Doctor's Note

What a laundry list of a video! I know I just buzzed through those, but have more in-depth videos on each of the major topics:

Advanced glycation end products:

TOR:

Viruses: Infectobesity: Adenovirus 36 and Childhood Obesity

Poultry workers:

Industrial pollutants:

The link between meat and diabetes may also be due to a lack of sufficient protective components of plants in the diet. That’s the subject of my next video: How May Plants Protect Against Diabetes?

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  • Alex

    Dr Greger, After min 3, you implicate animal protein, specifically the amino acid leucine. Leucine is abundant in soy, peanuts, some whole grains, nuts, and legumes (more or less in that order), comparable to beef, fish, chicken, eggs, with much less significant amounts of leucine in milk. Comparing against 100 apples (which have virtually no protein at all) is misleading; Soy (dry) has almost twice as much leucine as beef!

    • Wade Patton

      Here’s what the Doc said in an article:

      Some proteins are worse than others. One amino acid in particular, leucine, appears to exert the greatest effect on TOR. In fact, just cutting down on leucine may be nearly as effective as cutting down on all protein. Where is leucine
      found? Predominantly animal foods: eggs, dairy, and meat (including
      chicken and fish). Plant foods, such as fruits, vegetables, grains, and
      beans, have much less.

      • Alex

        I challenge the assertion that beans specifically have much less leucine than meat. Lysine (not a typo) is the limiting amino acid in grains but found significantly in legumes along with leucine. Thus the amino acid profile of legumes is a much more relevant comparison (comparing apples and cabbage is absurd).

        100 g soybeans (dry): 3 g leucine, 36 g total protein (8%)
        100 g almonds: 1.6 g leucine, 21 g total protein (8%)
        100 g egg: 1 g leucine, 13 g total protein (8%)
        100 g beef: 1.8 g leucine, 26 g total protein (7%)
        100 g peanuts: 1.7 g leucine, 25 g total protein (7%)
        100 g chickpeas: 0.6 g leucine, 8.8 g total protein (7%)
        100 g chicken: 1.5 g leucine, 25 g total protein (6%)
        100 g fish: 1.6 g leucine, 33 g total protein (5%)
        100 g wheat germ: 1.5 g leucine, 29 g total protein (5%)
        100 g pinto beans: 0.8 g leucine, 21 g total protein (4%)

        • Brian Humphrey

          The point is its much easier to get high amount of leucine from animal sources since 100g of chicken is 1/2 a chicken breast. Who knows how much the average american is consuming? I bet its not 1/2 a chicken breast a day!

          • Alex

            Totally agree. But then we’re really just talking about TOTAL protein; Leucine just comes along for the ride (in pretty much similar fractions for many foods: vegan and carnage alike). The article cited in the video explicitly states dairy and meat contains high amounts of leucine and is to be avoided, but neither dairy nor meat contains significantly more leucine than many beans and nuts, whether by weight, by percent of total protein, or by calories. On the other hand @Wegan (below) sniffed out a snippet from the abstract discussing protective benefits from many plant foods not found in dairy nor meat.

          • Lawrence

            Carnage. Exactly correct. http://www.thefreedictionary.com/carnage

          • John

            Alex,
            I think you’re making a valid point about leucine. If meat is a problem, so are some nuts and legumes. I probably listen to Dr. Greger more than any other authority on health, but I don’t think any of them are God, and I try to listen to their biases.
            John

          • Alex

            It could be bias (unavoidable really) but perhaps it’s just that being strictly correct would require so many qualifiers, that no one could follow the thread of meaning, certainly not in a five minute video. Every nuance would have a tangential nuance, each with its own set of tangential nuances, and we’d quickly forget what we’re talking about.

          • Hadley V. Baxendale

            As the video stated in pertinent part, no one knows the exact reason why animal protein is the culprit. So it may not be the leucine after all. The take away is the correlation between animal protein consumption and type-2 diabetes — not one specific problem of meat (whether it is fried, broiled, boiled, or just handled by meatpackers, etc.). So this discussion about leucine is a discussion that leucine may not be the real problem.

          • Alex

            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310004/figure/F4/

            This diagram says 1000 words. It coudl be that “high meat intake” is code for “any high leucine containing protein source” (because there’s no indication why animal LEU is not the same as plant LEU). However, dairy (which is not particularly high in LEU despite the implication in the abstract) triggers or contains IGF-1 and insulin. These three along with carbs/glucose set off a chain reaction leading to mTOR activation, potentially cascading to IR and T2D.

            To be precisely specific with respect to amino acids, hormones and pathways yet waive our hands around in general regarding animal vs plant protein is at best odd.

          • CastaNefasta

            Well then you should LABEL your statements as for “US people only”, I’m Italian.

        • Wade Patton

          I’ve been happy to find that chasing numbers and specifics of each various thing are total waste of my time with regard to living a healthy WFPB lifestyle. I replied above only to show that Doc has looked at leucine before, as folks often reply to videos here as if there weren’t 2,000 more videos and articles here and many of them are inter-related (and cross-linked for convenience). Maybe you were fully aware and had looked at such beforehand. Doesn’t matter.

          Diabetes is a disease of fat toxicity and meat comes with fat and meat fat comes with all sorts of other toxins. Diabetes will remain a top-killer in our society until we learn how to eat right (as a population). Quibbling over minutia won’t reverse diabetes.

          • Adrien

            Well said!

          • CastaNefasta

            In US society…I’m Italian, we do eat meat and fish and we don’t have same amount of problem you have, mainly because we actually avoid highly processed food (both for vegetables and meats), and prefer mediterranean diets (which still contain meats/dairy).

        • charles grashow
          • Alex

            Yes, fully aware. The point is that LYSine is the limiting amino acid in a vegan diet, therefore we need to (“only”) consider the protein profile of vegan foods which contain sufficient LYSine. Basically that means LEGUMES. And legumes have a LEUCine protein profile very similar to beef, chicken, and eggs. Thus vegans and carnivores likely consume similar LEUCine quantity as fraction of total protein intake.

            However, as discussed below, meat eaters (aka general population) likely consume a higher calorie and total protein intake. Further, many plants protect against the IGF-1 and leucine triggers.

          • M85

            It’s just so ironic that now the vegan diet has too much protein!!

        • Boxo

          Prolly a good idea to go with the lower end of protein intake, thus limiting leucine. WHO guidelines apparently are .4g per KG ideal body weight, and Dr. Greger mentioned that is the optimal requirement, meaning the minimum is lower. So, go higher on grains and lower on legumes.

        • Charzie

          I’m gonna go out on a limb here and suggest the possibility that a plant source can be different metabolically than an animal source, for ex. phytoestrogens vs animal hormones, heme iron vs the plant source of it, etc.

        • Carolyn

          Thanks Alex for this info. Finally, someone who is talking some sense and breaking things down:)

          To get an equivalent amount of total protein (26g) found in 100g of beef one would have to eat 295g of chickpeas and that would deliver 1.77g of leucine-almost the equivalent amount of leucine one would get from beef.

          One would also get a host of other things like fiber which would then impede some of the protein and mineral absorption but also sweep out waste; but if we are going to talk about “just” leucine, let’s not twist things around.

          • Alex

            Exactly. Sentient carnage often contains more protein in total, definitely more sat fat, hormones, and all kinds of nasties higher up the food chain. But leucine is leucine is leucine. It’s either implicated or it’s not.

          • Alimay

            Not sure why everyone so focused on the exact amount of protein for a vegan diet ( no one counts any thing healthy/unhealthy in average carnivore diet). I am vegan and train up to five horses every day, do barefoot trimming on forty horses and work nights as a nurse three times a week. Have endless energy no weight problems, normal labs ( in great range) low blood pressure etc etc. I’m 58 and can do more than people half my age. The fact is that animal proteins “are” loaded with toxins due to all the crap they’re fed and why don’t we look at the life they lead ( horrific) in order to be eaten?

      • CastaNefasta

        Are you even reading, or blatantly repeating what Dr Greger says without any analythical thinking.

        • Wade Patton

          No I’ve been studying this sort of thing for many years. Dr. G has most of his stuff in fine order. He has his faults, we all do. Mine is not parroting, but repeating for folks who won’t even trouble themselves to read a full article much less many books and studies. Also I’ve benefited personally much greater from meat reduction than from any other dietary change I’ve ever made.

          • CastaNefasta

            In my case was grains (all of them), legumes and dairy avoidance that has given the best benefits.
            And I’ve been vegetarian and vegan on a low fat whole food diet for a long time, even supplementing Vitb12/VitD…but didn’t work for me.

            I’ve been following Dr G from long time now, and still find many informations very useful, but some happens to be as biased as the one he tends to fight, that’s why I prefer people approaching even this stuff with a critic behaviour.

          • Blaice

            How did it “not work for you”? I am always curious as to what this quote entails, because the word prolific doesn’t even begin to describe it’s pervasiveness in any discussion around vegan/vegetarian lifestyles.

            Btw, I am not attacking your decision to abstain from eating grains and legumes, but I however, would never even contemplate doing so. So, I am curious as to what troubles you personally were encountering to come the conclusion that you needed to do so.

            I eat a TON of lentils with brown and red rice. In doing so my 6-pack is so much more defined that it looks as if I am flexing without doing so. I can say I have had the opposite experience than you, and will never cease eating them.

    • Darryl

      Leucine is the most common amino acid in nearly all food proteins, and the ancient anabolism/catabolism regulator TOR, common to eukaryotes (complex life) from yeast to man, have used leucine to monitor protein intake for over a billion years. You’re correct that animal and plant proteins have comparable leucine content. Animal foods average 8.3%, plant foods 6.7%, in the USDA database.

      Leucine itself is an mTOR activator, however this might have mixed effects on metabolic disease risk as mTOR in the hypothalamus also regulates satiety and food intake (1). This is the likely mechanism for high-protein weight loss diets, and obesity is a major idenfied risk factor for diabetes risk. That said, there’s was an amazingly strong relation of overall protein intake to diabetes mortality in last year’s Longo lab paper (2), though this was entirely eliminated when adjusted for % vegetable protein (see S5.

      A number of studies have found circulating branched chain amino acids (BCAAs, which include leucine), and their metabolites, predictive of metabolic disease risk. However, in animal studies BCAAs promote insulin resistance, but only in the context of high fat diets (3).

      • Veganrunner

        Darryl you are the fastest PubMed guy on the planet!

      • David Johnson

        As an example of what you were talking about, according to chron-o-meter, my WFPB diet yesterday provided 1731 kcal, which included 88g of protein (~20% of kcal). Leucine was the most prevalent amino acid at 4.9g, of which 1.3g came from soy products (one cup soymilk, one 3.5 oz serving tofu), 1.5g from grains (oats, whole wheat, kasha) and 1.1g from green peas, brocolli, corn and spinach. Chron-o-meter said I got 222% of the daily requirement, so only slightly below average for Americans. I really do not see how to significantly lower this percentage and maintain a healthy vegan diet. Since my intake was close to the average, this leads me to think the average amount is perfectly fine, and that problems come from the very high end, or else there is something else in play.

        • Alex

          Thanks for sharing that ‘real world’ example. Soy and peanuts have more leucine than meat and dairy by mass (100 g) and percentage of total protein. Perhaps you could reduce your soymilk and tofu intake. However! as @Wegan points out below “Plant-derived polyphenols and flavonoids are identified as natural
          inhibitors of mTORC1 and exert anti-diabetic and anti-obesity effects.” Soy and peanuts are packed with polyphenols and iso-flavones.

          • David Johnson

            Right, I should probably cut back a bit on soy (my Japanese wife says I eat too much soy, and that the Japanese diet does not typically include large amounts).

        • Veganrunner

          David is 3.5 oz of tofu a serving? That seems like a lot to me.

          • David Johnson

            Actually the package says 3oz, consistent with a quick search for “standard serving tofu”. There are 5 servings in the package (397g) so about 80g per serving. I usually cut it into 6 servings so I overestimated the amount by a tad.

        • Linda J.

          Do you know what % daily requirement of lysine and arginine you consumed?

          • David Johnson

            Lysine 3.5 g 208%
            Arginine not listed

        • charles grashow

          it’s a matter of semantics but SOYMILK IS NOT MILK. You cannot get milk from a bean.

          https://www.youtube.com/watch?v=s8_JxdE8aHE
          Lewis Black – Milk

          • Darryl

            Soy milk has been known as 豆乳 (“bean” “milk”) in Japanese for a very long time. English usage is by analogy to lait d’amendes (almond milk), which was preferred to lait de vache (dairy milk) in most recipes of Le Viandier de Taillevent of the 13th/14th century. A lawsuit attempting to prevent this rather traditional labeling was recently dismissed.

          • Adrien

            I like you speaking french ! :)

          • David Johnson

            Maybe worth adding that cow’s milk uses the same kanji for “milk”: 牛乳 (cow-milk) …so it is not just a matter of the English translation.

        • Alex

          Hi David (@disqus_GV2A3aXHLi:disqus), I wonder if you could plug in the same foods, but make it a ”healthy” carnivore version, maybe replace the soy milk and tofu with bovine lactation and a pork chop.

          • David Johnson

            Sure. Pork chop (no visible fat) 79g, 1 cup 2% bovine lactation:

            Leucine 6.2g 287% (Protein 101g from 88g).

      • Timar

        I think the striking difference between vegetable and animal protein in the Longo paper can only be explained by taking into account not only the amino acid profile but also what actually accompanies the protein in a typical dietary pattern. With animal protein usually comes saturated fat and all that is mentioned in the video, whereas plant protein usually comes with fiber and secondary plant metabolites (e.g. polyphenols) which exert protective effects, either by direct mTOR inhibition or by beneficially acting on a myriad of other metabolic pathways.

        Which means that you won’t reap the health benefits of a plant based diet by substituting the beef in the burger with a highly processed plant protein patty. You may avoid some nasty stuff, but you still won’t get the good stuff.

    • Veganrunner

      These are the 2 articles he is reading from during the video. Those statements are from the articles. You would need to read the articles to see if it makes sense.

      http://www.ncbi.nlm.nih.gov/pubmed/21157483
      http://www.ncbi.nlm.nih.gov/pubmed/22442749

      • Wegan

        The second link states this in the abstract:
        ” Plant-derived polyphenols and flavonoids are identified as natural inhibitors of mTORC1 and exert anti-diabetic and anti-obesity effects.”

        • Alex

          So meat eaters should supplement their diets with insects! :)

          • Sammi

            If you read any of the Paleo books they worry more about the lectins in beans and grains than leucine.

          • Charzie

            Ha ha, I was wondering about the health benefits of consuming insects since they are abundant and were probably a whole lot more popular during our evolutionary process before we supposedly become “fearsome hunters”! (Carrion scavengers?) Some areas still subsist on bugs, so I really am curious!

    • guest

      Methionine is bad because of the homocysteine connection. Leucine is bad because of the TOR connection. Two down; eighteen to go.

      • Wjgood

        You would be fine, if you would just quit eating food!

        • Adrien

          Some claim they did. I never had any news from those people ever since.. Ahahah

      • Joseph Gonzales R.D.

        “Good” and “bad” may be an oversimplification regarding protein recommendations and actual needs. Certainly we cannot survive without leucine and methionine so they are still considered “essential amino acids” and need to be consumed. It just seems eating on the lower end may be better for human health.

        • Alex

          I have heard that an egg was ‘defined’ as a perfect protein source — that our amino acid requirements were based less on evidence but simply the contents of specific foods, specifically four eggs — is there any truth to this?

      • Alex

        A 2000 kCal fruit and green diet (say bananas and kale) provides an perfect protein profile (60+ g), lowest in two specific amino acids: methionine (0.4 g = 64% AI) then leucine (3.3 g = 130%).

        * It also has a 1:1 omega-6:3 ratio, 100-5000% RDA for most vitamins but B12, 150-1800% RDA of most minerals except iodine, selenium, sodium, zinc.

    • Veganrunner

      Alex I have been looking at various charts including the one you list below. My brain cannot vision the gram oz thing. So was I seem to be seeing is that one cup of dried soybeans is not a serving size. The meat portions are 3 oz. that also is not a serving size for most eating meat.

      This looks like an accurate position size chart. http://www.healthaliciousness.com/articles/high-leucine-foods.php

      Let me know what you think.

      • Alex

        Sorry, I don’t understand the ‘portion size’ thing. In my simple mind, it’s either the size of my fist, a fraction of total calories, a bag, or 100 g. ‘Serving size’ is nonsense that someone just makes up for marketing or other random reasons.

        The numbers in my chart (which is ‘back of the napkin’ precision) are all based on the same weight. Then I took the leucine divided by total protein to get percentages. So it doesn’t matter what serving size, a thimble or a bucket, the percentages remain the same.

      • Alex

        Her chart is clearer, sorted by leucine per gram (rather than per total protein), with soy tight between cheese and beef, with seeds and nuts not too far below.

    • Joseph Gonzales R.D.

      Perhaps it’s an issue of the plant to animal protein ratio, whereas leucine in the form of plants (beans apparently being super high) is more acceptable. This may be why protein needs are low. Beans are packed with protein (and leucine) so thanks for pointing out. Animal proteins are linked to increased risk of bone degeneration and kidney diseases. It may be that the ratio of animal to plant protein intake is most important. In a paper I wrote about cancer prevention, Applying the precautionary principle to nutrition and cancer I reference a study pointed out to me by Dr. David Jenkins about the overabbundance of amino acids (Reference 46). An interesting take. In a world fueled by protein junkies I worry a bit.

      I just tried to answer a similar question, here. And one site user who is fascinated by the subject posted great comments throughout the video on TOR and Calorie Restriction. See if these links help? I just don’t think any studies have been done comparing leucine intakes for plant-based eaters versus omnivores.

      Since protein recommendations are taken as a whole, I’d suggest sticking to the low amount if you’re trying to keep leucine low. Here are some protein recommendations. Dr. Greger mentions how plant protein is preferable. The recommendations for protein intake vary from 10-35% of total calories. The tradition Okinawan diet is only about 10% protein, so perhaps the lower end of that range (10-35%) is preferred. Low-end of protein recommendations are between 0.8-0.9g/kg for adults. After 65 years old, based on this study I would suggests bumping up these recommendations.

      • DRHURLEY

        Joseph – If I may digress a bit on the subject of protein. A recent text on the 2-day diet authored by some reputable medics mentioned in passing that the hungry pangs we experience before a meal are driven by the need for protein: that “research suggests that our appetites are fundamentally controlled by our need for protein, and that the body will keep telling you that you are hungry until that need is met.” I was sceptical when I read it. Is there research to back this up that you or Dr Greger is aware of for this?

        • largelytrue

          Isn’t your question a little misdirected? Why are you giving this particular argument from “reputable medics” weight if they aren’t willing to do much more than tell you simply that “studies say X” for one of the most important points in the argument that they are introducing? In normal discourse we assume that the person making an uncommon claim should have got to their conclusion through uncommon expertise and investigation. They should have some concrete supporting evidence that they can give to you to use in your own process of discovery.

          Don’t get me wrong. I personally think intermittent fasting certainly has some sufficiently potent effects that could be beneficial. Also I haven’t studied their plan in depth. But what I see suggests that the diet plan is in the shaky low-carb territory of justification by weight loss alone:

          21. Is the diet safe for everyone?

          The 2-Day Diet is designed for weight loss and should only be followed
          if you are overweight. The diet can be adapted to one day a week, which
          can help maintain a healthy weight and prevent weight gain. This can be
          followed if you are currently a healthy weight, but concerned that your
          weight is increasing.

          • DRHURLEY

            I don’t see where my question was giving weight to an argument. But moving on to my actual question – it was just an open one – “what research exists to support the assertion that hunger pangs causation is rooted in a protein deficit?” The quote in my question is lifted directly from p.49 info box titled “What you need to know about protein”. Yes as you said the 2-day diet is a low carb high protein variant which I would be highly critical of – much of the content of the book is way off base and I believe damaging. I don’t need to be briefed on WFPB diets, but while promoting proper eating for homo sapiens, one has to stay abreast of what others are peddling – especially when sold under claims of “revolutionary and clinically proven” and published by people of significant standing in their medical practices industry. Invariably patients and clients are influenced by these promoted solutions that they encounter in the media, so one constantly gets challenged. That’s not a problem, I am well able to handle it. Unfortunately the current high protein emphasis is a big problem and many of the food industry newsletters I see reflect the industry promotion of this and are already talking about “what’s next after protein?”

          • largelytrue

            Thanks for the clarification, because I think it is reasonable to assume that if people are asking about a claim with reference to a particular source, it’s because they are entertaining the source as credible in some sense. Your added info about how these two are “reputable medics” added to that frame of credibility, and I thought it was important to take them down a peg. How does a skeptical attitude work in selling yourself to your clients, by the way? Would you have a problem if you asked to see some of the research referenced by Authority Y with respect to Practice Z before incorporating it into your training program? Some people do want to live in a bubble, but it seems to me that many others would respect a trainer whose behaviors demonstrates some care in sifting through the bunk.

            As for “hunger pangs”, I think that the answer to your question depends in part upon the definition of a “hunger pang”. The area of research that has been examined more carefully is not the ‘pang’ per se, but hunger after a given meal, particularly the proclivity to eat sooner and to eat more when food is presented at the next meal.

            The idea that our appetites are fundamentally controlled by protein needs is frankly ridiculous, and exactly the sort of crude lumping language that I would expect from a low-quality source. Protein has an impact on satiety and may even be the most satiating macronutrient in itself (it’s also the most toxic on a calorie-for-calorie basis, in that extremely high protein diets are essentially unsustainable). However, it isn’t the only factor that impacts satiety and I think you can probably see signs of distortion in the way that the claims about protein and satiety are communicated from primary research in this case.

            For instance, this article only talks about an established “macronutrient hierarchy of food, in which proteins are most satiating, followed by carbohydrates then fats” and use two citations in support of that claim. The first does develop an model in which isocaloric content of protein produces reports of higher post-meal satiety than fat (and carbohydrate has no effect), but other factors such as food weight are even more important, and boiled potatoes are highest on their satiety index, something which the protein fundamentalist of course blissfully ignores.

            The second reports that as compared with the carbohydrate meal, the protein meal (statistically) significantly reduces reports of hunger over the entire 24h. If anything that’s where your “hunger pangs” may lie although ‘pangs’ are not the only way to report hunger or evaluate it subjectively. Importantly, the study reports insignificant and insubstantial differences between the protein and carbohydrate meals (both low in fiber) on energy intake and energy balance over the entire day; the estimated differences amount to around 10 calories or so when converted from MJ. Also this result does not necessarily apply to the case of fasting, since all meals following the first were ad libitum.

            There is some evidence that when manipulating macronutrients alone, protein introduces an appetite suppressant effect. This study by Weigle et al is an interesting example, together with its reference to the group’s earlier work with a similar experiment involving a carbohydrate-fat exchange in the diet. But note how their effort to keep fiber constant at ~11g per day in both diets skews the balance in favor of animal products, which are high-protein, zero-fiber foods; in fact if you look at table 2, the low-carb diet seems somehow to weigh ~25% more than the low-protein diet, and is even heavier when you include beverages in the comparison.

            When looking at fiber as a factor a number of reviewers have indicated its importance to ad libitum weight management. And while the protein-fat experiment in Weigle et al is reported as producing a non-significant (P=0.13) greater weight loss of 1.2kg compared with the earlier carbohydrate-fat experiment, it’s trivial to pull up equally significant results favoring satiety on relatively modest introduction of fiber-rich calories into the diet. For instance this study reports a non-significant (P=0.1) trend toward 30% lower scores for hunger frequency (while on an aggressive energy deficit) in the group consuming 90g/2000kcal rolled oats.

            Weigle et al indicate that there’s something paradoxical about high dietary protein, at least in the animal-based context for introducing dietary protein. They talk about how satiety seemed to increase even as ad libitum energy intake dropped into a deficit during their protein-fat experiment, while levels of leptin remained essentially constant and ghrelin levels actually increased. We’ve seen this kind of apparently disproportionate response from dietary meat with respect to another hormone before. One hypothesis that I would consider is that protein regulates appetite, but does not regulate appetite in high protein diets because of the craving for sufficiency; it’s because protein is hard to digest and it’s relatively easy to approach conditions of chronic toxicity. So while the ghrelin system is rightly screaming that there’s less energy on the high protein diet, the digestive system tells the body that it can’t handle more of this type of food so soon and curtails intake by reshaping leptin sensitivity (as Weigle et al suggest), perhaps through Peptide YY or one of the similar hormones that also affects gastric emptying. Since “hunger pangs” can probably be defined in terms of sensations in the churning stomach (which die down during extended fasting as the digestive system downregulates its energy consumption), something like PYY would also quiet them. Another thing that would plausibly delay gastric emptying would be a diet rich in fermentable fibers. Fermentable fibers have been shown to promote PYY and glucagon-like-peptide in rats, and gastric bypass patients see an increase in PYY along with the change in their intestinal flora. Since gastric bypass often reduces the absorption of macronutrients, what may be happening in both cases is that when there is a significant change toward extensive fermentation in the colon, the colon starts contributing more calories (and maybe minerals) to the body, and the body has an adaptive response to this condition. By trying to slow down gastric emptying and intestinal transit a bit, the fermentation process should become more efficient.

            Overall I think that a lot is going on with satiety and appetite regulation, that there’s a whole network of systems that get involved at various stages of the digestive process. The protein fundamentalist is not wrong in saying that protein intake impacts satiety, but is absolutely silly in claiming that it is the only thing that fundamentally impacts satiety, or that may be manipulated in a diet to make a calorie deficit more satiating, especially if that deficit is only going to be maintained for a short-term semi-fast.

          • DRHURLEY

            I envy the time you have for writing so extensively here.
            I would not waste any energy dissing the authors. The book is aimed at a diet /weight loss conscious demographic that may not be versed in these subjects and so it has “popular science” / somewhat sensational and superficial language. Although there are references peppered through out the book the one I was enquiring about has none. It is essentially a how-to manual. Anyway my participation here was not to debate the merits of the 2-day diet, or lack there of, but to reach out to other R.D. / M.D. on the veracity of this reference to protein and hunger. I am familiar with the satiety research and this claim seemed a monstrous leap but wanted to check if I’d missed something. Much of what we have learned about Leptin and Ghrelin still needs a lot more work. Unfortunately when the little that is known gets out it is already in my experience being miss used/applied. This of course is reflective of the reductionist paradigm we live in. As is the micro-analysis of amino acid profiles evident on here.

        • Joseph Gonzales R.D.

          Hi Dr. Hurley,

          Thanks for your post. I am not familiar with the 2-day diet? Can you help bring me up to speed? Protein is an interesting macronutrient and certainly needed as 9 (if you count arginine in times of growth/pregnancy) amino acids are essential. I am sure Dr. Greger would know more and could give us a complicated schematic underlining the role of hormones, signals, amino acids, and satiety. I can tell you eating a lower protein diet never starved anybody out in our clinical trials. A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study, where half of 300 participants were asked to follow a strict plant-based low-fat, high-carbohydrate diet for 18 weeks with unrestricted portions. I can assure you nobody was hungry! The nutrient study conducted within this cohort found significant changes in macro and micronutrients.

          • Alex

            Cool studies, Joseph. Congrats on the publication. Were participants given specific meal plans, recipes, or cafeteria food? I’m curious what they actually ate.

          • DRHURLEY

            Joseph – You aren’t missing much, it is another low carb high protein variant which I heard being promoted as clinically proven on a radio programme. That of course made my blood boil so I decided to check it out before someone starts quoting it verbatim at me. I try and stay abreast of what others are promoting. And that particular hunger pang statement jarred with me – believe me you would have issue with a lot of the content. Largelytrue posted a link above and here’s another 2-day
            diet book. Cannot imagine you’d have time for it.
            If you do find anything on the causation of the hunger pangs I’d be interested. I must take a look at your trials when I get a chance. All the best DR

          • Joseph Gonzales R.D.

            I found a few studies on hunger pangs. One looking into if coffee can effect appetite and another with no abstract but the title looks fascinating, Starvation with and without Painful Hunger Pangs. It’s an old study, but if you’d like I can pull it.

          • largelytrue

            The “old study” is actually a short letter to the editor: you can see the first page with fewer subscription privileges than are required for the article itself: http://www.sciencemag.org/content/132/3430/841.extract

          • Joseph Gonzales R.D.

            Thanks for correcting me and providing that link.

          • DRHURLEY

            Thanks for the links. I will probably go back to the authors directly to clarify their claim.
            Coming back to the protein issue, I don’t think we are doing enough on the excess protein consumption problem. There is virtually no balance to the story in the media. The public is being misled by the vast majority of ill-informed TV personalities/broadcasters, be they qualified or not.
            What is even more disconcerting, is the lack of protein research following T. Colin Campbell’s team’s findings of more than 30 years ago. When asked he told me it fits the paradigm we live in.

      • For those interested in the “protein” issue I would recommend reading Dr. McDougall’s three articles written in his newsletters. They are available on his website for free. The dates/titles(paraphrased) are… December 2003, History of Protein; April 2007, Protein Sources; and January 2004, Protein Overload. I agree with Dr. McDougall… never a case of protein deficiency in the world given adequate calorie intake. Eat a WFPB diet and if anything don’t go out of your way to eat more protein…. see last article. Science makes it clear that plant protein is better than animal protein but that doesn’t mean you should go out of your way to consume more plant protein. As always these recommendations are general and may need to be modified given individual clinical situations. Remember the body doesn’t store protein and needs to excrete the excess. Last comment… I’m not a fan of “optimal” intake or health… the concept of “optimizing” complex systems isn’t consistent with the current understanding of complex aka adaptive systems. Dr. Campbell’s book, Whole, looks at this issue from a human nutrition standpoint. For a broader non medical/biologic introduction I recommend, Systems Thinking, by Donella Meadows.

        • Alex

          I find it difficult to get adequate B vitamins without loading up on nuts, grains, and beans which then sends my protein levels into body-building territory. In your opinion is attempting to hit 100%+ RDAs through whole food misdirected?

          • I think using the RDA as a goal is fine. Most of my patients seem to have no trouble meeting the RDA for B vitamins… with the exception of B12… with eating a variety of vegetables, fruits, starches and some legumes/beans.

    • Jim Felder

      But we don’t eat soy dry, unless you want to compare dry soy beans to beef jerky. Other than that I like your analysis.

      One thing to consider is whether the harm is coming from the absolute amount of leucine, or does it come from the leucine in protein consumed in excess of nutritional need.

      If the harmful effects of leucine come from the amount over metabolic need, then diets that keep protein intake close to metabolic need would result in lower amounts of excess leucine than diets that provided much higher amounts of excess protein. If this is the case, then the percentage of leucine per gram of protein in a given food would be less important than the total amount of protein in the diet with the fraction of represented by leucine being a secondary consideration.

      • Alex

        Below I compare the ratio of leucine to total protein which is constant whether dry or cooked. Soy is roughly 8% leucine while beef is 7% leucine of total protein.

        Exactly. It seems difficult not to double or triple leucine RDA in pursuit of adequate total protein. Leucine seems to be part of a trinity along with IGF-1 and insulin activating mTOR leading to IR and T2D. Leucine is just a messenger, but over-consumption of total protein (total
        calories, fat, etc) is the proximate problem that we humans should be able to control (rather than concerning ourselves with amino acid intake).

        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310004/figure/F4/

    • Joe Caner

      I have heard it argued that we are already getting entirely too much dietary protein, and that the recommendations in our protein obsessed culture has been doubled, and in some cases, doubled again, and once more if you are interested in bulking up by means of resistance exercise.

      There is no mechanism for protein storage so all excess protein is metabolized for energy. The problem is that protein is a dirtier fuel than either carbohydrates or fats because it contains nitrogen which is then transitioned in a number of steps from highly toxic nitrogen compounds such as ammonia to the more manageable ones like urea which in an of themselves can be problematic in excess, e.g. gout.

      By eating an excess of refined vegetable proteins, one is tacitly accepting the assumptions promoted by the same folks who have brought you the $1 beef hamburger, and who are more than happy to see it replaced with a $10 veggie burger. You are better off providing for your modest protein requirements from eating a variety of whole foods than to attempt to replace a beef steak with a soy or seitan cutlet.

  • Adrien

    Definitely a video that Barry Erdman should look into.

  • Chris

    Since I was a child my Irish Father cooked me eggs and oatmeal, eggs and toast…etc. I ate eggs probably 4-5 days a week. We never had cereal in the house. We ate fish chicken and steak…and lots of veggies. I still to this day eat eggs, meat, fish, butter…all of the bad stuff he talks about. My cholesterol is good, CRP is non existent…Homocysteine levels ultra low.I consume almost no sugar other than fruit. I eat 95% organic a lot of fruits and veggies along with all the meat I consume. I had a heart cath done at 36 and was free and clear of any disease….Now 43. I’m 6’5″ 245lbs and still run circles around high school and college kids…Please show me studies of fitness people and heart disease. Yes I’m sure if you ate all this and sat on your fat rear end (like most Americans do) you will have a heart attack. All my older body building buddies in their 50’s 60’s and some now 70’s all eat eggs,steak, butter…etc. So tell me more.

    • Adrien

      First what do you mean by cholesterol is good and CRP is non existent ? Precision with number is required to have a minimum of credibility here. After all, it’s just like people saying “my uncle smoked all his life and didn’t get lung cancer”. Well, that doesn’t mean that everyone is like your uncle. Or that smoking doesn’t cause lung cancer. In fact It does. And by avoiding smoking you can avoid 90% of your risk. That’s being said, on a population level, the type of diet that you are describing as your, is a major cause of disease and mortality. Causing a huge deal of pain, people suffering, money to the society and lives ! That’s absurd and could be other wise.

      • Alex

        Chris doesn’t sound like he fits squarely in with average population samples which include a majority of french-fry consuming couch potatoes (assuming he literally RUNS around (fit?) college kids and works out). While he might be healthier replacing the eggs with plant based protein, the oatmeal, (fish, unprocessed) carbs, fruits and veg are not doing him harm.

        • Chris

          Alex I am a Strength Coach/Personal Trainer with a Masters in Excessive Science. I train collegiate and HS athletes for football/baseball/volleyball..etc. Yes I do “show up” a ton of these kids daily. :)

          • Chris

            oops…sorry “Exercise”

          • Jim Felder

            Nope, 1.5 hour work out and then training 3 clients, Excessive Science sounds like a better description. :-)

            All diet is a balance of benefits and harms. There are few foods that have absolutely no harms and there are few foods that have absolutely no benefits. The key is maximizing benefits while minimizing harms. The foods with the best ratio of benefits to harms come from the plant and fungi kingdoms while those with the worst benefit to harms ratio come from the animal and processed food kingdoms (processed food might have originated in the plant kingdom, but after a trip through the chemical factory where food is stripped down and reassembled like Frankenstein’s monster, any resemblance to their place of origin as far as health goes is lost).

            But our health is not just the health of a single food, but the sum of all that we eat. So Chris you are indeed likely eating much healthier than the vast majority of the populations. But that is likely due to the plant foods you eat and much less or not at all due to any animal food you eat. As such you probably could improve the health of your diet by tending towards more plants and less animal foods with the optimum likely somewhere around all plants.

            There is no way yet to know that the optimal amount necessarily 100% whole, unprocessed plants. It could be that say 10% of calories from animal foods could be actually be healthier by a small amount since there are no large populations that eat 1) a diet high in healthy whole plant foods and 2) no animal foods. But we do know that the healthiest populations are those that eat the closest to a whole plant based diet. So personally have no problem with someone eating eggs and meat and saying that they eat a healthy enough diet for them. But I think there is enough science on the subject to say that their diet is healthy because of the plants they eat and not because of the eggs and meat. As for dairy, I think dairy is just evil for the body.

      • Chris

        meaning last test in May everything was perfect. High sensitivity CRP test was 0.11 (under 0.55 is low end normal) according to Dr and print on lab work. Lipids were right in range….And no this diet is not the cause of disease and mortality as you say..processed crap food is, sugar, palm oil, high fructose crap that is in all cereals and breads. Eating junk and sitting sedentary at a desk job all day….stress, smoking…excessive alcohol. That’s what killing people. If you ate a ton of veggies and salads and along with meat…you’ll be fine. Everyone in my family lived well beyond their 80’s. eating whole foods. And as my Cardio Dr said…if by 36 I show no signs of blockage after eating this way for better part 30 years…then I’m probably ok.

        • Chris

          also this goes hand in hand with the “Great testosterone debate” for years and years Dr’s alike were so anti androgen and TRT replacement…cause death, heart attack,stroke…etc. Now the jury is out and all of it is and was BS! Again Show me the studies of people that are ACTIVE and eat meat and butter…not the average Joe American who hits Mcd’s 4 times a month with pizza’s and potato chips thrown in.

          • Alex

            I too would like to see those optimized studies, but I don’t think many exist. A study comes about when someone is willing to fund it, which usually means there’s a product to sell. Who would that be? A powdered protein complex manufacturer is not going to pay to see how their product stacks up against grocery store bought veggies.

            If you’ll take an n=1 case, I went back and forth between meat to vegetarian/vegan over fifteen years (including exclusively wild meat/fish/whale/seal and frozen/canned green something diet above the polar circle in Greenland). On a vegan diet, I am lighter, more agile, faster, sleep less, more energy, look better, clearer head (and fart more). I went cold turkey from meat to veg during intensive capoeira training (while living with an inspiring vegan ultimate fighter, Brazilian jujitsu) and within a week noticeably easier to perform flips, balance, faster reaction, etc. It doesn’t feel like veg gives me something, it’s more that meat is a sluggish burden on my body, just a dead weight.

          • veganrunner

            I want to up-vote this about 100 times! Perfectly said.

          • Chris

            I don’t want you to think I’m a cave man and eat red meat daily…I just don’t shun it. I enjoy a steak a few times here and there. Maybe 1 time a month. I love eggs! I eat them still 3-4 times a week.But again I eat eggs, broccoli, and oatmeal for b-fast. Today I have 2 cups of black beans with Cumin tumeric mix and pepper and HIM Sea Salt and I chopped up two organic no anti biotic grass feed hot dogs in with them and ate 10 dark grapes and 1 1/2 cups steel cut oats. So I eat variety…and then I went and worked out for 1.5 hours and trained 3 clients!

          • Alex

            Oh, I don’t judge a fellow Master of Excessive Science. :) I also won’t claim a few sugary chocolate treats, likely with some bovine excretion, haven’t passed my lips. :)

          • Lawrence

            Alex, would you please give us a description of what whale and seal meat tastes like? Was it cooked/raw? Fatty/lean? Which part of the animal is eaten? And so forth. I will never eat such meat owing to lack of opportunity alone. But, I am really curious. Thank you in advance for your reply.

          • Alex

            Ha ha. This is like asking a recovering heroine addict about the high. :)

            Side note: “Eskimo” means “raw meat eater” in some Inuit dialect of Canada. Some may take offence, but it’s not entirely inappropriate. “Inuit” just means “people” which is clearly vague (“Inuk” is one person).

            The species of seal and age when shot determines the distinctly terrible culinary experience. I am told some seal are much tastier than others. There is a much appreciated tradition of stuffing a seal with appa (a guillemot sea-bird) setting both out in the snow to rot and develop a powerful bouquet. Most of the seal I have eaten however, was raw, fresh and sometimes frozen. I enjoyed the exotic experience, but never got use to the very oily, slimy, bloody, snot, pungent fishy smell, taste, and texture. The scent did not fade easily and I preferred to not to have seal in my home. Seal can be boiled in milk to minimize the taste, resembling chicken perhaps in a spicy Thai dish. A popular dish in Greenland is suaasat which varies greatly from family to family but is usually rice in seal blood, perhaps onions, potatoes, spices, and always chunks of land meat or sea mammal.

            We snacked on dried fish. My favourite came from far north, Uppernavik, I believe (ratlinger — spelling?), which was a white fish, maybe halibut, that was left to dry in the snow for months without preservatives. It retained it’s oil and lightly salted from the sea.

            Reindeer is popular, always wild and hunted. Sometimes solid reindeer fat flavoured the ubiquitous coffee.

            Muskox is without question the tastiest meat on planet Earth, a lamb under a ton of wool whose flesh is marbled with copious Arctic warm fat.

            Mattak must be the national snack of Greenland. It can be a few centimetres of skin and blubber from a variety of whale. It is tough and chewy. The uninitiated might spent hours chewing a piece the size of a die. Mattak is nearly always raw, although it might be fried or boiled, perhaps in sushi (modern innovation). Mattak is often partially sliced like a comb and dipped in soy sauce. It is the centre piece of many celebrations or luxurious “beer nuts” at a party.

            Whale meat can be very tasty although I never got the hang of cooking it myself. I think the crimson blood needs to be drained lest the whale steak tastes like battery acid. When prepared by a competent Greenlander, it’s a nice mildly fishy very dark meat, somewhere between pork and tuna with more flavour than either.

            I have never tasted polar bear, but when shot in town, it is often fed to the elderly and school children to reduce the demand for the flesh. I am told it doesn’t taste very good anyway. Eating the liver delivers a toxic dose of vitamin A. Woman are particularly susceptible to a hysteric condition called “Piblokto” (perhaps running around naked in the dead of winter -40 C, attacking friends family, or other crazy acts) which might be caused by vitamin A overdose.

            I likely accumulated several life-time doses of mercury, PCBs, and other neurotoxins. There are villages in the north with only girls, no boys born for decades, suspected (as I heard) to be caused by oestrogen analogues from pollutants concentrated at the top of the marine food chain. Whales and human mothers give their first born child a (often lethal) dose of these toxins in their breast milk.

          • largelytrue

            Which villages have such a profoundly skewed sex ratio, and is this confirmed in documentation? Preliminary investigation on my part suggests that if there is a problem with sex ratios due to these pollutants, the threshold for effect is reached almost nowhere, or the effect is relatively weak in arctic populations typically observed: http://www.ncbi.nlm.nih.gov/pubmed/22287096

          • Alex

            I obviously haven’t done the counts myself, but I’ve visited tiny villages (bygt) with no or few girls. Traditional villages (subsisting on marine mammals and hunts) have tiny populations today (teens and young adults often leave for the bigger towns for education, entertainment, divers nutrition, ..) so statistical significance is likely tricky.

            http://loe.org/images/content/070921/Health%20Effects%20of%20POPs%20in%20Arctic.pdf (last few pages)

          • Alex

            Another thing that you may find interesting is that a typical Greenlandic diet (even today) has a 1:4 omega ratio (n6:n3) while most of us subpolars eat something like 15:1 with maybe 3:1 considered well balanced. Danish nurses are warned that Greenlanders bleed more easily and longer. I’ve read/heard Paleo people deny that fish oil increases blood flow and minimizes clotting — I suspect because their oils are rancid — but I have direct experience with this bleeding (particularly after DE or straight shaving).

          • Lawrence

            That reminds me of a talk given by William Harris, M.D., a founding member of the Vegetarian Society of Hawaii (a going concern), in which he talks about the potential effects of eating too much flaxseed vis a vis bleeding:
            https://www.youtube.com/watch?v=9FF2tAvtW1I&feature=youtu.be#t=51m42s

            Dr. Harris isn’t mentioned in this forum that I have seen, but he has some very informative talks catalogued neatly as follows:
            http://www.vegsource.com/harris/My%20Videos.htm

            Dr. Greger is quite familiar with the VSH as he lectures there regularly (preferably in North American winter I would presume :-} ) along with others:
            http://www.vsh.org/videos.htm

            BTW, I enjoyed reading your vivid descriptions of Greenland dietary proclivities. You must be a very interesting fellow, indeed.

          • Alex

            Harris’ Hawaii lecture has some really interesting omega-* stuff. I’m surprised he had such strong reactions to only 2 teaspoons of ground flax. Considering the content of his lecture it’s fair to assume he limits his omega-6 drastically and was likely producing copious EPA (n3). I also notice mildly bloody shaving results just after consuming 2 TABLEspoons of flax.

            Greenland is a majestic and magical land. Do visit if you have a chance. Take it real slow.

          • Awesome info Lawrence, thank you. In the past month or so I’ve had very easy nosebleed events; simply washing my face in warm/hot water triggers it. So I have to use cold water. I’ve had no recent trauma to my nose although I have had it quarterised twice when in my early twenties (kickboxing injuries that probably aggravated an old injury when 12yrs old and had a hockey stick smack me in the face and knock some teeth out and cause a hairline fracture of my cheekbone). Now I cannot be sure just yet if the flaxseed is the main cause here but I’ll reduce my intake. Currently take 2-3 tablespoons a day, so will reduce to below 1 tablespoon. Cheers

        • Veganrunner

          You had an angiogram at 36? That’s interesting. I think what Adrien is saying is that a total cholesterol of 200 will put you in the normal range but it is normal to die of heart disease. Most doctors will not tell you to get to 150 or below. They just are dumbfounded when they see those numbers.

          • Chris

            yes I did as my older half brother died of heart disease…smoker, stress case, over weight. So I opt’d to “see” how the plumbing was working.

        • Sammi

          Chris a good test of your arterial elasticity is: take blood pressure then subtract the lower diastolic number from the higher systolic number the result should be between 40 to 50. The stiffer your arteries are the higher the number, the lower the number the less efficiently the heart is working.

          • Chris

            42

        • Adrien

          Lipids were right in range

          If you follow nutritionfacts you should know that “normal” range for blood cholesterol isn’t a healthy range:

          Optimal Cholesterol Level

          • Chris

            http://www.ncbi.nlm.nih.gov/pubmed/20598142
            http://www.ncbi.nlm.nih.gov/pubmed/15721501

            http://www.ncbi.nlm.nih.gov/pubmed/2549726
            Like I said…been eating eggs almost “daily” since a child…cholesterol has always been 200 range LDL 100’s and heart cath done and 30 years+ eating eggs and “high” (as you put it) cholesterol and no heart disease after 30 freaking years of eating higher fat…bunk.

          • Adrien

            Good for you, you are like my uncle smoking cigarette. An exception to the rule, probably due to your daily exercise regimen. But, you still have many years to live and It may change. I’m sure you understand that we can’t use your case to recommend anything to anybody, just like we can’t recommend cigarette based on my uncle story. On a population level these numbers are deadly, yes indeed, deadly.

            You can’t justify yourself with study already know to be bias.. and financed by the Eggs Industry!
            David Katz’s Study? You got to be kidding me! It has been debunked years ago.
            Eggs and Arterial Function
            https://youtu.be/guyQW6n3f6o?t=15m17s

            Personally I don’t care about your third study link “Various biochemical indicators in prenatally alcoholized rats”.
            My mother wasn’t an alcoholic rat, and I’m sure your mother wasn’t either. I’m not sure why you care about it..

            Personally I choose a good diet AND the exercice not one or the other.
            And I have way better than optimal cholesterol level to show.

          • Charzie

            Jim Fixx comes to mind…it ain’t just exercise kids! Personally, I prefer not to rely on the luck of the draw when I know how to do better!

          • Adrien

            I didn’t remember his name, but I remember reading about him in Healthy at 100 from John Robbins. He has a nice chapter about exercise and health. I think he mentioned Jim Fixx as a great exemple that exercice isn’t going to fix the damage of a poor diet. Which is true. Speaking to Chris recently remember me of this great example.

    • XCmanCraig

      You’re balanced with regular excercise. Most people expect results from diet alone. You can’t do nothing all day and expect to lose weight and be healthy. Diet and exercise go hand in hand.
      If you cannot do excercise due to injury, you midst lean heavier on a stricter diet.

  • Joe Caner

    Meat, meat, what a treat!
    Gangrenous diabetic ulcers
    And amputated feet…

  • Sammi

    I recently began a vegan diet and have been doing well with it and I eat beans at least once a day they are my main protein source. I had a blood anti body general food test and the results were that I had a mild allergy to a bean mix which were all in the phaseolus angularis family (black northern, green, kidney, navy, white). Range was 1-8 and I was a 1. Black eyed peas, lentils, garbanzo beans are a different species and not in the test. Does this mean if I continue to eat those bean species the allergy will escalate? Is it likely that the other species will not cause problems? I had no peanut or other food allergies so I am also wondering if the new diet has caused a temporary situation? I had this same food test as a meat eater 5 years ago and the meat I ate the most showed up a mild allegy, but on the new test showed non allergic. I would appreciate any comments or ideas? Alex you sure did your research and made some interesting points!

    • Veganrunner

      Hi Sammi,
      So you didn’t have any allergies before becoming vegan? And then developed allergies? Or did you have allergies and then go vegan and then have the tests? Just wanted a bit of clarification.

      For me I had allergies before going gluten free vegan. (Gluten/wheat gives me a stomach ache) I would go into someone’s house with a cat and my eyes would start to itch and water. Something really strange has happened. I can now (3 years vegan, 7 years dairy/gluten free ) pet a cat and not even wash my hands and no response at all! No runny eyes etc. Who knows-I could probably even have a whole wheat sandwich!

      It is crazy all the changes that can happen when one tweaks the diet.

      • Sammi

        Veganrunner thanks for the reply. No, I have never had significant allergies in my entire life. In my first antibody allergy test I was surprised I showed a 1 (scale of 1-9 Nine is worst reaction), I showed 1 on beef, pork, chicken which is what I ate one of everyday. On the recent test all meats were 0, but now the bean thing was all 0 back when I ate meat and now that is 1. Could it be that the body shows mild antibody response to any food eaten frequently? I am going to have a chickpea sandwich for lunch and see if I feel anything weird? Really bummed about my favorite beans but they were all the phaseolus angularis bean family and chickpeas, lentils, and peas are not.

      • Stewart

        Glad to see your story Veganrunner. My psoriatic arthritis came under control by eliminating gluten. Still had flair ups until I eliminated all animal products. Now I have no gluten sensitivity at all nor arthritis, and,,, after almost 50 years, the plaque psoriasis is greatly reduced and allergies seem to be greatly reduced as well. And I no longer have the gluten sensitivity. I will tell you though, it took a few years to be willing to go near gluten.

        Now I love my whole grain breads again. I do hope that works the same for you. I have been told by many others that this is common.

        • veganrunner

          Stewart that would be so great!

          I am a bit nervous about giving it a try though. I have an autoimmune disease called Acquired Atresia. So basically my eardrums thickened to 1/4 inch. Pretty difficult to conduct sound to say the least! So each of my eardrums were replaced. And they thickened–again! I went into the surgeon and said, “ok, lets replace them again.” He said I can’t do that they are inflamed and it will just repeat. I went home and spent days on PubMed researching the disease. Did he do the right surgery? Was I getting good care etc. And what kept popping up was autoimmune-inflammatory-allegies. So here is the kicker. I ate 99.9 % organic, a ton of veggies and vegetables etc prior to changing my diet. But I ate gluten and dairy. Once I gave those up my condition reversed. No more inflammation in my ears. So the surgeon agreed to replace my eardrums again. I have perfect hearing and no sign of inflammation at all 5 years later. But boy would I love me a veggie sandwich on a nice hearty bread!

          • Stewart

            I’m impressed. Yes my md did want to give me Methotrexate to suppress my immune system and when I found out what it was I got real interested in the research on how a haywire immune system goes off on you. When I went from constant pain to snapping my fingers and dancing again by avoiding gluten I had no problem avoiding it. Then I noticed after the wfpbd began and even the residual swelling disappeared that things that had caused a flair up no longer did. So I started challenging my body more and more and found the gluten sensitivity was gone.

            Your condition with hearing loss sounds, if anything, even more intense. In your situation I don’t know that I would be willing to challenge my body with a formerly known allergen or not. I do know that It took me a over a year before I was willing to do so. Pain can be very instructive. Maybe start with a half sandwich or less, maybe a whole wheat pita chip or two.

          • veganrunner

            Right. The thing is my symptoms is hearing loss and it’s too late. i love you story. When people say how can you eat like that? I respond, “I like to hear.”

          • Charzie

            Not sure if this would be helpful, but I switched to making my own sourdough bread with wheat, which essentially ferments the grains instead of just yeast rising them, and it seems to eliminate most of the issues even in people who are normally sensitive to wheat/gluten.

    • Alex

      Hey Sammi, I’m glad Veganrunner responded well; I don’t have a clue about allergies. But I’m all in for most other vegan questions. Ahimsa!

      Having had doubts myself, discussing with Paleo, Atkins, other dietary suicidal tendencies, and appeals to our desires and wallets in exchange for books and blog eyeballs, I’ve learned to be sceptical, always on the look out for the counter-argument. Your friends will challenge your nutrition (often desperate to justify immorality) and it’s good to know the facts, research afterwards, or refrain from discussion just to keep sane. We all have a responsibility to ‘keep the good doctor honest’ so that he can keep us well informed.

      • veganrunner

        Alex your original post was good. It made me research serving sizes. So when we consider serving sizes the animal is leaps ahead. Tofu can be an issue. When I first went vegan I was trying to figure out how to do it, so I would eat 1/2 block of tofu. Oh my! Way too much. I think an ounce is a serving size. The size of a couple dominos.

        • Veganrunner

          Correction. 3 oz. or 4.5 servings per block. Yup. I was over doing it!

          • Sammi

            At least it would have been more satisfying if the tofu had been chocolate cake. By the way I have a great recipe for silken tofu chocolate mousse.

          • Alex

            I’ve heard it’s fairly easy to make tofu oneself. I let the project lie because I don’t enjoy plain old cooked soy beans (but I do like tofu, hmm). My latest ‘innovation’ is making hummus from different beans, like black bean, yum. But I guess I’m kinda boring most days: chop or boil.

            When I do have to bake up a treat, I’m inspired by http://ohsheglows.com/ . She’s got quite a few no-bake vegan cakes that are hard to mess up and easy to love. :)

            https://www.google.dk/#q=site:ohsheglows.com+chocolate

      • Sammi

        Another idea is what makes posting worth the time. Someone else may have a perspective you never considered.

  • Robert Haile

    Alex has provided us with a lot of information and to be fair to him, I would like Dr Gregor to respond.

    • Joseph Gonzales R.D.

      I appreciate his links! I did reply to his original question. Please read it and see if that helps?

      • Robert Haile

        Thank you.

  • Wjgood

    I wonder why India and China are experiencing such epidemic levels of diabetes? One would assume they eat much less meat then Americans.

    • largelytrue

      Ever heard of the global nutrition transition? The huge presence of KFC in China? Consumption of junk has massively increased, and while much of India has a preference for vegetarianism, they love their ghee, their oil, their curd, and their sweets.

    • Stewart

      Yes they do on average eat much less meat than Americans. However the SAD tends to produce diseases of affluence. So as as some do become more affluent they adopt more of the greasy fast food that afflicts our society. And brown rice is no longer a healthy choice when infused with fat, milk or cheese and served with stir fried meat and now greasy veggies.

    • Adrien

      This may be informative for this topics:
      If White Rice is Linked to Diabetes, What About China?

      Oil consumption went up 20%, pork consumption alone went up 40%, and
      rice consumption dropped about 30%. As diabetes rates were skyrocketing,
      while rice consumption was going down.

  • Chris

    I see that! again…the categorize to many people all in the same group. It’s like when you get your test levels checked. The reference ranges are so across the board! And they lump everyone man’s numbers into those ranges. Now you telling me a 55 year old guy with diabetes and is sedentary should be used as a “study”??? Come on!! no! the should take men who are fit from 20-70 and work out with no heart disease and use these numbers to see where all men should be!! its all BS!

    • veganrunner

      But Chris that would be a different study. Which I agree we need. But that doesn’t make this population BS. It is actually most accurate because it is the population in the States. So you must have studied statistics and research in your masters program-right? But what great research that would make. Who knows it may actually have already been done. Did you look it up?

    • DRHURLEY

      Chris – I am curious what your Total Cholesterol and ratio of omega 6 to omega 3 is on that diet? As a fellow exercise professional who “benefits” from low cholesterol genetics, it still took dropping eggs and keeping animal protein intake to less than 10% of calories to bring Total Chol. down to 148. You also must know as an exercise professional that DOMS are dramatically reduced or eliminated on a WFPB diet.
      I am ten years older than you and at a recent training event was more than twice the age of the next eldest, and I too was showing them up. But at 43 you are reaching the point in life when things start to change that you have little control over – so pretty soon you won’t be able to bang out those press-ups like before. The World Heath Org suggests that given where we are in medicine and health understanding today, one should live to at least 92 years of age, and if you die say at 82 they track what they call years of lost life (10 in that example) Of course the crunch is the quality of life in the years up to 82.
      As regards balance there is no doubt that your diet stacks the deck in favor of prostate cancer – the land of your father’s birth is full of examples, from whence I come. I have an 83 year old uncle (an avid rugby player in his youth) who had a prostatectomy many years ago and now wears a nappy. Not pleasant. Good luck.

    • Jim Felder

      Chris, I so completely agree. At a minimum there should be an arm of the study that includes subjects who aren’t overweight, sedentary and sick to broaden the range of baseline values seen. In so many studies the range of values the thing being studies is so narrow in the test subjects that it would be impossible to see any difference. For example if you are looking at the effect of total dietary fat on soft end points of cardiac health like BP, cholesterol and maybe A1C and CRP, it is useless to have the high fat group eating 35% fat and the “low-fat” group eating 30%. There just isn’t enough range to pull a clear signal out of the results. Instead they should recruit folks who eat a 10-15% fat diet. Also they should include some that aren’t already obese and diabetic and hypertensive in each arm to see if the underlying health of the subject makes a difference in how they respond.

      But they don’t. Rather this very study concluded that a “low-fat” diet had no effect on lowering measure of risk for heart disease where nobody ate a low fat diet.

      Tufts University is currently exploring the feasibility of conduction a very large study they are calling ADAPT. They are looking for people who follow eating patterns like plant based, paleo, low carb, Mediterranean, Dash, and others with the intent of following this cohort for years. Now if this study gets off the ground this could be very interesting to see what the effects of these widely dispirit diets with widely different foods have on both soft and hard end points over a significant number of years.

      You can help out by taking a short study to help them determine if they can recruit enough people to make this study possible.

      http://hnrca.tufts.edu/studyadapt/

  • Veggie Eric

    Kudos again Dr G! So many great options and substitutions available. It’s really not that hard to dump meat in this day and age. The hardest part is learning to cook and prepare meat-less food at home… and on that note, I’m off to make a black bean and mushroom burger. yum!

    • Joseph Gonzales R.D.

      Awesome! FYI we’re about to announce a recipe list for NF! Finally! I’ll write more about how this recipe blog will come into fruition and how folks can submit a recipe, if interested. Stay tuned. Plenty of time to perfect the mushroom veggie burger recipe!

      • Joe Caner

        That’s a great idea! Accepting the notion that switching to a WFPB diet is ideally suited for optimal health given the preponderance research sited on this website is one thing. It is entirely another matter altogether to put that new dietary pattern into practice.
        Recipes, video demonstrations and cooking tips are the catalyst that can assist those who are interested in doing so make that transition.

  • Jim Felder

    It was right there on the screen, so why is it important if he read it or not? If he needed to suppress that little bit of information because he needed to carve off the edges of the square peg to make it fit into his round hole, why would he have not just edited that out? The answer of course is that Dr. Greger isn’t trying to hide anything. There are links to every study he uses in the video directly below each video. All you need do is click on the link and you can be reading at least the abstract if not the entire paper in seconds. He couldn’t make it any easier for you to fact check him. Are these the actions of somebody who is trying to actively filter results to fit a preexisting conclusion?

    You would have a much stronger case if you could back up that cherry picking claim by showing excerpts from the papers he cites that in fact show that the results of the study are the opposite of his statements about it in the video, or where he left out more significant fact contained in the cited studies and only focused on side issues raised in the paper. Are you able to do that? Even better you could do your own research and find other papers that come to different conclusions than those presented here and you could point out results that he was ignoring and why the studies not cited were stronger and/or relevant to the subject than the studies that were cited by the video. Are you up the challenge?

    • Wjgood

      Gosh Jim, I’m doors if I hurt your feelings,
      I’ll paste this from the website etiquette:
      Why does the site seem biased against certain foods?
      For the same reason that the website of the American Lung Association probably seems biased against tobacco. The Philip Morris Corporation has come up with more than a hundred studies showing the health benefits of smoking. For example, the nicotine may help schizophrenics with psychotic symptoms and smoking may affect immune function sufficient to benefit ulcerative colitis. The tobacco industry used these studies to accuse former Surgeon General C. Everett Koop of “selective reporting” when he argued that smoking caused cancer.

      The reason Dr. Koop chose to focus on anti-tobacco studies is presumably because he was trying to accurately reflect what was in the scientific literature. The best available balance of evidence strongly suggests smoking is bad for most people’s health, and the same could be said for many foods. So when the tobacco industry dismisses public health professionals as being biased against tobacco–of course they’re biased against tobacco. To be biased against smoking is to be biased against death and disease. That’s kinda their job.

      No one has to smoke, but everyone has to eat. So there’s an additional opportunity cost to eating unhealthy foods beyond just how bad they themselves may be for our health. Every Twinkie we put in our mouth is a missed opportunity to eat something healthier.

      Maybe if you WFPB diet people would tone down your dogma you might convince more people to take a look at your lifestyle. As it is you only alienate, when its my way or the highway. Have a great day, and peace be with you.

      • Alex

        Hey bro, I’d like to apologise on behalf of all “you WFPB diet people”. If you’re in my ‘hood, I’d invite you to a nice healthy tasty meal. I hope that’s all the convincing someone should need. Wa Alaikum as Salaam

        • Wjgood

          Thanks Alex. I appreciate your response. Maybe I’ll take you up on that! Peace.

          • Alex

            Drop me a note when/if in Copenhagen. I’ll do some GI research first (or whatever works best for you). :)

            I don’t know about religion, but vegan principals are ideally the result of logical and ethical conclusions. As part of a strategy to minimize harm by maximizing the number of conspiring humans, vegans could be more understanding of those who do not fully share, or not yet embrace, or unable to follow those same principals.

            Peace, indeed!

      • veganrunner

        When I first found this site many, many years ago I was eating meat. But I never tried to convince people on this site it was ok and that their “no animal” stance was wrong. I just listened to the videos daily (there used to be 5 a week). I read the various posted research articles. When a couple of the regulars suggested nicely to try giving up animal completely to see what I thought, I gave it a try. They were never dogmatic with me. Could it be that you are trying to convince others that eating meat is ok? The final nail in the animal coffin was after reading Finding Ultra and Eat to Run. Both athletes are vegan and competitive. I thought-why not!

        • Wjgood

          Honestly veganrunner I’m not trying to convince anyone that eating meat is right or wrong. But that’s my point. I admire people who eat a plant based diet and fully support them in their efforts. But it seems to me that a lot of vegetarians/vegans treat their diet almost as a religion. And while I have changed my diet immensely over the years I’m always seeking out new info.
          Just to be clear, I am a diabetic, type 2, thanks to some bad Genes I don’t produce much insulin. I’ve never been overweight (BMI 22) always exercise, and eat a low carb diet primarily wild caught fish, tons of organic salads and vegetables, berries, nuts and seeds.
          Following this I’ve kept my A1C at 5.5 for years now with no meds.
          I would venture to say I eat as much or more organic produce then your average vegetarian.
          Like I said I admire people who have gone strictly plant food but it hasn’t worked for me. Protein and veggies keep my blood sugars down. Grains and legumes spike it. I refuse to take insulin to cover blood sugar spikes.
          So there we are. I try to accept and respect all people wherever they are on this path of life. It just seems to me that when someone poses a question, or a differing point of view people seem to be quick to jump on them or correct them. There should be some acknowlement that no one way is right and we are all learning together. Thank you though for your kind reply.

          • Jim Felder

            Wjgood. I took a deep calming breath and would like to apologize if I came across as stuffy and prickly. As a researcher you just hit a chord with that whole cherry picking thing.

            I have family that are diabetic and others that are close and will end up diabetic if they don’t do something soon. I know that the conventional wisdom is to keep your sugar in check with a low carbohydrate diet. The trouble is that while such a diet does do that, it is only managing the symptom of diabetes, insulin resistance. It does nothing to treat the root cause of why you have insulin resistance. There are a number of videos here that review research on what is the root cause with a lot of evidence to show that it is free fatty acids being stashed in the muscle cells (so called intra-myocellular lipids) that are like gum in the insulin lock keeping insulin from doing its job of moving sugar out of the blood and into the cells, especially the muscle cells. The result is that sugar builds up in the blood. You can take two approaches. The low-carb approach works to reduce sugars so that gummed up lock or no, there isn’t much sugar to build up. The plant-based approach goes after the gum in the lock and has been shown to reduce the amount of intracellular lipids (fat in the muscle) dramatically in a little as one to two weeks. There have been a number of clinical trials of using a plant-based diet to not just control type II diabetes, but to actually reverse it. If as you say that you don’t have many islet cells left, you might never get back to normal sugar handling, but you should still be able to get your body to effectively utilize the insulin that it still does make even though you might still need to supplement it with other drugs or injected insulin.

            I highly recommend reading “Dr. Neal Barnard’s

            Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs”
            http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1?ie=UTF8&qid=1440212963&sr=8-1&keywords=barnard+diabetes

            And there are videos here that review the science behind this idea. There are far too many to list. Just type diabetes into the search bar and dozens will be displayed.

            Just one word of warning. If you do decide to give it a try, and are injecting insulin, please, please, please work with your doctor. This approach can be so effective at restoring insulin functionality that you might have to carefully monitor and be ready to scale back medications to avoid dangerously low blood sugar.

            Best of luck

          • Wjgood

            Jim, there is no need to apologize. It was I who came accross crass in my initial response. I appreciate your objective response and I totally understand how the term “cherry picking” could stir up ones emotions.
            I’m not a researcher by trade but have done a ton of research on my own over the years and at times have felt like just throwing my hands up in resignation. There are so many conflicting studies, and yes I could provide you with some, but suffice to say I would be only wasting your time and mine. I’m sure your familiar with many of the conflicting results from many well designed studies. However having said that I want to restate I find this website informative and very stimulating.
            Your right there are many great articles and videos on diabetes on this site that I’ve yet to explore. It’s just been so frustrating to deal with diabetes, but I’m not looking for sympathy. I take it as a challenge and refuse to be beaten by it. I also want to set an example for others dealing with this. I sometimes wish it was just insulin resistance as I could then more easily approach a full plant based diet. But I’ve had to tread carefully. I will say other then fish and occasional chicken I eat no red meat or pork.
            I have looked at some of Dr Barnard’s work and will check out his book at the library. I’ve also followed Dr Bernstein, himself a Type1, who is an advocate of low carb.
            I’m not a low carb fanatic, and only follow it as its work for now. Ultimately I’d like to try a program that Dr Mcdougall offers:
            https://www.drmcdougall.com/health/programs/10-day-program/

            Thank you for your thought out and reasoned response. One thing I’ve learned is I’m never to old to learn, and in the future I will pick my words more carefully. Thanks for the ideas and avenues to pursue.

            Bill

          • Jim Felder

            Bill, I think a lot of McDougall’s program as well. The thing I like about Barnard’s book is that he had recipes that featured low glycemic index plant foods that help to keep blood sugar under control while the diet helps your muscles do a little house cleaning and get the fat out. My understanding is only under high levels of circulating FFA do those fats get stash fat in the muscles, so given an opportunity the fat out of the muscles when the circulating levels of FFA drop. That means the effectiveness of the diet isn’t predicated on losing a bunch of weight, which is good since you say that you are already lean.

            The trouble is that the source of the free fatty acids is mainly from saturated fat, the very type of fat that is highest in most low-carb diets. So instead of fixing the root cause of diabetes, a low-carb diet that is high in saturated fat may in fact *be* the root cause of diabetes. Thus the recommended diabetic diet might in fact be the cause for why once developed diabetes only progresses and never reverses or stays the same! It is like treating somebody for a toxic effects of a low level poison by putting them on a diet containing the poison.

            Also non-estrified fatty acids (NEFA) that come from saturated fat also reduced insulin output from the pancreas.

            http://nutritionfacts.org/video/what-causes-diabetes/.

            So the same high saturated fat diet that is causing insulin resistance looks to be also reducing the body’s ability produce more insulin to compensate.

            The good news is that without the suppressive effect of saturated fat, you body might be able to produce more insulin than you think it can. And even better new is that the effects of going whole hog (so to speak) and going 100% plant based (with sufficient fore thought and planning and practice so it isn’t punishment food) appears to be rapid enough for many people that you could just take a food holiday, and give Barnhard’s diet a try for a month and see what happens. If it doesn’t work, you haven’t lost years to a futile treatment. And if it does work, you will have to decide which you like more, meat or being non-diabetic.

            Oh, and do make sure you eat enough. Plants foods have lower calorie density than animal foods so to get enough calories to be feel satisfied, you might have to eat what feels like obscene volumes of food. Not eating enough is a very frequent mistake people transitioning to a plant based diet make. So eat until you are full, not until you have eaten what you think is polite. For example my wife and I use large mixing bowls as personal salad bowls. And we make our own simple home made dressings that have all the flavor without the free oil. The result is a large amount of the most nutritionally rich food you can eat at the cost of just a couple hundred calories. And even then most of those come from the toasted pumpkin and sunflower seeds we put on top to get some fats to aid nutrient absorption.

            I wish you every good luck.

          • Veganrunner

            This is it! I felt the exact same way regarding my autoimmune disease! ” felt like just throwing my hands up in resignation.” I felt like there wasn’t a doctor out there to help and that I had to figure it out by myself. That is where this website and the posters helped. After going WFPB and seeing the miraculous change I would never consider going back. And the way I approached it was–why not try it and see what happens. I can always add the meat back in. (Did you say dairy and fish? No beef or pork?)

          • Charzie

            Just wanted to say that I’ve heard a number of anecdotes about a type of diabetes that more resembles Type I in that the body does not produce enough insulin, but it doesn’t show up until later in life. I had Type II which a WFPB diet did eliminate quickly, but just wanted to pass this on.

      • Jim Felder

        Really, I am not trying to pick a fight, but you really should know that the the term “cherry picking” is very provocative and serious charge to level against someone who stated goal is to present unbiased summaries of the best science available. It implies a degree of dishonesty on the part of the person being accused of doing the cherry picking and challenges their integrity. Perhaps you didn’t intend to be disdainful, but to a scientist the charge of cherry picking results is no small thing.

        My challenge to you was to back up your claim that Dr. Greger is cherry picking his results. I would still very much like to see if you have something concrete to back up your claim of cherry picking.

        Oh, and a little tip throwing out the term “dogma”, also not a great entree into a rational discussion either. So perhaps those of you who have reached a different conclusion would tone down your disdain, people would be less likely to treat you as a troll.

        Perhaps we can take a step back and try this again. May I ask what research and arguments is in particular that gives you the confidence to say that the evidence presented here and the conclusions drawn from them does not represent the best unbiased science currently available on the topic of human nutrition? Can you give me references to peer reviewed studies that you find convincing so that I can read and analyze them. Who knows you might be able to point to an alternate set of studies that people will find to be stronger and more compelling than the studies summarized here.

        But be forewarned, this is a very substantial challenge. Dr. Greger and his team have been spent the last 5 (?) years reading, reviewing, rating and integrating the results presented in tens of thousands of peer reviewed studies published in all English language journals stretching back decades that collectively and from many different avenues of investigation paint a consistent and coherent picture of a diet that best promotes long term human health.

        Still in science all it takes to completely overturn even a very dominant theory is one single unambigous counter example that is completely incompatible with the theory. For example J.B.S. Haldane, the famous evolutionary biologist, responded to the question of what it would take to disprove evolution with the answer “a single precambrian rabbit”. (https://en.wikipedia.org/wiki/Precambrian_rabbit). So do you have the equivalent of Haldane’s precambrian rabbit to share with us? A study or set of studies so compelling that they completely overturn the conclusions that Dr. Greger has drawn from all of the studies that he has reviewed.

  • Rhombopterix

    I just copied down that list of diabetogenic agents in meat and put it on the door of our Cold0genic chambre. NF is a comprehensive source of good nutrition info. This info helps me make good decisions starting every morning. Primary reason I have not drifted back to SAD. Hmmmm black bean burgers you say? Commin right up!

  • Lakota in Austin

    I’m totally confused about leucine. I wanted to learn more and googled “leucine mtor aging” and every link I clicked led to articles about how great leucine is. I didn’t read in depth because I’m just not motivated enough and would rather have it explained simply. So, mTOR dysregulation seems to be the problem, and leucine doesn’t seem (according to the info I skimmed) to be implicated in this. Whereas, mTOR activation is desirable for working out and building lean muscle mass? Que pasa?

    • Lawrence

      Hi Lakota, if you watch the following two videos, in order, the information therein may answer some of your questions. Also, have a look at ‘Doctor’s Note’ in each video for amplifying information. De nada.
      http://nutritionfacts.org/video/why-do-we-age/
      http://nutritionfacts.org/video/caloric-restriction-vs-animal-protein-restriction/

    • CB

      “I’m totally confused about leucine.”

      Leucine’s an essential amino acid that animals can’t produce, but that is in high concentrations in animal flesh.

      It’s pretty hard to overdose on it.

      What’s causing the epidemic of type 2 diabetes is not leucine, but high caloric intake and obesity. The reason people would rather focus on leucine instead of calories is because they aren’t interested in reducing their caloric intake.

      en.wikipedia.org/wiki/Leucine

      • Wjgood

        Thank you. A voice of reason.

    • Joe Caner

      Wíyuškiŋyaŋ waŋčhíŋyaŋke ló LiA,
      How about this as an attempt to simplify the matter?

      1. Leucine is an essential amino acid that in too low or high a quantity is problematic.
      2. Food is a package deal (http://nutritionfacts.org/video/food-is-a-package-deal-3/). One of the things that animal food products seem to have in abundance that are not so good for one’s health, along with TF’s, SF’s, cholesterol, bio-accumulated environmental & intentionally introduced toxins such as hormones and antibiotics, is Leucine.

      Leucine is just another nail in meat’s coffin as it were, or yours to the extent that one continues eating it…

      • Lakota in Austin

        I don’t eat meat, but I’ve been adding a rounded tsp each of soy and whey protein to my Greek yogurt every morning, and between these 3 protein sources it does seem like my leucine intake may be a bit high. On the other hand, my total protein consumption is well within reason and nowhere near body-builder levels, so perhaps I shouldn’t even concern myself with it. I only eat 2 meals a day, with most of the protein front-loaded in the forms already mentioned plus spirulina, nutritional yeast, chia seeds, and various nuts. My dinner is a giant salad with lots of crunchy watery veggies and dark greens.

        Oh, but wait, there’s more — I take a lot of amino acid supplements, probably because I’ve become kind of a supplement junkie in the last 4 years as I’ve tied to correct problems from mt history of alcoholism, drug abuse, and TBI from severe concussions. I take glycine, taurine, lysine, DLPA, ALCAR, NACysteine, tryptophan, creatine, beta alanine, and citrulline. BUT WAIT, there’s MORE: I’m also working my way through a 3 month experiment with hydrolized collagen at a total of about 24 grams a day, so I reckon that between all these sources, my protein may be much higher than I’ve been assuming. However, leucine from diet is probably swamped by these other aminos that I supplement. I have no idea. I’m one of those willing guinea pigs.

        • Joe Caner

          That’s a lot of supplements. I went through a phase where I was taking a lot of supplements. When I decided to change to a WFPB diet, I figured that I’d give them up to see if I notice any difference. I ended up feeling better which was great because the supplements weren’t cheap, and more importantly, they were very inconvenient. Some needed to be taken with food. Some supposedly worked better on an empty stomach. Some were recommended to be taken in smaller doses several times a day. Some supplements needed to be taken at different times due to undesirable synergies. They were a real PITA. I was happy to be shut of them.

          The nutritional yeast, chia seeds and nuts sound good, although, the spirulina, has been the topic of a few of Dr. Greger video blogs, and the news is not favorable: http://nutritionfacts.org/topics/spirulina/

          Perhaps, you should consider establishing a baseline without them to see how you feel, and if there are reasons/biomarkers that they are suppose to be targeting, you can compare to see what kind of efficacy they are actually providing.

          • Lakota in Austin

            Thanks for your well-considered reply. I’ve been aware, almost since the beginning of my supplement habit 4 yeas ago, that I’ve gotten into a psychological trap whereby any supplement for which a few promising studies in rats can be found is a supplement I decide I should take. My diet is impeccable, so maybe I’m channeling my inner junk food addict into supplements. I don’t notice an effect from most of what I take, but I can read about their ostensible “benefits” and that’s what gets to me.

            Also, all that PITA you mentioned, that’s a plus for me. I don’t have any ritual behaviors other than the way I prep breakfast and dinner and the way I take supplements. I’ve been single for many years so I don’t have anyone nagging me about all the supplements cluttering the bedroom. The most compelling reason I can think of to stop taking most of them is that I feel fairly confident that my gut microbiome looks upon the torrent of concentrated substances and says “WTF!?!”, whereupon many of the desired species give up hope and make way for less savory characters. This is pure conjecture but it seems pretty reasonable to expect, given that none of the microbes to which we play host evolved in conditions remotely like what I’m subjecting them to.

        • KYOT

          No, you are a dumbass, who takes all of these supliments, MADE FROM ANIMAL BY PRODUCTS! What a maroon! Your ancestors, if you are indeed indian, as am I (or native american, or whatever is proper to call your lordship this week) must be also saying WTF? This clown would starve in nature!

  • Matt K

    I would like to pose a question for Ask the Doctor/Dietitian:

    Some of you are probably familiar with the works of the dentist Weston A. Price who traveled around the world and observed and documented how individuals that lived on their native foods (mainly the addition of animal-based foods) had well-developed faces, mouths with straight teeth (these populations had no access to orthodontists), and fewer dental carries. His published works are found in the book Nutritional and Physical Degeneration.

    I was wondering if there has been any published scientific research done on the role of nutrition in development of healthy mouths?

    • Joseph Gonzales R.D.

      Hi Matt K. Check out this video on diet and oral health. Let me know if these help?

  • Matthew Smith

    I don’t think it’s controversial that meat can cause diabetes, and I am glad this video attempts to elucidate some of the reasons why. If the risk is at one quarter chicken breast, how does that flush out in the general population? In America, 29.1 million people have diabetes, including about one in four senior citizens, up from one in nine Americans in total. One website said that up to 25 percent of America has prediabetes. Is meat the main culprit? Other factors include weight, lack of exercise, and poor lifestyle. It is hard to imagine being overweight as a vegan. What should you do if you have prediabetes or diabetes? This website suggests a Whole Foods Plant Based diet can immediately correct blood sugar. There are other specific foods, including: hibiscus tea, cinnamon (regarded as toxic), flax seed meal, amla, beans, coffee, soy, flaxseeds, green tea, chamomile tea, purple potatoes, sprouts, whole grains, and vinegar. A study in the Lancet found remission in Insulin-Dependant Diabetes on 3 grams of niacinamide, with other vitamins being reported beneficial.

    • Jim Felder

      Strongly recommend reading “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs”.

      He also has a number of videos that you can find on YouTube, especially his TEDtalk, that are also informative.

  • Rhombopterix

    http://finance.yahoo.com/news/paleo-diet-based-flawed-logic-203001033.html

    There are better articles on this but something in this one caught my attention…
    I note that Karla pinched Dr. G’s “tag line” about 3 paragraphs down. Sincere flattery?

  • Rhombopterix

    I did a simple calculation that’s got me curious. I googled up “cholesterol in an egg” and found 210 – 213 mg. Also google provides data to the effect that a person has about 5 liters of blood. I think that is 50 deciliters right? So If I divide 200 by 50 I get 4 mg cholesterol/deciliter if all of that cholesterol goes into my blood. Is that right?

    There is no way that I am going to eat any cholesterol-containing “food”, especially something that could bump my good number up 4 whole points in 2 or three bites. Not to mention the saturated fats and other junk I don’t need that comes along for the ride.

  • John Tiffany

    Dr Greger—Your videos and articles
    are great. How healthy or harmful is bison burger?

    • Wade Patton

      I’m not he, but I’m pretty sure that if you look around here at the evidence already compiled you’ll find that any way you slice, dice, and cook up any sort of animal flesh meal you’ll be facing exogenous endotoxin issues. A little bit won’t kill you but it’s not a good daily choice. See: http://nutritionfacts.org/video/the-exogenous-endotoxin-theory/ (and related)

  • Rodrigo Cardoso

    at “They’re now exposed to hundreds
    of chemicals from their moms, straight through the umbilical cord, some of which may be
    obesogenic — obesity generated.”
    ‘obesity generated’ means generated from, or in, obesity, right? In the context of “Obesity in a six-month old is not
    related to diet or lack of exercise.” and this – https://en.wiktionary.org/wiki/obesogenic – could there be a mistake, and ‘obesogenic’ means something closer to ‘generating obesity’, or involved in the generation of obesity, instead?

    • largelytrue

      I think that Greger mumbled a bit on the last syllable and you heard “obesity generated” when he said “obesity generating“. ‘Obesogenic’ is what you think it is — just as ‘carcinogenic’ identifies something that causes or produces cancer, ‘obesogenic’ identifies something that causes or produces obesity.

      • Rodrigo Cardoso

        Thanks for clearing that up. Translation almost ready to go out.

  • walterbyrd

    Published 12 August 2015

    Funded by World Heath Organization.

    > Saturated fats are not associated with all cause mortality, CVD, CHD, ischemic stroke, or type 2 diabetes, but the evidence is heterogeneous with methodological limitations.

    http://www.bmj.com/content/351/bmj.h3978

    • george

      1st review I read on this ‘cholesterol deniers’ study was the good Dr Esselstyn. He’s on top of it already.

      “Andrew M Freeman MD
      Caldwell B. Esselstyn, Jr. MD
      National Jewish Health
      1400 Jackson St. J307 Denver CO 80206

      Much work has already shown adverse outcomes from too much
      saturated fat in the diet, in addition to the development of diabetes,
      heart disease, and other cardiovascular events. As such, your work
      published here has gone too far in that anytime one over-adjusts for
      important variables, the real data and trends become hidden. it is
      analogous to over-smoothing an image — the granular image becomes so
      smooth it obscures some of the salient features.

      As the authors indicate in their own work, a 5% increase in saturated
      fat increased mortality by nearly 5% — this is a highly important trend
      that was not included in the final conclusions.

      Furthermore, recent work (1) reported experience eliminating
      saturated fats in 200 participants with significant cardiovascular
      disease. They were requested to eat whole food plant based nutrition
      and avoid oils, meat, fish, poultry, dairy products, eggs, and sugary
      drinks. After 3.75 years of follow up highlights of the 177 adherent
      participants included:

      1 Program adherence 89.3%

      2 Elimination of major cardiac events (heart attack, stroke, death) 99.4%

      3 Resolution of angina 93%

      4 Evidence of disease reversal via angiogram,
      carotid ultrasound, stress test, resolution of claudication and erectile
      dysfunction.

      5 Twenty-seven participants successfully avoided
      previously recommended interventions of stents and bypass surgery.

      This study, the pioneering work of Ornish and more recently others
      employing similar techniques, makes it inconceivable to embrace
      saturated fats and disagrees with the findings of De Souza, et al.

      Caldwell B. Esselstyn, Jr., M.D.

      Director Cardiovascular Disease Prevention and Reversal Program

      Cleveland Clinic Wellness Institute

      1950 Richmond Road

      Lyndhurst, Ohio 44124

      Andrew Freeman, MD, FACC

      Co-chair, American College of Cardiology Nutrition Workgroup

      Director of Clinical Cardiology, National Jewish Health, Denver, CO”

      • walterbyrd

        Awsome find.

    • This will spread like the heavy metal kale story and the “A 40 something Vegan had a heart attack!” story. Oh how the Machine delights spinning up some bad news, Especially when it is phony.

    • Tom Goff

      Yes, but wasn’t it conducted by a team from Hamilton University which has had links with the Canadian dairy industry for some years? And the team acknowledged assistance from US academic RM Krauss who has a history of receiving funding from the meat and dairy industries, and the Atkins Foundation. Additionally, they had to adjust the figures to factor out cholesterol levels to achieve this null result. Since one of the key ways in which saturated fats affect human health is by raising cholesterol levels, this seems like a very convenient adjustment for saturated fat advocates.

  • Rodrigo Cardoso
  • Patrick Hocking

    I generally was interested in this article, but was very disapointed when I started noticing PETA funded false accusations. Unfortunately that does exist. The entire video was pointed to a negative conclusion, but some of the graphs listed were actaully positive. Why are meats and eggs being compared to cabbage and apples when regarding Leucine and why is meats blamed for problems caused by carsinogens. Just don’t eat burnt meat. Of course utilisation of Leucine will never be mentioned. Did they run these tests on a unhealthy babies? The tests will have totally different results when run with healthy males/females or even better, athletes and bodybuilders, but you will never hear that of course

  • Alex

    Hello Docs and Nutritionists, I wonder if you could comment on this article. The conclusion states that after cancelling out cofactors (smoking, etc) processed meat increases all-cause mortality but that red meat over vegetarian does not. But that’s not quite what I understood while reading the actual article. What’s your take?

    Meat consumption and mortality – results from the European Prospective Investigation into Cancer and Nutrition( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599112/ )

  • Brandon

    You mention that dietary fat, especially saturated fat, inhibits proper glucose uptake by cells causing insulin resistance and diabetes. You also note in another video that nuts correlate with general health and fat loss.

    Is it simply the source that matters? Are all fats other than whole plant fats harmful, while whole plant fats are healthful?

    Thanks so much!

    • Joseph Gonzales R.D.

      Exactly! The source seems to matter. Unlike saturated animal fats, plant fats don’t cause that inflammation spike immediately after consumption of animal foods, which makes sense because as you’ll remember it may be the dead bacterial endotoxins in animal products ferried into the body by saturated fats that are to blame. Dr. G talks about this in his comment on endotoxin theory.

      Here is more info on saturated fat, if interested. ​I also love these videos that explain the research between nut intake and body weight. Make sure to checkout the bottom of the video’s “Doctors Note” to see more links and info. Lastly, a follow-up to that video is solving the mystery of the missing calories.

      Thanks for bring up such good points!

      Best,
      Joseph Gonzales, R.D.,
      Nutrition Director

  • PatMH

    Question: You state that, “The main source (around 95%) of persistent pollutant intake is through dietary intake of animal fat.” [from the transcript] So does that mean if we are meticulous at trimming off every smidgen of fat that we are reducing 95% of our pollutant intake? Which would seem to indicate that, as far as pollutant intake, super-lean meat consumption is okay.

    • Joseph Gonzales R.D.

      “Super lean meat” is a bit misleading. That is even leanest skinless chicken breast is still over 20% fat. And just switching from beef to chicken may not lower cholesterol. In fact, lean beef and lean chicken has the same amount of cholesterol.

      I would imagine the pollutants are throughout the meat, not just on the outside. Having said that, trimming off excess fat is never a bad idea if you eat meat. Other may choose to avoid it altogether.

  • Lawrence

    I am always trying to convince people that saturated fat from animals is bad for them. One person recently cited this article, http://www.ncbi.nlm.nih.gov/pubmed/20071648 as supporting their argument that staurated fat is not bad for you. Have you ever considered this article and what is you take on it?

    • Veggie Eric

      That is another bogus study by the notorious “Sir-Tarino” crew… the studies are rigged… Sir-Tirino is one of the worst in medical research to confuse the public. They have been caught red handed fudging numbers and over adjusting variables to fit a predetermined conclusion. (Just like Gary Taubes was paid $700,000 to produce a “cholesterol denialism” book). As soon as you see “Sir-Terino” in a study a red flag should go up that the study was rigged.

      Have you heard of Plant Positive? He takes “Sir-Tarino” to task in two excellent videos I will link below.

      Here ~~~~> https://www.youtube.com/watch?v=a-Tx9dCbv-g

      and

      Here ~~~> https://www.youtube.com/watch?v=3Wi9dzkTiU4

      If you have the time I would really suggest going through Plant Positives “Primative Nutrition Series”. It will open your eyes about the cholesterol denialism crowds underhanded tactics to confuse the uninformed. Knowledge is power and the best defense against the disingenuous cholesterol deniers.

      Plant positives website ~~~> http://plantpositive.com/

      • Lawrence

        Thanks for taking the time to provide such a well considered answer. I will look up the links you have provided.

  • Jennifer Rooke

    It may be cortisol. When an animal is about to be killed it is fearful and stressed. It surges cortisol that stays in the flesh after death. When we eat the dead animal’s flesh, cortisol is absorbed by diffusion into our blood stream. After every meal of animal protein there is a spike in cortisol. Cortisol blocks the action of insulin. Increased salivary cortisol levels is associated with insulin resistance and impaired glucose tolerance.

    • Joseph Gonzales R.D.

      Interesting take! Dr. Greger mentions how certain foods can bump up DHEA (steroid hormone), which is like a cortisol antagonist.

  • How does TMAO play into diabetes 2?

    • Joseph Gonzales R.D.

      I’m not sure exactly, it may be a connection to TMAO causing inflammation. We know eggs are super high in choline and eating eggs seems to be associated with increased diabetes risk.

  • Florencio Mendiola Jr.

    There is a lot of health misinformation on Nutritional facts.org. I don’t know where their primary funding is coming from. Could be the Pharmaceitical Companies? I am a certified nutritionist and I disagree with half of the stuff they write about.

    • guest

      Actually, this site is run by doctors and registered dietitians who have high ethical standards and are absolutely NOT influenced by industry. That’s what makes nutritionfacts unique and why so many people trust it. You have it backwards, Nutritionfacts is funded by public donations from those who benefit from the information being presented. The idea that this site is funded by Pharmaceutical companies is laughable. The “health misinformation” finger you speak of should be pointed at the industry backed pseudoscience coming from the meat, egg and dairy industry.

      • Florencio Mendiola Jr.

        I stand corrected. One way to bring forth the truth…. Thank you….

  • Florencio Mendiola Jr.

    There are over 300 plus contributing factors to blood clots and plaque formation in the human cardiovascular system most sicknesses and illnesses are caused by multiple causes but foods is the one that impacts the body the most particularly if one consumes many toxic chemicals placed in our food supply, water and environment. I know of many people who are 100% vegetarians and have died of diabetes complication, heart attacks and strokes. So, life to me is one big mistery I don’t claim to have all the answers and I don’t think that most of the experts do so either. I just live one day at a time and hope for the best. I do try to live my life in the most purest ways…………..

  • Mn

    Don’t know what to say, people come up with lots of jargon, some new fancy things , but on the ground there is so many people eat beef and they don’t have any issues.

  • Brutus Maximus

    Do herbivore animals care about leucine and such ? no. I stick to simple whole foods, knowing that excess in anything will lead to problems down the line. We LOVE splitting and over-analyzing stuff instead of seeing things as a whole system. This has created a madness that the supplement industry is profiting from. Common sense is what’s lacking, even among plant based people. Guidelines are interesting but do what works for you ! Research has shown that a plant is complex and has thousands of phytonutrients, mostly unknown to this day. Maybe you’d get a lot of leucine eating peanuts but you also get the beneficial stuff.

  • tomblakeslee

    Since type 2 diabetis and obesity has increased dramatically, you emphasis on historical content of meat is a mistake. Its not the fat itself but the pollutants.

  • BenzoSt

    What to make of the meta-analysis titled “Branched‐chain amino acids, mitochondrial biogenesis, and healthspan: an evolutionary perspective”, in which branched chain amino acids, which include leucine, seem to be profoundly beneficial? Leucine does seem to stimulate TOR, but it also activates SIRT1, which protects against aging. Furthermore, BCAAs seem to maintain muscle, increase mitochondrial biogenesis, and improve body composition. At this time, I think the amino acid to limit is methionine, even though every protein does indeed start with a Met codon.

  • Phil Jacques

    Plant base protein doesn’t have the same reaction. This was proven with many studies. Only animal protein as this bad effect in our body.

  • Darryl

    A new pilot scale study that found that in mice and (19) men, moderate protein restriction to 7-9% of calories improved metabolic health, with a notable doubling of the insulin sensitizing hormone FGF 21.

    Fontana et al, 2016. Decreased consumption of branched-chain amino acids improves metabolic health. Cell Reports.

  • ron

    I assume total fat includes saturated fat and cholesterol, correct? If the nutrient label has 10 total fat and one(1) saturated fat, then, is the rest cholesterol fat? Or is cholesterol the saturated fat?