gold standard of allopathic medicine. When a ‘healing modality’ is based upon man-made, toxic petrochemical patented ‘magic bullets’ instead of the very ingredients humans have evolved with over time, what can we expect for improvement in health and its care?
    Thank you for what you do. I, for one, appreciate you and your work very much.

    • Joseph Gonzales R.D.

      Thank you! Very kind remark. Are you familiar with Kaiser’s work? I mention them in regards to your comment about “what can we expect for improvement in health and its care?” I think Kaiser Permanente is leading the way here! I posted some videos and their meal plan two comment’s below (under Veggie Eric’s comment) if at all interested. Thanks again.

      • I worked for the Permanente Medical Group in Northern California for 30 years. Over the last 8 years I have given 50 CME presentations to Permanente physicians on the values of plant based nutrition and exercise in preventing, stabilizing, reversing and curing type two diabetes, arterial diseases (e.g. blood pressure, coronary artery disease, back disease, sexual dysfunction) and achieving ideal weight. To clarify Kaiser Foundation is the nonprofit organization that teams with the Permanente Medical groups in each region. The Medical groups are separate. It is true that KP as a prepaid organization has always had an interest in preventing chronic conditions. It is also true they have recently introduced some programs involving plant based nutrition and a booklet. There was an article with promise published in the TPMG journal on using diet to treat type 2 diabetes. Unfortunately patient cited as success was still taking oral hypoglycemics… not success by my standards. In my work as Medical Director for Meals for Health, 50% of our participants in Northern California were Kaiser members. In one month our participants were off 80% of their medications… you can view testimonials on http://www.EarthSave.org. Large organizations with the resources they have at their disposal should be dramatically lowering the prevalence of type two diabetes, reducing the amount of medications being taken for chronic conditions including psychiatric medications, eliminating almost all gastric by-pass surgery and stents/by pass surgery and reducing the cost of their insurance. I’m very appreciative of the opportunity afforded to me by the KP program. Most of my colleagues either worked for or still work at KP. They work hard but in aggregate the results fall short of what is possible. We need to stop comparing organizations on how they are doing relative to each other and compare to be the best they can be. The organization that is doing the best job at controlling health care costs is actually Whole Foods Market. (see my article in PEJ entitled “Leading Innovations in Prevention and Cure”). I was fortunate to have had a nutrition course in the 1970’s in medical school but none of that is relevant today. The issue is not only training new professionals but providing education for practicing health care professionals. It is up to medical organizations to create a supportive environment for this to occur. My last visit to Kaiser I noticed the regional poster for Osteoporosis still touting dairy. Of course educational courses are only of value if they provide the best information. Everyone should be spreading the word to health care professionals whether MDs, NPs, PAs, RDs, PTs, NDs, Chiropractors, etc. to tune in to NutritionFacts.org for the latest in science so they can incorporate it into their practices as appropriate and beyond that practice a WFPD personally… better for our health, better for the animals and better for our planet. It is going to take alot of committed well informed folks working effectively to improve the dire straits of today’s medical industry.

        • Jen Drost, PA-C, NF Volunteer

          Well put, Dr. Forrester! :)

        • aprolifer

          My husband and I get our Medicare from Kaiser Mid-Atlantic and I have to say I don’t recognize a relationship except in name between what’s in CA and what’s in Balt-Wash. (One of my sisters gets care from CA Kaiser so I know…)They do give better care to heart disease & Type 2 diabetes and asthma than to their other patients (cancers — that’s what I have — get care once every 3 mos. for 20 min. from an overworked doctor, nothing here but whatever Big Pharma tells them to prescribe) but there’s nothing but hype here regarding preventive care, nutrition education, etc.

    • Granville Airton

      Hear, hear, Ms. Frompovich. You are spot on with your comments. Drs. Greger, McDougall, Ornish, Esselstyn and a number of others are to be congratulated and thanked for their stand in connection with plant based diet with relation to the cure of medical conditions. However, the lack of general medical support for plant based diets, in my opinion, is related predominantly to one reason, money. The medical profession, starting in med school and continuing for the career of the doctors, is brain washed by the drug companies and there is a lot more money to be made by doing bypasses and stents and shuttling the largest number of patients in and out of examination rooms as quickly as possible with a prescription than there is, in the latter case, taking some time trying to convince patients to change their eating habits. In Canada where I live, most of our health care is covered by government supported plans. We have the same epidemic of obesity here that you have in the US and one can only speculate on the amount of money that could be saved if doctors were to be successful in getting even one out of a hundred patients to try diet modification before medications and operations.

      • Bruce Cropley

        Here’s an idea – educate the health insurance industry. They are contributing to the financial support of people who are sick due to their diets, so their profitability could be dramatically improved by improving the average diet of their customers.

  • Anna

    Thank you Dr.Greger for amazing video! I just want to mention case of curiosity – in Italy a judge had to decide between mother and father of a little boy (parents divorced) how they have to feed their child. Mother preferred macrobiotic diet and the father over the weekend would give boy a traditional italian meals – full of animal food – meat and dairy. Mother complained that the boy is sick after he comes back from spending the time with his Dad. The judge ordered Mother that she must give meat to her son at least once a week and the father cannot give his son meat more than twice over the weekend! That makes is it three times per week total. Poor boy – his future health is in hands of the jury !

    • Joseph Gonzales R.D.

      Interesting. Not the first I have heard of food battles between mom and dad and what’s best to feed their kiddo. I feel for the kid in this circumstance. How awful to never know what is “okay” to eat! Not to mention any psychological affects from being in this tug-of-war situation.

  • justme

    Sad to say it seems many docs have a conflict of interest. It’s not as enriching to tell someone to eat veggies as it is to crack open the chest, monitor diabetes meds, or give chemo. Curing doesn’t pay; treating does.

  • Alef1

    Q: Dr. Greger asked: “What might happen if nutritional excellence was taught in medical school?”

    A. If effectively applied, the medical industry, and the doctors who make their living as part of the medical industry, would lose hundreds of billions – perhaps even more than a trillion – dollars in income each year.

    In 2012, the US spent an average of $8,915 per person on health care (really disease care), reaching a total of $2.8 trillion. Even just a 10% reduction in disease in patients resulting from an increase in applied nutritional excellence would result in a loss of 280 BILLION dollars of income to the medical industry. As the resulting potential reduction in disease care costs might seem far greater than 10%, this provides the medical industry, whose bottom line, like any other industry seems profit, with a profound disincentive to supporting effective nutritional approaches, and a profound incentive to dismissing or sidelining them.

    Ethically and morally, doctors suffer from a deep conflict of interest, in that the more they do, and the more expensive procedures they do, the more they get paid. Worse, today many health care decisions now take place on the amoral corporate business level rather than on the human level of the doctor patient relationship. This conflict of interest does not seem a new problem, as George Bernard Shaw pointed out in his “Preface on Doctors” written in 1909(!) for his play, The Doctor’s
    Dilemma. ( https://ebooks.adelaide.edu.au/s/shaw/george_bernard/doctors-dilemma/preface.html ) In my opinion no one has written a more devastatingly accurate – and funny! –
    critique of medical doctors and the ethical and moral problems they face before or
    since.

    • basehitz

      Nailed it.

      • Linda N

        He sure did!

  • Cait

    If it makes anyone feel any better, there is hope for some of our future doctors. My husband is currently attending an osteopathic medical school, and it was one of his professors who turned him on to NutritionFacts.org as a resource for nutrition information. I wonder if there’s a difference between the way that M.D.s and D.O.s are taught about nutrition.

    • Joseph Gonzales R.D.

      I think there is. D.O.’s and N.D.’s seem to put more of an emphasis on nutrition from what I gather. Please tell your husband we are thankful for him and his professor for sharing our website :-)

    • Maggie

      Chiropractors and ND have more nutrition education than DOs or MDs, who’s primary focus is on pharma.
      I attended a Chiropractic conference last year and was quite impressed.
      They provide nutrition education, herbal and vitamin supplements as treatment. I know of more people who have gotten relief under their care after multiple MD and DO did not help them. They are aware of environmental toxins, allergies, parasite infections, as well as the expected skeletal issues.

      My father in law is a DO and knows NOTHING about medical nutrition therapy or nutrition. My biological dentist has his CCN, which is very impressive. This is an additional certification on nutrition.

  • oceanfrontcabin

    We all know doctors need nutrition training in medical school, and not just training about it but training that says it’s important for the prevention and treatment of disease. But how can we have adequate nutrition training when most nutritionists preach the same ol’/same ol’ line of eat less red meat, instead eat more fish and chicken. And eat more fruits and vegetables. Nutritionist teachers need to be properly taught also that a whole foods, no-added-fat plant-based diet is what good nutrition is. Unless someone like Jeff Novick is doing all the teaching, nutritionists are not accurately taught. It’s not just the doctors who are losing out on proper nutrition education.

    • Joseph Gonzales R.D.

      I’m not sure everyone does know that doctors do not receive nutrition training. Perhaps medical schools need a platform first and then we can determine the who should be teaching and what is the best nutrition advice? Good thoughts regardless! Thanks, oceanfrontcabin.

  • VoiceofReason613

    Marvelous video. I urge everyone to forward it widely, especially to doctors and other health professionals.
    How about a demonstration at a medical conference, arguing that medical practice is malpractice if doctors do not inform patients of the negative effects of animal-based diets and the health benefits of plant-based diets.

  • gtrdoc911

    Part of the problem is what Dr. McDougall calls the “diet wars” that are currently being waged. Look at videos by Dr. Peter Attia and other LCHF advocates. These are VERY educated doctors that preach many things that totally contradict what Dr. Greger and others in his camp say. Of course both sides cite scientific studies that support their opinions. So the doctors have to get their house in order and come up with an undisputed consensus. No point teaching the two opposing points of view and just confuse everybody.

    • Linda N

      There is no consensus because, despite what Dr. Gregor is preaching here, NO one diet is right for everyone, period.

      • gtrdoc911

        I agree but can they not definitively decide if saturated fat is healthy or not?

        • Jen Drost, PA-C, NF Volunteer

          This sat fat 4 min video could change your life! :)Buttering up the Public

        • Linda N

          I believe the the answer to that is “it depends”. Some with certain gene snps in the LDL and /or HDL receptors might have to be on a lower or no saturated diet, others may do fine with much higher levels. I also think saturated fat is a bigger problem today than it was eons ago before the massively high levels of chemicals in our food, water, and air. Animals store chemicals in body fat.

          It may also depend how much Omega3 and Omega 6 fatty acids are in one’s diet. And much more.

          The problem with physicians not studying nutrition, and the pharmaceutical companies having convinced everyone that the double blind study is the only gold standard of evidence it that nutrition as a whole does not work that way, and nutrients are not drugs. Their are always the percentage that did not benefit from some drug or some nutrient or dietary change and that has to do with biochemical individuality and the very nature of how nutrients (both macro and micro work/behave in the body.

          • Veganrunner

            Linda-the pharmaceutical company didn’t “convince everyone.” It’s math. If you take a ton of people and divide them into two groups and you blind everyone so there isn’t any bias you have a powerful outcome. When you increase your n you water out the “percentage of people.” They have less value. You would probably enjoy picking up a statistics book.

          • Linda N

            We will have to agree to disagree here. Having taken courses in Functional Medicine from the Institute of Functional medicine, the limitations of the double-blind study were well taught as well as how the Double blind study was designed for drugs not nutrient and more. The limitations should be well known by now. In addition, most medical schools are funded in large part by Big Pharma, thus they control a lot of what is taught there. I invite you to read “The Disease Delusion’ by Jeffrey Bland Ph.D.

        • Jim Felder

          Yes they can. It is unhealthy. But the beef, dairy and egg industries can’t have that or they will go out of business. So they fund studies like the 2010 Siri-Tarino study to try to keep the “controversy” going. Here is a link to a very good analysis of this study that is supposed to be so good at showing that saturated isn’t unhealthy.

          http://plantpositive.com/siri-tarinos-meta-analysis-par/

      • Jim Felder

        But there are definitely diets that are very bad for the vast majority of people. There is no reason to throw the flood gates wide open to any diet just because their isn’t one specific combination of food stuffs that yields optimal health for everybody. There are a small faction of a percent of people with very specific sets of metabolic health problems that will not have optimal health eating a plant centered diet. But study after study shows that whole plant foods promote human health for the vast majority of people, period. That seems like a really good baseline on which to start, don’t you think?

        • Linda N

          I agree with you. And no I was not suggesting the flood gates get thrown wide open. Junk and processed and modern “food stuffs”, as far as I am concerned belong in no one’s diet, period. Plus there are those who cannot tolerate any legumes, and I am one of them. And those who cannot tolerate any grains (and I am also one of them), and those who are violently allergic to nuts and seeds (and I am one of these as well.) And to top it off with me I can tolerate no fruit whatsoever.

          But most (and I will not say all because who am I to know) people would do well to pile that plate with low glycemic veggies and less meat and animal protein, no matter what the food sensitivities or problems. Plants are powerhouses of antioxidants and phytonutrients.

          Since I do not tolerate most sources of plant protein, chicken and eggs do get a place on my plate, although a small one. And I am able to eat most veggies grown above the ground (root veggies harbor much mold for me to even get near them ) and I am able to eat quinoa and buckwheat at this point in time. I am also looking into trying some Amaranth and Kaniwa and hoping to find some other unusual plant foods to add to my seriously limited diet. If there comes a day that I can re-introduce gluten-free steel-cut oats that will be a day of celebration for me as I think with all my food sensitivities, mold, nut and seed allergies, and more, I think I miss oatmeal most of all. God how I loved that stuff!

          • Jim Felder

            My apologies. I was obviously projecting a dietary nihilism that seems very common today.

            And no oatmeal! My heart goes out to you. If it weren’t for oatmeal, I wouldn’t know how to start my day! Here is to hoping that you are able to one day add it back to your diet. Oh, and have you tried Teff? Another one of those grains that few have heard about. It is a staple in Ethiopia. Like quinoa and buckwheat (and oats), it is naturally gluten free.

          • Linda N

            I did try Teff once and the reaction I had was almost life threatening. More research on it revealed that traditional societies used it a lot as a fermented bread. And, in fact, without fermenting it at all, I had the type of reaction I get with fermented foods. Plus I could almost taste the fermentation. Not to belabor the point but on top of all my other food allergies and sensitivities, I have severe histamine intolerance with both critical Diamine oxidase snps homozygous (meaning I got a defective copy of the genes that codes for both Diamine oxidase enzymes both my mother and father. (2 bad copies each) That limits my food choices even more! Many of the foods that are allowed on a low histamine diet, (and the lists also very widely as to which foods are acceptable and which are not) I already could not eat.

            I do plan to try teff again at some point however.

            It’s tough going. I became a nutritionist in self defense! ;/

    • Jen Drost, PA-C, NF Volunteer

      Hi gtrdoc :) (Is that Gator Doc?) Anyway, thanks for your thoughtful comment. Looked at Dr. Attia’s work. Aside from the SuperStarch supplement he sells, his ideas about weight loss looked reasonable. However, I don’t see evidence that LCHF is a health-promoting diet. The science suggests plant-based help people lose weight AND reduce risk of our #1 killer, heart disease. I have yet to see any evidence-based studies that show LCHF will reverse or prevent heart disease. The LCHF diet and weight loss reminds me of one my favorite Cardiology attendings once said, “Sure cocaine will cure a headache…but only use it if you don’t mind having a heart attack.” Here’s one of my favorite pieces that talks about the <a href="convergence of evidence to date Would love to hear your thoughts, especially if you are in the trenches of healthcare with me :)

      • Stewart E.

        Jen, the title of your link is intriguing but I got a message saying there is a bad link. If you could repost it I would be most appreciative.

        Dr Attia advocates a ketogenic diet. I do look at the evidence of any advocacy pretty carefully and find myself skeptical to say the least at such a diet. The formal credentials of any individual is only suggestive of the level of scientific sophistication they might be able bring to any topic. The real issue is the scientific standards used. His scientific standards seem to be missing in action.

        • Jen Drost, PA-C, NF Volunteer

          Thanks, Stewart :)) I am technologically-challenged! Just fixed that link.

      • gtrdoc911

        Hi Jen, “gtr” stands for guitar (my hobby) and I’m a dentist so I do consider myself to be in the “trenches”. Unfortunately I can’t get your link to work. Any other way you can send it? I tried going vegan for 20 days but was losing weight so I’ve reintroduced some meat in my diet. Unlike most people, I struggle with keeping weight on. Intuitively, I believe a plant based diet is best for cardiovascular health but with extremely educated people like Attia promoting saturated fat diets I do find myself very confused.

        • Jen Drost, PA-C, NF Volunteer

          GuitarDoc, you are SO in the trenches with me. Even deeper trenches if they are dental caries, right? :) I, too, have to keep an eye on my total food intake and weight, as I have the same issue as you.

          • gtrdoc911

            Are you vegan? And if so, for how long? What tips do you have for healthy high caloric food so your plate doesn’t look like Everest every dinner?

          • Jen Drost, PA-C, NF Volunteer

            Don’t know if I qualify as “vegan” LOL but I follow a plant-based diet. Been at it for 25 years. I do sometimes have the Everest Plate phenomenon you mention! But mostly, I’ve just added a snack–like hummus + flax crackers or banana + peanut butter or quinoa salad–right after my workout in the AM and a snack mid-afternoon (ack, is that ok for my teeth?!?–I’ve always wanted to ask a dentist this! :) Interesting piece about how eating enough plants will boost our metabolism by 11% which is great but then we might need to make an effort to eat more than we used to. The fabulous Joseph, NF R.D., might have some tips, too.

          • gtrdoc911

            As far as snack being ok for your teeth, totally depends on what your snack is. If it’s sticky, sugary (e.g. most energy bars, any candy, honey. most sports drinks, etc then it’s not good for your teeth). If it’s fruit (not fruit roll ups), nuts .etc.-no problem. And if the snack is sugary but you brush after it, then that’s not a problem either. Did google search of “Joseph. NF” and didn’t come up with anything. Does he have a web site or YT channel?

          • Joseph Gonzales R.D.

            Hey gtrdoc911. This is my website (well, the website I am delighted to work for)! I don’t have much to add, but for high kcal plant-based foods you may try 1) simply eating more throughout the day 2) a few more nuts and seeds 3) a few more olives or avocados 4) lots of whole grains and dried fruits, peas, and beans 5) Smoothies can be a good option. I’d ditch the spirulina in the recipe I shared though 6) tofu, nut butters, and frequent snacking will also help. The idea is not just loading up on high fat foods, but adding more calories from different health supporting foods. Let me know if you have problems with these links I testes Jen’s and they work fine for me. Good luck! Let us know what works?

          • gtrdoc911

            Dr. G, thanks for your helpful response. I’m a dentist who works 6 days a week so frequent snacking can be difficult. But, I have started to put mixed nuts in my office so I can chow down between patients. Any chance the fats found in nuts can be detrimental if over consumed?

          • Joseph Gonzales R.D.

            It could be, depends on how much? Obtaining 1,000 kcals from nuts is pretty easy. A doctor I used to work for joked that cashews are like heroine, you start with one and before you know it you’ve eaten the whole bag! So I am cautious about folks eating too many nuts. Not sure if you’ve seen, but if interested, here is a great video by Dr. Greger that explains the research between nut intake and body weight. Make sure to checkout the bottom of the video’s “Doctors Note” to see more links and information. Lastly, a follow-up to that video is solving the mystery of the missing calories, which explains why nuts, although fatty, do not seem to boost weight gain. What about cut up fruit, veggies or whole grain pita and hummus/baba ganoush, rice cakes with some nut butter and jam? Just throwing out ideas. FYI I am registered dietitian :-)

          • gtrdoc911

            Yes I can certainly do cut up fruit. Hummus- garlic breath!, rice cakes with almond butter-sounds good. Thanks for the suggestions.

          • Joseph Gonzales R.D.

            That’s where your mask comes into play ;-) No problem and best of luck!

          • Jen Drost, PA-C, NF Volunteer

            So glad the fabulous Joseph got to jump in! Sorry didn’t mean to be cryptic! (Meant NutritionFacts Joseph!) Thanks for the explanation about snacking and brushing. I wish you were my dentist! :) See you on the site again soon!

    • Jim Felder

      True there are studies on both sides. But by the same token there are studies on both sides of the climate change issue, just that the number and quality of those two sets of studies is not equal in number or quality. The same is true for diet. One the one hand there are studies like the 2010 Siri-Tarino meta-analysis that purportedly showed that saturated fat didn’t make any difference in the development of heart disease that was weak and poorly constructed. They left out numerous studies that would have shown a clear relationship of saturated fat heart disease, plus the ones they included in the meta-analysis didn’t come to the same conclusions as the Siri-Tarino did. See plant positive’s fine evisceration of this study at his web-site. On the other hand there are many very strong studies, including metabolic ward studies, that show time and again that saturated fat raises blood cholesterol, especially LDL and that LDL is a very clear indicator of the risk of developing heart disease. So yes the “controversy” still rages, but only because those with weak evidence but large financial stakes need for it to. And that includes doctors who have every reason to turn a blind eye to “extreme” diets like WFPB.

      • gtrdoc911

        Thanks for the great response Jim. Still it is a bit odd how Attia claims he is following a LCHF diet yet all his bloodwork remains very healthy. Maybe more longterm his numbers will change or perhaps his extremely intense training regime makes up for the bad diet.

        • Jim Felder

          I would love to see what is “good” numbers are. Do you have a link? And it is worth remembering that what passes as “good” in the US is actually bad from an outcomes basis. A total cholesterol under 200 is still considered “good” by most doctors. But from a CVD rate total cholesterol is only truly good when it is under 150.

          I would be very surprised if Attia has a total cholesterol less than 150 given his meat-centered diet. But even if he is a metabolic one-off and has a physiology that can handle enormous amounts of saturated fat and animal protein without a rise in total cholesterol, the fact remains that in observation of large populations (Framingham, Uganda, China.) CVD rates only drop substantially once total cholesterol is under 150.

          • gtrdoc911

            http://eatingacademy.com/how-low-carb-diet-reduced-my-risk-of-heart-disease. In this article he discusses his bloodwork changes in detail. Please pass on any opinions you may have on this. There are many very bright minds that have totally opposing views to Dr. Greger et al. For the average person seeking good diet advice it can get VERY confusing.

          • Veggie Eric

            I found this video about Peter Attia helpful with regards to his work and subsequent dietary advice. Puts it into perspective.

            ~~~> https://www.youtube.com/watch?v=92TjZa1tC8U

          • Jim Felder

            Very interesting numbers and web-site. As a study with N=1, Attia does make for an interesting case study. It could be his extreme physical regime or it could be his unique personal genome, but likely it was in large measure because he lost a bunch of weight and specifically reduced his percent body fat to a very low percentage that is the primary cause of his improved his numbers. It is well known that your “numbers” get better just by losing weight without any change in diet. But cholesterol, be they small and dense or big and fluffy, HDL, IDP, LDL, or VLDL, is just one indicator of vascular health. Recent work by the Cleveland Clinic that TMAO produced by gut bacteria from dietary carnitine and choline, found only in animal foods, are an even better indicator of cardio-vascular risk than cholesterol level. If that is the case, then he might be at higher rather than lower risk of a cardiac event.

            http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

            But cholesterol, cholesterol ratios, ApoB/ApoA1 ratios and the rest are indirect indicators of cardiac risk. Since Dr. Attia is all about the testing, I would be more convinced of his claim of improved cardiovascular health if he had had before and after direct measurements of arterial health, such as carotid intima-media thickness.

            http://nutritionfacts.org/video/arteries-of-vegans-vs-runners/.

            or brachial artery tests that show that his diet improved the health of the endothelial lining of his arteries.

            http://nutritionfacts.org/video/the-power-of-no/

            Even better would be if he had a before and after SPECT scan which can actually directly measure the perfusion of blood into the heart muscle.

            http://nutritionfacts.org/video/low-carb-diets-and-coronary-blood-flow/

            This study in reviewed in this video was very definitive; those on a low carb diet had significant
            deterioration in blood flow to the heart, while those with on a
            plant-based diet saw an improvement in blood flow. Dr. Attia would have
            to explain why his low carb diet is different than the diet followed by
            the low-carbers in this study.

            The bottom line is that Attia’s cholesterol numbers are great, but does this translate to improved vascular health? Don’t know. Maybe he will get one or more of these test so we can see. Until then I will continue to give a lot more weight to studies with more than one person and those studies pretty clearly show that a low carb diet is damaging to ones health regardless of how much weight one loses.

            And all of this completely ignores all other disease pathways which are known to be effected by diet. So in addition to cholesterol (or ApoA1/ApoB ratio), I would need to see what his circulating levels of IGF-1 and IGF-1 binding protein and other measures effecting promotion of cancer (the second leading cause of premature death in America). Perhaps the good doctor could have some of his blood dripped onto some prostate cancer cells to see how they effect their growth rate to see if he is making his body more or less hospitable to cancer.

            http://nutritionfacts.org/video/developing-an-ex-vivo-cancer-proliferation-bioassay/ (+ the next several videos in this series)

            But even if all of these tests showed improvement, does the example of Dr. Attia provide good guidance for the average person. I am not sure. It sounds like he keeps the amount of fresh fruits and especially
            non-starchy vegetables in his diet pretty high. If this is a key feature of his diet (as it almost certainly would be to get the high levels of anti-oxidants and other phytonutrients needed to off-set all the known damaging
            effects of animal based foods) then it would be very hard for the
            average person to adopt his diet. He also exercises several hours a day. Again if this is what it takes to ward off the damaging effects of saturated fat, animal protein and environmental toxins that come in with the meat, then I don’t see that Dr. Attia and his diet and exercise program have much applicability to the average person.

            Instead what I fear would happen is that people will see Dr. Attia with his slim well muscled body and only hear the part about eating all the meat and fat you want while still losing weight and completely ignore the parts about having to eat large volumes of non-starchy and low-GI fruit and vegetables and work out for hours every day. As a result people with think they are following his diet/lifestyle, but actually aren’t and will get sicker (and very likely fatter) at an even faster pace than they already are.

          • gtrdoc911

            Jim, where did you pick up your nutritional knowledge? You sure know your stuff. Attia’s case is very intriguing. Did you see his pictures when he was eating high carbs? He was swimming 4 hrs per day but he was quite chubby. Personally I tried vegan for 20 days but was losing too much weight. I’ve always been very lean. So I’ve introduced meat back into my diet but continue to eat lots of fruits and vegetables.

          • Jim Felder

            I use nutritionfact.org as a central resource for relevant nutritional information. I have also read a number of books on nutrition, not textbooks, but for a more general audience. The China Study was my initial entry point

            But I really gained a lot of knowledge about the specious claims of the low-carb advocates such as Dr. Attia from working my way through the hours and hours of videos posted by a video blogger who goes by the nom de plume of Plant Positive. He has one of the sharpest minds I have ever encountered. He maintains a website (http://plantpositive.com/) as well as a YouTube channel. His approach is to examine the claims of folks like Dr. Attia who say that a low-carb diet is not only not bad for you, but actually health promoting. He does it by using their own words, especially errors of logic. He also uses the sources they cite in support of these claims and shows how their sources do not support what they are claiming, the methodological flaws or straight up biases in those studies, or where those studies stand in opposition to other much stronger studies. He has a series of videos specifically about Dr. Attia and his claims (The second half of the Drivers of the Herd playlist) as well as an examination of Attia’s parter in NuSci, Gary Taubes (the first 16 videos of the Nutrition Past and Future playlist). I highly recommend watching these video.

            And let me congratulate you on giving a plant-based diet a try. Most people will dismiss it out of hand. With respect to losing weight, my suspicion is that you didn’t add enough plant-based calories to replace those of the animal foods you removed. It is a issue that many have at first. We have been trained by a life-time of eating to consider fruits and vegetables as side-dishes, so it is difficult to convince ourselves to eat the large volumes of whole plant-foods necessary to get the necessary calories to maintain weight. This is especially the case when we fully embrace the recommendations and also remove the other hyper-concentrated calorie sources of refined sugars and refined oils. But it is possible. People have maintained healthy weight on diets with 90+% of calories from plants for thousands of years. Those diets obtain most of their calories from starches; rice, legumes, wheat, potatoes, etc. with small additions of nuts and seeds. What really isn’t possible is to maintain weight while eating mostly non-starchy vegetables and fruit (which is a good thing for the majority of people who desperately need to lose weight).

            So maybe you might try it again someday, but just focus on keeping your diet isocaloric. And if not, you are still doing your health a good turn by focusing on the plant foods and treating the animal foods as flavorings and condiments, like a couple strips of bacon to flavor pot of beans, or a few crumbles of feta on a salad. But if animal foods return to the middle of the plate and serve as the source of the majority of your calories, I think you will undo not all, but perhaps most of the good that you are doing by eating lots of fruits and vegetables.

          • gtrdoc911

            Thanks Jim. Once again you make excellent points. I had come across PlantPositive on YT before but his belittling, sarcastic attitude really turned me off. But if you say he speaks the truth, I’ll try to overlook that and give him another try. As Dr. Fuhrman recommends, I’ll try to keep meat as a condiment. Good day.

    • Veggie Eric

      I wouldn’t put too much stock in what Pete Attia claims. He outsourced his research to Gary Taubes and in the video below Plant-Positive shows were Attia purposely misrepresents his finding. if you are interested in the truth, then to be fair Peter Attia needs to be looked at with a critical eye. I admire his enthusiasm but he is being paid to promote a pro-fat diet to sell books and supplements like so many others. Not a good source for diet/health information. I would stick to what the Good Dr Greger promotes here on this site.

      This is a great video by Plant-Positive that talks directly to the issues I have with Peter Attia and his work, Hope this can help shed some light. Take care.

      ~~> https://www.youtube.com/watch?v=92TjZa1tC8U

  • 7in1

    The Biggest Cause of Death (in the world) seems to be the US Federal Reserve System.

  • basehitz

    I share the concern many expressed about money driving much of the accepted “wisdom” of the industry. Even if medical practitioners want to do the right thing, they are forced by medical “authorities” to follow said “wisdom” or risk their license and even imprisonment. The real sociopaths IMO are the moneyed interests. I’d look at Big Pharma first as the root cause of the problem.

    On the bright side though, I have the individual option of choosing what I will do personally. Since I began educating myself on nutritional science and putting this into practice, the improvement in my health is stunning. I thank Dr Greger and others who help us take charge of our own healthcare.

  • metrov

    A few years ago, I came across an article claiming that most medical schools were built, and are still financed by Big Pharma. If true, this would explain much, perhaps?

    • Jim Felder

      Don’t know about actually building medical schools, but they certainly supply the intellectual content. Dr. Campbell in the China Study talks about Big Pharma providing the text books used in medical schools free of charge. And you could knock me over with a feather if it turns out that those textbooks recommend prescribing drugs as a first line of treatment without nary a mention of lifestyle modifications other than in vague general terms (“exercise regularly and eat a moderate diet” whatever the hell that means).

      • Kim

        For a look at specifically how Big Pharma’s molded current perspectives on mental illness, see Whitaker’s Anatomy of an Epidemic. He makes the case that long term outcomes are worse for people who are medicated vs. those not, and that there’s zero evidence to back up the idea that mental illnesses have any kind of biological basis. He talks about the control over what ends up in textbooks as well, the “seducing” of academics with payment of consulting fees, payment for giving lectures, etc.

  • elfel

    But of course the pharmaceutical industry would object! They might be cut out if you’re looking for cures.

    • Wade Patton

      Big Pharm is intertwined with Big Chem and thus with Big Oil and also to Big Food, and anything with Big Money is deeply hooked into the those who rule their countries (poor people have never established armies and countries and rules of law and incorporation).

      Gets really tricky out there.

  • Mary Ann

    On the Holisitic Holiday Cruise in March 2015, I had the pleasure of meeting 3 young doctors – just having completed medical school within the last 5 years or less. When I asked each of them, separately, how much education they received on nutrition and/or diet, each one said “ZERO”!. When I asked how much education they received on pharmaceuticals, they said 4 semesters! don’t know why I was surprised. Just “follow the money”!

    • Joseph Gonzales R.D.

      You’ll make a great doctor, Dr. Mary Ann! Best of luck and how great you participated in the Holistic Holiday Cruise!

  • allen cohen

    I am a cancer researcher, and everything I have seen tells me you are 100 % correct about plant based nutrition. However, modern medicine is about a profit, I am sorry to say. How long would a physician stay in business, if 90 % of his patents whom came in complaining of a problem, were told change your diet ! Most of the patients would most likely state aren’t you going to give me a prescription ? In my opinion most patients are going to say why did I go to the doctor if all he could tell me was change my diet. I could have figured that out by myself and not pay for an office visit. I wish I was wrong about the above, however, I am afraid not.

    • Joseph Gonzales R.D.

      Scary stuff. Thanks for posting this and being honest about the industry you work for. I too have some experience in cancer research. I find it difficult that even with the newer inclusion of integrative cancer centers, patients might still need referrals from their GP and often insurance will not reimburse for lifestyle medicine. Perhaps it is getting better? I think many insurances cover acupuncture for cancer, as significant findings for reducing and/or eliminating xerostomia with acupuncture has been documented. I wrote more about my experience with MD Anderson Cancer Center and added links to some of the resources we used in our comprehensive lifestyle changes study. Check out more if interested, here. I worked closely with stage 3 breast cancer survivors in this study.

      Keep up the good work! At least some doctors like you exist. Gives me hope that we may be a better path in the future, especially for cancer research. Dr. Lorenzo Cohen is making important strides in the field I highly suggest looking into his work if you do not already know of him.

      Best,
      Joseph

    • Wade Patton

      Expand your analysis of the visit. Doc finds patient in “normal” situation after 40 years of SAD. Doc gives two options:

      A. I can cut you open and rework the circulatory plumbing for a 100k or so and you might not survive the procedure, will never recover fully, and will need lots of Rx. Will likely have repeat events/surgeries.

      B. You can learn how to eat right and clear up this mess yourself.

      Some might chose plan B. I have, albeit before things got out of hand, and without any direct physician contact and with my own self-education (thanks to many-Greger is on that list!).

      Doctors needn’t lose money, when they can serve patients in this way, they can manage much larger practices and some folks aren’t going to do ANYthing for themselves anyway.

      Tipping Point is out there. Hope we see it. Humanity needs it.

    • Kim

      I think this is part of the problem, for sure. It’s not just the pharmaceutical industry’s desire for profit or doctors’ desire for prestige, their pride at the “sophistication” of the nature of their work, etc. The problem is with what patients demand, too. Many patients want special pills and surgeries to make everything better, and they have more confidence in that than the power of lifestyle changes, even though it’s lifestyle change that has solid backing!

      I’ve got mental health on the brain lately (see my other comments on here), and I think the problem exists there, too. I’ve tried sharing Greger’s antidepressant video, the one showing that there’s no clinically significant difference between them and placebo, to people suffering from mental health issues, with little warm reception. People are convinced that they need their drugs, that the drugs help them. The evidence simply does not support this.

  • SeedyCharacter

    I wonder if anyone has heard about patients having heart attacks, subsequently learning about the efficacy of reversing heart disease with diet, and then suing doctors for malpractice? If the science is solid (which it appears to be, overwhelmingly), then it seems patients could win lawsuits claiming their doctors did not inform them of effective, science-based nutritional approaches as complements or alternatives to medications, surgeries, etc. In other words, a breach of informed consent.

    This could apply to type 2 diabetics. To people who take statins and develop serious side effects such as rhabdomyolysis, to people with osteopenia who are never tested for vitamin D levels, etc And on and on . . .

    • Wade Patton

      The courts wouldn’t let this floodgate open. And the defense is that he/she was doing as the rest of his field was doing. That is why the nutritionally astute doctors are “testing the waters” for who gets sued. Things change slow, law changes slower.

      Never forget that anyone can sue anyone else for anything. Prevailing and having the finding/award withstand appeal and the never-publicized remittitur (reduction in award amount) is key.

      • SeedyCharacter

        Thanks so much, Wade. This all makes sense. I know doctors are under huge pressure to use the “big guns” treatments in order to avoid lawsuits. Resulting in high C-section rates and a plethora of other interventionist, “defense” medical procedures. If it weren’t for the specter of antibiotic resistant bacteria, too many docs would still be prescribing antibiotics for colds and other viruses. (I recently got letter from my health plan explaining that antibiotics don’t work on viruses and to therefore not request them from my physician.)

        • Wade Patton

          Quite welcomed. On the antibiotics. Those who have been listening have been hearing that fact for what ~30 years? And it just now gets out there to the insurance folks? Oh it’s costing them/us money?

          But without going down that ranty path, I wanted to say that I now realize that the Meat Factories are where the real antibiotic development “labs” are, from Dr. Greger speaking to this subject…

          [cannot find that video, found all others. In one of his annual talks he explains how meat factories reproduce the conditions of the trenches in WWI that brought us the first pandemic which killed about 25% of Americans (anyone know where it is?)]

          THAT in itself is a fantastic reason to reduce meat factory product consumption. I’m not your “animal rights” sort, but that issue has world health on a very thin bit of ice. Hope we get some better practices and controls before we depopulate the planet.

          • Jen Drost, PA-C, NF Volunteer

            Hi Wade :) Well, I couldn’t resist jumping in to my favorite game of “Name that Dr. G. video!” Here’s the one you mentioned about bird flu and antibiotics The point you mention starts about minute 37:00.

          • Jen Drost, PA-C, NF Volunteer

            And another more recent daily Dr. G. video here about the effects on humans from antibiotics given for preventive purposes to farm animals. Happy viewing! :)

          • Wade Patton

            thanks Jen!

  • Lucypi

    Although I understand the point that physicians might think they would not survive financially if they recommended a plant-based diet to their patients to avoid and treat chronic health issues, physicians think their own health and the health of their families and friends is vitally important, so I cannot imagine they would withhold nutrition advice for themselves and their inner circle. They must lack the knowledge. Few would be apt to treat with nutrition in a clandestine manner for one set of people and adhere to the usual practices for most others with the idea of benefiting monetarily.

    • Jim Felder

      Actually Dr. Esselstyn mentions in his book “Prevent and Reverse Heart Disease” that the big muckity-mucks at the Cleveland Clinic went to him as well as sending family members to learn how to actually treat rather than spackle over their heart disease. But these same folks in policy making positions didn’t (at least at the time) publicly espouse what they privately embraced.

  • Sidney

    LOL. One of my IM attendings didn’t even know about the benefits of green smoothies; he looked at me in amazement when I told him I drink a smoothie with all sorts of superfoods he hadn’t even heard about. My chief resident in IM would eat a big burger every call night. I didn’t say anything, as I learned a long time ago to not rock the boat. Perhaps they don’t talk about nutrition because if everyone got healthy then who would do all the caths and other money making interventional procedures?

    • Linda N

      I love green smoothies! As someone who has serious snps in the methyl cycle, and has just been recently diagnosed with histamine intolerance (Both genes for critical Diamine oxidase enzymes that breakdown exogenous (food etc.) histamine are homozygous! (very bad!) I think before knowing about this recent addition to my health woes, drinking green smoothies daily (but with no powders or anything, just real fresh greens and veggies (cannot tolerate any fruit at all) probably saved my life due to the antioxidant and antiinflammatory properties and nutrients contained within. Green smoothies are tops!

  • SpikesDad11

    Brilliant presentation of one of the biggest problems with our health system. I wonder if this is the case in other countries? Or, more specifically, are there other country’s systems that we could use as a model?

    • Joseph Gonzales R.D.

      I think Dr. Greger touches on this in his video Uprooting the Leading Causes of Death. He shares statistic on our healthcare system and where it ranks in the world if I remember correctly. Certainly countries that spend less money on healthcare and have less hospital visits and illnesses could set the example for our country. We know cancer rates are lower in India. Hopefully more folks can offer some insight here on statistics from other countries.

  • Gregory Overcashier

    Students today go to medical school for one reason, to make lots of money. There is no money in healthy patients. Once a society has accepted and embraced profiting off the sick, the society and it’s population are morally bankrupt. I take care of my 86 year old mother and witness the medical industrial complex regularly. More is never enough in health care when it comes to profit. If you don’t get that watching this video then you are in denial.

  • Rebecca McDowell PA-C

    I find, in clinical practice, my patients would rather take s pill than change their diet. When told they must loose weight, they come back with “Easy for you to say, you’re skinny.”
    RIGHT! Because I’m VEGAN!
    Rebecca McDowell PA-C

    • Joseph Gonzales R.D.

      So wonderful you educate patients about nutrition! Do you have any resources you’ve found useful? Have you ever tried an “addition” approach? Not sure it’s best for for those stubborn to change, I attempt to ease the dietary transition by simply telling patients to “NOT change their diet, take nothing away, but add some fibrous foods.” Simple as that. Make a list of tasty fibrous foods and add them to your existing diet. An extra apple per day, a half an apple, whatever it is, the idea is a positive mindset, not overbearing, and achievable results. I’ve found folks start eating more health supporting foods and the health depleting foods naturally come down. Anyway, forgive the rant. I have many resources if ever interested. Everything is free and just ideas to help patients. Thank goodness for Doctor’s like you!

      Best wishes,
      Joseph

    • Jim Felder

      There are so many voices in people’s ear these days saying what they should and should not eat and what is the “best diet” (all focusing on just losing weight as opposed to being healthy AND losing weight) that people are just confused. Like anybody with information overload, people tend to latch onto tradition, something that a family member of friend does, or a diet which lets them feel good without having to give up any of their favorite foods (eat all the bacon and ice cream you want and still lose 20 pounds!!). To make a difference, I think doctors have to out compete and perhaps simply out shout all those other voices. Some have criticized Dr. Caldwell Esselstyn for the zeal with which he approach counseling patients enrolled in his clinical trials. And perhaps in today’s environment that such an approach may be necessary to be heard over the din.

      I am wondering, do you ever write a actual physical prescription for a WFPB as a “therapeutic diet”? And if you do, do you approach it with the same sit them down, look them straight in the eyes, take these as directed or else, deadly seriousness that you would if you were putting a patient on a whole spectrum of powerful drugs? To me that is what a WFPB diet is, just as if not more therapeutic and powerful drugs.

      Plus injured/ill patients are often referred to a physical or occupational therapist to help them stop doing what was causing the injury and/or give their body a break so it can heal. So perhaps a second prescription should be written to send them to someone(s) who is a combination of a R.D. and a cooking instructor/coach so that they are shown how to regain their ability to cook tasty satisfying meal within the “limitations” of the therapeutic diet. Might be a lot to find in one person, so might have to be a team effort.

  • Linda N

    Once again, “plant-based” is not equal to “plant only”. One does not need to eat a plant-only diet to eat a healthy diet. Plus a cholesterol of 150 or less is ludicrous. Having said that, the video is right on. Medical education provides no training in nutrition which absolutely is the key to avoiding most chronic diseases. MD’s are woefully ignorant of nutrition. While another poster said that the patients are just as ill informed about nutrition, (and I have to agree there), they are not the one’s tasked with giving out nutrition advice to sick people, MD’s are.

    • Tim

      What is ludicrous about 150? It took 2years eating this way and I’m down to 138 :-)

    • Veganrunner

      Hi Linda. I have the same question as Tim. Why is 150 ludicrous?

    • Claudio

      Same for me, cholesterol dropped from 185 to 153 in 18 months, < 150 expected very soon :-) with plants only (vegan diet)

      • Linda N
        • Claudio

          I wouldn’t rely on those studies, they are not supported by “real life” (e.g. hemorragy is not more frequent in vegans, depression is even less frequent). Maybe the sampling was not correct: imagine for example that a type of cancer lowers cholesterol and you take 100 random people with low cholesterol for your study (including many with this cancer), you may conclude that low cholesterol is correlated with cancer but in reality it is the effect not the cause.

          • Linda N

            To each his own. I would be frightened if my cholesterol was 150 or below. I know what cholesterol is necessary for in the body and having a cholesterol that low would absolutely terrify me. The idea that the lower the better for cholesterol is not what my research over the years says to me. There is definitely such things as both too high and too low cholesterol, and if someone has too high a cholesterol count one looks for the reasons behind it; inflammation, infection, hormone imbalance etc. For the record, I do not have a paleo slant. Nor do I have a vegan slant. I have a whole organic natural foods view that is moderate in scope.

          • Jim Felder

            Healthy human babies are born with a LDL cholesterol of around 70 +/- 24 with a total around 158 +/- 44 (http://www.ncbi.nlm.nih.gov/pubmed/11142836). That is a pretty clear indicator we can be healthy with cholesterol levels at or below 150 total and 70 LDL. There are large populations that have total cholesterol levels that average less than 150 and they have some of the lowest chronic disease rates in the world. Dr. Esslestyn only saw regression of cardiac plaques when total cholesterol was under 150. Other researchers have also noted that CVD only occurs in their subjects that had total cholesterol greater than 150.

            In the wild Chimpanzees, our closest relative, has an LDL cholesterol level in adults of around 70 (having trouble finding a citation for this, but I remember reading it previously. Can anybody help me out?).

            It would seem that a total cholesterol of 150 or lower and an LDL of 70 or lower is necessary to maximize your chances to avoid cardio vascular disease and even to reverse the CVD that we already have.

            There once was some concern with low cholesterol levels because of a correlation was found with some cancer to low cholesterol levels. This turned out to be a case of reverse causation. It isn’t low cholesterol that causes cancer, but cancer that causes low cholesterol.

            Hopefully that helps to allay your fears.

    • Joseph Gonzales R.D.

      Thanks for your comment! You may find this video on “flexitarian” diets useful, as it seems you are right and one doesn’t need to go fully plant-based to reap the benefits. I may argue many folks choose to be very strict with their diet when they are diagnosed with a life threatening disease. The choice is of course always up to the patient, but how great is it when their MD gives them the choice, backed by scientific evidence? Let’s hope this becomes the norm in the future! Dr. Greger discusses optimal cholesterol levels here, if interested.

  • Nelson

    It seems to me then that ‘the world’s leading killer’ are medical schools

  • Kevin MacArgel

    Dear Dr. Gregor,
    You have just become one of my favorite Doctors on the planet ……………..you simply laid out the truth…………and although you may not leave this place as the Doctor with the most wealth ……………doing this kind of thing with spreading the truth will have you leaving here knowing you made a real change , and contributed to your fellow human beings in a tremendously positive way. That sir is our true purpose in life as it opens the door to have the greatest of all the treasures one could ever wish for behind it ………..JOY, LOVE, PEACE, and of course HEALTH.
    Thank You Dr. Gregor
    Kevin MacArgel

  • Alexandroc Sofokleoyc

    I wanted to apologize for my recent Fb comments, however they were only intended as a tactic to neutralize fear. I don’t know if they worked. I don’t know when we’re going to have the freedom of expression to find the courage and say: “hey, the education system appears to be rigged by the government, creating a future labor force and not really a useful member of society”.
    maybe there isn’t any need for it. If the education system had worked to benefit society, there wouldn’t be any need to come on the internet and look up information.
    I’ve had my serious health problems. Did the education system come and knock on my door to offer any help, no. Did any of my school mates, no. They’re too busy at some stupid job that pays them money. And that’s just where I live. I can’t imagine what could be happening across the world in the United states. I guess playing monopoly has become more important than actually caring for each other in any society. It’s not that humans are greedy. We’ve been misdirected to fear one another with great success and I don’t know how long it has been going on. What I know, is that in that movie, “Jesus of Nazareth” he furiously stormed into the priest temple where people were hoarding, trading, and conducting the same crime that goes on today, smashing up the place. I don’t remember any other time when Jesus became more angry than he did around money. Leading cause of death? Banking, and everything that comes out of it.

    • Tim

      Not banking, capitalism.

  • Claudio

    Is Hippocratic Oath still used? Hippocrates said “Let food be thy medicine and medicine be thy food”… nothing of this principle is in today’s medicine

  • Claudio

    Is Hippocrating Oath still used? Hippocrates said “Let food be thy medicine and medicine be thy food”… nothing of this principle is in today’s medicine

  • RayT

    There no money in learning about nutrition.
    The medical system is not about making you well, but to extract maximum profit.

  • Sylvia Boecker

    I have heard Dr. Greger speak on the MSC Divina, have heard all the other plant based doctors speak, have heard Dr. Michael Eades speak (he advocates high protein, low carbs) and they all say doctors get no education on nutrition.
    With all the diets available, what on earth would doctors be taught or learn about nutrition in medical school? Would they learn high fat, low carb, Mediterranean, macrobiotic, vegan, plant based, vegetarian, Atkins?
    That is my question. If nutrition were to be taught, what would be taught?

    • 2tsaybow

      Right, all very confusing. But it isn’t really is it; the science is pretty clear. A diet focusing on plant foods and low in animal products is the most healthy one. A diet high in fiber and low in processed food is the most healthy one. A whole food plant based diet is the most healthy. You can have a bit of face every once in a while if you need to, but it isn’t necessary.
      Actually, this way of eating is the best for all of us and the best for the planet as well.

    • Joseph Gonzales R.D.

      Important question! Actually, Kaiser Permanente – the largest U.S. managed care organization that publishes patient education materials, is leading the pack in the field of nutrition and doctor education. Here is a great video explaining the work of Kaiser. Kaiser has established a very healthful meal plan that could help doctors.

    • Jim Felder

      The one supported by the preponderance of the the evidence. One only need to look at the huge number of studies cites in videos on every facet of human nutrition presented on this site to know which dietary pattern that is.

      Perhaps a dietary “congress” could be convened by the National Academy of Sciences that brought together the leading proponents of the different diets and they could present the scientific results that support their dietary claims. A panel of nutritional and biochemical researchers might serve as a panel of judges. It would be important that none of the judges have financial ties to specific food industries or financially profit from any of the particular diets. The criteria for judging a given diet would not be whether the judges think people would adopt it or not, or whether they themselves would eat it. The only criteria for judging would be the degree to which proponents can show in the peer reviewed literature that their diet promote human health and avoids and/or cure human illnesses.

      The presentation of the benefits of a plant-based diet are already literally in the can. The three one-hour presentations by Dr. Greger “Uprooting the Leading Causes of Death”. “More Than an Apple”, and “Table to Able” are an excellent synopsis of the benefits of a plant-based diet based on actual science.

      Also allowed would be rebuttal presentation by detractors of a given diet who can try to show, again only using peer reviewed research, why the promoters of a given diet have it all wrong. And there too a plant-based diet has its rebuttal in the can with the videos by Plant Positive with regard at least to Paleo, Low-Carb, Wheat Belly/Brain and the “Butter is God” folks like the Weston Price. The trick would be to get Plant Positive to come out of the shadows to make the presentations. Perhaps the Diet Congress would accept audio-only Web based presentations so he could keep his anonymity and keep the focus on the science and the facts. The trick there will be to convince him to not take 36 hours to do so ;-)

  • Emily Blanchard West

    Two weeks ago I had a rheumatologist tell me that diet could not reduce inflammation. sigh….

    • Charzie

      Right, and ten years ago mine told me the same, and that I needed to schedule knee replacement surgery. She actually told me that thinking that diet would resolve my issues was about the same as wishing upon a star! Ha, after switching to a WFPB diet when I was diagnosed with diabetes, apparently it was just “coincidence” or wishful thinking that the diabetes resolved (along with a whole slew of other health issues), and my knees improved so much I am now doing 5 miles on a recumbent trike instead of using an electric cart to just get around! If it weren’t for the internet, REAL caring doctors, and sites like this, I would have never got the info I desperately needed from any conventional doctor!

    • Joseph Gonzales R.D.

      Well that is unfortunate. I would suggest politely saying something like “that is so interesting because I have been reading about auto-immune diseases and diet and I did come across some research. What do you think of research study A, B, and/or C? Do you think I could try diet as an avenue even if this research is not 100% conclusive? I would love to get your take!”

      Anyway, that is frustrating to say the least. Hopefully your next visit goes smoother.

      Best,
      Joseph

  • guest

    Many patients choose not to follow diets even when given them to maintain a healthy lifestyle, so I don’t think it’s completely fair to argue that because of lack of training people are dying of heart diseases related to nutrition. Yes, better training would help doctors make informed decisions, but it takes a willing patient to make the change or better nutrition education to the general population not just medical schools..

    • Wade Patton

      Part of that is that “WORD” hasn’t gotten out that “diets” don’t have to calorie restrictive and otherwise miserable, because that’s all they know-calorie restriction and misery from “doctor’s orders diets”/common ignorance nutrition. They (docs and the public) don’t really have any exposure to what tasty joy eating can be without animal products (and super processing) and without the counting and sizing of every portion (for some negligible, short-term result!).

      They just don’t know, haven’t experienced it. Everyone resists change-at first. Eat well, be well, spread the Joy.

    • Joseph Gonzales R.D.

      Agreed, but patients must be informed so they can make the decision. So many doctors assume their patients won’t change and I do not think that is their decision to make.

  • Marilyn

    MDs just hate me for the past 30 years. Complimentary medicine is the best of both worlds. If med schools taught nutrition, the patient and the doc could work together, but unfortunately, medical arrogance prevents healing vs treatment. The drug perk$ help of course to keep the good and well intentioned me in the big Pharma realm and not go outside the box. Nutrition education should be started in grade school so that it’s just part of life, like basic math skills. But someone like me – as a holistic practitioner – continually goes up against adversity with the primary goal of assisting humanity return to health, only to get continually criticized for offering high density food. It’s so crazy but the powers of be want control and money and THAT is the bottom line. Everything is opposite. Time to educate the doctors and rebuild a productive and thriving society for our kids innovations vs the continued growth of sickness and disease. MDs, please let people like me assist humanity’s return to health as well…

  • Ray Tajoma

    Asking Doctors to prescribe fruit instead of surgery and drugs is like asking Car mechanics to advise drivers not to pour water in their gas tank. That’s not their job and there is a huge conflict of interest. Car mechanics make a living fixing broken cars.

    Health Insurance companies should be in charge of advising patients because both patients and insurance companies have common interest to keep patients in optimum health at minimum cost. Hospitals, doctors and nurses want the opposite – without sick patients they go out of business and they should never be trusted for this reason.

  • shirleycolee

    It’s just not lucrative to tell your patient “Eat wisely, exercise and stay away from alcohol and tobacco.” Chronic illnesses from poor lifestyle choices are the bread and butter of the medical profession.

    • Wade Patton

      Has been proven that the medical field is not trained (some videos here on that fact) to even know what “eating wisely” is, much less the patient. And smart folks would shift their enterprise if all of the sudden everyone was cured (by actually eating healthy).

  • shirleycolee

    I think most educated folks have at least seen the comparisons on the Seventh Day Adventists to the rest of the general American population as an example of longevity and minimal diseases as a result of a certain diet.

  • julie

    I have been plant-based for the past 2 years and gluten intolerant. I regularly work in the ICU as a physical therapist and see patients that are on enteral feeding either thru a PEG line or a nasogastric line.

    I also spent time in a Haiti hospital where I saw a stroke patient being feed thru a nasogastric line. However, instead of the “North American brown feeding formula (I suspect being quite far from plant-based and probably containing gluten and milk proteins), the family would put soup or mashed bananas in the tube. At first, I thought this was just terrible! But them, I started to question myself. If I was in a major accident with a head injury and required enteral nutrition, would I want to be fed with the formula or would I want instead to have my Vitamix in the ICU and being fed a plant-based ,balanced protein/fat/sugar green smoothie that would be alkaline forming and anti-inflammatory to help decrease my brain edema?

    The answer is clear for me but I am 100% sure it would be a huge fight with the medical team, considering that the dieticians in our hospital still drink their glass of milk every day at lunch. We are far from acceptance of a “plant-based” enteral nutrition.

    Anything in the literature on this toping? If not, it would be such an interesting toping to study: rate and quality of recovery and inflammatory markers of neurologically injured pts – plant-based vs traditional enteral feeding.

  • Jemeniano

    Well, this is Great!!!

  • this video is too long

  • Charzie

    I went to the doctor with my sick and diabetic ex, who refuses to make the connection or take responsibility for what he shovels into his body, and has been going downhill, quite alarmingly. Since his strategy seems to be… wait for disturbing symptoms and run to the doctor to “fix” it…like so many people, I was hoping she could stress that improving his diet would improve his health, since he has such high regard for whatever she has to say. Her response? “Everyone knows they should eat better, but telling them does nothing”! I almost fell off my chair.

  • timn

    Are there any recommendations on how to find a doctor who keeps up to date with nutrition and/or supports a plant based diet? I have been quite frustrated by our family doctors and would like to know how to locate a diet educated GP in New Hampshire.

  • Robert Payne

    Wonderful presentation. Dear Dr. Mc said failure to offer meaningful nutritional therapy is medical malpractice. I agree and filed a Criminal Medical Malpractice Complaint against the Charleston SC Veterans Affairs Medical Center with the state. This is a simple one page document which can be filed in each state against each hospital that treats vice cures. I don’t know how this will turn out but it will certainly get some attention.

  • Marko Mkd

    Doctors should have some math knowledge in order to be able to read statistics. And physics and chemistry in order to know how particles interact. Yet this is no excuse for the lack of nutrition courses taken by the future doctors.

  • kev

    Of course if this was implemented it would cost the pharmaceutical companies a lot of money.

    As far as Doctors not promoting nutrition to their patient, I don’t know if its (1) vested interest, (2) pride or (3)ignorance that is the cause of this.
    (1) do they get kickbacks form the the drug companies?
    (2) given they have spent years learning their profession and maybe they don’t want people to be able to heal themselves, that would take away some of their importance perhaps.
    (3) as Dr Greger says, they are not educated in nutrition and so they simply do not know how important it is.

    I once asked an Arthritis Specialist about diet to treat the disease, and he said “diets are a load of sh*t!!! I found his response rather surprising and even more so when I later discovered one of his patients who was almost crippled, had a miraculous recovery after changing his diet.

  • FrankR

    Are the hospital dietitians any better? The things I see persons in hospitals rooms and cafeterias do cause me to worry.

  • Rui Nunes

    Give Dr Greger and his team the … Nobel prize in healthcare …..

  • John Axsom

    Another course that medical students are never taught is how to induce the placebo effect into their patients to get the body to heal itself. Oh yes, of course, everyone knows that medical students are taught about the placebo effect…..but they are not taught how to INDUCE the placebo effect with an array of many techniques. Ancient Greek doctors have been noted in history of actually healing broken bones in just a 24 hour period. We don’t know the exact accuracy of these statements, but they do suggest that Ancient Greek doctors were getting some very interesting results without the modern operating room or MRI diagnostic tests. But, this avenue of knowledge has no value in bringing in money to the medical community…..and God help the unlicensed person who would dare to try to treat people with inducing the placebo effect…..especially if they had success…..because the FDA would be crawling all over their back.

  • Holly

    Had a question about dentures
    I have been to four specialists and it was stated that my jaw was too thin for implants so I need the old fashioned regular denture that sits on the gums.
    I watched a video, that i could not find again so I am writing my question on this one, stating the health risks of plastics. Does Dr G has any suggestion for someone who is getting getting dentures?
    Thanks
    Holly

  • Eve

    How many hours of nutrition education is in the curriculum for Naturopathic Doctors? I’ve heard they have the same approx “20 hours” as an MD, however, attendance at the Nutrition courses for ND’s is mandatory — while attending the Nutrition courses for the MD is elective; they don’t have to attend them. Is this true?