Image Credit: Kristina DeMuth

Optimum Nutrition Recommendations

Updated 2019

I go into specifics of the Daily Dozen foods I recommend in my video, Dr. Greger’s Daily Dozen. And for a more thorough dive into the science on these foods, check out my NYT best selling book, How Not to Die. The balance of scientific evidence suggests that the healthiest way to eat is a vitamin B12-fortified diet of whole plant foods. For optimum nutrition, we should be sure to include in our daily diet not only an array of whole grains, beans, nuts, seeds, fruit, and as many vegetables as we can eat, but also specifically dark green leafy vegetables, berries, and white (or green) tea.

Attention should also be paid to these nutrients:

Vitamin B12 (see also Which type of vitamin B12 is best)

  • At least 2,000 mcg (µg) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach
    • or at least 50 mcg daily of supplemental cyanocobalamin (you needn’t worry about taking too much)
    • or servings of B12-fortified foods three times a day (at each meal), each containing at least 190% of the Daily Value listed on the nutrition facts label (based on the new labeling mandated to start January 1, 2020—the target is 4.5 mcg three times a day). 
  • Those over 65 years of age should take at least 1,000 mcg (µg) cyanocobalamin every day.
  • Tip: If experiencing deficiency symptoms, the best test is a urine MMA (not serum B12 level)

Omega-3 Fatty Acids

  • 250 mg daily of pollutant free (yeast- or algae-derived) long-chain omega-3’s (EPA/DHA)

Vitamin D (daily recommendations for those in the Northern Hemisphere; D3 from animal or plant sources may be preferable to the D2 sourced from fungi)

  • Below approximately 30°latitude (south of Los Angeles/Dallas/Atlanta/Cairo)
    • 15-30 minutes of midday sun (15 for those with lighter skin; 30 for those with darker skin)
    • or 2,000 IU supplemental vitamin D
  • Between 30° latitude (sample cities above) & 40°latitude (Portland/Chicago/Boston/Rome/Beijing)
    • From February through November
      • 15-30 minutes of midday sun (15 for those with lighter skin; 30 for those with darker skin)
      • or 2,000 IU supplemental vitamin D
    • From December through January
      • 2,000 IU supplemental vitamin D
  • Between 40° latitude (sample cities above) & 50°latitude (Edmonton/London/Berlin/Moscow)
    • From March through October
      • 15-30 minutes of midday sun (15 for those with lighter skin; 30 for those with darker skin)
      • or 2,000 IU supplemental vitamin D
    • From November through February
      • 2,000 IU supplemental vitamin D
  • Above approximately 50°latitude (north of Edmonton/London/Berlin/Moscow)
    • From April through September (or even briefer above 60°latitude (Anchorage/Stockholm))
      • 15-30 minutes of midday sun (15 for those with lighter skin; 30 for those with darker skin)
      • or 2,000 IU supplemental vitamin D
    • From October through March (or even longer above 60°latitude (Anchorage/Stockholm))
      • 2,000 IU supplemental vitamin D


  • At least 600 mg daily via calcium-rich plant foods—preferably low-oxalate dark green leafy vegetables, which includes all greens except spinach, chard, and beet greens (all very healthy foods, but not good calcium sources due to their oxalate content).


  • For those who don’t eat seaweed  or use iodized salt, a 150 mcg daily supplement
    • The sea vegetable hijiki (hiziki) should not be eaten due to high arsenic levels
    • Kelp should be avoided as it tends to have too much iodine


  • All menstruating women should increase their absorption by combining foods rich in iron and vitamin C at meals and should get checked for iron-deficiency anemia every few years
  • Men should be checked for an iron overload disease before any attempt to increase intake


  • Northern Europeans may need to take a supplement or eat a daily Brazil nut

-Michael Greger, M.D.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

627 responses to “Optimum Nutrition Recommendations

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    1. Hello! Flax seeds have 2338 mg per tablespoon. Isn’t that enough in a day instead of the supplement? Or the difference is in the absorption of the fatty acids? I’m a medical doctor from Portugal. Would like to hear your opinion about it as here is difficult to find this supplements. Thank you so much!

        1. Thanks for this. I am curious as to the reason DHA supplemetation is not part of Dr. Greger’s daily dozen. But aftre watching that video, I am convinced that the potential rewards of EPA/ DHA supplementation outweigh the financial risk of getting ripped off by smarmy supplement purveyors.

      1. Best source for this information is in writings of Johanna Budwig, doctorate in physics and chemistry, whose entire life was devoted to this topic. Some of her works are in English and the website for the Budwig Foundation is translated into multiple languages.

    2. Hello Dr Greger: Your good friend, Dr. Mercola, has just posted (Sept 17, 2016) an article entitled:

      The Case Against Veganism — Carefully Researched Book Spills the Beans — I respectfully think that you need to address this post as soon as possible, as many of your viewers are also viewers of Dr Mercola. Thanks. J. Bloom
      You can find it here:

        1. I’m confused, doesn’t this article by Dr Mercola say vegans can not thrive on this diet.he seems anti plant based to me, but Dr. Greger just replied he agrees with the article? am I missing something

          1. Dr Mercola is not anti plant based. If you listen to him he tell you that you should get your nutrition from food, mostly raw vegetables. He is just not against grass fed beef. So yes, that is what you are missing. I hope I was able to help.

          2. Someone named Gregory replied, not Dr. Greger. I doubt that Dr. Greger’s views on nutrition align with those of Dr. Mercola. I really and sincerely doubt that Dr. Greger would support the consumption of any beef, grass fed or otherwise.

    3. Hi, Dr. Greger!
      I know you recommend 250mg of DHA + EPA, but I was wondering… I have IBS and I’m also on the pill (a very strong one). Since I have poor circulation to begin with, what dosage would you recommend? I’m scared of taking too much.
      Also, if it’s an algae-derived supplement, does it contain iodine?
      Thank you!

    4. Hello and thank you for specifically outlining the supplements that should be taken when following a WFPBNO diet. I would like to ask about zinc and vitamin K2. I read that those are recommended as well. ( Zinc 15-30 mg and Vitamin K2 25-50 ug or mcg). Could you please clarify? Also, how much iodized salt consumption is equivalent to the recommended daily intake of iodine?

    5. Thank you for this evidence-based nutrition information!

      Regarding Vitamine B12, can you comment on cyanocobalamin versus methylcobalamin?

      Thanks again.

      1. Hello Georgan,
        Thank you for your question. I’m a family physician with a private practice in lifestyle medicine, and also a volunteer moderator for this website. Dr. Greger has done several videos on vitamin B-12.

        Here are two that discuss why it’s important to take B12 supplements, and also where in nature Vitamin B12 occurs:

        Here is the specific answer to your question, as to which type is best, by Dr. Greger, back in 11/2012:

        I hope this helps.

    6. hello … i was wondering if cyanocobalamin as you recommend is a more unnatural source of b12… compared to methylcobalamin … this is because cyanocobalamin often tends to leech us of methyl donors that our body produces in contrast to methylcobalmin that supplies us with more methyl donors… as we understand methyl donors are necessary for methylation… please let me know if you recommend cyanocobalamin for a specific reason…

      1. Hi Nimesha,

        My name is Dr Renae Thomas and I am one of the moderators. To the best of my knowledge, Dr Greger supports supplementation with cyanocobalamin as that is the type the majority of the research into B12 has used (with no adverse side effects documented) and it’s much cheaper and more readily available than other forms.

        For more from Dr Greger on B12, see his five-part series here-

    7. You recommend 250mg of algae derived long chain omega-3’s (epa and dha). That’s great, but the only readily available supplements I can get include carrageenan or ascorbyl palmitate or something else. I don’t know the amount of these ingredients in these gelcaps. I had a bad experience. It could be correlation and not causation.

      I gave my dad algae based epa and dha with both of those other ingredients in the capsule (opti3). Within a few weeks my dad had blood in his stool and was frequenting the toilet often. He’s 81 and showing signs of dementia (incontinence, poor memory, poor executive function, anosmia). I stopped the gelcaps and now he’s not bleeding anymore, though he’s still incontinent.

      Why do they add these ingredients in the first place? Carrageenan is shown to induce inflammation and Is used for that purpose in medical science. Why add the palmitate ester when the biochemistry shows that it turns into palmitic acid, something that encourages atherosclerosis? Can’t they use something benign? Can’t they make an EPA/DHA product that’s free of ingredients with undesirable side-effects? I could look past the vegan issue if they could make the epa/dha product all good stuff and no bad stuff.

      1. With mounting demand from well-informed seniors (and their loved ones) for proper nutrition, we might believe product marketers would be responsible and cautious in their formulations. Unfortunately, such marketers face no penalty for reckless, indifferent or even irresponsible actions, exploiting the naive trust desperate consumers place in them.

        Individual consumers must take the lead, exactly as you have– asking, probing, searching. The product which failed your father may have involved less research in its development than you have invested in seeking to isolate the problem (it may have caused). Which elevates forums like this one as a field for leads and even solutions.

        My family is also interested in an effective and safe algal-sourced DHA product, but some algal products have questions attached. Even if promising, many such products are also beyond the reach of a monthly household budget. Clearly, pressure is mounting for a cost-effective product without consumer issues.

      2. I’m a nutritionist. Look at brands like Pure Encapsulations and Designs for Health. These brands are medical grade and do not add harmful fillers.

        1. Pure Encapsulations and Designs for Health are both made from fish oil – exactly what we do not want to consume.
          Looking for algal made omega 3’s.

      3. I take Deva Vegan and I was shocked to see all these ingredients. I have not had a bad reaction and once this bottle is finished I will not buy more. Personally I am just not going to take any of this anymore and just go back to having 3 tablespoons of flax or maybe I will try krill oil after I do some research. If you find any clean sources of vegan omega 3’s please post it.

      4. Dr. Fuhrman’s algal DHA/EPA supplement is free of undesirable ingredients. It’s in liquid form. My wife loves it as she has a hard time with pills.

      5. Hi Arthur, for you and everyone reading, carrageenan is only in the soft gel capsules. What I do is bite the tip of the capsule so the content flows inside my mouth, and then dump the capsule.

        About ascorbyl palmitate, it breaks down into vitamin C and palmitate when eaten, and yes palmitate is a saturated fat so technicly increases risk of atherosclerosis, but I believe there is just very little palmitate per capsule to be relevant, don’t you think? It is used as anti-oxidant so the oil doesn’t get rancid.

        1. You make some good points.At the moment i’m using fish oil gelatin capsules. They use vitamin E as the antioxidant. I could look into getting the vegan capsules again. I just need to find a supplier who can store them properly so that i’m not buying spoiled algae oil.

    8. Dr. Greger, just wondering why you recommend the 7th Edition of Dr. Spock and not 8th or 9th?

      Thanks! You’re the best!!!

    9. Please can you tell me the best foods for PCOS and best foods for iron and potassium, I’m new to plant based and don’t know very much about what is best for these conditions. Thank you

      1. Hello!

        I am a volunteer moderator who helps Dr. Greger answer questions posted to the site. Thanks for your question and for being part of our community!

        Dr. Greger did a deep dive on PCOS in February of this year. You may wish to view his video, Best Foods for PCOS here.

        Best of luck and let us know how things go for you!

        Lisa Schmidt, MS, CN
        Mindful Benefits

        1. I am man 53 y.o. BMI is 22. In summer, my testosterone was 493 ng/dL. I started to do exercise (YMCA) and four month later my testosterone became 390 ng/dL. Could you explain this dropping. or who can explain.

    10. Dear Dr. Greger:

      Thank you for your life’s work. You are amazing and saving lives! I’m one week into being plant based no oil. I’m trying to find a vegan-friendly supplement online, but everyone I’ve seen contains either oil or xylitol or something else that you don’t want with the vitamin. Which brand do you recommend for B12, DHA, and Calcium/Magnesium?

      1. Hey Mary, we don’t usually get into recommending specific brands – unless there are no other options. There are certain companies – Thorne Research and Pure Encapsulations are the only two I’m aware of – who produce supplements to which no binders, fillers, or excipients have been added. If you’re not sure of the product, call their Customer Service line and see if they can help. Thanks for your question!

    11. Is there a daily minimum fat intake you would recommend? I have heard, if my fat intake is too low, I can get hormonal problems. I count all my calories and macros and I am currently switching to a plant-based diet. I do still use oil because it allows me to easily adjust my daily fat intake.

      I am:
      183 cm
      2200 kcal/day
      82.5 kg
      sedentary lifestyle

      I currently eat
      240 g carbs per day
      150 g protein per day
      71 g fat per day

      I can easily reduce the fats by reducing the canola oil. How far should I reduce my total daily fat intake? Whatever value you tell me, it goes into my excel sheet and then that is how much I am eating.

      Is fat from canola oil worse than fat from whole peanuts? If so, why? Which step in processing is the exact problem?

      Can I get too many healthy fats, if I stay within my daily calories?
      I get that I should avoid saturated and trans fats. Is there a problem with getting too many healthy fats from canola oil (except obesity if it causes me to eat too many calories)?

      I am currently listening to your audiobook, and I love it! Good work and all the best in the future. If it turns out you are indeed right about this, the world is indebted to you.

      1. Hello Matthais,

        Thank you for your question. I am a volunteer moderator who helps Dr. Greger answer questions posted to NutritionFacts. I am also a whole foods plant based dietitian nutritionist located in Scottsdale, Arizona. Dr. Greger has done some videos on oils versus whole foods plant based sources of fats (such as nuts) to weigh in on the question: how much fat do we need? I recommend you view his video on Extra Virgin Olive Oil versus Nuts to bring yourself up to speed on his recommendations. Dr Greger ALWAYS recommends whole plant based foods over supplements, refined oils, etc. as a way of meeting our nutritional needs.

        As for what percentage of your diet you should be eating (carbs, fats, protein) that question is variable. I myself eat close to 80% of my calories in the form of whole food carbohydrates, with 10% protein and 10% fat. The fat comes (mostly) from whole plant foods, like nuts, as does the protein. Fruits and vegetables make up the difference! I do not have a hard and fast rule, however, since I’m not worried about my weight, and eat a wide variety of whole fresh plant based foods. I guess you could say I go by appetite and taste, and allow for the occasional indulgences.

        Dr. Greger has an amazing app you can use to keep track of your Daily Dozen – which you can download from the APP store. As Dr. G says, “some foods, though, have particular medicinal qualities; and so, I then center my recommendations around a Daily Dozen checklist of all the things I try to fit into my daily routine. So, for example, I recommend a quarter teaspoon of the spice turmeric a day, a tablespoon of ground flax seeds, berries every day, greens every day. I talk about the healthiest beverages, the healthiest sweeteners, how much exercise to get. The whole Daily Dozen list with recommended serving sizes is available as free apps for both Android and iPhone; just search for Dr. Greger’s Daily Dozen.”

        If you use whole plant based sources of fats, you can then not worry about “adjusting” your caloric intake through the use of added oils, and since refined oils remain controversial for health, you can dodge that bullet. Or, you can eat like an Okinawan and maybe make it to 100!

        Thank you for being part of our community!

        Lisa Schmidt, MS, CN
        THE Mindful Nutritionist
        Scottsdale, AZ

    12. Thank you for coming into my life through your book How Not to Die! I have chronic migraines – between 9-15 month. I tried ground ginger in place of my Imitrex and am thrilled with the result. However, I have weaned off my chronic migraine medicines, but still get them. The ginger helps when I get them, but what can I do preventatively? I really do not want to be on chronic meds. I am vegan and have given up most sugars except the occasional treat.

    13. hello.. I am new to veganism and am experiencing tiredness. I live in the Caribbean so I don’t think I need vitamin d.. I am post menopausal so I don’t think I need the iron but would be grateful for your recommendation. I love how I am eating and how I feel inside.. I’m just soooooo tired.. thanks in advance.

    14. What is your take on freeze dried (not dehydration) versions of the foods you have recommended. I am more likely to eat food as a freeze dried veggie snack throughout the day than the whole food version.

      I am particuallary interested in starting to eat freeze dried beets daily and purchase my own freeze dryer. They run around $2,500 so I want to make sure this is good investment before I leap in. I have read freeze dried foods retain close to all their nutrition.

    15. Dr. Greger; I’ve recently seen a study (on webMD) which indicates that B12 supplementation increases the risk of cancer. Since I have been supplementing with B12 on your advice, I’m concerned about this. What are your thoughts?

      1. Hey,

        yes, it’s safe to take a B12 supplement. Please note that more than 3,200 of the men involved in the study were current smokers, 139 of whom already had lunch cancer. Also the D’Ambrosio, of Dietetic Directions and spokesperson of Dietitians of Canada, said this: “The researcher I would say is a low-grade cohort study, and again we’re at no place to state that vitamin B12 or B6 causes lung cancer,” so don’t smoke and don’t exceed dose 20 miligrams of B6 and 55 micrograms of B12 per day and you should be fine :) High doses of B6 should be avoided anyway, since they could lead to nerve damage. So it may be similar to betacarotene. Betacarotene increase the risk of getting lung cancer if you are a smoker. Yet we don’t consider betacarotene to be dangerous.

        1. The problem is that Dr. Greger recommends we take at least 250 mcg of B12 a day, and the research says more than 55 mcg of B12 a day already doubles your risk of lung cancer as a male, even if you are not a smoker.

          What are we supposed to do now? I seriously don’t know what to do regarding B12 anymore. I used to take 1000 mcg every other day (as 1000 mcg is the only dose available here), but now I’m confused. I’m not a smoker, but I am male.

          If I take only, say, 3 mcg a day (this is literally the only other alternative I could find for the 1000 mcg where I live), I guess it might not be enough? Unless I take those 3 mcg three times daily, but that also seems a little bizarre.

          1. I only looked over these studies briefly, so you’ll need to fact check what I’m telling you, but my impression is that these people are taking excess b12 (i.e trying to use it as a “medicine”), while the rest of us unprocessed vegans are deficient and would get very sick without supplementation. BIG difference.

    16. What about iodine suplements from kelp (this seems like most common of suplement source) ??? Amount of iodine in them could be controlled.

      1. Urbanek Mike,

        I’d be more inclined to use an iodine supplement, not from kelp sources. You’re correct in terms of the amount of iodine if and only if it’s sold as a supplement, not as a food source.

        Also when you’re using kelp you get a multitude of additional minerals including some, such as radioactive materials, dependent on the source of the kelp….and other contaminants that will not be indicated on the label…….probably not the best choice.

        Dr. Alan Kadish moderator for Dr. Greger

        1. > I’d be more inclined to use an iodine supplement, not from kelp sources.
          Are there non-kelp iodine supplements?
          Excluding salt, of course.

          Regarding additional harmful minerals:
          This would be the case if kelp for supplements is really sourced from the sea. (1)
          Whereas, I heard that for supplement production kelp is farmed in a lab, therefore free from pollutants.
          This is what I heard from a drugstore employee, so not a reliable source of information.
          Would love to see some article on this.

          To find out whether particular supplement is produced from kelp growing in the sea versus kelp farmed in a lab, I think it’s best to ask the manufacturer.


    17. I’m feeling really discouraged about the Omega 3 bad capsules issue. And my understanding is flax doesn’t do the job well enough. I do wish you would cheeky address this issue. I read numerous comments attempting to give an answer. But there seems not to be one.

      1. Thanks for your question.

        Flaxseed can indeed help elevate omega-3 intake and although conversion from the fatty acid present in it (ALA) is not very efficient to EPA and DHA. 4 tablespoons of ground flaxseed a day could do the job.

        Nevertheless, taking microalgae oil based supplements could be a viable alternative.

        Hope this answer helps.

    18. My B Complex that I bought prior to reading this has B12 as dibencozide, Methylcobalamin 500 mcg. It cost around $30.00. I know you recommend the cyanocobalamin. I am vegan (whole food plant based diet). Should I not waste my time taking this? What is the difference?
      Also, it says to take 1 to 2 daily, not exceeding recommended dose. Why would that be? I thought any excess just gets flushed through your system.

      1. Thanks for your question Vickie.

        I found a 2015 publication that states the following:

        “Vitamin B12 (cyancobalamin, Cbl) has two active co-enzyme forms, methylcobalamin (MeCbl) and adenosylcobalamin (AdCbl). There has been a paradigm shift in the treatment of vitamin B12 deficiency such that MeCbl is being extensively used and promoted. This is despite the fact that both MeCbl and AdCbl are essential and have distinct metabolic fates and functions. MeCbl is primarily involved along with folate in hematopiesis and development of the brain during childhood. Whereas deficiency of AdCbl disturbs the carbohydrate, fat and amino-acid metabolism, and hence interferes with the formation of myelin. Thereby, it is important to treat vitamin B12 deficiency with a combination of MeCbl and AdCbl or hydroxocobalamin or Cbl. Regarding the route, it has been proved that the oral route is comparable to the intramuscular route for rectifying vitamin B12 deficiency”

        A recent review has recommended the following for plant based eaters:

        “At present, there is no international consensus for supplementation in vegetarians. According to Carmel, a single oral dose of 50 μg, 500 μg or 1000 μg will be absorbed at an amount of 1.5 μg, 9.7 μg or 13 μg, respectively. To meet the daily requirement of Cbl, one oral dose of 50–100 μg daily or 2000 μg weekly divided into two oral cyanocobalamin doses could be sufficient to meet the needs of 2.4 μg/day for healthy vegetarian adults, taking into account the efficiency of absorption and the passive route.”

        Hope this answer helps.

    19. “or servings of B12-fortified foods three times a day, each containing at least 25% U.S. “Daily Value” on its label” you mean four times a day each containing at least 25%? My breakfast cereal “great value bran flakes” claim to have 100% b-12, is it optimal to have just one serving each day of that? it just says 100% it doesn’t give me the measurement.

      1. Hi, tofues. Good question. The percent daily values for nutrients are based on a 2000 calorie per day diet for adults and children aged 4 and older. You can find the reference values here. The daily value for vitamin B12 is 6 mcg per day. Based on that, your cereal should provide 1.5 mcg. These values are generally higher than the Dietary Reference Intakes (DRI) established by the Food and Nutrition Board, Institute of Medicine, National Academies of Science, which may be found in summary form here. As you can see, these top out at 2.4 mcg per day for the highest need population, pregnant or lactating women. To meet the daily value for vitamin B12, you would need to eat 4 bowls of cereal daily, or consume the equivalent from other sources. However, just a bowl and a half would meet the DRI for most people. The real question is how much of that intake is being absorbed, and that tends to decline with age, as our stomachs make less of the intrinsic factor needed for that process. In my clinical nutrition practice, I advise everyone over the age of 50 to take a vitamin B12 supplement for this reason, and I follow that advice myself. There is no known toxicity for vitamin B12, and so it is highly unlikely that you could overdo it, even at high doses. Given the serious consequences of deficiency, including the possibility of permanent neurological damage, I think it is best to be on the safe side. I hope that helps!

        1. Hi. My father (70 yo) has kidney disease. I’ve been reading about the benefits of a WFPB diet for him, and so he has been eating this way for the last couple of months. My biggest concern, though, is his daily supplementation of vitamin B12. I have read that cyanocobalamin can hurt the kidneys of people on CKD, so I am really lost. He drinks fortified milk once a day, but from the comments I’ve read, it is adviced he takes a vitamin B12 supplement, especially because of his age. Please advice. Sometimes I am afraid I’ll do him more harm than good.

          1. Hi I’m a RN health support volunteer. Thanks for your great question. Your dad is lucky to have you watching out for him.
            Chronic kidney disease patients need different doses of some medications and may have different vitamin needs that the general population. But it is very important to avoid B12 deficiency. That is very dangerous.
            CKD patients do not want to take in excess vitamins as their kidneys may not be able to filter the excess out like ours can. but they do want to take in enough to avoid deficiency.
            The B12 recommendations for CKD patients are “2-3 ug/day supplement recommended for CKD (dialysis and non-dialysis); deficiency can cause permanent nerve damage.”
            There is some research Methylcobalamin B12 may be better than cyanocobalamin B12 for CKD patients, but I’m not sure how well this has been studied:
            “Typical B12 supplementation often uses the form of cyanocobalamin. A cyanide group is cleaved from this chemical, and the resultant cobalamin group is used to create one of two active forms. Methylcobalamin is the form needed for cysteine synthesis and glutathione production. In renal patients, the cyanide group has a higher tendency to accumulate due to the reduced glomerular filtration (Nephrol Dial Transplant 1997;12:1622-1628; Clin Chem Lab Med 2013;51:633-637). Glutathione is then required for the detoxification of cyanide. Supplementing with methylcobalamin may be more effective (Am J Kidney Dis 2010;55:1069-1078, but this supplement is more costly.”

            You could supplement with methylcobalamin if that eases some of your worry. If he going to avoid supplementing, make sure to get his B12 level checked to make sure he is not deficient.

            Please wish your dad all the best from all of us at NF.

    20. 600 mg daily calcium is suggested. I searched the entire comment list for information about whether or not the 600 mg value also applies to elderly folk, especially those diagnosised with osteopenia.


      ps – could a search page box be added to this site to aid locating a keyword? my workaround was to cut and paste the page text into OpenOffice and then search within the copied text.

    21. Hello from Canada! Great site, good job Doc and all your volunteers! A quick question … is it healthier to eat meat substitute products, like soy analogs (typically loaded with who-knows-what-ingredient chemicals) … or … just to eat less meat products?

      1. Thanks for your great question. I just listened to Dr. Greger’s live Q&A that he did on 12/28 and he referred to those as good transition foods as you are transitioning to a whole food plant based diet. He does one on youtube and one on facebook. Sorry I can’t remember which one it was, but if you want to check them out, they are both great. I wait all month for his life Q&A.
        Meat substitutes are plant based, but they are not whole foods as they are highly processed. When I learned this, I figured out a way to make homemade garden burgers.

        Dr. Greger uses a traffic light system. Red light foods should be avoided all the time if possible. These are your processed animal products. Yellow light foods should be limited and eaten with caution or avoided. This is where processed plant foods, like meat substitutes, fall. Green light foods should be enjoyed in excess. This is your unprocessed whole food plant foods. This video explains it well:

        We recommend following Dr. Greger’s Daily Dozen which is a free App:

        All the best.
        NurseKelly Moderator

    22. hey doc, my name is Sergio Rey. I am a disabled police officer that is now 160lbs overweight. I lost 40lbs with the atkins diet but I know how dangerous that is so I want to switch to a plant based diet. my only fear is whenever I start eating carbs I gain weight quickly. can you please direct me to a weight reducing vegan way of life.i am 53 years old and feel like I’m 80. I am mobile ,my disability is a right hip injury needing a hip replacement that happened on duty and now serious left knee osteoarthritis, right knee arthritis ,along with other joint pains. I can’t believe this is going to be the rest of my life, please help me. thank you s.rey

      1. Hi Sergio and thanks for your question. While weight loss is common with a low carb diet, I agree with your concern regarding long term adverse effects of following this type of diet. Fortunately, a whole food plant based diet will allow for steady weight loss, beneficial health effects in terms of reducing risk of cardiovascular disease and cancer and is sustainable for a lifetime. Getting started can be difficult however there are many useful online resources which can help, including this one: I would also suggest educating yourself regarding the health benefits of a WFPB diet by watching videos on this site, reading Dr. Greger’s book “How Not to Die,” and watching documentaries such as “Forks Over Knives” to keep yourself motivated. For you, adding lots of green leafy vegetables may be helpful as these are very nutrient dense but do not add many calories. Try adding cooked and raw green leafy vegetables to every meal. The addition of gentle movement/exercise will help with weight loss as well. Walking and work with resistance bands in a pool can be great exercise for those with joint problems. Keep at it and you will be successful!

    23. Hi Dr. Gregor,
      I am assuming you know (by now) about Laetrile/Amygdalin for cancer treatment? What about consuming enough bitter Apricot seeds to get Vitamin B17 (Amygdalin) and Vitamin B15? I read we can also get these vitamins by consuming apple seeds…what are your thoughts & recommendations in regards to these 2 vitamins?

      Thanks a lot!

      1. All available unbiased peer-reviewed evidence that I’ve seen points to the fact that Laetrile and Amygdalin are not vitamins and not effective cancer treatments with no beneficial value whatsoever. In addition, they are potentially toxic. Here is a link that reviews these facts:

        Dr. Ben

    24. Hi Dr Greger, what is the percentage of the fat in the optumum diet? I use 2 tsp of tahini and 4-5 walnuts and I take DHA supplement 3 times a week. But I am not sure If I am eating too much fat, or to little. I came from the McDougall diet, but without fat, I had some problem. So I think your approach is better for me.

      1. Hi Francesca and thanks for your question. I wish there was a one size fits all recommendation in terms of the amount of fat required in the diet, but needs vary depending on age, weight and other health related issues that one might have. The diets promoted by Drs. McDougal and Ornish are very low in fat and may not be tolerated by some but have shown benefit in others when studied. A varied WFPB diet with fats derived from whole food sources including nuts and seeds is beneficial for prevention and potentially reversal of many chronic diseases. One ounce of raw walnuts and a tablespoon of flaxseed is any easy way to add additional high quality fat to your diet while providing essential omega 3 fatty acids.

    25. I have read your book and was wondering if there is a list/cheat sheet that list each food item and what is is good for all on one page. I find I can remember the foods that are good, but not what they are good for. Would be nice to not have to go back through the book.

    26. I have been following you Daily Dozen app since reading your book, How Not to Die. I do have Hashimoto Autoimmune disease so my concern is that I have also been told to avoid gluten, barley, rye, and oats so while my diet is getting extremely restrictive, is there anything else I should be aware that may interfere or interact with my autoimmune disorder? I am getting very confused about what my iodine intake… if I am getting too much or not enough. Also, I have read mixed messages about taking soy with thyroid issues… can that be clarified. ?

      1. Julie,

        There is no question that some people do react to gluten and it exacerbates their autoimmune disorder…..key word “some”….. it would be prudent to experiment with your diet and see what really works.

        In practice I have seen the range of responses from much worse to no change and yes we did check both blood levels along with subjective criteria and it depends on the person.

        If you want to dive into the chemistry of the effect you might consider testing cytokines and see if your pro vs anti-inflammatory cascade is changed with an introduction of glutens. I appreciate that this is an expensive method however it’s only one option. A much simpler and cheaper method is to use the CRP hs testing as an inflammatory marker. I’d go with the food introduction and keep some good records…..

        Iodine is a hotbed of testing questions and ambiguity. I’m still not convinced that we have a great answer for you however eating sea veggies occasionally, after rinsing them well might be adequate for most, except for those who are pregnant.

        Oh soy….. you may want to take a look at this video by Dr. Greger : can-soy-suppress-the-thyroid/……

        Dr. Kadish moderator for Dr. Greger

    27. Hello Dr. Greger
      I would like your advice in an important issue with my daughter. She is 2,5 years old, she breastfeeds. But I am exhausted, because she wakes up very often during the nights. So I want to stop. The problem is that she doesn’t like food. She refuses to eat fruits, vegetables, juices, … she only want potatoes, and white bread (to my regret). I think she has revulsion to food. And she doesn’t like to try any new food. In this way, it’s more difficult to stop the breastfeeding. She can be several days without eating; because she knows then she will have the breast.
      Anyway, I know that you say not to take any multivitamin, because we can take the vitamins with food. But in her case, when I stop the breastfeeding, she should take any? I am worried because now is the moment for her to grow up. Now she takes B12.
      It´s really difficult this situation.
      Thank you!

    28. Do the recommendations change with the diseases, like Cancer?

      My vet has Cancer and I am gathering information from you for him.

      He showed me diets for dogs based on diseases and nutraceuticals and said “I have been able to talk the dog owners through this for twenty years and no doctors are able to do that for me.

      Thank you for doing it.

    29. Hi dr gregor …my 15 yr old son has been plantbased with us for exactly 1 yr…everything is great but dr was concerned when iron reading was 27 and trans sat 59 which is high apparently….previously back in 2014 iron was 9.8 and tran sat 22

      I told her he eats lots of beans every day so thats why iron high (she was expecting it to be deficient )

      Now is sending us for haemochromatosis gene assay test bc normal teenager range for trans sat is 5-40

      Is it possible their range is just too low for a healthy, 6’1 bean- munching plant based 15 yr old male?….ie should we reduce beans????

      1. Hi, georganne. I think it would be wise to go ahead and have the test for hemochromatosis. If it turns out your son has a genetic profile that leads him to accumulate more iron than his body needs, which is more common in males than in females due to menstruation, then that could explain the high trans sat reading. In that case, it could be a good idea to reduce his dietary iron intake. He could also mitigate his high iron levels by becoming a regular blood donor, when he is old enough. I hope that helps!

    30. Hello,

      Thank you dr Greger for your tremendous work to help people stay healthy and alive (and making Earth a better place as a side effect).

      I have a big doubt about vitamin K2. On the Internet there is a lot of information that K2 is so much different from K1 and that we need K2 to transport calcium from our arteries to the bones and that if we don’t have enough K2 then we will end up with calcified, clogged and stiff soft tissues/arteries. There is also information that our bodies can convert K1 (easily found in many plants) to K2 but that this conversion is either too small and we don’t get enough K2 from K1 conversion or that due to antibiotics (and other factors) this conversion doesn’t take place.

      Could you please answer (1) whether vegans should supplement K2 and (2) whether it is true that K2 deficiency can lead to calcified, clogged and stiff soft tissues / arteries?

      I know that there are SO MANY people that would like to hear about it from you (check for example comments under this video for instance: A lot of plant based eaters are concerned with possible K2 deficiency, so it would be really helpful for all of them. There are many anti vegans who attack WFPBD/veganism claiming that this diet is unhealthy because of the lack of K2 in this type of diet.

      I would be really happy to know your opinion on K2 (not K in general but K2 specifically).

      Best regards,

      1. As one of the volunteers for, I read your question and found a response Dr Greger gave to a similar query in 2012: You can check it our at:

        What are the best sources of vitamin K?
        Written By Michael Greger M.D. FACLM on November 8th, 2012
        To summarize that questioner mentioned he’d read a magazine article which prompted him to ask:”… should vegetarians take supplements of vitamin k2 mk7 (created from natto)?”
        Dr. Greger’s response:
        “Not sure what magazine you were reading, but the scientific consensus is that either one (phylloquinone or menaquinone, formerly K1 and K2) is fine for maintaining human vitamin K status. The recommended intake is about 100 mcg. A half cup of kale? >500. No need for natto; just eat your greens.
        In fact dark green leafies are so packed with vitamin K that if you’re on the drug coumadin (warfarin), a drug that works by poisoning vitamin K metabolism, you have to closely work with your physician to titrate the dose to your greens intake so as to not undermine the drug’s effectiveness!…”
        Bottom line: Dr. Greger mentions EITHER Vit. K1 or K2 are adequate to supply Vit. K needs.
        You are certainly correct, Artur, in noting that there are SEVERAL mentions of use of and benefits of Vit K2 supplements, but very little research showing Vit K2 is definitely needed. does not recommend without solid research behind recommendations at this point it appears more research is needed. In the one PubMed article I found citing a study which hinted at possible benefits of K2,
        but also urged caution: “…, the literature is sometimes confusing and care must be taken to clearly look at the differences in actions of vitamins K1 and K2. There is a need for more research to be done on vitamin K2 …” This at least may help into perspective the comments of those who overstate (and sell!) the benefits of Vit K2 with weak evidence.

        1. Hi Joan,

          Thank you for your answer. Of course I knew about dr Greger’s response, but: (1) this response is pretty old – it was posted 6 years ago; probably a lot could have changed since it was posted; (2) it is not sure whether it takes fully into consideration different function of vitamin K1 compared to K2 – this might be a new discovery (3) it is also not sure whether it takes fully into consideration that conversion rate from K1 to K2 may not be sufficient (due to different reasons like antibiotics etc.)

          As there are more and more materials about K2 on the Internet suggesting that vegan diet may be deficient in K2 and that it may lead to some serious problems (i.e. calcification of arteries), it would be REALLY GREAT if dr Greger could write a short post on it in which he would mention whether K2 should be supplemented or not and why. There is really a need to either confirm or smash theories about K2 (its different function and potential need for supplementation).

    31. I’ve been counting macros. I recently learned of your book and am moving towards the plant based life. My nutritionist has me on 1950 calorie diet with the following macros that I’m tracking
      Protein -125g
      Carbs -199g
      Fat – 70g
      Is this the right mix?
      I started doing the macros to make sure I was getting the right mix of foods. But now I’m questioning if this is correct?
      For exercise I’m 5-6 days a week of weight lifting and abs (takes me about 1.5 hours for my various routines and my heart rate is up there!) weights being that building muscle burns more calories during the day.
      I’m 49. Overweight but losing an average of 2 lbs a week and follow the 16/8 intermittent fasting.
      Trying to be healthy and lower my BMI.
      I’m enjoying the plant based eating and your book and cookbook. I’m just trying to make sure using the daily dozen that I’m still getting the right mix of calories carbs/fats/protein. Help!

      1. Hi,

        I am a Nutritionist too, your ratio seems totally fine. Make sure you are meeting your portions and don’t forget to add B12 which is the most important suplement in a vegan diet. Vitamin D is also very important if you don’t take the sun.

        Yared, Health Support Volunteer

    32. Hi, my name is shlomit and I live in Israel. I’ve been following yr recommendation for a month and a half and have lost only one kilo( ten to go) it seems to little. What do you think?

    33. Thank you for all your good work. I do have a question about omega3 supplements. I understand you recommend 250 mg daily yeast- or algae-derived long-chain omega-3’s (EPA/DHA). I am finding sources, however many are much larger doses: 500 mg and more, most use carrageenan, some have DHA only with no EPA, and some include 1000 mg of D2.

      I am 68 and also use 2 tablespoons of ground flax daily.

      1) I need help deciding on a good supplement.

      2) Does your organization have any plans to develop a line of necessary supplements such as omega 3’s?

    34. Hello Dr. Greger,

      In your recommendations you mention at least 600 mg of Calcium a day. I have read some things about the “optimum” ratio between Calcium and Magnesium as being 2:1 and I was wondering about your opinion on this.

      I noticed that while being on a healthy plant based diet, Magnesium intake can get high quite quickly. Especially when you have to eat a lot of calories to maintain your weight. Mine is around 1400 to 1500 mg of Magnesium a day, only coming from whole foods, so no supplementation. On the other hand, my Calcium intake is never going to be double that amount. In fact it is around the 1000 mg a day (which includes two portions of calcium fortified plant based milk).

      My questions to you are:
      Is my Magnesium intake too high (in relation to my Calcium intake)?
      If Magnesium is too high, how can I get it to go down when almost all healthy plant based nutrition is rich in Magnesium? Or should then Calcium go up?
      I was also wondering about your opinion of calcium fortified plant based milks, if you recommend them when you already reach the 600 mg of calcium through whole foods. (As I assume it is like supplementation, right?).

      Thanks you so much for your answer!

      1. As a volunteer for NFO, I looked in PubMed and found one study that referred to Calcium/Magnesium ratio.
        Modifying effect of calcium/magnesium intake ratio and mortality: a population-based cohort study.
        As you will see this is very tentative research with no firm recommendations that a specific ratio should be reached. It seems at this time better to focus on the healthy diet you are eating, and if you want to improve seek more caldium through whole foods, rather than the fortified plant based milks. As you say most healthy plant-based food is also magnesium rich and you should continue consuming those. Perhaps focusing on the Daily Dozen will give you more reassurance that you are eating just what you should be and you needn’t worry about the Calcium/magnesium ratio unless new research confirms stronger need to cut back on Mg.

    35. What are the recommendations for all of these in this list for children? I have a 6-year old and we just started to follow a plant-based diet. Thank you!

    36. I am wondering why there is no distinction between recommended servings for women versus men. Shouldn’t women eat less? Can you help me understand? If I can’t manage to eat the quantities recommended, should I then just try to eat at least something from each of the daily dozen? I have 100 pounds to lose so don’t want to overeat. Just want to know if, as a woman, I should aim to eat all the recommended servings, and, if so, why that won’t end up making me gain weight if I’m eating as much as men?

      1. Because some men are smaller than some larger women, the serving sizes are not diminished for women. However if you find that eating all the recommended servings is too much for you you can cut back, esp on the carbs, nuts and seeds- all higher calorie foods.This will help your weight loss but still give you the required nutrients. There are many videos on weight loss that can encourage you to successfully and healthfully lose the weight you need to. Use the search box to find helpful videos on weight loss.

        1. Thank you so very much for this helpful information, Joan. I will definitely check out Dr. Greger’s videos on weight loss and follow your advice re reducing serving sizes in those are.

          So grateful for your help – thank you!

    37. What is a source of yeast or plant based DHA and EPA supplement that NutritionFacts deem of good quality? I was not able to find it. please advise,

      Since fish oil and cod liver oil are not advised by NutritionFacts, we vegans need a supplier of DHA and EPA supplement to be able to follow Dr. Greger’s advise,

      please advise,

      1. Alejandro,

        Dr. Greger and our support team do not recommend specific supplements in order to remain as objective as possible. With that said, the form of the EPA/DHA supplements suggested is from Algal sources. There are many suppliers.

        The science behind delivery of a good quality oil is not trivial and many of the supplements on the market are less than optimal. The key to picking the better of the products is a process. May I suggest a few key points ?

        There needs to be a preservative in the formulation as most oils are susceptible to oxidation (rancidity) . Avoid the use of additives and colorants and any unnecessary fillers. How will you know, there are some good tips on a commercial site, at Nordic Naturals ( and for more on understanding what to look for when purchasing supplements you can go to another commercial site at Vital Nutrients ( as well as articles, such as:

        Two commercial aggregators of quality products includes: and The two groups have aggregated a select group of suppliers. I am in no way suggesting that every one of their products meets our clinical threshold however, they are one way for a consumer to move in the right direction.

        Trust this gives you some options and considerations as a consumer.

        Dr. Alan Kadish moderator for Dr. Greger

    38. Hello,
      Not sure if you’ll get this but my school professor today told my whole class in biochemistry that eggs are ‘healthy to eat’. When I disagreed he said this below. Any help would be most appreciated.


      ‘There is no scientifically accepted definition of healthy or unhealthy. Healthy is generally taken to mean – contains important nutrients and no harm is observed at “normal” consumption thresholds. Your opinion on eggs is considered dated and not supported by modern understanding of nutrition or science. I can support my stance, mostly because it’s the stance of every expert in the field. From nutrition textbooks and reviewed publications, registered dietitians, nutritional analysis of eggs, the FDA and even the World Health Organization – virtually every credible person in the field agrees.

      Eggs contain a host of nutrients considered necessary and hard to find (and widely deficient in the average American diet). Eggs do not contain substances known to cause harm and no negative effects of consumption have ever been observed at a threshold of 3 eggs or less per day. Eggs are highly digestible and allergies to eggs are extremely rare. Eggs contain trace vitamins and minerals necessary to life – small amounts of virtually every mineral required for humans. Eggs contain all essential fatty acids and are a high quality source of hard to find essential fats. Eggs are one of the highest quality sources of protein found in nature and one of the few sources to be considered complete for humans.

      In what regard do you consider them unhealthy? Could you share any source that agrees with your stance or evidence that supports your stance? I ask because I am not aware of any credible person or organization that still holds the egg as an unhealthy food item. That WAS common belief back when we thought cholesterol caused heart problems – which has been debunked for about 7 years.

      Could you give me an example of something you DO consider to be a ‘healthy’ food? What about that food makes it healthy?

      Dr (name withheld)

      1. Hi Emily!

        Thanks for reaching out about this! Thankfully Dr. Greger has a wealth of information about eggs, such as this video published today about the link between eggs and different forms of cancer – I’m not sure if your professor is aware that eggs are actually one of the most common food allergies, hence why it is listed in bold in the ingredients list if a food contains eggs. I would send them over this article –, and suggest they check out this video – to start.

    39. I was wondering about your recommendation of 250 mcg daily of cyanocobalamin. The Mayo Clinic website shows the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms. Is cyanocobalamin and B-12 the same, and if so, then are you recommending that we take more than the RDA? (Or am I missing something here.)

    40. My doctor has prescribed the AREDS 2 supplements for my moderate macular degeneration. I changed to a whpb diet 6 months ago, I think I now get the amounts of everything listed on the bottle except for the high amount of vitamine E and Zinc which I question if I really need. It also includes copper which Dr. Greger has talked about in a possible connection to Alzheimer’s.

      The AREDS trial did show “that people at high risk for developing advanced AMD…. reduced their risk of developing advanced stages of AMD by about 25 percent when treated with the combination of “antioxidants plus zinc.” And state that “.. the high levels of nutrients that were evaluated in the AREDS are very difficult to achieve from diet alone” (in other words, take the supplements). Also, the study was done in collaboration with Baush and Lomb and includes a red and blue dyes and other additives, and does not state what diet the trial participants were eating.

      My doctor is really pushing this, and as a compromise I have been taking 1 pill/day instead of the 2 recommended (just in case it can help).

      I was wondering if Dr. Greger has an opinion on taking the AREDS 2 formulation.

    41. My son and I have been whole food plant based lifestyle for 2 years now. We were tested on B12 and both of our B12 is slightly on the low side around 200-350. So, I started B12 supplement. My son’s pediatric md. Is not a fan of plant based, I don’t what strength of B12 should I give toy son. Could you please suggest? Thank you.

    42. Hi Dr Greger,
      I started eating a WFPB diet ( with added olive oil) five months ago to decrease my blood pressure which had been steadily increasing in the past year. My blood pressure is now down to around 110/70 but I just had my cholesterol checked and it has actually increased. I try to follow the How Not to Die recommendations but I do use olive oil and eat a lot of nuts. Are there people who can not decrease their cholesterol on this diet or do I just need to drop the oil and decrease the nuts?

      1. Tracey,

        Nice work on the transition and change in blood pressure !

        You may or may not see a difference in your cholesterol. It’s so individual that the next step is to see what works for your body. Elimination of the olive oil may make a difference and it’s worth a try.

        Keep in mind that the tests are not totally reliable as they are influenced by your last meals and when you took the blood sample, etc.

        The use of nuts and a modicum of oil is part of a good WFPB diet….. so experiment and see what transpires over time.

        Dr. Alan Kadish moderator for Dr. Greger

      1. Hi, Alicia! This was posted in 2011, and has not been updated. It is intended for adults. Children have slightly different needs because they are smaller but growing, and do not eat as much as adults. You might be interested in this: and this: The Daily Dozen may be applied to children by adjusting portion sizes. I hope that helps!

    43. I thought you said recently that methylcobalamin is a better choice over Cayanocobalin since this article was written in 2016 maybe you’ve upgraded your choice.

    44. Hello Dr. Greger,
      I am a huge fan and financial supporter. I have a question. I take B12, Vitamin D and eat 1 Tablespoon of flaxseeds daily. Do I need iodine, brazil nut and Omega 3s daily? Also I am experiencing hair thinning/loss. I’m age 60. I try to follow the daily dozen, but don’t get enough beans and nuts. Any suggestions to help slow/reverse the hair thinning?
      Thank you so much!!!

      1. Hi, Dawn Booth! Thank you for your support! We really appreciate it! The short answer is yes, you should probably include iodine-rich sea vegetables and one Brazil nut each week, along with an algae-derived EPA-DHA supplement in your routine. Hair thinning can have many causes, one of which is low thyroid function. If your iodine and selenium intakes are low, this could be a factor. More on iodine here: I hope that helps!

    45. do you have a recommendation on which DHA EPA supplements to buy? Or maybe better to ask which supplements do you buy?
      Thank you!

    46. Years ago I learned that Iron blocks the absorption of Vitamin C, and so when menstruating I take an iron supplement before sleep. I just read the opposite above. Please advise. Thank you so much.

    47. what and what quatities should an elder person(75 and above) consume in order to get about 80 grams of protains per day?Thanks

    48. I would love it if you could take a stab at ranking foods in each daily dozen category. It can be hard to remember all of the benefits and drawbacks to each food. I know you’ll probably say, some foods are better for men or women or special populations, but just a general guess would be helpful. For example, I’m trying to make a daily diet that’ll check all the boxes, and I’m wondering if I am better off with a different whole grain here or a different leafy green there, etc. I read about spinach/oxalates and brown rice/arsenic, but I’m luke warm on collards and quinoa because of the taste. I can probably make kale work, but is arugula just as good? You get my point. Thanks!

    49. Tufts University’s “Health and Nutrition Letter” for January 2020 has an article on the front page titled “High Doses of B6 and B12 Supplements Associated with Increased Risk of Hip Fracture” The “high doses” they refer to are 30 micrograms per day or higher for B12. Their article references a “study published recently in JAMA Network Open.”

      This article suggests that, at least for women, there may indeed be an upper limit on B12 supplementation?

    50. Hi Michael,
      Have read How not to Diet – awesome: book, information and delivery. My personal health and weight loss progress is amazing, after many years I’ve now got the plan for me. Thanks!

      Working through How not to Die now and will purchase you cookbook.

      Keep up the great work!


    51. I take 1-1 1/2 tbs of ground flaxseeds /day, and I understand that taking the vegan/algae EPA/DHA supplement is also recommended (because flaxseed doesn’t provide the full range ?). I’ve read many product ingredients labels and reports by consumers that many of the brands of these supplements contain carageenan, which has been given unhealthy, concerning reports by numerous people-consumers as well as medical folks. What are your thoughts? Thankyou.

      1. Hello Rich,

        Dr. Greger has made a video and article (linked below) on the topic of carageenan. As of now, we don’t really know the impact that carageenan may have on our health and the evidence is conflicting. Ultimately he comes to the conclusion that carageenan is another reason to avoid unhealthy foods, but should not deter us from healthy foods (eg. algal oil) until we know more. If you are concerned, there are algal oil brands that do not contain algal oil at all.

        I hope this helps,
        Dr. Matt

        1. Thankyou Dr. Matt. From what I read I got that the carageenan is an extract of seaweed. So if I avoided a supplement without the algael oil that would take care of the carageenan issue?

    52. How does one square these recommendations with a serious Nickel allergy, where many staples of plant-based nutrition including many legumes, grains, and greens are off limits? At the same time, meats and other animal products are held up as “safe” choices for not having high quantities of the rash-inducing metal, to say nothing of their dubious nutritional content, additives, and accretions present in abundance. What is one supposed to do other than eat more potatoes and green peppers?

    53. Follow on to above (Is anyone replying to these posts ?) :

      Per NIH ( ) updated 3/30/2020, RDA for B12 is 2.4mcg/day, but Dr. Greger says above, it’s 4.5mcg 3 times a day = 13.5 mcg/day – Why this discrepancy ?

      I’ve also answered my own question above about why my nutritional yeast bottle says 1 serving = 14mcg B12 = 580% DV. This is because the company is calculating DV based on 2.4mcg/day (per NIH guidelines), so 2.4 * 5.8 = 14 mcg. So this again leads to the discrepancy question above.

    54. Hi! I’m Mateus, from Rio de Janeiro, Brazil. Vegan for some years.
      I’ve been studying about iodine, and I’ve found no explanation about the “tolerable upper limit” of iodine intake of 1100mcg a day. I found just the explanation about why 150mcg is enough to avoid goiter.
      I have found no robust evidence of inorganic iodine-induced thyroid toxicity. I’d like to understand it because it’d be much easier to take an iodine supplement like Lugol’s iodine than finding edible seaweed here.
      I found, however, doctors like David Browstein, and in the literature doctors like Guy Abraham, that claim that there is no such iodine toxicity in doses up to 50mg, and that the “iodophoby” is based on bad science. They emphasize that the safe form of iodine is the inorganic, non-radioactive form, I2 (iodine) and KI (potassium iodide).
      However, I couldn’t find studies on PubMed about what they say either.

      Could you please help us solve the iodine confusion?
      I’d be very happy!
      Thank you a lot for all your work! You are a life saver.

      1. Hello Matthew,

        The incidence of iodine-induced thyroid issues is rare, but does happen and that is why there is an upper-tolerable limit. The exact amount of iodine that is an issue is not known and certain people may be at higher risk than others, which is why it’s best to “play it safe.” I have linked 2 studies that discuss the issue. As for the doctors you’ve mentioned, I am not sure what they are basing their claims on.

        Dr. Matt

    55. What about protein. I’m over 60 and would like to rebuild muscle mass that I have lost. I’ve been following the plant based diet but I am concerned I am not getting enough protein to build muscle. Would adding greek yogurt to my daily dozen be a good idea?

    56. I guess overnight soaked grains, fermented foods are good sources of vitamin B12.
      And in india people eat fermented foods in the name of idli , dosha , utappam and over night soaked grains.
      I think this is more than enough to reach the vit b12 goal .
      Sir! There is no much reasearch regarding this. Can u please consider this natural b12 and do any research regarding this ?
      Am a mbbs student and am willing to do one after this pandemic or so .
      What do you think about this source as natural vitamin B12.?
      Please get back to me sir .
      Thanq sir !

    57. I follow Dr. Michael Klaper’s website where he says we don’t need much b12 just 2.4mcg/day so I’m confused because you’re saying there’s no limit. i think you’re both great plant based doctors.

    58. I am so confused with what B12 to buy because I can’t find any without “other ingredients”. Do you have any suggestions? I want to take a weekly dose.

  1. My 11 yr old Daughter is currently being taught the MyPyramid and MyPlate systems of health in School. She is having a difficult time with the Teacher because as a Vegan, she strongly disagrees with a lot of what the Teacher is trying to impose on her. Can you offer any science and research to help back her up?

    1. I’ve got a whole string of new videos queued up about the new MyPlate recommendations, so stay tuned. In the meanwhile, please feel free to check out all of my videos on plant-based diets and if her teacher has any questions or concerns maybe she could post them here!

  2. If what who is light skinned is out for more than 15-30 minutes in sunlight, can the Vitamin D be cumulative ? and I have heard different ideas on the use of sun screen and vitamin D absorption, or is there a different post on sun screen and vitamin D ?

    1. Thank you for your question Jill. Sunlight-induced Vitamin D is indeed cumulative but the same wavelengths that produce D in our skin can also cause us to burn. Sunblock can delay sunburns, but also interferes with the vitamin D production. So the recommendations above are for those not wearing sunblock.

      1. I’m sure you are aware of Dr. Fuhrman. I read recently on his site that many commercially available sunblocks contain chemicals that can be harmful to us (I can’t remember if he suggested they were *as* harmful as the sun damage, or not). He also offers a sunblock product for sale. Do you have any opinion on the scientific truth of his claim about commercial sunblock products? Or is it just a marketing ploy?

        1. Hi Scott, I just happened to see your question here and I would share my quintessential information source for sunscreens and all categories of personal products. The Environmental Working Group has been investigating , reporti g and rating products for years . I only use mineral sunscreens. happy reading!

    1. Dr. Greger mentions the most important things we can do diet-wise is to drink 10 to 12 cups of water a day and reduce animal protein, reduce salt, and eat more vegetables and plant-based foods. Also I would mention that when you have healthy gut bacteria such as Lactobacillus Acidophilus that can help in breaking down the oxalates.
      Lactobacillus acidophilus

  3. Hi Dr. Greger.

    I saw you speak at the Toronto Vegetarian Food Festival on the weekend, and I have to say Thank You so much! The crowd was enthralled with your program, and we all learned so much from your indubitably entertaining style. How does it feel to be a “rock star” of nutrition (lol)? Hope to see you next year!

    1. Oh, you’re so sweet. I’m glad you made it in. I felt so bad about all those that were turned away at the door. Hopefully they’ll have a better venue next year!

  4. Dr. Greger–I have to second what Mike just said–you are the nutrition guru! I attended your presentation in Baltimore and found it both entertaining and informative.

    Someone on another post (can’t remember which one) asked if you would share a representative day or two of what you eat. I think that we would find that helpful. I am also raising my children vegan (just starting this summer). There are some good suggestions in the Vegan for Life book about nutrients for kids, but if you could share your thoughts on covering kids’ nutritional bases (or additional resources), I would appreciate that as well.

    Thanks, as always! Love the site!

      1. The article you linked too by Dr. Mangels recommends flouride suppliment for children. I have read numerous articles stating flouride was poisoness to our bodies. I cant remember the exact details. Can you comment on that?

  5. Hi Dr. Greger,

    I asked this on the “Ask the Doctor” post but will repeat here:

    I have some questions about B12… is there any difference between taking B12 as cyanocobalamin versus taking methylcobalamin and dibencozide? Also, is the cyanide resulting from the body converting cyanocobalamin into methylcobalamin harmful?


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  9. Spinach is a yay for antioxidants but a nay for calcium. Darn…how do we deal with this Spinach conundrum??? Any tips?

    Also just re; vitamin D [which i recognise as being oh so incredible]… there are 2 things I would like to mention. One. Have you see the research on obesity and vitamin D? One is in AJCN. Very interesting. Obese have significantly lower peak vitamin D level post sun exposure compared to normal weight individuals- despite the same amount of precursor in the skin. The problem is, it is sequestered in the fat cells rather than entering the blood. Less of a problem with oral vitamin D supps, peak levels were similar for the 2 groups. My point is, with the shocking rates of obesity and overweight in the western world, maybe it’s time we put more emphasis on the ol’ supps here and not mister sunshine. My second point is that skin cancer is the most common of ALL CANCERS. That is all i have to say. It’s just my opinion, but even to give people the knowledge that hey, if you are obese… take a supp. And if you are light skinned…take a supp. Just my opinion [until I rule the world!] :P

  10. Can a deficiency in vitamin D cause hypertension? Do people who already have a diagnosis of hypertension need to take more than your 2000 IU recommendation? What about people diagnosed with hypertension who now have it under control with diet and exercise – what level of vitamin D do you recommend for them?

  11. Hi 7worhips, I know of no study linking Vit D deficiency to hypertension. Current science seems to support going with the same recommendations for Vit D for those with and without hypertension. Vit D is an evolving, complicated and confusing area. Dr. Greger’s video helps provide a good context please see his video and the blog comments at Final comment is that for my patients who have normal pressures and are following a healthy whole foods plant based diet with exercise I consider them “normal” not “hypertension controlled with diet and exercise”. Elevated blood pressure is the normal response to the SAD… standard american diet. A study a number years ago showed that labeling patients as hypertensive compared to a control group with the same blood pressures lowered their quality of life and increased the days of work missed. Congratulations on your success.

  12. Hi Dr. Greger. I’m wondering, what is your understanding of the pros and cons of supplementing with lithium orotate (or some other non-psychiatric version – none of them at psychiatric dose levels)? I got thinking about it since you’ve included iodine, and the two of them have roles in up- and down-regulating the thyroid, and lithium seems to have some benefits that might prompt one to want to get some more of it (or any of it at all, should ones food sources somehow be lacking it, much like a lot of commercial soil has come to lack iodine over the years, thereby yielding iodine-poor produce).

  13. Hi Dr. Greger,
    My question concerns your recommendation of “250 to 500 mg daily of yeast- or algae-derived DHA and/or EPA”. I understand that one can get EPA from yeast and DHA from algae. Could you please provide more information on which of DHA or EPA is the preferred form to take and what concentrations is best? Thank you in advance for your response.

  14. What nutritional or vitamin supplement do you recommend?  I know there are different brands with varying absorptions. 

  15. Dr. Greger
    There seem to be a lot of mixed recommendations on the
    necessity of DHA supplementation even among proponents of whole food vegan
    diets.  Other than B12 I do not take any supplements
    and believe in general that our bodies provide us what we need so long as we
    feed it a well balanced diet which in my case is  a whole foods vegan diet with 2 tablespoons of
    flax andor chia seeds per day.  In
    someone with an near optimum diet do you still recommend DHA supplementation
    and if so can you provide references to the data demonstrating that need.

    1.  Hi Jason,
      While I certainly agree that your whole foods vegan lifestyle is optimal, I also believe in (and have seen) great value in certain supplements, for a number of reasons.  To answer your question, I do agree that DHA supplementation becomes more important as we age, because EPA (that you are getting from flax/chia) will not be retroconverted to DHA as efficiently.  This information was obtained from the Vegetarian Nutrition Dietetics Practice Group in an article on essential fatty acids by Mark Messina (sorry no link to it though).

  16. Hi Dr. Greger,

    I am a runner and have always tested low in iron. I eat all the right vegetables but my ferritin level remains around 20 unless I supplement with iron. I also am vegan. My endrocrinologist told me years ago that certain Europeans has a tendency towards enermia? I think he said Yugoslavians?

    Are you still opposed to an iron supplement in runners who tend to be a bit low? I feel much better while running with my iron a bit higher. It makes a huge difference.

    1. In regard to foods, all beans are rich sources of iron so you may want
      to include them regularly. Whole grains are also an excellent source as
      are dark green leafy greens.

      Iron absorption can be increased by, avoiding tea and coffee at
      meals (because of the tanins in them) and by including a source of vitamin C at meals (fruit and/or veggies).
      Calcium supplements taken at the same time as iron can inhibit its
      Also, including garlic or onions will increase iron and zinc absorption.

      1. Thanks Toxins. I am pretty good with all the things mentioned. I am thinking garlic in my smoothy! Man, that thing is turning into a blended salad! :-) I am going to need a spoon soon.

  17. i have a very low d level, was told to take 10,000 u daily. i have had trouble with some formulas and now am taking 2000 iu of a liquid trying to build up. it worries me that im so low and having a hard time. the nature of my work prevents me from being able to get midday sun even though i live in florida. any advice is appreciated. i am allergic to shellfish and so i avoid those varieties never mind that i am plant strong as well.

  18. As for the sunshine exposure – is that full-body (ie total nudie) because the one day per week the sun comes out during winter I can stand doing my chest, arms, and face but not full-body.

    Thank you for providing this excellent resource. I am also a medical student trying to sift through nutritional evidence and maintain my own health.


  19. Dr. Greger:

    I am still very concerned about your recommendation of algae-oil DHA. I closely follow the work of Brenda Davis, who I am sure you are familiar with.

    In ‘Becoming Raw’ (2010), Davis and Melina argue on page 127-128:

    “DHA is the most highly unsaturated fat in the diet and also the most unstable (meaning it is easily oxidized by free radicals in the blood). Oxidized fats are bad news; they contribute to all sorts of disease processes, including cardiovascular disease. It’s possible that our bodies are smart enough not to bother making DHA when it’s not needed. In addition, it’s possible that when DHA is in our bloodstream, it’s rapidly transported to locations where it’s needed and incorporated into tissues, such as the brain and the retina of the eyes.”

    Overall, Davis and Melina have not endorsed algae supplements for the general population. Nor has the American Dietetic Association as per their 2009 review paper on vegetarian diets.  

    Furthermore, a recent study (Am J Clin Nutr 2010;92:1040–51) argued that despite having zero intake of DHA, vegans made comparable levels to omnivores.

    Dr. Greger you seem like a great guy, but I worry that you may have jumped on the bandwagon too soon with this one.

    I hope that you can provide us with a very clear rationale as to why a healthful vegan (plant-based diet, no-oils omega-6:omega-3 in the range of 2:1 to 4:1) should need to take this oil.

  20. Should omega-3 supplements be taken by men given the recent finding that fish oil pills increase the risk for prostate cancer?

      1. Drew and Paul, Dr. Greger recommends 250 to 500 mg daily of yeast or algae (not fish-based) sources of DHA and/or EPA Omega-3’s above. Hope that helps!

  21. I see that your recommendation for B12 intake are 250 micrograms every day; however, everywhere I search says that the recommended daily intake ranges from about 2 micrograms to 6 micrograms. I am wondering if perhaps someone misread the unit symbol for micro- “µ” when in reality the source of data had pico- “p”? I could be mistaken, and if I am, then that means a VAST majority of people are probably B12 deficient. The B12 supplement that I take daily has 6 micrograms of B12, so if I am mistaken, I would greatly appreciate my correction.

    Thanks in advance,
    Nolan Muck

      1. Thank you for the link to the videos; however, I have a new question. If we re-absorb 99.9% of the vitamin B12 already inside of our system, that would mean if we have 5.5 mcg of B12 (the average between 4 and 7) in our system, then we only lose 0.0055 mcg of B12 daily, and if I can absorb 1.5-2.0 mcg + 1% of my daily supplement, I should be fine(and actually be slightly above the daily requirement) if I take a daily supplement of 6 mcg?

        1. Well, not exactly.

          When we take a 500 mcg dose, we absorb 1.5 mcg through our receptor system and 1% of the rest. So 1.5 + .01(498.5) = 6.48 mcg, this falls into the 4-7 mcg per day range. We could also multiply the dose by 10, so 5000 mcg and take that weekly. It would average out to 7.3 mcg a day. The first section of our large intestine can absorb vitamin b12 so this is constantly recirculated allowing us to take weekly doses.

          250-500 mcg of vitamin B12 a day, or 2,500-5,000 mcg of B12 a week is all that is needed. Or you can take the more complicated route and eat something fortified with atleast 25% of you B12, three times a day 4-6 hours apart. 25% = 1.5 mcg

          1. So what you are implying is that we lose about 4-7 mcg of B12 everyday (the 0.01%). And that to replenish this we need to intake the amount lost? Also for the formula saying 1.5+1% of the amount of B12 ingested does that 1% intake even hold true at these high daily dosages, and at the even higher weekly doses? Also Dr. Greger does say that if you take too much B12 into your system, that your body will “pee” it out, so if your body registered one of the mega weekly doses, would it not just “pee” the rest out? Another thing, Dr. Greger says that the reason that we as humans only lose 0.01% daily is that our ancestors would sometimes get very very small amounts of B12, so would that not confirm what I stated in my previous comment?

              1. Those resources are very informative, and now I do believe I have read or watched everything that Dr. Greger has about B12. However, my questions weren’t really answered, and I attempted a brief over view of some of the sources from the videos and found nothing in them that helped me either.

                1. If I may backtrack and clarify, supplementing a single dose of 6mcg will not be sufficient for the day as you will only absorb 1.5 grams + 1% of 6. The rest will be excreted. I am unsure what specifically you are asking, perhaps you can restate your question in a different way?

          2. What b12 do you recommend? I have found a few veg friendly brands on amazon, but all include a “natural” flavoring in the ingredients with no explanation of what that natural concoction is

            1. I personally use twin lab 5,000 mcg weekly dose. I am unsure what the natural flavorings would be, but overall I don’t think my health will be seriously harmed by whatever it could be.

  22. I’ve a hard time to find other sources reccomending such high amounts of B12. Most sources i find says none to few reported side effects of overdosing b12, but some report increased cancer risk and other bad things. For exemple:

    Should I take my normal veggie pill with 15 mcg daily (higher then swedens reccomended amount) or should i take 500 mcg pills each day? Confused :S. Sources for your claims would be good.

    Thanks in advance

  23. Dear Dr. Greger, can you tell me if calcium minimizes the absorption of
    iron? I seem to remember you said in one of your presentations it
    doesn’t matter if the sources are plant based but I´m not sure…
    This morning I had overnight oats (oats, soy milk & fruit) for breakfast so it made me wonder again…
    Also because there´s not only iron but calcium in oats as well. (Both minerals not mentioned on the packaging!)

    Thank you and I hope my English is ok.

    1. Yes, calcium does inhibit absorption of iron but not to the point where it should be a dietary concern. A whole foods plant based diet will give you more iron then you would think. If you want to test to see how much of each nutrient you are getting, you can put it into cronometer which is the USDA nutrition database. Its like a food diary and it will give you the total nutrition profile of your meals.

  24. Is there anything to the theory that eating foods in certain combinations helps us absorb more nutrients from them? For example, I have read that fruits should be consumed by themselves, never as part of a meal. Or that water or other liquids should not be consumed with a meal, but 10 to 15 minutes before or one hour after a meal.

    1. Diane: There is definitely something to the theory that eating foods in certain combinations is a good idea. For example, if you eat foods rich in vitamin C with foods rich in iron, you can increase the absorption of the iron.

      Dr. Greger talks about this and other food “synergy” options on this site. You might start your research here:

      However, just because the concept in general is valid doesn’t mean that everyone’s theories are valid. I’m not an expert, so I can’t say for sure. However, I am under the impression that the two examples you site are not valid – at least as stated. Especially the one about eating fruits separately.

  25. Maybe you can explain why I don’t sunburn anymore. I always used to burn. Now, I can work at establishing new gardens in our East Texas summer sun for up to 6 hours and show no signs of sunburn. (I could probably stay out longer, but run out of time and need to get on to other things.) The only differences are a shift to a mostly whole plant diet… as free from GMO, herbicides and pesticides as possible. More and more of our food comes from our own and our neighbors’ gardens. We make sure beans and greens are a staple in our diet. This was the year of the musk melon (aka cantaloupe). Which of these changes could have made such a radical difference in the sunburn factor? Just curious, but very grateful too. I am a 68-year-old Caucasian female, if that makes a difference. After years of the rat-race, we are enjoying raising our own food and shopping far less.

  26. How do you determine 150 mcg for iodine? Dr Furhman says 150 mcg, too, but dieticians Jack Norris and Ginny Messina say only 75 mcg every few days. Others like, Dr McDougall, don’t recommend supplementing anything other than B12. I don’t eat much salt and rarely eat seaweed. With conflicting advice, I don’t know what to do.

  27. Hi Michael I have brought recently some 1000µg B12!” tablets as I couldn’t find any in the dosage you recommend in the UK. How many of these should I take weekly? Thanks for your amazing work btw :-)

    1. When we take a 1000 mcg dose, we absorb 1.5 mcg through our receptor system and 1% of the rest. So 1.5 + .01(998.5) = 11.48 mcg, Divide this by 2 days and we get 5.74 mcg. This falls within the 4-7 mcg range. So 1000 mcg every 2 days would suffice.

    2. You would take tablets once weekly. One week take two tablets and the following week take three tablets which will average to 2500/week. Maybe take the odd number of pills (i.e. 3) on the first and third week of the month and the even number (i.e. 2) on week two and four. Hopefully 2500 ug tablets will be available in the future to make it easy. Of course you can occaisonally check your levels and if you have symptoms you should be seen by your health care provider.

    3. You can review the series of video’s on Vitamin B12 in February 2012 for the details. You could alternate 3 tabs once a week with 2 tabs once a week. You can get your B12 levels checked occasionally and if having symptoms you should your regular health care provider.

      1. Thanks for your help. No I don’t have any symptoms of B12 deficiency just trying to eat an optimum diet for health as advised by Doctor Greger. I am vegetarian but have recently reduced my intake of eggs and dairy and Doctor Gregger states even ovo lacto vegetarians are not getting enough B12 for optimum health even though they might not be deficient in B12.

  28. Dr. Greger,

    I had a thought/question based on trying to integrate your findings into practical dietary changes…Do you have suggested menu plans somewhere? I’m struggling to find hearty sources of protein as entrees since we now know meat, eggs, chicken, cheese/milk products are bad, bad, bad!
    Karyn Scher

    1. Karyn,

      Good luck on your path to eating healthy. I have some thoughts for you.

      1) Your assumption that you need “hearty sources of protein” is quite understandable given what we have been taught by our government and the food industry. However, it turns out, you simply do not need to focus on “protein” to eat a healthy diet. Here are two sources that will help you understand why this is so:

      and Dr. McDougall’s newsletter articles from December 2003 and April 2007:

      2) But that still may leave you with the question, “What does a healthy diet look like?” I recommend that you check out several sources from PCRM (Physician’s Committee for Responsible Medicine):
      a) Power Plate
      b) The new 4 food groups

      c) 21 Day Kickstart Program – it is free and contains 21 days worth of meal plans and other great info and support

      With some minor differences, I believe that all of this information fits in with what Dr. Greger would recommend or approve of.

      You might also consider getting a good whole plant food based cookbook or two. Let me know if you would like some suggestions along those lines.

      Hope that helps.

  29. Doc, you are literally a god-send and Im not saying this just because I have a question. Thanks You.

    I have heard that those deficient in Iodine may have trouble getting fluoride chlorine and bromine out of their system and that there are considerations like sodium and vitamin C levels. I was made to believe that it was too complicated to handle on my own…

    I hope you can clarify this. Thanks

  30. “Selenium

    Northern Europeans may need to take a supplement or eat a daily Brazil nut”

    Why do northern Europeans need extra selenium?

  31. Hi Dr Greger, I’m currently breastfeeding my son and I purchased 2,500 mcg (µg) cyanocobalamin to make sure I had enough for my son and I…. two years ago I needed injections to bring my levels up. When I got Home the bottle said that pregnant and nursing mothers should not take the supplement… I’m confused…. Can I take it ot not?

    1. Have you found an answer to your question? I’m curious now.
      Also, why is an injection necessary when levels are low? Does taking an oral supplement not do the trick?

      1. Hi Douglas, thanks for answering. No I haven’t found and answer to my question yet. As to the injections, the doctor said my B12 was so low it needed an urgent boost.

  32. I just want to thank you Dr. Greger! You are a sweetheart of a person and professional! I feel I can truly trust your recommendations because you are not trying to make money off of them! And you lead by example!!! If you are married with children I hope they take your info and example to heart and do the same! I wished mine did!

    1. It is important to focus on your omega 3 intake and mostly ignore you omega 6 intake. Omega 3 is harder to get, omega 6 is plentiful. You want a ratio of about 4:1 of omega 6:3 or lower.

  33. I’m vegan and have hypothyroidism. I’m tracking everything and getting over rads. Doctors think I’m deficient in minerals or not enough protein. I get brain fogs.

    How much EPA and DHA is recommended? Just trying to pinpoint evertything

  34. I try to vary and not eat 2tbsp because then I’d be stuck eating 2 tbsp flax, and 1 brazil nut per day. I workout and am trying to put on some muscle and eat 80/10/10 so like to add 1 tbsp of pumpkin seeds after working out.

    1. Derrek, you are getting far too specific and your specificity is negligible. You can eat a meal of brown rice and veggies after exercise and it will still be sufficient protein to gain muscle. Protein needs match caloric needs. There is no reason to seek “protein rich” foods. Simply eat when you are hungry till you are full.

  35. Would about vitamin E? I’m vegan and struggle getting enough on 80/10/10. Any advice? I don’t want to supplement with harmful vitamin E as you showed it isn’t good to supplement.

  36. Is there any particular reason flax seed is not suggested for omega-3?

    I’m also wondering if seaweeds are being contaminated due to pollution, as well as radioactivity depending on the origin (Japan, American coast). Would love if someone shared some insight. All I was able to find were blogs and unscientific stories.

  37. Is it possible to get enough DHA / EPA from leafy greens and greens such as purslane? or as a vegan do I need to take an algae supplement?

    1. Ken: I’ve never heard of purslane, but I do know that it is very possible to get all of the omega 3s you need from a vegan diet. BUT, the devil is in the details. To understand those details and see hard numbers on how greens and other foods like flax seed can get you the omega 3s that you need, I *highly* recommend the following talk by Jeff Novick: From Oil To Nuts. I’ve watched this talk multiple times and keep picking up new info. And I’ve shown it to many family and friends:

      As I said, the devil’s in the details, such as truly eating enough of the right kinds of foods and not eating the wrong kinds of foods. If you aren’t aware of or up to following those details yet, then I’m thinking that an algae supplement would be good insurance. In fact, supplementing with an algae-based DHA/EPA is one of the few supplements that Dr. Greger recommends:

      Does that help?

    2. Ken: I’ve never heard of purslane, but I do know that it is very possible to get all of the omega 3s you need from a vegan diet. BUT, the devil is in the details. To understand those details and see hard numbers on how greens and other foods like flax seed can get you the omega 3s that you need, I *highly* recommend the following talk by Jeff Novick: From Oil To Nuts. I’ve watched this talk multiple times and keep picking up new info. And I’ve shown it to many family and friends:

      As I said, the devil’s in the details, such as truly eating enough of the right kinds of foods and not eating the wrong kinds of foods. If you aren’t aware of or up to following those details yet, then I’m thinking that an algae supplement would be good insurance. In fact, supplementing with an algae-based DHA/EPA is one of the few supplements that Dr. Greger recommends:

      Does that help?

  38. Thanks Thea, purslane is a common weed that is loaded with omega 3’s (and grows wild in my garden and on my patio). I thought it had DHA-EPA,but upon farther reading I’ve found out it only has ALA to offer – though in good quantity. Yes, I’m familiar with the association of omega 6’s and 3’s and I never use olive oil, but these days it can be hard to avoid consuming too much omega 6. Thank you so much for sharing your knowledge.Thank God for algae oil.

  39. I find calcium and iron difficult to replenish at optimal levels with a vegan diet. Could you please enlighten me with more specific advice (e.g specific foods I could eat to get to DRA). Thank you!

    1. Mery D: I recommend that you get a hold of a book called, “Becoming Vegan – Express Edition” by RDs Brenda Davis and Vesanto Melina. It is a great reference book for your type of questions. Ie, when you want to know a healthy way to meet RDAs (Recommended Daily Allowances) for certain nutrients. They have done a great deal of research. For a wide range of nutrients, you can find a ton of background information plus recommendations on foods to eat and how much. The book even has a set of meal plan examples. Good luck.

  40. When Dr. Greger says 250mg of long-chain omega-3′s (EPA/DHA) does he then mean you have to take 250mg of EPA and 250mg of DHA, or does he mean you have to take 250mg of omega-3s containing EPA and DHA? :)

    1. Hi Harriet,

      Thanks for the great question! The amount of B12 stored in the liver is quite variable from person to person. For some people they have liver stores that can last several years but for others even a short period without B12 can cause trouble. So, for most of us, a supplement sooner, rather than later, is the best plan.

  41. Hi,
    Vegan since of NF (and met Dr. G as a friend back in 1990s when he was student at CU in Ithaca) I’m wondering if you could clarify something for me about calcium (for a research project I’m doing, about which I hope to be able to share about in some weeks).

    Michael was interviewed by my friend Emily of Bite Size Vegan and in the series said that we need 600mg. That’s not my question,
    that’s what he really said (confirming longtime impression I had that
    “1000” was overkill) He said one does *not* want to go below that, but
    that’s what one really needs.

    (I do regularly read NF also but have not seen one on calcium
    specifically rec amounts in last 12 months on N so I assume it’s safe
    to go with the info he gave in a life video feed interview with Emily a
    few months ago…)

    Ok…except nutrition labels don’t give “mg” they give “percents” as you know! :-)

    What is their 100% (how many mg per day) is my question, part 1.


    it is about 1000 (with more for men and women 9-18 and for women over 51) but somewhere 1,000-1,300.

    2, based on part 1, is how should one adjust the “percent” on nutrition
    labels if one is aiming for 600mg (or maybe a bit above, but not
    much). Can you confirm this is correct:

    I assume 1,000 is
    their “100 percent” so I divide by 0.6 to get the actual percent out of
    600 (I know the math is right, that’s what my doctorate is in…I mean
    the nutrition :-) so for example if it says:

    “6% of calcium in one serving”

    6% divided by 0.6 is 10% (which also makes sense looking at it another
    way, “6%” of 1,000 is 60mg, which is actually 10% of the 600mg one is
    aiming for)

    Anyway does this sound right?

    Or are they using 1,200 instead of 1,000mg as their “100%”?

    Or something more complicated?

    like the “last mile” of internet connection, the connection we have is
    only as fast as that last mile (or as fast as the slowest segment) and
    the best most amazing vegan advice works only if we can “translate”
    it..and as you can see this one single part of my research project I hope to create a web page about, is about translating so
    consumers, or human beings as I prefer to call them/us, can use the NF
    recommendations etc….thanks,

    1. The The American Dietetic Association recommends 500 mg of DHA/EPA per day, twice as high as your 250 mg. Is there a danger with going with the 500?

    2. Great question! Reading a nutrition label can make your head swim, or at least it makes mine swim sometimes. ☺

      For your first question: The DV for calcium is 1,000 mg for adults and children aged 4 years and older and that is what the nutrition labels are using. So if a food has 33% of your DV it has about 330mg of calcium in it.

      For your second question: Yes, you are right on. The easiest way (I think) to figure out how many mg of calcium are in a food is multiply the %DV by 1000. If a food has 10% of the DV multiply 0.1 by 1000 and (viola!)- your food has 100mg of calcium.

      Let us know when you get your website done, I’d love to see it! Anything that makes nutrition information more accessible is great.

  42. An article in Science News “How vitamin B12 makes pimples pop up”
    As per Dr. Greger’s recommendations my wife and I, both 65, take 1000 mcg of B12 daily. We do notice more pimples it seems. We just thought it was part of getting older…Acne for the elderly. Is 1000 mcg daily REALLY necessary or would every other day be OK?
    We’re both WFPB no/lo SOS followers and Dr. Greger is one of our Gurus.


    1. The acne is caused by the cyano part of the cyanocobalamin. Some people are more sensitive the the small amount of cyanide in the cyanocobalamin. Use methylcobalamin b12 instead and your problems should soon clear up. There should be some B12 supplements in your local grocery store that use methylcobalamin instead of the cyanocobalamin. Let me know if you do and if it works!

  43. I’m a little confused about the selenium recommendation . . . why is it recommended that Northern Europeans should take a supplement or eat a brazil nut daily? Is this recommendation applicable to individuals living in North America? Thanks!

    1. Hi Sara,

      Most people in the US get their selenium from meat since selenium is stored in muscles. However, plants certainly contain selenium as well. The amount of selenium in plants depends mostly on the amount of selenium in the soil and in the US, even in low selenium areas, we are almost always above the US RDA. In some areas of China and Northern Europe though the soil levels are low enough that vegans can be in trouble. So you should be fine if you’re in the US!

  44. Hi Dr. Gregor, I was checking out recommended daily allowances for various minerals and vitamins and saw that adults get 1000 mg of calcium daily. Now this doesn’t concur with what you have written above for calcium. Could you explain, please? Thanks a lot. Heath

    1. Heath: There is plenty of evidence that 500-600 is all we need. There are cultures who eat primarily whole plant foods and which exercise plenty and which do not get osteoporosis. The book, “Building Bone Vitality” by Lanou and Castleman is a real eye opener on the issue of calcium and bone health.

      Even Brenda Davis and Vesanto Melina, who are very much into following the RDAs acknowledge that “There is good evidence that intakes less than 525 increase risk.” From: Becoming Vegan, Express Edition. (Which means that over 525 is not an increase of risk – ***all else being equal***.) They also point out that getting enough calcium is about an intake balance. The total amount of calcium you get is less important than balancing how much comes in vs how much goes out. Diet and exercise affects this balance/flow.

      My point being: So, coming up with a single recommendation for large numbers of people is really hard. But the range between 500-600 seems to be relevant for people eating whole plant food based diet. (And truth in writing: Davis and Melina do say, “Until more definitive research is released, it’s a good idea to make sure you get the recommended [RDA]…” After reading the Building Bone Vitality book, I feel confident enough to go with the 600 range myself.

  45. I have just recently discovered your site and I must say I am quite enthusiastic about it. I am unsure about where to get the basic information for a plant-based diet. I thought any non-animal food would be good, but I have since learned things like coconut milk or olive oil should be avoided. Do you have a book to help out the novice, laying out the less obvious things to avoid and other things to be sought out?
    Thanks, and great site!

    1. Joanne: Welcome to NutritionFacts!

      Rumor is that Dr. Greger has a book coming out in December which should answer your questions. In the mean time, I think this page that you are commenting on is a great summary. Notice Dr. Greger is generally listing whole plant foods on this page, instead of highly processed foods like olive oil (or any oil, except maybe some algae DHA). So, the idea of “whole plant foods” (or as Jeff Novick puts it, “minimally processed plant foods”, which I find to be a helpful description) could be your guiding principle.

      There are some exceptions to the principle of only eating minimally processed plant foods. For example, Dr. Greger generally seems to promote cocoa powder (cacao beans with much of the fat removed). And various teas come out looking very good. But in general, if it is flour or oil or isolated __ protein, etc. Then that would be a plant food you would generally want to avoid.

      If you don’t want to wait until December (and who wants to wait?!), I believe that the free PCRM program called 21 Day Kickstart is very close to Dr. Greger’s recommendations. This program will hold your hand for 21 days, including meal plans, recipes, videos, inspirational messages, and a forum (moderated by a very respected RD) where you can ask questions. You might want to check it out to see example of what is in vs out.
      (Click the green “Register Now” button.)

      Hope this helps.

  46. I might be reading this wrong but it seems like the cities and latitudes under the vitamin D recommendations don’t match up? Or maybe you just rounded down to the nearest 10? Just checking b/c I’m in Phoenix and was thinking I would be able to get by without a supplement year-round, but we are above 30 degrees latitude.

  47. You’ve stated that the African diet is mainly plant-based and very high in fiber, which is why heart disease and diabetes are nearly unheard of in Africa. So how do they get their B12? Because without B12, we humans are subject to some pretty scary health issues.

    1. Their diet is “mainly plant-based” so they do eat some animal foods. Unchlorinated stream or well water will likely also contain B12. Unwashed plants will also have B12. Herbivorous animals like elephants and gorillas need B12 from their diet and do not suffer from B12 deficiency. I believe that they obtain it mainly from bacteria in the soil on plants and in water.

  48. This post is dated Sept. 2011. Can I assume that you review these recommendations intermittently? In other words, are these your current recommendations? If so, it might be a good idea to add the most current review date up top read the date of the post. Thank you for all of the amazing work that you do Dr. Greger.

    1. Still valid! If the science changes he’ll change these recs :-) Good catch though I know it’s misleading to see Nut. Recs posted 2011.

  49. Hallo, I’m vegan and I have found that I have magnesium (28,4), selenium (62,4) and zinc (3,5) deficiencies. I think I need to take supplements but I don’t know how much per day and for how long, maybe you can give me an advice please. Many thanks,Fleur

  50. What do you think about the health value of low fat or zero fat cheeses? I realize they are certainly not a plant based food but I’m hopeful that the low fat content might move them closer to the healthy range. Thanks

    1. David: It is a very reasonable question and one that is shared by others. Unfortunately (for those people who like dairy cheese), removing the fat just means that you have more of the lactose (sugar) and animal protein. And it does nothing to eliminate the many harmful contaminants and (I think) hormones found of dairy cheese.

      This site has many videos listing the problems with animal protein in general. And with the contaminants found in diary cheese. Here is the topic page for cheese. Not everything on this page will apply if you take out the fat from the cheese. But a great deal of this information would still apply I think:

      Here is some information on animal protein in general:
      or check out this for a super good reason to skip the animal protein:
      And the entire series on IGF-1 (linking animal protein to cancer) is a must-see. The beginning of the series starts here (and you just keep clicking ‘next video’ until you get to the end of the series, something about body building):

      And here is some information on lactose:

      My take-home from all this is that fat-free cheese is about taking an extremely unhealthy product and making it just as unhealthy in different ways.

      Make sense? What do you think? Would you be interested in some ideas for getting rid of the dairy?

  51. Hello!
    I became vegan about 8 months ago and have been noticing that my skin has been breaking out more. I was wondering if there is a vitamin I am lacking in my diet, or if there is one you suggest to take more of? Thanks so much for writhing what you do! Looking forward to your response!

  52. Hi Dr. Greger! I saw you speak in El Paso and I have since finished reading your book (part 2). I’ve tried implementing the Daily Dozen checklist into my eating habits for the past week and I can’t meet them because I’m so full! So I calculated out the average calories that meeting those requirements would take and it was about 200 calories/day higher than my calculated basal metabolic rate (not counting exercise). This is great because it forces me to avoid junk foods… but I am concerned about long term weight gain. Any thoughts on this?

    1. I will let you know my experience, I do eat his daily dozen and have lost weight, same with my wife. “Calories” is very loose concept, our body doesn’t work based on Calories. For eg, in one of videos Dr. G for nuts, even eating tons of nuts, none of the participant in the study gained any weight.

  53. Hello! I was wondering if Dr Greger (or anyone else) has any thoughts about the need to supplement -choline- for people eating exclusively a plant based diet (vegans also) ?

  54. Can you please list any supplements for depression and anxiety? also is a turmeric curcumin supplement fine to take everyday? I do not like eating turmeric. do u know any good brands or sites that sell it if so? i can’t have corn products.

    1. Unknown: Dr. Greger’s new book, How Not To Die, has an entire chapter about depression and mood disorders. I don’t remember recommendations to take specific supplements, but there is plenty of recommendations about a general diet. If the book doesn’t interest you, you can do a search on this site for depression and see what you come up with. I think you will find some interesting information. But in the end, I think the general recommendation will be to implement the diet you see here on this page. Good luck.

  55. I couldn’t find any videos on this topic surprisingly, but a wonderful piece of advice would be knowing what specific line items to request when getting blood work done. Do they report things like omega 3 / omega 6 ratio? Do I have to ask specifically for vitamin D? Do I need to get fasting bloodwork, or non-fasting? I need a cheat-sheet to hand the doctor or lab.

    1. Some of these are things that most docs do routinely and some are not. I think it’s a good idea to go in to the doctor with a list and inquire if he/she is planning to do any of these tests. If not I would request them. Most reasonable docs will go ahead and order them if you request them. If not then it may be time to start shopping for a new doc. There are tests for omega 3/omega 6 but a regular family practice doctor may be more reluctant to order those as some are not comfortable interpreting the results. A cardiologist should be quite comfortable interpreting them though. As a last resort, there are direct labs online such as or who do labs direct to the consumer. I do recommend caution when using these labs though since you won’t have the benefit of having a doctor to help you interpret and make recommendations based on the results.

  56. I believe for a person to obtain the proper amounts of nutrients ( c, d, b12, etc) you must determine the amount of the nutrient found in the blood by testing your blood. After you know the test results you can adjust your intake up or down. The problem with this is you have to get your doctor to approve your blood tests (NOT EASY). Another problem is knowing what the OPTIMAL blood level of the particular nutrient is. I believe research at University of California shows that 70 to 100 millimoles/decileter of vitamin d is optimal.

  57. How do you get enough omega-6 if you eat no oil, HFPB? I add flaxseed to get enough omega-3 but frequently seem to be low in omega-6 according to

    1. Sarah: Are you eating whole grains? If you follow Dr. Greger’s recommendations, your diet would include 3 servings a day of whole grains (such as barley, brown rice, quinoa and millet). I recently looked up the omega 3 and omega 6 content of barley recently and there is a lot more 6 compared to 3. (You can see the fat content of a cup of barley on the following page. Just scroll down to the relevant section.

      Dr. Greger also recommends about 1 serving of nuts (1/4 cup whole nuts or 2 tablespoons nut butter) a day. Most nuts have WAY more omega 6 over omega 3.

      I think that including grains and nuts in your diet is a way to balance out the omega 3 and omega 6s ratios. It’s kind of funny that you are having trouble getting enough omega 6 since most people have the opposite problem. While no problem is good per say, it feels to me like you must really be on the right track.

      One question I have is: Why do you think you do not have enough omega 6? I know that cronometer measures nutrients in your diet, but I’m wondering if cronometer is specifically telling you that you are not getting enough omega 6? Or are you assuming so based on some kind of formula?

      1. Hi Thea, if I can jump in and my situation might be different than Sarah’s but, some of us are wondering about not percent omega 6 but absolute amounts because a) following both Dr. Greger and others I am trying to eliminate or strongly cut down on extra virgin olive oil – the only oil I use -and to get from whole foods only b) in the 1990s I hurt my health living on a near-zero fat diet (my too high triglyc. and my too low HDL got better when I added vegan fats/oils and I know exercise helps too but we’re focusing on diet here) and c) I’m probably ok since I do enjoy raw almonds, but what amount of almonds per day (in grams, say) will get the minimum (not percent but absolute amount) to have enough mg of omega 6?

        That’s my main question but I also wonder out loud whether we need to emphasize nuts more loudly because if we are moving people away from adding any and all oils, those who eat vegan and eat nothing but grains, fruit, and veg and no nuts (and no seeds) I suspect may not get enough fat to avoid too-little fat (as I say, some may dispute that one can damage health from too-low fat but my 1990s experience suggests it’s not as impossible as some may think!) if one has no nuts, no seeds, and no oils, just veg/fruit/grains. Anyway is there a simple “X grams per day” of almonds (I’m allergic or dislike most other nuts) that will rise mg of omega 6’s (and hopefully, total fat) to above some (pretty low I admit) min threshold and up into the safe and even Health zone of enough of those good fats? Thanks!

        1. harelb: I don’t know that I have a definitive answer for you, but I have some thoughts that may help.
          First, note that 1 tablespoon of almonds has 1085 mg of omega 6. There are 4 tablespoons in 1/4 cup, Dr. Greger’s daily recommendation for nuts. So, 1/4 cup of almonds has 4340 mg of omega 6. Meanwhile, 1 cup of hulled barley (which is 2 out of the 3 servings) is 1838 mg omega 6.
          So, now your question is, how does all that stack up to how much omega 6 we need? I don’t know a definitive answer, but here is how I tried to puzzle out an answer for you: From what I remember (off the top of my head, which may be wrong), women need about 1.1 g (note: units in paragraph above are mg) of omega 3 a day. And if you will pardon the ratios for a moment, if I remember correctly, the ideal ratio of omega 3 to omega 6 (depending on who you talk to) ranges between 1:1 and 1:4. This means that if you really need 1.1 g omega 3, then you need between 1.1 to 4.4 g omega 6. Even if you didn’t eat a single additional omega 6 morsel than the two foods listed in the paragraph above (1/4 cup almonds and one cup barley), that’s about 6.2 g omega 6, more than enough. All of which shows to me that it is easy to get enough omega 6 on a whole plant food diet, especially if one is following Dr. Greger’s Daily Dozen.
          I have another track to take to try to get at another part of your question, which talks about a “health zone” which I presume you mean an amount of fat that is above and separate from a minimum amount of fat. From what I have seen, I don’t think the majority of people’s experience mirrors your own, but of course I believe you when you talk about your experience. And I have seen a few others on NutritionFacts who report similar experiences with lower fat diets. Thus, I would suggest that there might be some play in how much fat a person needs in her/his diet. (Not as much play as the Atkins or paleo people would have us believe, but still some play.)
          Dr. Greger does not recommend that people stress about macro nutrient percentages (I could probably find that page for you if you want), and I tend to agree. But to try to answer your question, let’s try to figure out what percentage of fat a healthy diet would include. Let’s start with the traditional Okinawan diet, a diet that has produced some of the healthiest people on the planet. There was a study of thousands of Okinawans. I don’t have the reference with me right now, but I can get it if you want. If memory serves, the Okinawan diet was less than 10% fat. People who have successfully been following (thriving on) a whole plant food diet on this site tend to report 10 to 15% fat in their diet when they track it through Brenda Davis, a well respected RD and promoter of plant based diets and who once did a guest blog here on NutritionFacts, has proposed on page 60 of her book, Becoming Vegan, that vegan diets between 15 to 30% is a good goal. But depending on your situation, (such as dealing with obesity or some diseases), Brenda says you should aim for the low end of that range. And given that T2 diabetes is a disease of excess fat, my personal opinion is that 30% is way too high for most people. This gives you the idea of the “play”/range of fat that might be optimal for you. I think 10 to 20% is probably best for most people, the exact amount being best for a person depending on their particular situation.
          Putting it all together: If you absolutely must put a number on how much omega 6 fat would be ideal for you (as opposed to focusing on whole foods as Dr. Greger and others recommend), you could figure it out this way: a) how many calories a day you think are good for you?, b) what percentage of fat you think is ideal (perhaps aim for 15%)? and then using cronometer. com, c) make sure that when you eat 15% fat in a whole plant food diet with no oils, the amount of omega 3 and 6 in the diet meets or exceeds the 1.1 and 4.4 g numbers listed above and which have appropriate ratios to each other. If so, then that amount of omega 6 would be the right amount for you.
          Is this a more satisfying answer? What do you think of that logic?

          1. What an extensive response, thank you
            Thea. I just want to clarify two things first..For one thing I don’t
            want to give false encouragement to the Adkins type so when you say you
            compare me to others who don’t do well on “lower fat diets” I think I
            *DO* well on what I’d call “lower fat” diets, just not on what I called
            near-zero or ultra-low. Maybe I should have clarified I’m a 20+ year
            vegan who eats mostly unprocessed and minimally processed foods, cooks
            home meals etc. So while I don’t want to completely discount people who
            say they don’t do well on “lower fat” diets, I’m not one of them.

            vegan whole food minimally processed and throwing out the oils (if you
            don’t get to eat a half avocado or more many days a week) is indeed a
            very to ultra low diet depending on whether one skips nuts and seeds
            entirely or not…Back then I had much less to no nuts/seed and no oils
   very very low oil/fats. I’d be happy to email you 19 blood
            test results from early 1990s to 2015…they bounce around a lot, yes,
            but still there’s a pretty clear before and after, that matches the very
            same 1-2 year time when I started adding avocado, olive oil, and later
            nuts, to my diet. It’s pretty stark…a “before” and an “after” are not
            hard to discern.”After” Trigly ranges 72 to 182 for example over 7 blood
            test 1999-2015 recorded in that text file right from lab printouts.

            1994-1999 in 10 blood tests ranged from one “outlier” low for me of 111
            and one 191, and the rest (another 8 readings!) being in 300s, 400s,
            500s two in 570s, and one reading of 685 for triglyc…Compare that to
            the 7 blood tests 1999-2015 with the HIGH being 182..night and day.
            Don’t want to get this too long so won’t look against at HDL but recall
            also notable change. I have LDL and VLDL and total chol for many, but
            not all, and didn’t look carefully since those were not “bad” in the
            “before” period; issues were high trig. and low HDL…still today
            somewhat but far less so than my early days. How many other things have
            they cahnged recommendations sinc e1990s? a lot actually! Remember when
            they told us “monounsaturated” was “ok-ish” and “polyunsaturated” was
            “awesome! by far better!” ?

            It’s too bad this still isn’t
            automated so it takes fanatic record keeping typing it all in as I have,
            some day it will be automatically online one hopes (we’ve been promised
            this technology for many years) so without such dedicated habits
            someday everyone will be able to say: “Computer, show me the last 15
            years of HDL in a graph with key points labelled” and then start to
            cross reference with dietary changes.

            Second about ” If you absolutely must put a number on how much omega 6 fat would be
            ideal for you (as opposed to focusing on whole foods as Dr. Greger and
            others recommend)” I am absolutely wanting to know whole foods based just to know the amounts of whole foods…

            done detailed tedious hand calculations of 5 day averages for myself
            for protein, calcium and iron, and other than calcium where I decided to
            make changes, going by feel has been fine. I have been too busy or too
            “lazy” to do the same for fats, but I can tell you it’s low fat now and
            was crazy-low in early to mid 1990s. I have to find the time to hand
            measure now, and/or, find the time to do the whole cronometer
            thing..maybe someday..!

            Thanks to you we can do this
            calculation..since I needed still more conversion help from what I knew
            (number almonds, and grams) to info you kindly looked up (1/4 cups
            and/or tablespoons) but how does this look Thea:


            cup how many grams? If we can trust that website the answer depends on
            form:For 1cup ground or sliced (95g and 92g) is a different answer from 1
            cup slivered (108g) and 1 cup whole:143g.

            Now Blue
            diamond natural almonds serving size says “1oz, 28g, about 24 nuts” and I
            have counted enough times to know that my average to be sated ranges
            16-24 almonds.

            1/4 cup would be 143/4 = 35.75grams by their estimate

            How many almonds? (35.75/28)*24 or about 30.64 almonds, a third of an almond shy of 31 almonds.

            a lot to eat in a day…but if it gets over 4gram omega 6then getting
            1.1-4.4 grams isn’t too bad. That leaves mostly to worry about just

            you said you could be wrong about needing 1.1 grams of omega 3’s (I
            weigh about 135, 5’8″..though I did have unwanted weight loss down to
            close to 120 once..they ruled out cancer and I’m back to mid to upper

            b) That 1:1 to 1:4 ratio is pretty wide…but this isn’t to complain that it’s wide but to ask a question – could it be that 1:4 is closer to optimal for one level (X) of, say, omega 3’s and that 1:1 is closer to optimal for another level, Y, rather than “The Truth” being some unknown number in that range that applies to all (absolute) levels of either? Maybe if one fat level is on the higher end then one ratio will do, but if it’s at the lower end, a somewhat different ratio?

            That aside, your info was a great help to get me to the calculation I made above to get at least a sense in #almonds/day :-)

            1. harelb: Thank you for your reply. It always makes me feel so good to know that I have helped someone!

              There are a few follow-ups I wanted to give you based on your reply to me.

              1) you wrote: “issues were high trig. and low HDLL…still today somewhat” I agree that a high trig number can be concerning, but I wouldn’t worry about a low HDL number. Low HDL is a natural progression of a healthy diet and not a good indicator or risk anyway. Dr. McDougall has a great article on this topic. Also, here is a recent study that addresses this topic: “Protective Effect of HDL Null if LDL Levels High: High-density lipoprotein (HDL) cholesterol may not protect against heart disease if low-density lipoprotein (LDL) cholesterol and triglycerides (TG) levels remain high, according to a study published online in Circulation: Cardiovascular Quality and Outcomes. Researchers monitored cholesterol levels and cardiovascular disease risk for 3,590 participants from the Framingham Offspring Study. The authors conclude that high LDL and/or TG are more predictive of heart disease risk, regardless of HDL.”
              FROM: Bartlett J, Predazzi IM, Williams SM, et al. Is isolated low high-density lipoprotein cholesterol a cardiovascular disease risk factor? New insights from the Framingham Offspring Study. Circ Cardiovasc Qual Outcomes. Published online May 10, 2016.

              2) you wrote: “If we can trust that website” If you look at the bottom of the Self Nutrition nutrition pages, they tell you the source of the data. I believe it is all or mostly from the USDA database that everyone uses. That doesn’t necessarily make it accurate. But I think it is as accurate as we can get.

              3) you wrote some question/concern about where I got the 1.1 grams for omega 3 number. I got it from what I remember from a talk from Jeff Novick (a famous RD) from a talk called: From Oil To Nuts ( ). I did some quick research and you can find a similar recommendation on this page: says, ““According to the National Academy of Sciences, adequate daily intake of omega-3 fatty acids is 1.1 grams for women and 1.6 grams for men. This translates to between 1-3% of our daily calories or about ¼ to 1/3 of a teaspoon a day! Not very much at all and easy to attain with even the most basic plant food based diet.” Matthew Lederman, MD and Alona Pulde, MD” I don’t know who Mathew Lederman is nor how accurate the quote is, but I believe that these are the numbers that I got from Jeff’s talk.

              4) What is the correct ratio of omega 6 to 3? Could it depend on the situation? You raise a great question. I’m not an expert and haven’t done a extensive amount of research on this topic. However, I did a little research after seeing your question and came up with the following quote, which I found interesting and thought you might also:

              “Most of the studies used in the BMJ review do not address the omega-6–to–omega-3 ratio. There is evidence that a 4:1 ratio is required for maximum benefit for cardiovascular disease and less than 2:1 to have any effect on cancer. This is almost impossible to achieve with our diet today (Canadian guidelines are currently 6:1). An excellent book, Omega-6/Omega-3 Essential Fatty Acid Ratio: The Scientific Evidence, reviews this.5” from:

              Again, I hope these thoughts prove helpful. Best of luck to you!

  58. My daughter just turned 12 months. So now we switch to cows dairy whole milk according to AAP guidelines. I’d like to give her a plant based milk instead. Do you recommend almond, or soy? She eats a well balanced diet, but I need a milk with protein, calcium, and fat. Thoughts? Thank you!

    1. KELLY: The Vegetarian Resource Group (VRG) has some great info on raising healthy kids. Here is their main families page. Scroll down to the Nutrition section. I particularly like this article: and this one: If you aren’t familiar with VRG, they are a very well respected and well researched source of information. I believe that Dr. Greger has also recommended that site before.
      Another source of great information for raising healthy kids is the Physician’s Committee for Responsible Medicine (PCRM) site.
      To specifically address your question about non-dairy milks, almond or soy should work very well. But if you can help your daughter develop a taste for soy milk, that could be particularly beneficial at this age. NutritionFacts has a video around here somewhere which talks about how eating traditional soy products (traditional = products like soy milk and tofu rather than say fake meats) regularly at an early age is particularly beneficial in preventing breast cancer. (This is not the info I was looking for, but it is all I can find right now and is generally relevant: ) And here is a video which specifically addresses the benefits of soy milk:
      If GMOs are a concern for you, just get an organic soy milk. And if calcium is a concern for you, then get one fortified with calcium. NutritionFacts has another video that talks about how calcium from non-diary milks are absorbed by our bodies just as well as calcium from dairy milks – as long as you remember to shake the container.
      Does this help?

  59. What should I eat to promote faster hair growth? What should I eat to improve my height without consuming cheese?
    thank you

  60. At age age 64. taking once a week sublingual 2,500 mcg (µg) cyanocobalamin, as I am now doing, appears sufficient.. My question is, should I switch to daily 1000mcg (ug) cyanocobalamin at age 65?

    1. you could always get your blood tested before and then after changing the dose but why the worry? the excess is just pee’d out anyway like vit C.

  61. Dr Greger: I’m currently listening to “How Not to Die.” Why am I listening? because my second embolic stroke has robbed me of a great deal of my eyesight. After the first stroke, in 2010, I had no side effects because the clot ended up in a part of my brain, the function of which, is so far unknown. My thinking said the reason the clot traveled the maze of vessels in my brain without being stopped is because my no-added-fat whole foods plant-based diet allowed my vessels to be clear.
    My vessels are clear, my lipids are 126 CHOL/90 TRIG/68 LDL/40 HDL, my hsCRP is 0.5, HOMO is 7.8. I walk 3-7 miles a day. You make it sound so easy, but I strictly follow the Esselstyn diet and have been low fat plant based since 1999, but I’ve had 3 TIAs that I know of and 2 embolic strokes. Do you have any other suggestions for me? I’m game for anything.
    You are definitely one of my heroes. I’ve appreciated many of your lectures at McDougall Advanced Study Week-ends. I’m very sad to be missing this upcoming one in September.
    Jill Princehouse

    1. since they are still taking patients, i think it would be in your best interest to make an appointment and a trip to visit either dr esselstyn or mcdougal without delay.

      im kind of in the same boat but need a plant based endocrinologist and probably will travel half the southern states to go to one i’ve decided on, about 950 miles.

  62. Please help. So difficult to get through the options. What Brand of Omega 3 long chain should I take? Or if you hesitate to recommend a specific brand, maybe you can just tell me what brand you personally take, and then I can go from there. :)

    1. Thanks for your question Louise.

      I do not think any registered health professional will specifically advise you on a certain brand but if you look for them in Amazon for example, there are lots of them:

      See here.

      Just make sure that these are in line with the recommend dose and are from an algae based source to avoid contamination issues (which is quite a problem in Fish Oils).

      Hope this answer helps.

    2. Louise Comfort: One of our well respected forum participants did some research once and found out that the majority of algae-based omega 3 pills are all made in the same small number of facilities. In other words, it really doesn’t matter what brand you buy. So, get one that is in your price range and has a pill size that you like etc. And of course, as Darchite says, pay attention to the dose so that you are getting the amount that you want.
      One other factor you may want to look out for is whether the pill contains only DHA or DHA and EPA. You can see on this page: that Dr. Greger recommends getting a pill with both. I’ve seen some commercial brands in the past that only had the DHA.

  63. Hello , I m diagnosed with hashimoto. Does boosting my immunity by eating or drinking certain food will make my case worse ? Every doctor I ask try to ignore the question while my problem is an immunity issue. Thank you

  64. Dear Dr. Greger,
    Many thanks for your book “How Not to Die”!
    I started reading it right after it was delivered. In “Supplements” ( page 408) you recommend to buy cyanocobalamin
    type of Vitamin B12. While trying to find the right brand I encountered into many comments glorifying methylcobalamin.
    Do I miss something?
    Thank you in advance,

    1. Hi Stella, I am a volunteer for Dr. Greger. I am glad you are enjoying “How Not to Die”. Methylcobalamin is under-researched, and one study shows that it did not reverse the vitamin B12 deficiency for at least one subject. This leads to concern over whether the methylcobalamin source of B12 is effective for only some people. Therefore, the science today currently suggests that cyanocobalamin is the most reliable source to date.

      1. Michael and Raphael: If you review the videos on this site, I think you will see that Dr. Greger generally recommends the flaxseed because of the lignans it contains. Lignans are powerful nutrients for fighting cancer (and maybe some other health problems I don’t remember at the moment).

        Omega 3 is a different question. You can get some omega 3s from flaxseeds, but your body has to convert the type of omega 3 in flaxseeds to the kind that your body needs. There is a question about whether people can generally convert enough of the omega 3s in plants such as flaxseeds in order to maximize long term brain health. You might consider looking up the series of videos on NutritionFacts concerning DHA. Dr. Greger did recommend taking algae derived DHA supplements as his conclusion. However, he also lays out the evidence for that conclusion and there are people who think that the evidence is not strong enough to warrant taking the DHA or making the recommendation. Bottom Line: Those who want to error on the side of caution would take the DHA supplement. This is not the type of situation like B12, which is really a hard, firm recommendation. You might consider reading the comments under the DHA videos for some interesting perspectives.

        In terms of the question from the angle of “Can Dr. Greger clarify what he recommends?” The recommendations on this page have been confirmed recently. So, you can rely on what you see here as being what Dr. Greger currently recommends. You can also find these nutrition recommendations, along with additional details, in Dr. Greger’s recent book How Not To Die.

        Hope this helps.

        1. Hello fellow readers:

          I have just spent over two hours reading all the comments/Q&A on this page here about Vitamin D3, B12 and algae based Omega-3 (DHA&EPA) supplement which seem to be the most essential ones a WFPB vegan should take while other recommended nutrients above can be mostly found in whole food.

          I used the word “essential” because I really don’t want to spend every day/week taking more than a dozen supplements if they are not absolutely necessary for “optimal” health according to Dr.Greger’s findings. After all, supplements are not whole food.

          While I completely understand about D3 and B12, I have yet to find anyone here could clearly answer the concern about the adverse health effect of algae based Omega-3 (DHA&EPA) supplements which contains ALSO “Carrageenan” which many findings indicate it is a bad stuff!

          Example: (ingredients contain Carrageenan)

          Can any moderators helping Dr.Greger here probably address this concern which has been raised many times by readers here but have not been answered clearly?

          Should we still take the highly recommended Algae based Omega-3 (DHA&EPA) supplements REGARDLESS of the fact that most of these products containing “Carrageenan”?

          Another reader also cited this Example: (Ingredients also contain other stuff than just Algae oil, stuff that I have no idea if it’s harmful or not)

          Why can’t Algae based Omega-3 supplements be made by JUST 100% Algae oil Omega-3 extract and skip the other stuff? This REALLY makes it difficult for me to decide whether I should take this supplement or not.

          Please confirm my understanding after literally hours of watching and reading here…..

          According to Dr.Greger’s dosage recommendation for the followings

          1. Take Vegan D3 every day as I’m not exposed to Sunlight on daily basis and I personally avoid Sunlight to prevent premature skin aging and risk of skin cancer and don’t wanna put Sunblock on my whole body every day. I put Sunblock on my face and mostly wear long sleeves or stay indoor

          2. Take Vegan B12 every week because the lack of animal product in my diet

          3. Take Algae based Omega-3 (DHA&EPA) supplements as the ALA converting into DHA&EPA from eating ground Flaxseeds is not enough and our ability to do that conversion will deteriorate as we age

          BUT please answer my concern about the ingredient – Carrageenan!

          Of course I have also learnt and understood that other than these 3 supplements, I need to have a balanced Whole Food Plant Based diet preferably with no refined oil doesn’t matter how extra virgin it is, no refined added sugar except Date sugar as natural whole food sweetener and best if diet is low fat and low sodium.

          I have spent many many hours the past couple of months reading all the information here as I’m really trying my best to convert to veganism for health, moral/ethical and environmental reasons, despite the fact that in a Chinese food culture here in Hong Kong where I live, it’s almost impossible if not extremely difficult to be vegan! Vegetarian is relatively easier as many here are buddists but vegan is very challenging given that 99% of restaurants here contain animal, diary and egg products. Any Chinese food eater would know.

          I really hope the mighty Dr.G or any Moderators with medical backgrounds here can CLEARLY help answer my concern above and confirm my understanding.

          For most of you reading from USA or Western countries, just so you know that we can’t even buy Spinach, Kale, Raw Salad green, Berries, Nuts, fresh herbs etc in my local wet market or chain supermarket. These are abundant in western food culture! I use the word ‘local’ because of course most of us ordinary HK folks don’t live in Central on HK island where most expats can afford to buy those stuff I mentioned above all imported from overseas and priced outrageously in Premium Supermarkets only located in mostly ‘expats areas’.

          I am using the Daily Dozen app and I’m really trying my very best here!

          One last question is about Honey, I know added sugar should be avoided while fructose from eating whole fruits is good. I know honey is a form of refined sugar but I’m asking particularly what I consider as the Super Honey – Raw Organic UMF certified New Zealand Manuka Honey produced in New Zealand.

          Anyone can provide scientific findings whether this particular form of Manuka Honey is good or bad for our health in a whole food plant based vegetarian diet?

          I know most vegans consider Honey as animal products but I have a deep interest in NZ made Manuka Honey which is scientifically proven to have health benefits so I wanna find out more of its effects on our health with regard to the “Sugar” content.

          Can anyone help please?

          It’s really not easy to change to WFPB vegan diet I feel as I need to educate myself with a LOT of information based on the latest science regarding Food and most of the time what I find out is on the contrary to what I used to be taught or believed in!

          Thank you so much for your attention!

          Trying my best!

          1. Lots of good questions there. As Dr. G has not updated his carrageenan vid that I can see, I would imagine there is no human studies on it, so his vid still holds true as far as I know = avoid carrageenan.


            Instead of looking to algae, why not get your omega-3s from walnuts, chia and flax seed? I do.

            B12 makes me a little nervous with the new B12 lung cancer study that was just published, although I am no doubt being paranoid ascribing to one study like this. Still, its easy to get under the 55ug level studied. Also, don’t forget that you only need about 2.4ug/day for most people and can only absorb about 10ug/day. I buy liquid B12, put one drop in a bottle with 6 cups water and then drink 1 cup per day. I test my MMA, B12 and homocysteine several times per year so I’ll update if I have any issues.

            D3: the studies I’ve seen don’t seem to fully account for the benefit of sunlight vs supplemented D3. Sunlight seems somewhat more beneficial, so I put my swim trunks on and lay out in the Hawaiian sun almost every day for about 5 minutes per side. I’m fair skinned, and only have a slight tan from this. My D3 was very low until I started sunning. My D3 is now solidly in the normal range.

            Dr. Ben

          2. CalvanVeganWannabe: I won’t be able to address all your questions in this one post, but I can address some of them.

            First, I’ll address an easy one, your concern about DHA supplements. Here is Dr. Greger’s bottom line on the topic of carrageenan from his latest video after looking at the science through 2013: “Similarly, I’d use potential concerns about carrageenan as additional motivation to avoid unhealthy foods. But, until we know more, I wouldn’t cut out more healthful foods—though I would suggest those with inflammatory bowel disease, or other gastrointestinal problems, try cutting out carrageenan, at least temporarily, to see if your symptoms improve.”

            If you watch the latest series of videos on the topic of DHA, you will see that Dr. Greger does think that DHA supplements are a healthy thing to do. So, bottom line is that whatever concern people might have for carrageenan, it’s not a proven health hazard and not a reason to avoid DHA supplements. (Also consider that there would be very little carrageenan in a pill. We don’t know what amounts are harmful and the “dose makes the poison.” My lay person’s opinion is that the amount in the shell of the pill is unlikely to matter.)

            Also consider the following: If you watch the video series on DHA, it appears (at least to me) that Dr. Greger’s recommendation for DHA supplements at all is based on being extra cautious and making general recommendations for the general public. In other words, the recommendation to take DHA supplements is not as strong/as strongly backed by science as the recommendation to take B12. You don’t have to take DHA supplements at all. If you are concerned, you can get your DHA levels tested to see if you might even need it. Even then, at most, DHA supplements are helpful only for very long term concerns as far as we can tell now. This means, while you are transitioning to a diet of whole plant foods, this is something you can worry about in the future. You don’t have to stress about it right now. (“Don’t stress the small stuff.”) Come back to this topic and think about it after you have made the bigger, immediate changes.

            If you decide that you want to supplement with DHA, and you want to avoid the carrageenan, I can happily share with you that the carrageenan is in the shell of the pill. So, buy a pill that has the flavored oil on the inside and just cut or bite the pill and suck out the oil. I know people who do this. It’s very do-able. While more expensive, another option is to get the DHA supplements that are not pills at all, but are liquid drops.

            I haven’t seen any other ingredients in the DHA supplements that are worth worrying about at the doses/amounts that are in the supplements. Bottom Line: other than *possibly* worrying about carrageenan, you can get whatever algae DHA supplement is convenient and cheapest for you if you decide to supplement at all.


            You wrote about wanting to educate yourself as much as possible, and that this transition is difficult. I just wanted to share my admiration for the path you are walking. It *is* difficult and it can be scary when you have previously been taught different things. Also, I sympathize with the difficulties you are having being in a country that doesn’t have some of the foods that are staples in America, but which you can’t get or would have to go broke getting.

            Some thoughts for you to try to help: 1) It does get easier! Lots of people struggle to transition. Once they get over the learning curve, they report that it gets so much easier and that they are so happy that they made that transition.

            2) Don’t stress about nuts. If nuts and seeds are hard to get, just skip them. Jeff Novick, a well respected and knowledgeable plant based RD, has an excellent talk about nuts (and oils) . While Jeff says that nuts are healthy, the bottom line from his talk was that you certainly don’t have to eat them. And for people with weight problems, they are better off skipping the nuts. Dr. Greger disagrees on this point. But most of the plant based doctors I follow would agree with Jeff Novick and he uses a lot of research to back up his view. I felt Jeff’s research was better than Dr. Greger’s on this point.

            3) Don’t stress the small stuff. While a transition can be difficult, the topic/guidelines for eating healthy can be very easy. If the Daily Dozen is stressing you out, just do something simple like the PCRM (Physician’s Committee for Responsible Medicine) Power Plate. The Power Plate is also an evidence-based system and is ridiculously easy. The goal is to generally fill your belly with about 1/2 starches (beans and intact grains) and 1/2 fruits and veggies. Aim to generally hit those ratios over the course of a day. Eat more starches if you are hungry. Eat more non-starchy fruits and veggies if you need to lose weight. After you get the very easy Power Plate down, you could transition to the Daily Dozen for a more refined option in the future.

            4) Substitutions. Don’t let your location be an excuse. :-) I’m not familiar with what’s available in your area, but if spinach and kale is hard to get a hold of, I’m guessing that there is *something* green the locals eat. Sea vegetables? Something??? Starches: Can’t get a potato? No problem, eat the rice. Pinto beans failing to appear on the shelves? No problem, eat the edamame. Fruit: Can’t find berries? Eat other fruit (lychees?) for now.

            A Suggestion: Please continue to post questions on this site if you think our community can help. I think your questions are great and I don’t mean to belittle your confusion and frustration in figuring out what to do. I’m just trying to address those feelings so that you feel more confident. Post your questions on the latest video page so that more people will see it. Try to keep each post to one topic/question so that people are more likely to read your post. Do you have any additional questions you would especially like me to answer?

            Best of luck to you!

  65. Me essential tremor seems to have increased Allot after taking dha &
    epa algea oil supplements. Is their a connection ? is their harmane in alge oil ?

  66. Hello! I love your videos and articles and often refer my patients to your site and your book.

    I wanted to ask you about probiotics and if you would add that to this list? If so, do you have a specific recommendation for these?

    Thank you for all your work!
    Christina Palmer

    1. Christina-Glad you’re finding helpful. Regarding probiotics, Dr. Greger has several videos about their use. Please check out “” You’ll find several other videos on probiotics listed below this video.

  67. I recently got a copy of How Not to Die and was just skimming through it. In the section on Alzheimer’s, you mention arterial plaque as a possible contributor. I recently read another article (or three) asserting that some in the medical field were beginning to conclude that it is related to (caused by?) insulin resistance, and calling it “type 3 diabetes” (and thus, more a result of sugar and refined carbs than about fats). Not that this this would alter your recommendations about how to eat in order to minimize the risk and/or abate the effects, but I was just wondering if you knew of any evidence to support this idea, or if it might have just been junk science aimed at promoting animal-based foods.

    1. ScottTrimble: You wrote, “…beginning to conclude that it is related to (caused by?) insulin
      resistance, and calling it “type 3 diabetes” (and thus, more a result of
      sugar and refined carbs than about fats).”

      I’m with you right up until you blame insulin resistance on sugar and refined carbs. It turns out, insulin resistance is a problem of fats getting inside the cells. When that happens, the cell gets blocked up, and the insulin can’t do it’s job of getting the glucose into the cell. You will learn more about this phenomenon in How Not To Die, but you can learn more about it right now if you want with this NutritionFacts video: What Causes Diabetes

      Bottom Line: Eating sugar and refined carbs are not healthy, but they are not generally the cause of diabetes/insulin resistance either.

      So, I think this new understanding of Alzheimer’s, both from How Not To Die and from the other sources you are hearing, all goes together rather than being a contradiction or new problem for plant based diets. Make sense?

      1. Yes, thanks. I will skip to the diabetes portion of How Not to Die to get the deeper explanation, and I’ll check out that video, too. Thanks again.

  68. In a separate post, you provided a recommendation on exactly where and what to buy for a B12 supplement. Could you do the same for your “250 mg daily of pollutant free (yeast- or algae-derived) long-chain omega-3’s (EPA/DHA)” supplement recommendation? I have searched many online stores and am more confused than ever about which one to buy. Many thanks!

      1. It’s from NutraBulk, but the link gives an error now. I would love to see another B12 product that ships to the whole world, because NutraBulk does not and all other products I have found have some kind of toxins :(

  69. What to do with a baby when the time of breastfeeding is over. Ho much b12 is recommended to give in a supplement.
    I use 500mcg of spray every two days,and the wife uses it every day because she is breastfeeding the little one.
    (our baby is just 13 days old :) )

    1. Berend: Good for you for thinking ahead! Congratulations on your 13 year old.
      See if you can get your hands on a book that Dr. Greger recommends called Becoming Vegan, Express Edition. The book contains a chapter on specifics for feeding children. And at the back of the book is a chart of specific nutrients (including B12) that humans need at various ages. That should answer not only your B12 question, but any other nutrient questions for infants as well. Good luck.

    2. Hi Berend, I am a volunteer for Dr. Greger. Ideally, babies should be exclusively breastfed for about 6 months (perhaps besides vitamin D supplementation). In the next 6 months, soft foods can be slowly introduced. At one year or later, depending on maternal preferences, babies can stop receiving breast milk and continue to be exposed to new foods. During this process, babies should be weaned off of the breast milk. I encourage you to check out the American Academy of Pediatrics for their recommendations and answers to FAQs here:

      Also, Dr. Greger’s current vitamin B12 recommendation based on the science is to take 2,500 mcg of cyanocobalamin once per week. To see more about vitamin B12, search the website or check out this video:

    1. I’d say this page is a reference for dr G supplements recommendation, so I’d say what you find here is the most recent info dr G could find, and in this sense, it is up to date. More on B12 can be found at . Regarding daily dose, even the page you referenced, says “recommendations for B12 intakes vary significantly from country to country”. I’m no expert, but it seems there are more opinions, dr G recommends 4-7 mcg/day absorbed B12 (but as you would see in the link I provided above, in order to absorb that quantity, you have to take a supplement containing a much bigger quantity of B12).

  70. A whole plant based diet can create some deficiencies, and dr G listed in this article the nutrients we should pay attention to, and if the case, we should take some supplements.

    On the other side, in other videos I saw remarks about how useless, or even dangerous supplements can be, or that the nutrients from supplements may have the opposite effect of eating the same nutrients from food, and the fact that is very difficult for the producers to extract, put into a pill, and save the synergistic action of the nutrients that otherwise are found in natural form in food.

    Isn’t it suspect that the exact nutrients that may be deficient in a whole plant based diet raise no problem for the producers to put them into a pill, and taking that pill doesn’t cause any side effects, or any smaller effects comparing to the natural form of these nutrients?

    1. Hi George, typically artificial vitamins in a pill form come in one chemical form which is vey unlike what nature provides us. When we get an overload of one chemical type while the cells may have receptors for multiple types of the particular vitamin it creates a relative defieiciency in the ones that are not provided. For this reason it is always more advantageous to ingest the nutrients in their natural, unprocessed, whole food form. The same can be said for B12 which is the main nutrient that vegans – strict vegans are warned to supplement as the human body can’t manufacture it on our own. B12 also comes in several forms that are absorbed in varying degrees depending upon the person and what they need. People with reduced stomach acid, those that make decreased amount of intrinsic factor – required for absorption and those that have had small bowel surgery will need a different form of the vitamin to get an adequate amount absorbed. One thing I find fascinating it that of all the B vitamins, of which excess is usually just excreted, B12 is actually stored. Typically a very strict vegan will run out of stored B12 in about 20 years. This, to me conforms with the method of eating that most indigenous peoples practiced wherein animal products were consumed very sparingly and more like a condiment than the manner seen in the standard American diet. Absent pathological problems like stomach or intestinal reasons for lack of B12 absorption one would probably get enough B12 eating what is now referred to in a flexitarian manner during your life. However, for strict vegans that ingest no animal products whatsoever, there will come a day when their reserves dwindle and become at risk for disease. At that point they will have to find the type of formulation that will effectively replace the deficit and a pill form may well not be the answer.

  71. “At least 2,500 mcg (µg) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach”

    What about capsules containing powdered B12? Is there any reason to suspect they don’t absorb as well as chewable, sublingual, or liquid B12?

    1. nah, unless your the one in ?? who doesn’t absorb B12 correctly then don’t worry about it.

      next time you visit your doc have him add a B12 level to your bloodwork if worried since we have decades stored up in our bodies anyway:

      {{and that it usually takes ≈20 y for stores of the vitamin to become depleted.}}


    2. This is from the NIH: Dietary supplements

      In dietary supplements, vitamin B12 is usually present as cyanocobalamin [5], a form that the body readily converts to the active forms methylcobalamin and 5-deoxyadenosylcobalamin. Dietary supplements can also contain methylcobalamin and other forms of vitamin B12.

      Existing evidence does not suggest any differences among forms with respect to absorption or bioavailability. However the body’s ability to absorb vitamin B12 from dietary supplements is largely limited by the capacity of intrinsic factor. For example, only about 10 mcg of a 500 mcg oral supplement is actually absorbed in healthy people [8].

      In addition to oral dietary supplements, vitamin B12 is available in sublingual preparations as tablets or lozenges. These preparations are frequently marketed as having superior bioavailability, although evidence suggests no difference in efficacy between oral and sublingual forms.

      If you’re interested in the full article, here’s the link:

  72. As a 22 year old male that rarely eats animal products (aside from 1-4 servings of dairy once or twice a week, sometimes it’s hard to avoid), I’m now supplementing the following:
    -teaspoon of fresh ground flax seed every day
    -1000 mcg of B12 alternatingly 2 and 3 times a week
    -330mg of EPA+DHA a day
    -35 mcg of D3 a day

    As you can see, the numbers are slightly different from the recommendations as they are the closest I can get using the supplements available here, but I reckon they are in the ballpark, right?

  73. Please update a recommendation for a B12 product that ships to all over the world. NutraBulk does not and other products I find have all some toxins.

    1. Arin,
      Good question. Probiotics can certainly be helpful: Dr. G. has done videos discussing the benefits of probiotics for:
      1) Preventing the common cold
      2)Preventing and treating diarrhea

      However, probiotics are usually not necessary, if you eat a healthy diet with lots of natural fiber, which promotes the growth of a healthy gut flora. This is known as “prebiotics”. Here are a few videos by Dr. G about that topic:
      1) General video about prebiotics
      2) Video about “gut dysbiosis”

      So probiotics can be very useful in treating certain conditions such as acute diarrhea. But eating a fiber-rich diet will prevent you from getting sick in the first place. That is why Dr. G doesn’t recommend probiotics as a needed supplement for everybody. I hope this helps.

  74. Hi!

    Regarding the selenium tip for northern europeans, it’s interesting to note that people at the technical university of Denmark runs its own database of foods and the nutrients they contain, and according to them a brazil nut contains 103 mcg per 100 grams of nuts, making it necessary to eat 10-12 nuts per day rather than 1. And when eating 10-12 nuts per day I get the impression that may lead to a selenium overdose if the quantity turns out to be more like 1917 mcg per 100 grams of nuts which claims after all? So I guess supplementation is better?

    Mentioning possible toxicity:
    Nutritiondata on brazil nuts:
    The Danish Techical University’s (DTU) food database on brazilnuts, which in danish are called “para nuts”:

    By the way I contacted DTU about the vast difference in reported values, and they claimed that it was equally likely that their own result was as accurate as the one Nutritiondata has (from USDA maybe?), being based on a similar number of measurements maybe?

  75. I just went to a talk by a Cardiologist who referenced your website and gave a list of the best 20 foods for your heart. While I can glean the healthy and non healthy recommendations, I have not been able to find a concise list on the website (I found the list a helpful reminder). Does one exist? Thanks so much.

  76. Dr. Greger and volunteer team,
    What are the current supplementation recommendations for children who are eating vegetarian and/or vegan?
    Thank you.

  77. Hi Dr Greger,

    Thank you so much for your book, “How Not To Die”. I have been suffering from IBS for eight years; your book has changed my life, and I only finished reading it three weeks ago :)

    My question is regarding the Daily Dozen (cheers for the app, it’s very helpful). Re. recommended serving sizes, do these apply to everyone regardless of weight/height or are these an average? I am fairly slim (5’7, 115 pounds) and am finding it difficult to fit everything in!

    Thanks in advance,

    Viv (Australia)

    1. Viv: Congratulations on the progress you have made so far!
      To answer your question: It’s my understanding that the Daily Dozen is geared toward about a 2000 per day calorie diet – much like the recommendations that come out of the government. I think people are working on a way to present the Daily Dozen for those people who need to adjust the system for different calorie needs.
      In the meantime, I suggest that you think of the Daily Dozen as a guide for 1) learning which foods are healthy and 2) understanding healthy ratios/proportions of those foods compared to each other. For example, the Daily Dozen recommends about 3 servings of whole grains and 3 servings of “other fruit” and 3 servings of beans. Those recommendations give you a sense to eat about the same amounts of those food categories over the course of a day. If your calories needs are higher or lower, you just adjust the serving sizes to meet your needs.
      In other words, if you can’t eat all that food based on how Dr. Greger defines servings, you can still eat those food categories and in those general relative proportions. For example, suppose that you can take in 3/4 of the Daily Dozen worth of food. Then go ahead and eat about 3/4 of each serving in the Daily Dozen. Scale it all down a bit. It doesn’t have to be terribly mathematical. I’m just making a point that you could eat smaller serving sizes and still be following the principles of the Daily Dozen.
      I would exclude some of the categories from this “shortening idea”. For example, you would probably still want to eat the recommended amounts of flaxseed and spices and do the same amount of exercise.
      What do you think?

  78. I have a friend who has terrible problems with food allergies. She would like to transition to a plant based diet but is allergic to legumes. This seems like an impossible situation for her. Is there anything that Dr Michael might recommend, any advice at all?

    1. martyn ives: I forwarded your question to our volunteer medical moderators. We don’t have enough volunteers to answer every question, but at least your question is in the pile. In the meantime, I thought I would take a stab at answering. I’m just a lay volunteer, however so take the answer for what it’s worth.

      Dr. Greger’s meal plan is summarized by the Daily Dozen (which you can download as a free smart phone app or review here: ) You will see that legumes are considered so important, they get on the list with 3 servings a day. However, there are still 9 other food categories on that list. I don’t see why your friend couldn’t eat more starchy foods from other categories to make up from the lack of legumes. Your friend might also review Dr. McDougall’s The Starch Solution diet/book for another way of looking at whole plant food based eating. I don’t think that formulation of the diet would specify beans. So, your friend could just leave those out.

      One other idea for you: You have to be careful with allergies, but I wonder if your friend is really allergic to *all* legumes? Maybe she is allergic to most, but maybe could tolerate say lentils or something. The point is, maybe she could experiment (again, you have to be careful with that and remember I’m not an expert) to see if she could safely eat some kind of legume in order to get that food sometimes. But if not, I don’t see why she couldn’t do a perfectly sound/safe/healthy diet and just skip the legumes.

      Make sense?

  79. I would like to make a correction to one of the recommendations, namely regarding the selenium recommendation:
    I live in Finland (Northern Europe), and all fertilizers here have been fortified with selenium since 1985, solving the problem of selenium deficiencies in the population. Recommending people to eat brazil nuts/to take a supplement is not necessary in Finland, and in some cases might lead to an overdose of selenium. I’d recommend adding a note to this recommendation saying that eating a daily brazil nut/supplementing is not necessary in Finland. On average, people here already get more than the recommended daily amount.


  80. Dr. Greger and volunteer team,

    I followed the discussion about Cyanocobalamine versus Methylcobalamin and saw that there is information about Cyanocobalamine stating that it is not found in nature and that it is bound to a cyanide molecule which is poisen. I do understand that the amount is not that high, but would like to know if due to these reasons Methylcobalamin would be a better choice?

    Thank you in advance and best wishes,

  81. Karina,

    First some a clarification, cyanocobalamin contains cobalt not cyanide as it metal molecule….huge difference….and did you know that it’s used for cyanide poisoning and FDA approved for this since 2006 ?

    My personal experience is the use of either methyl or hydroxy cobalamin, is preferable. One of the reasons we don’t use the cyano is the cobalt build up, over time, and most of the injectables on the market are complexed with preservatives.

    Dr. Alan Kadish moderator for Dr. Greger

  82. What are your thoughts on all oils, onion, garlic, chives, leeks, wheat, brussels sprouts and all foods that may people consider healthy but are acid and mucus forming for humans? I am of course referring to Professor Arnold Ehret’s recommendations and foods listed in his many books and also in Ragnar Berg’s Food Analysis tables. Thank you.

    1. Hi, Mark. This is a big question with many answers, but I’ll try to be brief.
      Dr. Greger agrees that oils can be harmful to health. You can find out more here: and here:
      His opinions on onion and garlic may be found here:
      Chives and leeks have not really been covered here on NF, but they are allium family members, like garlic and onions, and are likely to have similar effects in the body.
      Wheat is covered here:
      Brussels sprouts have not been specifically covered here on NF either, but they are members of the brassica family, which have numerous documented health benefits.
      I hope that helps!

  83. Can anyone help me with a B12/B vitamin question? As an insurance policy, I sometimes like to take a whole foods B complex vitamin when busy and unsure I’m getting enough B vitamins. It has a tremendous amount of B12. Should I be worried about an imbalance or the B vitamins competing with one another? I’m guessing I wouldn’t have to worry about them competing with B vitamins found in my food throughout the day, even if it was the case with the complex vitamin, since it’s my understanding that we use and excrete B vitamins very quickly. But don’t we store B12 quite well? Dr. Greger says not to worry about getting too much, but then does that mean I don’t have to worry about it competing with other B vitamins?
    Oh how I wish we could just eat dirt and hangout in fruit bearing trees like the good ol’ days… sigh… simpler times.

    1. Hi there S,

      Thanks for your question. I’m a volunteer for Dr. Greger, so hopefully you’ll find my response helpful.

      You should not need to worry about vitamin B12 competing with absorption of other B vitamins. They all use different receptors and are absorbed fairly easily by the body. As long as you have a good balance of whole plant foods in your diet and adequate caloric intake, I see no reason to take a supplement of any B vitamins except vitamin B12, which you should take if you are not consuming any animal products.

      But even if you do take the B-complex supplement, competition for absorption should not be an issue.

  84. For those of us that have had our gallbladder removed, do we need additional supplementation to ensure adequate absorption of EFAs? Thank you!

  85. Hello, I am very confused regarding the daily amount of Vitamin B12. Your recommendation is for 250mg (µg) per day. Here in the UK most of the Vitamin B complex supplements available show a tiny amount – typically 2.5mg – and this is shown as 100% NRV. This would mean taking 100 tablets a day to match your recommendation. This can’t be right… right? I hope you can clear this up for me and others.
    Many thanks

  86. Hi Phil,

    I am a volunteer for Dr. Greger. Thanks for your question.

    Dr. Greger recommends 2,500 micrograms once per week or 100 micrograms daily. 2,500 micrograms is equal to 2.5 miligrams (mg). You should be able to find these supplements online or at a local supplement store for fairly cheap.

    I hope this helps to answer your question!

    1. Hi Paul. I am one of the volunteer moderators here at This link answers your question. I think each company must be researched very thoroughly. More importantly, eating a balanced and varied diet will help us naturally meet all nutritional requirements. After all, the Okinawans achieved greater health and longevity the old fashioned way – a plant based diet and plenty of exercise. I doubt that they took supplements back in 1949, 1959, 1969, etc. If you do a video search, the “Living to 100” video is very informative.

      I can obtain all of my calcium through food alone. I use a free app every once in awhile to assess my routine. I suspect you can too :)

      1. My calcium came back under and Vit D.
        Maybe its related to my Vit D why calcium is under.
        I can hear my bones clicking and feel very weak when moving so just feel really fragile.

        I hear a lot about K2 so thinking of getting along with D2.

        I just wish if i knew if selinum, zink etc was ok as that was only reason i was considering multivit.

        Do you take any supplements?

  87. No need to be sorry! Yep, it’s me again- one of the volunteers. In the past, I have taken supplements. Loads of them. Three months later, I completely gave them all up. It seemed as if I were spending a ton of money with very few results. Absorption is an issue. Just because one swallows a pill doesn’t mean that the “good stuff” is actually being absorbed through one’s small intestine and into the bloodstream. In one of Dr. Greger’s comments, he talks about a vitamin B12 pill under the tongue. It’s easier to absorb that way. I concur. I’ve also done a bit of research. Other cultures probably had better access to some of their micronutrients (better food sources years ago- like fresh seaweed!), but most of us aren’t so lucky. I am sorry to hear that you are feeling fragile. Please consider whole foods first and then talk to a professional if need be. If our diet is balanced, then very few supplements should be required. My goal is to not need more than one. Good Luck !

  88. Based on Google link research(sic) I find:

    – Fish-based Omega-3 EPA/DHA are not sustainable, nor is their source, krill oil.

    – most vegetable sources such as seeds, contain mostly AHA which has very low efficiency of conversion to EPA/DHA

    – now comes the recommendations to use algal oil. The species Schizochytrium provides DHA and is available in expensive supplement form

    – EPA is not in the most often mentioned algal sources, and is stated to be available in “brown” algae.

    – search of the various usual sources of supplements turns up no products based on brown algae and being therefore high is EPA

    Can Dr. Gregor offer recommendations of brands that contain either or both EPA and DHA in algae sourced form?

  89. Hello! I’ve been recently experiencing some pretty heavy brain fog. The feeling of not being able to think clearly, retrieve information, being mildly confused, and worst of all, being “Half here, half somewhere else” when around loved ones is really beating me up. I’ve never experienced this. I am a 6 foot 237lb plant-based man who exercises regularly. I generally struggle with low hunger, and my fiance strongly believes I don’t eat enough. I have a major issue with not being able to simply shove as much food in my mouth. Can brain fog be related to me switching from more grain-based foods and eating less frequently to a lower calorie diet of mostly fruits and vegetables with little grain?

    I am a huge lover of all of your work @ NutritionFacts.Org and I am eternally grateful for any direction/input on my situation.

  90. Hey Kyle! So happy that you love the site. I’m Crystal, a nutritionist and moderator with, and I’ll do my best to help you.

    Your daily caloric needs should be roughly 3700 to maintain your current weight. You can calculate the exact calorie needs using an online calorie calculator. If you consume the exact calories or close to this amount, you should be eating enough, as long as you include a variety of plant-based foods.

    The brain fog can be a symptom of gluten sensitivity, zinc deficiency or hormonal blood sugar imbalances. Zinc deficiency is common in men eating vegan diets and zinc is essential for mental clarity. The key is to eat a balanced diet full of a variety of plant-based foods and make sure you are getting enough zinc.

    You might find this article interesting:

  91. I’m in the UK, the daily recommendation is 10 mcg of vitamin B12. Im confused as to why why you recommend 250mcg. Is it 250mcg for a vegan diet or for everyone.
    Many thanks

  92. Hi Elaine,

    I am a volunteer for Dr. Greger. Thank you so much for your question.

    I can’t find anywhere that says that the recommendation in the UK is 10 mcg of vitamin B12. That doesn’t mean it doesn’t exist, but I couldn’t find any evidence for that. Dr. Greger’s recommendation is 2,500 mcg or cyanocobalamin-based vitamin b-12 once per week. A daily intake of 250 mcg is based on that fact that a small percentage of that dose will be absorbed, and there aren’t any worries about getting to much B-12, so better to be safe than sorry. This is especially true because some people have very poor absorption of vitamin B-12.

    I hope this helps answer your question!

    1. whollyplantfoods,
      Regarding your statement “there aren’t any worries about getting too much B-12″… that does not seem to be the case based on this 8/25/17 summary of a study that showed “Using more than 55 micrograms daily appeared to quadruple cancer risk”.

      Can you tell me whether Dr Greger has examined this study and if so, has he changed his B12 dosage recommendations?

      The Atlantic Magazine summary of the study is here:

      And the link to the study itself is here:

        1. Hi Quickdraw,

          Any study we look at, we need to look at the context surrounding that study. This study only found this association in men. Secondly, it was primarily found in men that were smokers. This suggests that there may be a combined role of taking large doses of vitamin B-12 with smoking. The simple solution, then, would not to tell smokers to stop their B-12 supplementation, but to tell them to stop smoking. Those eating whole food, plant-based diets, who are in need of vitamin B-12 supplementation, are at low risk of lung cancer, especially if they do not smoke. The risk of lung cancer is so low already, that any increased risk of lung cancer in such a healthy population would be extremely marginal. Further, even if there was an increased risk of lung cancer from B-12 supplementation, the risk of cardiovascular disease from NOT taking a vitamin B-12 supplement would far exceed the risk of lung cancer. Finally, this is the first significant study to find such a relationship, and much more research should be done to investigate this topic.

          Individuals consuming primarily plant-based diets should NOT use this article to change their habits, unless they are also a smoking male; in which case, the only change that should be made is to stop smoking.

          I hope this helps!

  93. Hello, thank you for all the work you,, do. Your work has greatly benefitted me.

    I’m wondering how to respond to a study published in the Journal of Clinical Oncology that suggests a correlation between vitamin B supplements and lung cancer. Would you help me evaluate this article and implications it might have? (Long-Term, Supplemental, One-Carbon Metabolism–Related Vitamin B Use in Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort,

    1. Hi JacobCStephens,

      I recently responded to another individual’s question on this study, and so I will copy the response below:

      “Any study we look at, we need to look at the context surrounding that study. This study only found this association in men. Secondly, it was primarily found in men that were smokers. This suggests that there may be a combined role of taking large doses of vitamin B-12 with smoking. The simple solution, then, would not to tell smokers to stop their B-12 supplementation, but to tell them to stop smoking. Those eating whole food, plant-based diets, who are in need of vitamin B-12 supplementation, are at low risk of lung cancer, especially if they do not smoke. The risk of lung cancer is so low already, that any increased risk of lung cancer in such a healthy population would be extremely marginal. Further, even if there was an increased risk of lung cancer from B-12 supplementation, the risk of cardiovascular disease from NOT taking a vitamin B-12 supplement would far exceed the risk of lung cancer. Finally, this is the first significant study to find such a relationship, and much more research should be done to investigate this topic.

      Individuals consuming primarily plant-based diets should NOT use this article to change their habits, unless they are also a smoking male; in which case, the only change that should be made is to stop smoking.”

      I hope this helps clarify the take-away message from this study.

      1. Thank you very much. I see now that the fact that the cohort studied were smokers could have a large impact on the results of the study’s conclusions, and that they need to stop smoking in order to reduce their risk of lung cancer! I have returned to ease of mind about taking B12, as I do not smoke, and this study is a reminder for me to keep staying away from smoking.

  94. I was just looking at Dr. Greger’s video on Parkinson’s and Uric Acid, and doing a bit of research on kidney failure, and it seems confusing to keep track of all the different blood components that have to be in perfect balancein these and other conditions. So, it occurred to me that it would be really helpful to have a list of ideal ranges for various parameters measured in bloodwork, similar to the optimal nutrition recommendations.

    I don’t really expect tht to be a post o the site, as I’m sure Dr. Greger is way too busy for stuff like that nowadays, but does anyone have any resources that list optimal–as opposed to merely “normal”–reference ranges for bloodwork for those on WFPB?

  95. Does Dr. Greger have a recommended daily minimum intake of sodium? The RDA currently recommends 1,500mg/day which seems like hard to achieve on a whole, food plant based diet without adding salt to your food. Thanks!

  96. Your comment that Northern Europeans should supplement selenium seems like it should be those living in Northern Europe, rather than, for example, a those of Northern European decent living the in the US where selenium is plentiful.

  97. Hello:

    Your video on 40 year vegan dying of heart disease. I can’t understand why I would eat vegan
    if the meat eaters in the studies you presented, lived the same age with less mental health issues.
    Why fuss with the vegan when meat eaters were the same. duration??

    Thanks Terry

  98. Terry, thank you for your question. I am a family doc, and volunteer moderator for this website. What video are you talking about? I have never seen a video by Dr. G. that showed meat eaters lived as long as vegans and with fewer mental health issues. Please clarify.
    Volunteer moderator for

  99. You often talk about low sodium diet, but what are talking about here. Is low sodium < 200 mg per day or under 1000 mg per day ??? Is it just important to lower salt (NaCl) but ALSO up potassium to close to the RDI of 4700 mg per day. Difficult to get that much Potassium in a day is it ok to take Potassium Citrate tablets as a supplement in order to get enough Potassium. I don't like taking too KCl (Alt Salt substitue).

  100. Hello,

    Dr. Greger isn’t a huge fan of supplements (except those he mentioned in this article). If you still want to take it, it’s up to you, but keep in mind that while rare, side-effects CAN occur and they include: Nausea, vomiting, diarrhea, and stomach pain. Taking it after meals will help prevent these side effects. If any of it occurs., tell your doctor or pharmacist promptly. Common side effects “feel like throwing up” or vomiting. Potassium tablets can elevate otassium levels in the blood (hyperkalemia). Tell your doctor right away if any of these unlikely but serious side effects occur: muscle cramps/weakness, severe dizziness, slow/irregular heartbeat, mental/mood changes (e.g., confusion, restlessness), tingling of the hands/feet, unusually cold skin. DO NOT take it without your doctors approval if you’re nursing or pregnant, taking any medication, have any disease, especially diabetes and/or heart or kidney problems.

    Complete list of side effects is available here:

    This may seem a little scary, but it’s important you got all the facts.

    I hope I answered your question,

    Moderator Adam P.

  101. I want to use Dulse as my source of iodine like Dr. Greger recommends on his book How Not to Die BUT…

    Is just half a TEASPOON of dulse enough?

    According to the label on the dulse flakes from Maine Coast Sea Vegetables, there is about 330% DV in one TABLESPOON of Dulse so one TEASPOON equals about 150 mcgs. This means that half a teaspoon is only about 75 mcgs right? Is that taking in consideration that I MAY get the rest from other foods?

    If so… I live far from the ocean so the soil here probably has low if any iodine.

    Does that mean that if I use dulse flakes as my iodine source that I should use 1 teaspoon instead of half teaspoon like Dr. Greger recommended?

    Is it ok to eat a teaspoon of dulse every day or is the variance of iodine too big?

    I know that the upper limit is like 1100 mcg of iodine but since I plan on using this stuff every day I want to get as close as possible to the correct amount.

  102. In the video Avoiding Iodine Deficiency Dr Greger warns “The problem with seaweed is that we can actually get too much iodine” and my review in PubMed reveals that there is considerable variability of iodine content in common commercially available seaweeds. I’d make sure you have a reliably labeled product then focus on the recommendation of 160 micrograms/day. I’m not sure what the ½ teaspoon recommendation Dr Greger mentioned referred to but by looking at this recommendation and the label on your product you should be able to calculate correct dose. Hope that helps.

  103. Hello,

    I am having some major confusion between D2 and D3. I am probably (most likely) severely Vit D deficient. I wear physical sunblock religiously 365 days rain or shine as I use retinols, Vit C serums, and AHAs/BHAs for my skin and avoid the sun as these make my skin more photosensitive. Of late I have noticed many Vit D deficient symptoms, especially severe lethargy, severe tiredness, severe sluggishness and tenderness in my wrists (taking 2500mcg B12 once a week for 2 years now so ruled out B12 def). For the first time in my life, I have decided to supplement with Vit D as I barely get any sun. In older posts ( from Dec 15, 2011,, Dr.Greger very clearly states that D2 and D3 are bioequivalent and unless supplementing with a 50,000IU or very high weekly doses both should work. But here he specifically states D3. Now I have finally found a brand that uses no careegegan and other fillers at my price point but it is 2000IU D2. Since I am so severely deficient should I supplement with a higher dose and if not should I supplement with D3 only or should the D2 be fine in getting rid of the symptoms? Also, I only came across this post now, and others who mentioned seeing blood in their stools from using the opti3 brand DHA/EPA.I have not seen these symptoms luckily, but I cannot for the life of me find any DHA/EPA without fillers or careegegan etc. I totally understand where Dr. Greger is coming from when it comes to not revealing the brands he uses but on the other hand, it causes so much confusion for the average person like me (especially one on a budget). Maybe even a few brand suggestions rather than just one would go a long way esp. for the DHA/EPA as I see I am not the only one struggling.
    Many thanks in advance.

  104. HI, What is the daily intake for sodium (in milligrams (mg) ), even without adding any to foods?
    I ask because I wonder if sodium can still be too high in plant foods due to how the crops are produced perhaps causing the plant foods to contain more sodium than humans require?

    I ask because one video states that plant foods contain more vitamin C than they used to but
    have decreased in many other nutrients.


  105. Hi Mik,

    I am a volunteer for Dr. Greger. Thank you so much for your question.

    I would not say that there is any advice to stay away from spinach because of the low bioavailability of calcium. However, what is true, is that you cannot rely on spinach as a source of calcium. Therefore you must include other sources of calcium in the diet, such as other dark green leafy vegetables.

    To answer your question though, baby spinach will still have a high oxalate content, which is what reduces the absorption of calcium. Therefore, there is little to no difference as to whether the spinach is in the “baby” form or not.

    I hope this helps!

  106. I have not been able to find clean vegan Vitamin D supplements that don’t contain additives and toxic ingredients. Are there any you recommend? I have seen that you mentioned Throne research in previous comments but theirs is derived from cholesterol that originally came from sheep lanolin. Is it ok to take this? non-vegan supplement honestly are way more affordable and I live in a cold area I need to supplement. Also, what is a clean brand where I can get a 2,500 mcg B12 from cyanocobalamin?

    Thank you so much!

  107. Is your recommendation of 250 mg (DHA/EPA) the total combined DHA and EPA mg? Some bottles break down the amounts on the label. For example the label will say: Omega-3 600mg then below break it down to DHA 360 EPA 180. Also if a label only says Omega -3 and doesn’t break it down into DHA EPA do I assume they are both there or is the label representing one and not the other? Thanks!

  108. Hi Rachel,

    Thank you for your question. I am a volunteer moderator helping Dr. Greger answer questions on the site. I am a WFPB dietitian nutritionist located in Arizona. I personally look for a brand that breaks down the EPA/DHA into its components. You cannot assume that both are on the label if you are hoping to take both EPA and DHA.

  109. Hi. I am whole food plant based and I am eating “Brightline Eating”. I find it is a bit restrictive on the fruit, and veggies. I see you said we should eat all the veggies we want, but I have almost 100 pounds to lose, so maybe this is a good thing?

  110. I just saw a study from Australia that says broccoli sprouts have a component that cuts down the amount of sulferophane by up to 50%. It promotes the use of radish sprouts as much better. Could you look into this please. Ken

  111. Hi Dr. Greger and team! I really enjoyed the book, now onto a burning question of mine. Can I take the portions down a little? I’m 5ft 2 inches and 53 kilos. I sometimes feel like I have a smoothie/ pack of sprouted lentils in my hand all the time just to get the nutrition I need. I have no problem with the recommended foods and I will keep to the guidelines if necessary but I just find i’m always eating and I miss feeling hungry too! 130g of beans looks like a lot to me, can I take these portions down to 100g or less?

  112. Based on going though all the information of the site about probiotics and microbiome, three questions that came up repeatedly and really need an urgent answer for someone on a whole food plant based diet:

    1. If one is getting prebiotics through food, should one not worry about getting probiotics?
    2. If one does recommend getting probiotics, then what are good and safe source of probiotics? The information on the site suggests that Kombucha, Kimchi and Probiotic supplements are not good/safe sources, so will be very helpful to know which ones of the remaining sources are safe and how effective each one is.
    3. Dr. Greger what is your source of probiotics if any? And if one does need to boost it for some reason for short periods of time, do you rely on a food source (if so which) or a supplement? Or just focussing on prebiotics is always enough?

    I do see some discussion about probiotics but the message is not very conclusive and comprehensive.


    1. Excellent question but not to worry. The source of the probiotics is the same as every other nutrient: the food. Ever seen the white haze on the outside of a fresh grape? That’s billions of all the right bacteria just waiting to become part of your microbiome. Same goes for broccoli, tomatoes, greens and any other fresh fruit and veggie. Water will not wash them off. Other than B12, and possibly D3, you’ll be better served staying away from supplements as Dr. G has reported.

      Dr. Ben

  113. Hello Dr. Greger,

    I read your Book and my Family switched to a plant based diet. We use also your checklist app which is a great motivation.

    We have one question concerning the recommended daily amount of fat, carbohydrates and protein (in gramm) – maybe you can help and give your recommendation/thoughts on this?

    Best regards from Germany!


    1. Great question: fat is as little as possible, but there is no need to squeeze out every gram. As long as you’re eating a varied WFPB diet you’ll be fine. It should end up about 10% of calories from fat. Protein is 0.8-0.9 grams protein/kg body weight or about 5% of calories from protein. Again, no need to obsess on this as eating a varied WFPB diet will feed you adequately. Carbs will make up the remainder of your diet.

      Dr. Ben

    2. If you’re consuming a wide variety of whole, plant-based foods and NOT using oils or going overboard on nuts, coconuts, and avocados, you shouldn’t have to worry about calculating your carbs, fats, and proteins. If you’re concerned about getting enough protein, anywhere from 0.8 – 1.6 grams of protein per kilogram of body weight per day is considered optimal for building muscle mass (when combined with resistance training). Research shows that those with kidney failure should limit protein to 15 – 19 grams of plant-based protein per day, which is a sufficient amount to prevent any signs of protein deficiency.

  114. I know Dr. Greger states that one needs .8-.9 of protein per kg of body weight but what about fat? And carbohydrates? In grams or percentage of calories? Thank you!

  115. Is there any recommendation for vitamin A consumption? I have seen so many food products have over 100% recommendation level of vitamin A, even in some healthy snacks, such as kale chips. Is it harmful to over consume vitamin A? And what is the maximum and minimum level of daily vitamin A we should consume?

  116. Vitamin A is a fat soluble vitamin so can be taken in excess. Excess is toxic. If you eat a varied WFPB diet you will get all the vitamin A you need.

    Dr. Ben

  117. Hello Dr. Greger
    I would like your advice in an important issue with my daughter. She is 2,5 years old, she breastfeeds. But I am exhausted, because she wakes up very often during the nights. So I want to stop. The problem is that she doesn’t like food. She refuses to eat fruits, vegetables, juices, … she only want potatoes, and white bread (to my regret). I think she has revulsion to food. And she doesn’t like to try any new food. In this way, it’s more difficult to stop the breastfeeding. She can be several days without eating; because she knows then she will have the breast.
    Anyway, I know that you say not to take any multivitamin, because we can take the vitamins with food. But in her case, when I stop the breastfeeding, she should take any? I am worried because now is the moment for her to grow up. Now she takes B12.
    It´s really difficult this situation.
    Thank you!

  118. Hello,

    I recommend speaking with your pediatrician about this. If your daughter is not getting proper nutrition through food then a multi is probably a needed.


  119. Hi Dr Greger and All,

    I am not taking Ca supplementation and I do eat a plant based diet for the past 3 years or so, but I do use protocol for brushing my teeth twice a day. It works well for my gums and teeth since I have gum recession due to eating sticky food in the middle of the night for lower blood sugar reactions for the first 20 years after being diagnosed with diabetes as a kid. I do not do this anymore but the damage is done from the decay to the teeth and gum line. It seems to get good results for my mouth, and less plaque when I get my teeth cleaned twice a year. But am I damaging my heart with the calcium in the brushing mixture? There is another twist, I have had a calcium CT of my heart before I went to a plant based diet, and then again last year after being on a plant based diet. In the new calcium CT of my heart all the arteries looked good without plaque except one, the left anterior descending artery, which is a main artery. And the calcium score went up to 28.54 from the prior one I had done, which in my opinion should have gone down after years of a plant based diet. I exercise daily, and I am 50 years old without any other health issues, I have no long term diabetes effects, spots, blots on eyes, peripherally no neurological signs, and kidneys are good as well. I have had diabetes for 33 years and am under tight control, last A1C was 5.8 which is low I understand, and I am trying to avoid lows and inflammation to the heart from too tight of control. My prior A1C was 6.5 and I had more readings at that time above or below 60/200 mg/dl with my CGM, the last lower A1C had half the amount of readings outside of the 60-200 range. What is your opinion, and have you seen this before? The calcium brushing would give an explanation of why it has gone up rather than down after switching to a plant based diet.



    1. Hi Eric- Your situation is complex. To answer your main question, there is not a direct relationship between calcium intake and coronary artery score based on the most recent data. BUT, there is a relationship between blood levels of calcium and calcium score. The blood levels are modulated by a variety of complex interactions in the body. We can’t clearly blame the calcium from he product you use for your calcium score. That said, to find out if it’s related in your specific case, you could consider talking with your dentist about other options for maintaining gum health, and stopping the calcium therapy for a couple of months, then rechecking your coronary calcium score.

      I’d say your use of a plant based diet is very important for heart disease reduction in the setting of lifelong diabetes. The closer you follow a whole food, plant based diet low in salt, sugar, and fat, the better will be your control and risk for heart disease.

      Best luck! -Dr Anderson, Health Support Volunteer

  120. I am trying to decide whether to eat meat or not. After reading “How not to die” I decided not to eat meat. I just finished reading the chapter about meat in Mark Hyman’s new book, “Food.” Drs. Hyman and Greger appear to be living in two different research world’s and I would like some clarification. Here are some examples:
    GREGER: IGF-1 is a cancer-promoting growth hormone. The more you have in your blood the higher your risk for developing cancer. The release of IGF-1 appears to be triggered by the consumption of animal protein.
    GREGER: Eating even just a little meat increases the odds of becoming diabetic.
    HYMAN: 40% of the fat in beef is monounsaturated and polyunsaturated fat, the same type found in olive oil, seafood and nuts. It also contains a very healthy trans-fat called CLA, which is a powerful antioxidant that slows the growth of cancerous tumors. It also prevents plaque from forming in your arteries and causing atherosclerosis. It reduces the risk of heart disease and type 2 diabetes, lowers triglycerides, and helps with weight control and metabolism. Grass-fed meat is far and away the best source of CLA. P48
    GREGER: Meat consumption is associated with increased risk of dying from cancer, heart disease and dying prematurely in general. The reason is thought to be the heme iron because it causes cancer-causing free radicals.
    HYMAN: A study found no link between red meat and heart disease. If anything their results indicate that a higher intake of animal fat and animal protein is protective against cardiovascular disease. The foods found to be the biggest drivers of disease were high-glycemic carbohydrates like potatoes, bread, and cereal. P41

    GREGER: Meat contains the type of iron (heme) particularly associated with colorectal cancer. The more meat consumed the higher the risk of colon cancer. This can be mitigated by eating fruits, beans, and vegetables (and eating less meat).
    HYMAN: In a study women who consumed the most meat had the lowest rates of colon cancer. P44
    HYMAN: There is evidence linking processed meats to colorectal cancers. But the association has been overblown. Eating one piece of bacon every day raises your risk from 5% to 6%.

    GREGER: IGF-1 is a cancer-promoting growth hormone. The more you have in your blood the higher your risk for developing cancer. The release of IGF-1 appears to be triggered by the consumption of animal protein.
    GREGER: Eating even just a little meat increases the odds of becoming diabetic.
    HYMAN: 40% of the fat in beef is monounsaturated and polyunsaturated fat, the same type found in olive oil, seafood and nuts. It also contains a very healthy trans-fat called CLA, which is a powerful antioxidant that slows the growth of cancerous tumors. It also prevents plaque from forming in your arteries and causing atherosclerosis. It reduces the risk of heart disease and type 2 diabetes, lowers triglycerides, and helps with weight control and metabolism. Grass-fed meat is far and away the best source of CLA. P48
    GREGER: Meat consumption is associated with increased risk of dying from cancer, heart disease and dying prematurely in general. The reason is thought to be the heme iron because it causes cancer-causing free radicals.
    HYMAN: A study found no link between red meat and heart disease. If anything their results indicate that a higher intake of animal fat and animal protein is protective against cardiovascular disease. The foods found to be the biggest drivers of disease were high-glycemic carbohydrates like potatoes, bread, and cereal. P41

    1. This back and forth by you two, each just repeating your stance, is amusing. Why don’t you, Hyman, send Dr Greger the studies that you are referring to so he can review them with his critical scientific mind, and then let us know what he thinks about it?

    2. Maureen—there is no back and forth here. Drs. Hyman and Greger are both physician, both experts in nutrition, both well-respected. They are citing different published research that is contradictory. For example, the finding that there is no link between red meat and heart disease and that red meat is actually protective against heart disease comes from this study: Grasgruber, P, Sebera M, Hrazdira E et al. Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries. Food Nutrition Research. 2016 Sept 27; 60:31694.

      Dr. Hyman’s new book, “Food” has many other citations.

      I have heard Hyman’s views and would like to know Greger’s views and why the research in this issue is so contradictory. I am trying to make an informed decision.

  121. Very good question. Here is the answer: notice that there is no clinical study showing large cohorts of animal product eating patients living LONGER and with LESS disease than matched patients eating WFPB? Data showing no association between animal product consumption and disease is NOT necessarily evidence of a lack of association. It may be a poor study or a BIASED study supported by the meat/egg/dairy industry. If there were studies showing a real clinical benefit with animal product consumption, then this might be compelling evidence for animal product consumption, but considering this lack of evidence, and the clinical evidence showing death/disease association with animal product consumption, there is no compelling reason to consume animal products and good reason to avoid them. Trying to add in the lab studies like “meat has component X which is supposed be healthy” is not a compelling argument when put up against the overwhelming evidence of real early death in large cohorts of animal product consumers. There is no demonstrated risk in not consuming animal products, and plenty of evidence of increased risk of consuming animal products. So why do it?

    Dr. Ben

  122. I am struggling to see how it would be possible to get 600mg calcium a day from low-oxalate greens. You could eat a cup of bok choi, a cup of kale and a cup of broccoli and still only make half this amount. Could you give an example please?

    1. Justine,
      Thank you for your question. I’ll try to help. If you are following the “daily Dozen” you would likely get at least 600 mg of calcium per day. See the following estimates; of course it varies with your specific food choices.
      250 mg from greens
      250 mg from 1 1/2 cups of legumes
      120 mg from 1 1/2 cups of whole grains
      40 mg from 1/4 cup of nuts
      This scenario adds up to 660 mg and does not include the small additional amounts you would get from other vegetables

      1. Hi Kjgrier

        Thank you so very much for responding to my query on I am so impressed with all the people who answer the huge volume of queries on there. You guys do an amazing job – thank you!

        As with your suggestion of what one might typically get by following the Daily Dozen, I do mostly manage at least 600mg Ca/day from a variety of sources. My worry is that Dr Greger advises in his Optimum Nutrition Recommendations ( ommendations/):

        The sample menu you provide gives only 250mg from greens, some of which no doubt will sometimes be from not so low oxalate types. So my question is how does someone get 600mg from low oxalate greens. Short of consuming 7 cups of kale or 4 cups of bok choi or 10 cups of broccoli I don’t see how it can be done. And I can’t believe it is really a great idea to eat so much of such a restricted set of foods, not to mention how unappealing/unsustainable it would be.

        If Dr G’s advice for calcium isn’t realistic for most of us then I’m left wondering what people are supposed to do as second best. Should they just get their calcium from a mixture of low and high oxalate sources as in your sample menu (which I suspect is what most of us following Dr G are doing)?
        Or resport to a bit of sneaky cheese? Or fortified foods? It would be really helpful to have some realistic advice for those who can’t face 10 cups of broccoli every day :-).

        What do you think?

        Thank you so much for any advice!


        1. I initially sent this reply as an email with a screengrab of the advice above regarding calcium, but it didn’t come out in the online version. What I quoted was Dr Greger’s advice from higher up this page, which states that one should aim for ‘At least 600 mg daily via calcium-rich plant foods—preferably low-oxalate dark green leafy vegetables‘. It’s this that I can’t see how to obtain. 600mg calcium from a variety of plant sources is one thing, but from low oxalate greens alone it’s pretty much impossible for a normal person.

      2. I too struggle with reaching 600 mg and I eat a lot of whole foods. Can you please provide examples of actual foods that meet these levels you are indicating?

        250 mg from 1 1/2 cups of legumes
        Throw out wing beans, because does anyone know where to get them? Looking at all the bean options on Eden Foods I see an average of about 50-60 mg per half cup.

        120 mg from 1 1/2 cups of whole grains
        No amaranth if we are avoiding oxalates

        40 mg from 1/4 cup of nuts
        No almonds if we are avoiding oxalates

        Can you provide examples? I need help.

        Thank you.

  123. Including kale, mustard greens, and collard greens in your diet will avoid this problem. Beans, whole grains, and fruit (especially figs) are great sources of calcium as well.

    The main example of the above advice is spinach, which is high in calcium, and also high in oxalate, which binds the calcium, making it unavailable for use in the body. So while spinach has many health benefits, it’s not a great source of usable calcium.

    -Dr Anderson, Health Support Volunteer

  124. i bought “How not to die cookbook” You suggest to use a high power blender but you do not make any recommendations or suggestions about blenders. There are hundreds out there. I looked at VITAMIX but they have many different models. Which one of these models would be appropriate to use with the recipes of your cookbook?

  125. I bought “How not to die cookbook” You recommended juicing with a high power
    blender but do not recommend any type of blender. There are hundreds out there!
    I looked at VITAMIX but they have many different models. Which one should be the best for smoothies?

    1. Hi Marguerite: It really depends on your preference and budget. I know a lot of people that like the Vitamix and Nijna. I personally have a Vitamix, but purchased it through their reconditioned program to save money. Blendtec is another popular brand. I would recommend talking to friends and reading online reviews to see what might be best for you. Happy cooking!

  126. I have both a $400 Vitamix and a $20 Walmart blender. The Vitamix is more durable, but they both work fine. If you run the Walmart variety on viscous items with minimal water for an extended time, they will burn out, so keep your receipt handy for an easy return.

    Dr. Ben

  127. Hey can i have optimum nutrition pro mass gainer with no weight training ? Purpose is to gain weight. :) If yes ? Then how much should i consume ?

  128. This article was brought to my attention this past weekend.
    It states if you are male that has been taking vitamin B12 supplements for a period of 10 years or more then you have a 30 to 40 percent increased chance of getting lung cancer.
    I have stopped taking vitamin B12 (which is recommended on the Daily Dozen App)
    Would anyone care to comment on the article to help clear up any confusion and concern that I have?

  129. Actually the study you referred to has been in a news for a while, although the headlines looked troubling, this is one of those times you really need to look at the detailed study before jumping to any conclusions. Let me try to at least put this in some perspective so you won’t get worried unnecessarily. (Please note I’m not saying reading such a headline isn’t worrisome, but there are some things to consider before stopping taking your Vit B12 pills. We KNOW that if you are totally eating a WFPB diet you must have adequate intake of Vit. B12. (Use the Search button on to find videos to confirm that need).

    Now let’s look at that study: I’d encourage you to look at the study in detail as opposed to just the sensationalized headlines.

    It’s important to note that the dose being reviewed as possibly increasing cancer risk is MUCH higher than the dose recommended for vegans not taking in B12 through animals. Dr Greger recommends 250 micrograms per day The subject of this study were taking 55 mgs/day That’s 55,000 micrograms–a really huge jump. The fact that women did not experience any increased risk nor did those who never smoked also seems to indicate there’s not a direct link between B12 supplementation and lung cancer. Others have also pointed out supplements can be contaminated which may have confounded results.

    Sometimes studies like this mean very little if they cannot be replicated, so the reassuring fact is that the study authors are already investigating with two additional studies are underway gives some additional perspective One study will examine associations in post-menopausal women in order to confirm the current finding of no elevated risk in women. The second will examine B6/B12 high dose, long-term supplementation in a second large prospective study of men in an effort to determine whether the increases risk observed in the current study can be replicated.

    One other way to look at this is to consider Dr. Greger’s response when asked about antioxidants. The comments he made about this topic reflect the common sense no-panic approach when headlines cause worry;

    I will forward your question to Dr. Greger for possible future response, but wanted to give you this much information now. I read a comonsense review of this study in WebMD and suggest you read this over for some general guidance:

    Meanwhile I really suggest you speak with your own healthcare physician or a trusted dietitian about your decision to no longer take B-12.

    1. Copied from the Abstract:
      When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (> 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (> 55µg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers. For vitamin B6 and B12, the risk was even higher among men who were smoking at baseline.
      B6 was millgrams, B12 was micrograms.
      Where would one get milligrams of B12?

    2. Joan, the study specifically stated 55 micrograms mcg not milligrams mgs.

      At least the link that you referred to and other links also confirmed 55 mcg. Are these all typos and confused units?

      If the study was indeed milligrams not 55 micrograms then sure, it’s way higher in dose than anyone should possibly take, but that’s not what the links say. They say 55mcg which is LESS than Dr. greger recommends.
      P.s. I also just commented at the bottom of this thread then found your reply. Has Dr.Greger responded to this yet? Thanks!

  130. I am new to vegetarian lifestyle. If I absolutely must have some meat, which is the least harmful. I am certain that I have eaten my last piece of chicken or seafood.

    1. DBT,
      Thank you for your question. For the vast majority of people, oral B12 works just fine. As people age, their stomach tends to produce less acid. Acidity in the stomach activates intrinsic factor. This is needed to absorb vitamin B12. Sublingual B12 is absorbed directly into the blood stream via the sublingual blood vessels, thereby eliminating the need to absorb it via the GI tract.

      1. I understand that, but when you are taking the suggested dosages, aren’t you getting most of it through passive diffusion rather than intrinsic factor anyway?

  131. Hi Dr. Greger. I have questions… is wfpb the best type of diet for everyone? I transitioned into it and instead of feeling good and healthy, I felt horrible. 2 months of no energy, looking sick, headaches, increased anxiety and depression, acne, etc. Was sure to include the staples. Foods fortified with b12, d, and dha omega 3s as well as plenty of veggies, whole grains, nuts and seeds including chia and flax; soy, leafy greens, beans, etc. My boyfriend did the same eating the same food I cooked, but he felt good. :( why on earth is this? Gave it 2 months and there was no improvements. Added back organic vegetarian fed hormone free poultry, organic hormone free dairy, wild caught sardines and salmon, and some egg products. That helped me feel good again, and my skin started clearing up again. I am still tired, but feeling my normal anxiety issues vs the extreme I felt going wfpb. I didn’t introduce foods I didnt already eat. It just plain wasn’t working for me. I want to eat wfpb and feel good! Is it possible my genetics simply aren’t compatible? What else could it be?

  132. Hello Sarah. I’m a health volunteer here at Nutrition Facts.

    Thanks for your comment, and congrats for trying to improve your diet and overall health by adopting a plant-based diet. In the first place, if you changed for this type of diet is because you already know all the health benefits of this diet pattern.

    I’d say that a plant-based diet is suitable for everyone, as long as you know which foods to include and which ones have the best nutritional profile. According to what you’ve described you were eating, I think you were doing good, however, the symptoms you described, it makes me think that maybe you were not eating enough calories to fill your energy requirements.

    Headaches, low energy, bad mood, cold sensation and tiredness, all can be considered symtomps that you have not enough calories in your diet. So, you can check on that.

    Another thing, if before going to WPBD, your eating habits were very poor, you had a high consumption of sweets, candies, or other sugars for example, a fast trantition to a new and healthy diet can also makes you feel anxious or in a bad mood.

    These are some recommentations of experts (including Dr. Greger) to transitioning to a plant based diet.

    Check them out and hope it helps.

  133. I’ve been tracking my nutrient intake for several months now and I’m averaging 558 mcg of Vitamin K per day. The recommended RDA is 120 mcg.

    I follow Dr. Greger’s daily dozen very closely so the bulk of my Vitamin K is coming from my daily intake of Kale, Broccoli and Romaine Lettuce.

    I’m just wondering if this number is something I should be concerned about. My manganese and copper intake are also about 250% of normal as well, all from the daily dozen.

    I would very much appreciate any thoughts on this.

    1. Hi DavidHT. Thanks for your comment.

      You shouldn’t been concerned about your vitamin K levels; if you’re not on anticoagulants drugs like Coumadin or Xarelto; vitamin K levels is not a problem for you.

      Acording to FAO, “When taken orally, natural K vitamins seem free of toxic side effects”. Besides, there has not been stablished an upper level fo vitamin K intake:

      “Rationale: No adverse effects have been associated with vitamin K consumption as food or supplements in humans or animals, so it is not possible to set a UL”

  134. “At least 600 mg daily via calcium-rich plant foods—preferably low-oxalate dark green leafy vegetables”

    Is this saying we should get 600 mg via “calcium-rich low oxalate dark green leafy vegetables” or is this saying we should get 600 mg and “plant foods are calcium-rich, but don’t count high-oxalate ones” ?

    Specifically, in my case, should I be getting 600 mg from my collard greens or in total (collards plus other non-leafy foods)?

  135. Nutritionfacts / Dr. Greger

    I’m writing to inform you of a study I would hope you would comment on:

    Brasky, T. M., et al. (2017). “Long-Term, Supplemental, One-Carbon Metabolism-Related Vitamin B Use in
    Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort.” J Clin Oncol: JCO2017727735

    The study suggests:
    Male smokers who took more than 55 micrograms (µg) of B12 each day for 10 years were nearly four times as likely to develop lung cancer as smokers who never took B12. As for those who quit smoking more than 10 years prior? They were 89 percent more likely to get lung cancer than those who didn’t take B12.

    I’m a former pack/day 40 year smoker. I quit in 2011 when I was 61.
    I also became Vegan at that time, started following the advice of Dr. Greger, T Colin Campbell, John McDougall, Cauldwell Esselstyn, Neal Barnard, Jeff Novick and Joel Fuhrman. Still am and am grateful to all of them.

    This February 2018, a chest X-ray showed that I had a 6.7cm tumor on my right lung. My last chest X-ray was in 2013 and it was clear.
    In March, the upper lobe of the lung was removed.
    I’m now 68 and I have been taking 1000 µg of B12 every day, following Dr. Greger’s
    Optimum Nutrition Recommendations for those over 65.
    1000 µg is quite a bit more that 55 µg. I’ve only been a non-smoker for 7 years
    and I’ve only been taking 1000 µg of B12 for, at the most, 3 years but I can’t help but wonder if there is a connection. I doubt if anyone could say conclusively either way.
    I know if I had to choose at what caused my cancer: 1000 µg of B12 for 3 years or 40 years of smoking, I know which one I would choose.

    But I was under the impression that your body would just take the B12 that it needed and flush the rest away. My son, who is 40, was also taking 1000 µg of B12 and he said when he had his physical his doctor said his B12 was “through the roof”.

    I do know that Thomas Campbell, MD last month, May 2018, changed his B12 supplement recommendation, siting this new study.
    For now I’ve stopped taking B-12 and plan on having my B-12 checked and then supplement accordingly.
    Anyway, I’m looking forward to Dr. Greger’s opinion of this study.

  136. If I eat unsalted roasted peanuts which are technically from the pea family do I count it as a nut on my daily dozen or as a bean?

    1. Hi Brandeeg! Although they are a legume, Dr. Greger includes peanuts in the “nuts” category because of their nutritional similarities!

  137. I am concerned that the following recommendations are NOT included on the page

    a. the issue of iodine. Morton’s Salt Substitute (Potassium Chloride) contains no iodine (I contacted the company), and I expect relatively few followers eat seaweed.

    b. Dr. Greger’s preference for an algae or yeast based Omega 3 is not list on the Supplement page.

    Please consider adding these to the supplement page.

  138. I see that Dr. Greger’s recommendation is for 150mcg of Iodine, I was looking for a high quality source (like Pure Encapsulations) and I see there Iodine is 225mcg, is that much of difference? Would it be best to cut them in 3/4’s to have it closer to 150mcg?

  139. Hi, Ryan.
    I think it would be best to get your iodine from sea vegetables rather than from supplements. Sprinkling a little dulse (I like dulse flakes with garlic!) on your food can do the trick.
    Yes, there is a big difference between 150mcg and 225mcg. The supplement you describe is almost twice as much as Dr. G. recommends. You might be interested in these videos:
    I hope that helps!

  140. The Deva Nutrition DHA-EPA Delayed Release capsules have 500mg of Microalgae Oil which typically provides 120mg to 140mg of DHA and 60mg to 80mg of EPA. Which is less than the 250 that Dr. Greger suggests in his Optimum Nutrition Requirements list on the web. So is the approx. 200mg of the EPA/DHA combination enough? Or should I take 2 capsules which would the numbers closer to 400mg daily.

    1. Hi, Yale! I would suggest alternating each day between taking 1 capsule and 2 capsules. You would end up averaging about 300 mg per day, just slightly over the 250 mg recommendation.

    2. Do you have the information that when Dr. Greger make the requirement list which included the EPA/DHA number as 250 was there actually a range of numbers and he averaged it out at 350.

  141. I am not trying to downplay the benefits of a WFPB diet but I switched to this lifestyle in January 2017 and for the first 6 months I was greatly pleased with the results. My energy level was great, although I didn’t need to lose weight I was able to eat as much as I could without having to worry about eating too much. My challenge became keeping weight on. The occasional colds and respiratory tract infections went away. Then everything started to change. My energy level started decreasing and I started feeling weak. This is all while eating the daily dozen basically every day of the week. I went for a physical and was diagnosed as being anemic. I immediately adjusted my meals to include iron rich non-heme iron foods. What I didn’t know at the time was that match green tea inhibits iron absorption. I was mixing a match drink every morning prior to eating iron and then was having another one in the afternoon after eating an iron rich meal. Needless to say my iron levels (hemoglobin, ferritin, and iron) continued to drop to very low levels. I reduced the match tea to one cup per day with 2 hours in between eating and my iron levels continued to drop. On paper I was eating more plant based iron than I should’ve needed. My doctor put me on iron supplements and referred me to a GI specialists to make sure there wasn’t another reason for my anemia besides iron deficiency. The doctor scheduled me for a colonoscopy and endo scan. The next day while researching the common foods that I was eating large quantities of I discovered that turmeric is an iron inhibitor and being studied as an iron chelator. Based on your instructions of eating turmeric everyday I was added a large quantity to my extremely large daily lunch salad of kale, spinach, and swiss chard. This probably cancelled out the majority of the non-heme iron that I was consuming. My ferritin level got down to 3.3 and has increased only to 4.9 over the past two weeks. My hemoglobin dropped to 10.4 and has increased only to 11.1. After almost 2 years of eating as healthy as I ever have in my life I am experiencing the biggest medical problem that I ever have faced and unfortunately all signs of the problem are leading to an iron deficiency caused by diet. Any thoughts that you have would be greatly appreciated. It would be nice to hear from Dr. Greger himself. When recommending foods more consideration needs to be done to what happens when certain foods are mixed together and that a simple thing like what could happen if turmeric is added to a salad packed with iron.

    1. Hi I’m a RN health support volunteer. On the turmeric, I don’t know how much you were eating, but Dr. Greger recommends only 1/4 teaspoon per day. I don’t think this enough to counter the iron in the recommended 2 cups of greens and 3 servings of beans.

  142. It would be greatly appreciated if someone could respond to the comment above. Is iron-deficient anemia common among people that follow a WFPB diet?

  143. Keep in mind that everyone is slightly different and there is no “one size fits all”. For me, I don’t eat anything processed. I call it “UP” (Unprocessed Plants). Food items that are ground up, powdered and dried are processed. I eat a highly varied whole food plant based diet that is mostly raw and all fresh or frozen. This might work better for you. Some people do best on totally raw. Others eat mostly cooked. Just need to find the right niche for you. While you may have ended up iron deficient, this is completely reversible and nothing like the silent killers (heart attack, stroke, diabetes) running rampant through those eating a “healthy” western diet with lean meat, dairy, eggs etc, so that is certainly not the answer.

    Dr. Ben

    1. Thank you for the reply. However it still does not address that there should be warnings given along with the daily dozen about what foods should not be eaten together or what foods inhibit absorption of certain nutrients. This would’ve helped me avoid my iron deficiency. Since heme iron sources are not part of the diet iron becomes challenging to ensure that the proper levels are achieved. Dr. Greger focuses on vitamins B-12 and D but does not mention iron as a potential challenge with the diet.

  144. This is a great summary, but could be better if the Vitamin D information was less wordy. I have an example I would be happy to send by email. Also, Since Vitamin D from the sun depends on surface area, I’m not sure the complete story is listed.

  145. I would love a response to this statement: Cyanocobalamin, in summary, is a low-grade, low-quality and slightly toxic (cyanide) form of vitamin B-12 that’s used by all the cheap vitamin manufacturers. I recommend avoiding it completely. It won’t kill you to take it, of course, but there’s a better solution for B-12.

    1. Hi I’m a RN health support volunteer. I’m not sure where that statement came from and I’m not sure what the better solution is that the statement maker is proposing, but Vitamin B12 deficiency is very problematic. With all of medicine, we weigh risks versus benefits. Vitamin B12 deficiency is far riskier than any risk of the supplements. One way or another, you need to make sure you are not B12 deficient. I know Dr. Greger recommends cyanocobalamin over methylcobalamin because it is more shelf stable.
      If you don’t want to supplement, fortified foods are another option:


  146. I understand iodine is important but salt is unhealthy. I am a raw vegan and I cut salt for health benefits. Should I go back to using iodized salt just because of the iodine? I´m really confused with this. I basically eat salads, I had already gotten used to no salt but I got worried. Can anyone help me out? Thanks.

    1. Hello Felipe,

      No need to worry, you have a few great options here. Salt, like you mentioned, is an unhealthy food, but table salt is also a reliable source of iodine. Dr. Greger recommends to avoid salt, and instead get your iodine from sea-vegetables such as dulse or nori. Dulse is great sprinkled on top of a salad, so you may enjoy that. The only sea vegetables you should avoid are hijiki (due to arsenic levels) and kelp (too much iodine). If you don’t feel that you can consume sea vegetables on a regular basis, or simply do not like sea vegetables, a 150mcg supplement can be taken daily to meet all your iodine needs.

      I hope this helps.


      1. Thanks so much for your answer.
        Not realistic to get sea vegetables, though. Is lugol a good option in terms of suplementation? How about kelp? Being a controlled amount (pill of 150) is acceptable or still risk of too much?
        Thanks a lot, flattered by your help! ❤️


        [] Livre de vírus.

  147. Hello–is there a specific kind of iodine that is absorbed best? I’m seeing a lot of kelp supplements and then some potassium iodide tablets and drops. A recommendation for a good supplement would be great. Thank you…

  148. You asked about a specific kind of iodine that is absorbed best. You can read what Dr. Greger has to say about iodine by going to Topics and searching under Iodine.He states “Sea vegetables such as nori, dulse, and alaria are excellent sources of iodine” You may also want to look at
    Generally this site does not make specific brand name recommendations for supplements and guidance is to use a respected supplier who can provide information on supplement content. .

  149. Hi Dr.
    Do you have any recommendations/comments on the use of Berberine? There are a few studies showing 500mg/ 3 times a day can drop LDL levels by 25 points, with no significant side effects.

    Thanks for all the info.

  150. Hi, Jaclyn! This meta-analysis is certainly interesting. I would like to see more study on this issue, but my take is that reducing triglycerides while increasing both LDL and HDL, if the increase is slight, may have negligible effects, especially if the diet is otherwise devoid of cholesterol and low in saturated fat, as a whole food, plant-based diet is. You can find everything on this site related to omega-3 fatty acids here:
    I hope that helps!

  151. Are there any critiques of the science the book “nourishing fats why we need animal fats for health and happiness” is based on, and the conclusions that are drawn from it?


  152. Hi, Dave. The short answer to your question is that the book you mention is not based on scientific fact at all. The authors cherry-pick and distort scientific data to fit their desired narrative. While it is true that fat is a necessary nutrient, it does not need to come from animals. In fact, fats included in whole plant foods are healthier than animal fats. It is also true that hormones are made from cholesterol, but the human body makes all the cholesterol it needs. Dietary cholesterol is not only unnecessary, but can be harmful. I hope that helps!

  153. Hello! Every day i drink about 300 ml coconut milk enriched with D2. 0.75ug per 100 ml, my question is – if it’s ok i take 1 softgel D3 2000IU dayli and drink coconut milk as well? Or i must to stop milk and take only softgel vitamin D3?

  154. Hi I’m a RN health support volunteer. There has been some research that coconut milk has some potential negative cardiovascular risks. You may want to discontinue or limit the coconut milk for that reason. I don’t think the coconut milk and vitamin D supplement together are an issue. That would not be an excessive amount of vitamin D. There are just some other potential issues with coconut milk.


  155. No. It’s processed. This means good, important components are being thrown away, like fiber. If you’re concerned about protein, eat some fresh soy beans in the pod (edamame) post workout. This is what I do. Evidence shows for maximum effect, it should be eaten about 1/2 hour after the workout.

    Dr. Ben

  156. Regarding EPA/DHA vegan supplements: Which product does Dr Gregor recommend?? I have been taking Pure Encapsulation product. But it was recently discontinued because of manufacturing sources/issues. As a gastroenterologist I would like to recommend to people a toxic free source of algae for epa/dha.. What do you recommend??? THANKS, TOMMY J. POIRIER MD

    1. Hello Dr. Poirier,
      I am a family medicine doc with a private practice in lifestyle medicine and also a volunteer for this website. I think any algal source of DHA/EPA would be fine. If you look up “vegan dha/epa” on Amazon, you’ll find a long list of good products. The one I use and recommend to my patients, after researching the cost, potency, and reviews has the cute name “O-Vega 3”. Here is the Amazon link:

      I hesitate recommending specific products, as you can imagine, but I’ve found that patients appreciate having specific recommendations. FYI, I do NOT receive any benefits from this company. I hope this helps.

      Dr. Jon
      Health Support Volunteer for

  157. Hello, I often heard/read that we also need to supplement Magnesium and K2 if we take Vit. D supplements, but none of both are mentioned here. I would like to know your opinion on the connection of these 3. Thank you.

    1. Thanks for your reply Christine, and thanks for the link, I had already viewed all that info which was why I wondered about its absence in the daily dozen. Consensus from many relaible sources, including this page, seems to confirm 150ug supplements are the way to go. Daily ingestion of sea vegetables seems to me both unreliable and not easily obtained. The alarming effects of iodine deficiency certainly demand attention. Thanks for all your efforts on the site, kind regardsTrevor.

  158. Hello Trevor,
    Thank you for your question and comment. I am a family doctor with a private practice in lifestyle medicine, and also a volunteer for this website.

    Dr. G clearly realizes that iodine is an important nutrient (which supports proper thyroid function), which is why it’s in his list, above. None of Dr. G’s Daily Dozen is a supplement — they are all foods, plus beverages, turmeric (spice) and exercise. So I’m not surprised that he doesn’t include iodine in his daily dozen list.

    As to why he doesn’t include sea vegetables in the Daily Dozen, I think you answered your own question when you said “Daily ingestion of sea vegetables seems to me both unreliable and not easily obtained.” Dr. G mentions these issues, above, when he says: “The sea vegetable hijiki (hiziki) should not be eaten due to high arsenic levels”; and “Kelp should be avoided as it tends to have too much iodine.”

    Also, most people get all the iodine they need by ingesting iodized salt. However, my personal experience provides a great example of why some people DO need to take iodine supplements.

    I follow a low-salt diet, due mainly to my tendency to high blood pressure. And the small amount of salt that I do consume is often “sea salt” — which has gained popularity, even though there is NO evidence I know of that supports any benefit over regular salt. But sea salt has the big disadvantage that it does not contain added iodine.

    So, long story short, a couple years ago, about two years after switching to a completely vegan diet (and hence not eating fish, dairy, or eggs — all of which are important sources of iodine), I developed fatigue, which was noticeable every time I tried to do strenuous exercise, such as running. Turns out I was deficient in iodine, and about 2 weeks after starting an iodine supplement (I take a 225 mcg vegan capsule), the fatigue resolved completely.

    Dr. Jon
    Health Support Volunteer for

    1. Regarding the omega 3 index issue: I am a recently retired pathologist WFPB eater (no oil or salt added in my cooking) and have been taking Dr. Fuhrman’s EPA/DHA supplement for more than a year. I recently had some testing done by a Quest lab in California, hoping to see how I measured up with Dr. Greger’s recommendation to have an omega 3 index of >4.4%. I was disappointed with my result of 3.3%. However, that put me in their lowest risk quartile (for heart disease), so I guessed that their methodology was likely different from the test Dr. Greger recommended in his video. I am guessing that the test he referred to was analysis of omega 3 content in the RBC membrane. I talked with the Quest laboratory director by telephone, and he informed me that the test they are doing is a plasma level and not an RBC membrane analysis. He could give me no information about the comparability of the results of the two methods. Although he told me “Nobody is doing the RBC membrane test anymore,” I have found the test available online from Vital Choice (89$).This is a test where one collects whole blood from a finger stick onto filter paper and mails it in. Do you have any sense of equivalency of these to methods? I am not really concerned about my own result, but feel other of Dr. Greger’s followers might be getting the plasma level test and could be disappointed/confused by their results.

    2. Hi Jon
      Thank you for taking the time to reply, and apologies for my slow respose.
      Your reply has helped me to clarify my thinking.
      Kind regards Trevor

  159. I’m confused that Boston has been placed under the Latitude 30-40 category for D3. Google suggests it’s 42.3 degrees. Is that close enough that you can consider it the 30-40 category? Google says I am located around 43 latitude. I was figuring I was close enough to Boston so should follow those suggested times of year to supplement, but only just tried looking up the actual latitude now and see that both seem to fit the Latitude 40-50 category. Portland is also confusing because both the one in Oregon and the one in Maine are also above 40. Is Google not accurate enough? Thanks!!

  160. Since they seem to be a bit oxidation ‘fragile’/unstable, what is the best way to consume flax seeds? I have been buying Bob’s R.M. flax meal & storing it in the refrigerator, but it certainly wasn’t refrigerated when I bought it.

    Thank you for all you do! Love our book & just bought a T-shirt.
    ~Shel Lynn

  161. Thank you for all the knowledge you are sharing with us!! I recently came across a 2017 study about a possible link between vit b12 and lung cancer increase in men. The study doesn’t conclude anything but just shows there is some correlation. What are your thoughts. I think you have way more practice at reading and interpreting these studies/data and method from the average joe.

  162. Hello VisceralWay,
    I am a family physician with a master’s degree in epidemiology; I have a private practice in lifestyle medicine and am a volunteer for this website. It turns out that I previously answered this same question back in March of 2018 in response to “Bjorn.” Following is his question and my response. I hope this helps. Analysis of epidemiologic studies can be confusing. (Sorry….)

    Dr. Jon
    Health Support Volunteer for

    Björn says:
    AUGUST 28TH, 2017 AT 2:15 AM

    There seems to be a study with ~77.000 participants that links lung cancer and B12 intake (only in men). What is your advice on this & can you maybe make a video to explain what to do and how & why?
    Link to study:
    Thank you!

    Dr.Jon, NF moderator says:
    AUGUST 30TH, 2017 AT 11:04 AM
    Hello Bjorn,
    Thank you for your question. This is an interesting study. I just looked at it in detail, and scrutinized the tables of data. I do not think their conclusion is warranted.
    Here is their conclusion: “When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (> 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (> 55µg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers.”

    I see several problems with this conclusion:
    1) If B12 consumption is associated with lung cancer, then the more B12 you consume, the higher your risk of lung cancer should be. This is called a “dose-response” relationship. But here are the data for men (Note: there was no significant association for women), using their figures for 10-year average daily consumption of B12. First, their categories of consumption, with the number of cancer cases in each category in parentheses:
    Non-user (n=179), 0.1-5 mcg/day (n=78), 5-25 mcg/d (n=138), 25-55 mcg/d (n=23), >55 mcg/d (n=28).
    The relative risk of cancer in these groups, when adjusted for a bunch of different variables, including smoking:
    Non-users RR=1.00 (by definition); 0.1-5 mcg/d: 0.93, 5-25: 0.94; 25-55: 1.04; >55: 1.98 (confidence interval 1.32-2.97).
    There is not much of a dose-response relationship here. The risk is actually LESS than that for non-users for the first two groups; only the highest category of B12 consumption (>55 mcg/day) was associated with increased risk of cancer.

    2) The number of cancer cases in each group is very small (23, and 28 for two of the B-12 consumption groups). This means that any association they find is somewhat suspect — even if it is “statistically significant” — i.e. the confidence interval doesn’t include 1.00.

    3) There is clearly confounding, by smoking status. By their own admission, “the risk was even higher among men who were smoking at baseline.” But what they don’t say, until you delve into the tables, is that, due to the small number of never-smoker lung cancer cases (n=20), this group was excluded from the analysis!! Note, that they DID analyze (see immediately above) two groups of size 23, and 28, so why did they throw out a group just because it only has 20 people. I suspect that is because there is actually NO relationship between B12 intake and risk of lung cancer among non-smokers.**

    4) If there really is a relationship between B-12 intake and lung cancer, why does this only occur in men, but not women? It doesn’t make sense biologically. They try to give a rationale for this sex difference in their discussion, but I don’t buy it.

    So, my conclusion is that if you are a male smoker, there may be some reason to worry about taking B-12 supplements, but given the very small numbers in this study, and the lack of a consistent dose-response relationship, this is a long ways from being proven.


    ** NOTE: Researchers love to have significant results, and manipulating the data to make results look more significant has been documented to occur.

  163. Fortified vs Supplementation. What is the difference? We should not take calcium supplements, but we can drink calcium fortified milk? I read that the difference can be the dosage. But can we not just take smaller doses similar to what is in the fortified products? I am very confused by this. Even NIH says we should get our vitamins and minerals from food sources…yet it lists fortified foods as dietary sources for vitamins and minerals. I don’t understand. Does our body do something different with almond milk fortified with 100mg of calcium than it does with almond milk with 100mg of my calcium pill dumped in to it?

    1. I would treat fortification the same way I would treat supplementation. So consider that as a supplement.

      Matt, Health Support

  164. Thank you for the response on the B12-Lung Cancer study concerns. I’m still concerned as I just heard about this when it was mentioned on “The Real Truth About Health Conference”. The levels are concerning because apparently the US daily requirement is less than 10 mcg per day for B12, the study talks about concerns with lung cancer risk at 55 mcg per day, Dr.Greger recommends 150 mcg per day (also saying don’t worry about too much). Has Dr.Greger himself responded or commented on this 55 mcg study with B12 and lung cancer in men?


    1. Hi David- Several things are true: those who eat whole food, plant based are more likely to develop vitamin B12 deficiency. Vitamin B12 deficiency can have very harmful effects: anemia, neurologic problems like numbness, tingling, and cognitive dysfunction. Also found is that, among male smokers, aged 50-76, who obtained sufficient vitamin B12 in their diets who then took over 55mcg daily vitamin B12 and/or B6 for over ten years had an increased risk of lung cancer. This association was not found in women, nonsmokers, any male age group other than 50-76, or those who lack a dietary source of B12 (like plant based eaters can). The best plan to completely avoid this risk is to not smoke. If you are not sufficiently reassured, you could get B12 from fortified foods like some cereals or nutritional yeast or take less than 55mcg daily. Plant based eaters without a reliable fortified food source of B12 could develop deficiency with less than 55mcg daily, though. So, if you are a male smoker, aged 50-76, getting sufficient B12 in the diet, but taking extra B12 every day for ten years, and can’t find yourself able to change any of the changeable behaviors, you may want to get a B12 level checked.

        1. Hello David,

          I am a family doctor and am (another) volunteer for Dr. Greger for this website. I previously responded to a similar concern back in August of 2017 about this same study. As Manderson states above, the only group for which the authors found an increased risk was a tiny group (n=28) of smoking men. BUT, as I pointed out in my previous response, appended below, there are several reasons not to believe this study at all. I hope this adds to your understanding. Dr.Jon.

          Dr.Jon, NF moderator says:
          AUGUST 30TH, 2017 AT 11:04 AM
          Hello Bjorn,
          Thank you for your question. I am a family physician with a private practice in lifestyle medicine, and am a volunteer moderator for this website. I also have a master’s degree in epidemiology. This is an interesting study. I just looked at it in detail, and scrutinized the tables of data. I do not think their conclusion is warranted.

          Here is their conclusion: “When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (> 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (> 55µg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers.”

          I see several problems with this conclusion:

          1) If B12 consumption is associated with lung cancer, then the more B12 you consume, the higher your risk of lung cancer should be. This is called a “dose-response” relationship. But here are the data for men (Note: there was no significant association for women), using their figures for 10-year average daily consumption of B12. First, their categories of consumption, with the number of cancer cases in each category in parentheses:
          Non-user (n=179), 0.1-5 mcg/day (n=78), 5-25 mcg/d (n=138), 25-55 mcg/d (n=23), >55 mcg/d (n=28).

          The relative risk of cancer in these groups, when adjusted for a bunch of different variables, including smoking:
          Non-users RR=1.00 (by definition); 0.1-5 mcg/d: 0.93, 5-25: 0.94; 25-55: 1.04; >55: 1.98 (confidence interval 1.32-2.97).
          There is not much of a dose-response relationship here. The risk is actually LESS than that for non-users for the first two groups; only the highest category of B12 consumption (>55 mcg/day) was associated with increased risk of cancer.

          2) The number of cancer cases in each group is very small (23, and 28 for two of the B-12 consumption groups). This means that any association they find is somewhat suspect — even if it is “statistically signifiant” — i.e. the confidence interval doesn’t include 1.00.

          3) There is clearly confounding, by smoking status. By their own admission, “the risk was even higher among men who were smoking at baseline.” But what they don’t say, until you delve into the tables, is that, due to the small number of never-smoker lung cancer cases (n=20), this group was excluded from the analysis! Note, that they DID analyze (see immediately above) two groups of size 23, and 28, so why did they throw out a group just because it only has 20 people? I suspect that is because there is actually NO relationship between B12 intake and risk of lung cancer among non-smokers.

          4) If there really is a relationship between B-12 intake and lung cancer, why does this only occur in men, but not women? It doesn’t make sense biologically. They try to give a rationale for this sex difference in their discussion, but I don’t buy it.

          So, my conclusion is that if you are a male smoker, there may be some reason to worry about taking B-12 supplements, but given the very small numbers in this study, and the lack of a consistent dose-response relationship, this is a long ways from being proven.

          Health Support Volunteer for

          1. Thank you so much, Dr.Jon. It’s appreciated and also extraordinary that volunteer Doctors are indeed involved and answering concerns on nutritionfacts. CheersDB

    1. Hi Dennis, yes this is Dr. Greger’s current recommendations. We do update this page if his recommendations change.

  165. I’m having blood work taken next moth. It’s the first since I’ve switched to a plant based diet. What items in particular should I ask my physician about for overall long-term health, and to make sure I’m consuming adequate nutrition? Also, do you have a list of recommended levels (e.g. LDL cholesterol, Vitamin D levels…)? Heart disease runs in my family so that is why I’m particularly interested. I’m a 30yr old female.

    1. Hello Ashley and thank you for your question,

      I’m a family doctor with a private practice in lifestyle medicine and also volunteer for Dr. Greger on this website. If I’ve interpreted your questions correctly, you want to know what blood tests you should request, and also what supplements you might want to consider.

      Regarding supplements, the good news is that if you are eating a good plant-based diet (veggies, fruit, whole grains, legumes, and some nuts and seeds), you don’t need to take many supplements. Dr. Greger has a short list that he recommends:

      To summarize those recommendations, you should take: 500 mcg/day of vit. B12, as cyanocobalamin, 2,000 IU/day of Vitamin D3, and probably also an algae-derived DHA/EPA capsule daily. Also, for those who don’t use iodized salt and also don’t regularly eat seaweed, you should take iodine 150 mcg/day. You don’t need supplemental calcium if you eat plenty of calcium-rich plant foods. And assuming you are menstruating, you need to eat foods rich in iron, and combine with foods rich in vitamin C to increase absorption. Dr. G also suggests that northern Europeans should consider eating a daily Brazil nut to maintain adequate selenium levels.

      Regarding blood tests, there are quite a few that you could check (and some doctors will want to order a large panel), but not many that are really necessary. You should definitely get:
      1) a cholesterol panel; and, in view of your family history, consider getting a “cardiac C-RP” (C-reactive protein) — correlates with risk of future heart attack;
      2) a complete blood count (CBC) — to screen for iron-deficiency anemia (since you’re a menstruating woman);
      3) if you are not taking a vitamin D supplement, get your vit. D level checked (Note that there is some controversy about screening vit. D levels in people with no symptoms — such as fatigue);
      4) if you are not taking a vit. B12 supplement, get vit. B12 level checked;
      5) (if you haven’t had it checked before) consider getting a “chem-14” — inexpensive panel to check for liver and kidney disease, and calcium level.

      I hope this helps.
      Health Support Volunteer for

      1. Oops, didn’t realize that I didn’t need to give out that link to Dr. G’s recommendations, duh. (Since that’s the article under which you are commenting). Dr.Jon

  166. I can’t seem to find a good cyanocobalamin b12 supplement for children. Any recommendations? My son is almost 4. He takes a multi, vitamin d (since birth), iron (he’s slightly anemic undergoing treatment for that) and Sunday my better judgement cod liver oil (for more).

    1. Hello Kristine,

      I have also found that B12 supplements generally don’t come in more dilute dosages for children. I would recommend speaking with your pediatrician about how to dose your child as it is likely that they need a smaller dose. On the other hand, there aren’t any major risks with consuming excess B12; therefore, the most important thing to keep in mind is that your child does indeed get B12 on a regular basis.

      I hope this helps,

      Matt, Health Support

    1. Hi james Wright – Thanks for your question! Pressure cooking can be a great, convenient option for quickly cooking up items like dried beans and oat grouts! Dr. Greger uses a pressure cooker himself too.

      -Janelle RD (Registered Dietitian & Health Support Volunteer)

    2. I really appreciate your work and effort to give useful, well documented and explained informations about health on your site.
      An answer to James about pressure cooking. I’ve checked up on this subject anf pressure cooking where preparation time is less than usual and gives less oxidation means that the food is more nutritious (generally more vitamins and minerals). As with a blender and a juicer where juicing means less time to prepare and less damage to the vegetables/fruits surface in the process. Juicing generally means more vitamins and minerals than using a blender:) explains about your diets effect on your health and skin when eating an anti-inflammatory diet. I also found a very interesting study showing how food keeps nutritions the best. They found pressure cooking to be best way of preparing food with the less loss of vitamins. I hope this answer could be of any help :-)

  167. I have been an ovo-lacto vegetarian for the past 10 years. I would find it difficult to prep n consume meals utilizing 11 different food groups. Could I turn your guidelines into a weekly dozen?

    How can I regulate serving amts so I get enough calories to sustain myself?

    I am afraid I had consumed too much sugar, especially fructose rich sweeteners during that time, that has caused my liver to being depositing fats. Accidental discovery of those fat deposits in my liver forced me into researching nutrition recommendations, Luckily discovered your org, and knowledgebase.

  168. Meltem,

    Although it does pose some preparation its’ in ones best health interest to try to get the widest variety of foods from the different food groups as possible. There are creative ways to maximize you intake, have you checked out Dr. Greger’s cookbook or the How not to Diet new book ?

    NAFL is indeed an important issue and glad you’re on track to reduce this disorder. Keep working on the sugar restriction and the WFPB approach, with minimal oil intake.

    Dr. Alan Kadish moderator for Dr. Greger

  169. Thank you for all the excellent analysis of the available research.
    My 6-year-old granddaughter will not eat any meat or fish but will eat eggs.
    She had 3 fractures recently in her fibula from minor gymnastic injuries.
    Do we need to encourage the ingestion of certain food groups or supplements to optimize her cellular growth, musculoskeletal development, and her brain growth?

    Best regards,

    Michael Faer, MD