Plant-Based Foods that Fight Macular Degeneration

Image Credit: Marufish / Flickr. This image has been modified.

Foods for Macular Degeneration

Anyone who has gotten a bad sunburn knows how damaging the UV rays in sunlight can be. Imagine what those same rays are doing to back of our eyeballs (our retinas). The eye is designed to take sunlight and focus it like a magnifying glass into the back of our eyes. Thankfully, we have a layer of cells called the retinal pigment epithelium that supports and protects our delicate retinal eyesight machinery. The layer builds up yellow plant pigments like zeaxanthin from our diet, absorbing blue light and protecting the retina from photo-oxidative damage. The yellowing of our corneas when we develop cataracts may actually be our bodies’ defense mechanism to protect our retinas. In fact, when cataracts are removed, the risk of blindness from macular generation shoots up (because we removed the protection). Instead of trading one type of vision loss for another, it’s better to pigment the back of our eyes through diet instead of pigmenting the front of our eyes with cataracts. The pigment in the back of our eyes is entirely of dietary origin, “suggesting that the most common cause of blind registration in the Western World could be delayed, or even averted, with appropriate dietary modification,” according to authors of a study on age-related macular degeneration.

Where in our diet do we get these pigments? The egg industry brags that eggs are a good source, but have nearly six high-lutein, free-range, certified organic eggs a week for three months and the pigmentation in one’s eyes may only marginally increase (see Egg Industry Blind Spot). Instead of getting the phytonutrients from the egg that came from the chicken that came from the corn and blades of grass the chicken pecked on, we could get it from the source. One cup of corn and a half cup of spinach a day for three months seems to dramatically boost the protective eye pigment in subjects. In the video, Dietary Prevention of Age Related Macular Degeneration, you can see a comparison of the amount of these phytonutrients from eggs compared to corn and spinach. If we cut out the middlehen and get these nutrients from plants directly, we see a substantially larger increase in protective eye pigment.

Three months after the subjects stopped eating the corn and spinach, the levels of these pigments remained relatively high, indicating that once we build our macular pigment up with a healthy diet, our eyeballs really try to hold on to it. So even if we go on vacation and end up eating more iceberg lettuce than spinach, our eyes will hold out until we get back.

Eggs can increase zeaxanthin levels in the blood, but they can also raise bad cholesterol levels and increase the risk of heart disease. Thus, as researchers conclude, “an egg yolk-based dietary strategy to increase plasma zeaxanthin cannot be recommended, and an alternative, cholesterol-free, food source is desirable.” One such alternative would be goji berries, which have up to 60 times more zeaxanthin than eggs. A modest dose of goji markedly increases levels in our body. Consumption of goji berries may be an effective, safe whole food strategy to increase zeaxanthin in the bloodstream.

But we don’t need it in our blood, we need it in our eyes. A group of researchers performed a double-blind randomized placebo-controlled trial to test the effectiveness of goji berries at increasing pigment levels. To preserve eyesight in the elderly in traditional Chinese medicine, people are often prescribed 40 to 100 goji berries a day. In this study, participants consumed only about 15 berries a day for three months. Even at this small dose researchers  found that goji berries could protect against loss of pigment and prevent the buildup of debris that builds up in the back of the eye. Both loss of pigment and debris buildup are associated with age-related macular degeneration.

Macular degeneration is the leading cause of legal blindness in older men and women, affecting more than ten million Americans, so increasing our consumption of these pigments as a society could significantly decrease the prevalence of blindness. In the above study, researchers gave the goji berries in milk so the butterfat could increase the absorption of these carotenoid pigments. A healthier way to get the same effect would just be to eat goji berries with nuts or seeds—in other words, goji trail mix.

Though they didn’t appear to boost a measure of immune function (Boosting Natural Killer Cell Activity), goji berries are one of the most antioxidant packed snacks out there. A tip on getting them inexpensively can be found in my video Are Goji Berries Good for You?

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.


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.

90 responses to “Foods for Macular Degeneration

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  1. Goji berries are from the nightshade family and can cause intense pain-issues and neurological ailments in certain individuals whose bodies’ can not effectively deal with the alkaloids in nightshades. A nightshade-free diet eliminated most of my joint pain and arthritic and neurological issues.

  2. Since you, Dr. Greger, found out how much much better Indian Gooseberries are, couldn’t one substitute org. Amla Powder for the Goji Berries (I did use a teaspoon per person in my morning smoothie)?

    1. Obviously I can’t speak for Dr. Greger, but one interpretation is that if you want good anti-oxident protection you add Amla whereas if you want corneal pigments you use Goji berries.

      I wouldn’t be surprised if half a teaspoon of each wasn’t better for you than a teaspoon of either.

    1. goji berries covered in dark chocolate are probably healthy as long as you aren’t particularly sugar sensitive and you avoid other sugar sources. They would probably be significantly less healthy for the pocketbook, though.

  3. There seems to be an error in describing the goji berry dosing used in the cited studies. Here and in videos, Dr. Greger says the the studies used 15 berries/day. However, as I read the studies cited the doses used were 13.7 grams/day in one and 15 grams/day in the other. I’ve counted out and weighted goji berries and found that it took roughly 80 berries to make up even 14 grams. That is nearly 2 tablespoons, and would be more in line with the traditional Chinese medicine dosing (40-100 berries) that Dr. Greger mentions.

    Please check, clarify, and correct if needed.

    I have early macular degeneration and have been using goji berries at the 15 berries/day dosing since Dr. Greger’s videos on the subject; but I guess I had not checked the dosing against the cited studies until today.

    I would be happier at the low dose, because Medline says goji berries exert “Moderate” interactions with medications, including suppression of the liver’s p450 cytochrome detoxification system– which might cause an unwanted increase in blood levels of one of my antiviral meds.

    There have been case reports of serious interactions with warfarin.

    These potential drug interactions might be worth noting.

    I would much prefer to be told I’m missing something, or otherwise mistaken about the study dosing.

    Thanks to Dr. Greger for all your work, and a happy new year to all!

    1. I sympathize with you because I know someone who struggles with this problem too. It takes a lot of toughness to cope with MD. What if you back off the berries and compensate with some spinach? I if you don’t like spinach (like me), you might try mixing in with swiss chard, arugula and kale. For some reason I love the blended flavours of green leafies. the more the merrier! Best wishes to you. Keep up the fight!

      1. Thanks. I’m lucky to like spinach, with or w/o other green leafies. Actually, my habit lately has been to have spinach daily, in a mid-morning smoothie that includes goji berries. (But how many???) I’m also lucky to have no symptoms so far from my macular degeneration– that’s what I meant by “early” (at 63 it’s not early onset).

      2. It amazes me how spinach and asparagus can be so disgusting cooked to dark green and sloppy (with or without mayonnaise) and yet so delicious raw (spinach) or lighly sauteed (asparagus) topped with a little vinaigrette.

        Arugula and kale have their own benefits.

        (oops… I thought MD meant Muscular Distrophy. I was wondering if you were a mind-reader.)

        1. I grew up with cooked spinach (with cream) and I like raw spinach as a smoothie with an orange or a pear. But lately I must have had too much smoothie as my breakfast because I have been told by an older sweet MD (gone to be with the Lord already at age 96) before when the output still has almost the same color as the input then it did not get digested well enough. And he used to give me a product called Zypan (=pancreatic enzymes + …) and that helped me in the past (to be taken with a meal that is not hotter than lukewarm), but I did not like that he thought I would have to keep taking this with meals (that my digestion would not improve). He said that older people do not have enough stomach acid for digestion? Any thoughts on this? And does the spinach and the corn have to be raw to be of benefit?
          Thank you for any and all input!

  4. Hmmm. I typed “What causes macular degeneration” and searched with (It doesnt track you), and all the hits say it is caused by getting old and genetics: “although early onset cases are becoming more common in patients as young as 40”. Pretzel logic. Round up the usual suspects. You’re all helpless victims.

    Shouldn’t someone write the Retina-International folks a letter? With letters after their name?

  5. Bilberries were used in WWII for pilots to protect their eyesight. It is likely blueberries also support eye health. While the dark anthocyanins characterize dark berries, often the lighter pigments occur as well, and there are other health advantages to blues. In addition, they are not in the nightshade family. Blues are widely available, sourced in the U.S.

    1. I am extraordinarily fond of this story. It is widely reported and re-reported, and is occasionally debunked as a myth. When Sir Winston Churchill ordered an attack on a German dam, he ordered a very precise night strike that would be very hard on the eyes even during the day using bouncing bombs to avoid torpedo nets. I believe these pilots were told to improve their night vision and I believe they used carrots. It is said by some that the RAF pilots were told to say that they were eating bilberry jam to confuse the German spies that were present into thinking that would cause night vision improvement. I feel this story today shows that purple pumpkins or purple carrots, possibly their original color, would actually be better for the eyesight than they are now. Those are the foods that are known to improve eyesight. It is actually not really known if bilberries are good for eyesight, but they would be good for anyone who eats them! Goji berries can improve vision, reported here.

  6. Bilberries were used in WWII for pilots to protect their eyesight. It is likely blueberries also support eye health. While the dark anthocyanins characterize dark berries, often the lighter pigments occur as well, and there are other health advantages to blues. In addition, they are not in the nightshade family. Blues are widely available, sourced in the U.S.

    1. Brite, legal blindness is defined in America as 20/200 as best possible corrected vision in either eye. Unaided vision is not defined in blindness. According to optometrists, 20/20 is average vision for America for all ages. What is the standard deviation of eyesight? Eyesight can worsen throughout life. Only more than 3.6 million Americans over 40 have vision less than 20/40 according to optometrists. I am surprised at how good American vision is, very few people have less than perfect vision according to optometrists.

      1. Thanks a lot, Matthew, for your veryy clear and complete answer.I think that the contradiction leans in the possibility of a correction ( it is said “even with eyeglasses).

        1. Thank you! Perhaps eye wear is worn mostly to correct astigmatism. Or, as you say, perhaps only 3.6 million Americans have eyesight that cannot be corrected to 20/20. Please excuse the typo I corrected. “were” to “wear.” I think it is very challenging for the brain to see and hear at the same time, and uses brain waves to achieve that goal, the alpha to see, the delta to hear. Even on a pot of matcha tea a day I still cannot see 20/20 with my alpha brain wave being very over active. Did you know all optics, including the human eye, produce an image that is upside down and mirrored? The central optic nerve in your brain has to reverse and invert this. The delta brain wave might help generate depth perception. Nuts and seeds can cause the delta brain wave, and maybe so can elder flower tea. It is very challenging to produce the cones that it takes to hear in three dimensions with a flat ear, it is challenging to locate a sound. I think the delta brain wave works with the alpha brain wave to achieve this, location in hearing. This is a very difficult task that can cause pain or disease if it becomes disoriented. I have often wondered why people with brain damage still do not have problems of perception in seeing or location in hearing. Perhaps these brain waves are deep inside of us. Perhaps they use the whole of the nervous system. Thank you for your help.

          1. ” the alpha to see, the delta to hear.”

            I think it’s a lot more likely that delta is needed to both see and hear and alpha is needed to coordinate and report results. I would bet that delta brain waves occur during pattern recognition on non-myelinated, heavily circular neurons and alpha brain waves occur on myelinated neurons that stretch relatively straight between brain regions. I am sure a neurologist could probably come along and find a couple errors in my understanding, though.

            “The central optic nerve in your brain has to reverse and invert this.”

            I think the central optic nerve reports to the processing center in the back of the brain *as mapped* and the inversion happens somewhere after that. I am not really even sure that “Upside down” is a well-defined concept. Think of sensory perception as a topological phenomenon – you can stretch and turn without changing things, but “between” is meaningful (although with a different meaning at the nerve source than at the brain center target) and the primary conserved property is consistency of destination. The same point on your body will always send impulses to the same processing column in your brain regardless of what other factors change. Distance between areas on your body (I am talking about touch instead of vision now – hopefully the metaphor holds) are determined experimentally by your brain based on a signal pattern running across your body in pulses whose timing trigger the mapping on the brain structures.

    2. Also if you have less than 20 degrees of vision you are termed “legally blind”. So a person could see 20/20 but still be legally blind if their vision field is less than 20 degrees. Most people have 140 degrees of vision.

  7. When cataracts are removed, the implants that replace the human lens almost all have UV blocker incorporated into the material, so the risk of macular degeneration after cataract extraction doesn’t necessarily increase.

  8. I’ve been reading a lot about the hazards of blue light coming from computer monitors (LCD screens) and full spectrum light bulbs. It seems to be more dangerous for people who have had cataracts removed. Best to wear the yellow tinted blue light filter glasses while working on computers.

  9. I am sick and tired of reading about high cholesterol allegedly causing heart problems. This is the Medicine of the end of the 20th century!! Good cardiologists like Dr Sinatra, who also thought of cholesterol as the culprit, his practice made him change his mind back in the 1990s. And there are scores of others. People who have suffered a heart attack, their cholesterol level was high only in 50%, which means it is NOT a scientific argument.

    Dr Greger in order to bias his vegetarian/vegan views serves us with his theories about eggs causing high cholesterol.

    Dr Lair Ribeiro, a Brazilian eminent cardiologist and nutriologist considers eggs as the most important food after maternal milk. He cannot start a day without eating 3-4 eggs. There are scores of videos on youtube. But unfortunately even first class physicians like Dr Greger will never understand it without getting rid of their prejudice. Such physician should read/see cardiologists like Dr Sinatra, who laughs his head off when he hears about cholesterol causing heart problems.

    I wish I had higher cholesterol. (I have it only slightly above 200. I eat around 10-12 eggs per week and I cannot reach 250 cholesterol levels. I am probably not human even though I lead a sedentary life. This is THE EVIDENCE, Dr Greger. I also love vegetables and fruits and .. fish and meat as well. The last two may sound to you like a red rag to a bull. Sorry about that. This is called Meditarreanean diet. Have you heard of that? I am not talking about the studies done in the 1950s or 60s, but a recent publication from 2012. Dr Greger, if you have an open mind, you should present this study here in your posts instead of cherry picking limiting your mind to only plants. Plants are GREAT! But only plants is the same as relying only on mainstream media and showing big-headedness.

    1. RichardoRichard: re: “People who have suffered a heart attack, their cholesterol level was
      high only in 50%, which means…” Your conclusion is not logical based on the evidence. What your statistic really means is that the labeling of “high” by traditional medicine is grossly incorrect. Or perhaps an even better way of looking at it is: “high” is not a helpful category when an entire population is on average too high. Instead, what we want is “safe” levels of cholesterol.

      So, what we know is that a total cholesterol below 150 and LDL below 70 makes one pretty much heart-attack-proof. But above 150, a person is in the danger zone. This explains your 50% statistic. Those are people who traditional medicine does not label as high, but in fact who are “high” if by “high” one really means “a level that will lead to hard attacks”.

      I understand why you think that cholesterol is not relevant. There is a lot of misinformation out there that has convinced people such as yourself that cholesterol does not matter. It sounds like you care deeply about evidence and as you say, cherry picking is not good. If you want to know how the cholesterol denyiers cherry pick and outright twist their evidence, I highly recommend the scholarly work from Plant Positive. Plant positive directly addresses the issues/claims you have been exposed to.

      1. Thea, thank you for your reply.

        Please tell me why the French have on average 250 cholesterol level? And it is one of the last nations in Western Europe who suffer from, CVD. And what is their staple diet? Unfortunately they have problems with cirrhosis… but it is a different story.

        Yes , I was imprecise about high cholesterol. Sorry. You have scored a point. But our body needs cholesterol badly! Look, the cholesterol deposits in the arteries is the body’s reaction to help patch up the scars in the arteries due to the mechanical damage (huge pressure) chemical damage resulting from scores of other factors – lack of nutrients, toxification, etc.

        The worst is inflamation, blood inflamation in this case. If it weren’t for the helping hand of the cholesterol we would die from internal bleeding,!!! Thank God we have cholesterol! Besides, cholesterol is needed to synthetize vitamin D, whose importance even Dr Greger talks about. We need it for our hormone production – testosterone, estrogen. Every cell needs our cholesterol, and last but not least our brain.

        Do you want to starve your body? – if so, it is your choice. But before you do it, just open your mind, read at least Dr Sinatra or just see this . These are only snatches. Go deeper. If you want more, I can give you other links.

        There are scores of cardiologists who follow the same idea. Neither of those “pro-cholesterol doctors want us to eat a meat meal 5 times a week, if you have it once or twice a week, you won’t suffer from cholesterol deficiency. That Brazilian doctor I mentioned last time is around 70 years old and he looks at most 55. That “eggs-eater” should have been dead long ago if cholesterol were not a myth. I should have been dead as well.

        I know it is hard to shake or uinlearn our way of thinking and change it when the evidence is in front of us.

        Sorry, I have to leave you – two soft-boilt eggs are waiting for me.

        1. Ricardo, you are unfortunately employing the “cholesterol is necessary” argument, a common argument used to support cholesterol rich diets.

          “Given the capability of all tissues to synthesize sufficient amounts of cholesterol for their metabolic and structural needs, there is no evidence for a biological requirement for dietary cholesterol. Therefore, neither an Adequate Intake nor a Recommended Dietary Allowance is set for cholesterol.There is much evidence to indicate a positive linear trend between cholesterol intake and low density lipoprotein cholesterol concentration, and therefore increased risk of coronary heart disease (CHD). A Tolerable Upper Intake Level is not set for cholesterol because any incremental increase in cholesterol intake increases CHD risk.”

          There is no dietary need to consume cholesterol. If inflammation is what your worried about, diets rich in saturated fat and cholesterol are by far the most inflammatory of all. Those 2 hardboiled eggs your eating, as performed in this study, resulted in endothelium impairment after consuming. A clear sign of inflammation.

          You can see other mechanisms of inflammation here.

          1. Toxins, you are unfortunately employing the “cholesterol is not necessary” argument, a common argument used to support non-cholesterol diets.

            What you say, according to your “scientific data” I should have already been dead, because I have been eating like that all my life. My crp is 0,7., triglycerides – 55.

            You are absolutely right – try writing to Dr Sinatra or Dr Mercola or Dr M. Ali and scores of others – they will laugh at you.

            I am still alive – the best living proof that your scientific argument is at most theoretical. LDL is also fine as long as it is not oxidized. Lp(a) is highly inflamatory form of LDL. I am not afraid of it.

            I hate hard-boilt eggs. Where did you take it from? Were you dreaming? Read more closely, please.

            Stick to your non-cholesterol diet and be happy. No wonder, there is no argument to make you see clearly.It is no use debating either with fanatics or with prejudiced people. It is not my job to convince you.

            Have a nice evening. Here in Europe it is the dead of night. Sorry, I have to leave you. Long live cholesterol !

            1. Ricardo, I am not arguing that dietary cholesterol is harmful because we don’t need it. I am arguing that it is harmful to consume and strongly inked with heart disease. Your argument that: we need serum cholesterol so we need dietary cholesterol, is illogical. I hope you understand this difference.

              Heart disease takes time to develop. Americans eat a high saturated fat, high cholesterol diet but most do not experience heart disease till later in life.

              “try writing to Dr Sinatra or Dr Mercola or Dr M. Ali and scores of others – they will laugh at you.” Should I consider these people nutrition experts and authorities? What difference does it make if these individuals agree with the science or not. Dr. Mercola himself is a well known quack and I would hardly consider him a reliable source of information.

              To say that cholesterol is unrelated to heart disease is to turn a blind eye to the countless studies showing this link and cherry pick a meager few. This is indeed the theme of the video we are commenting on. Please look at the evidence coherently. I have seen both sides of this argument and know the arguments people use to support a cholesterol rich diet. I hope you will take the time to truly understand what you are getting yourself into and see the other side of it. Here is a good place to clear up the cholesterol confusion.

              Lastly, ” hate hard-boilt eggs. Where did you take it from? Were you dreaming? Read more closely, please.”

              Came from your comment. “Sorry, I have to leave you – two soft-boilt eggs are waiting for me.” I’m sorry, I should have said SOFT boiled egg instead of hard. I didn’t know there was a difference.

              1. Toxins, let’s take the argument from a different angle. Do names like Gregg Braden, Deepak Chopra or Rupert Sheldrake to name just a few ring a bell in your mind? Especially the last one.

                There are two aspects, both are based on science – experiments in vitro and experiments in vivo. Dr Sinatra is a good example of the latter and in point of fact this is what matters – his 35 years of clinical practice.

                You see, I have lost faith in the so-called science of the 18th century, which we still practise today, even though I myself have a PhD (not in the field). The paradigm of what is science and what the science is not, is in the process of a change.

                If you are a good observer, you must have noticed that there has been a huge uproar against the old-fashioned science and it is still on the increase. The reasons are obvious. Delve into Sheldrake’s Science Set Free (American title) or just watch scores of videos showing how “science” tried to enslave him. His life is a good example. This one is good stuff Science has turned out to become a religious belief. No wonder there are so many alternative approaches in almost every field, because people are fed up with those egg-headed 18th century individuals who live today. The pure example is Richard Dawkins. Those “scientists” have led themselves to the dead-end street. And they are blocking any development.

                But our discussion has become something else.

                Returning to the cholesterol issue, there’s hardly a difference if you argue one way or another. For me you are like Dr Greger limiting himself to showing views that only support a vegetarian or vegan diet. Why doesn’t he comment on the recent Spanish study on Meditarranean diet? Why doesn’t he want to face the reality? It is not very comfy, is it? Obviously, it isn’t, because his vegetarian diet will have to be scrapped.

                I have always tried to see both sides of the argument. It gives me pleasure to read NutritionFacts but I don’t wear blinkers, or blinders as you say in America. I remember my being afraid of cholesterol in the 1970s, which did not make me vegetarian. I am omnivore because a human being has always been like that. And I am too old to go into fads.

        2. RicardoRichard: Sorry it took me so long to get back to you.

          re: “But our body needs cholesterol badly!”
          That’s always such an interesting argument to me, because no one I know disputes that our bodies need some amount of cholesterol to function correctly. I would say that it is a strawman argument, except that I think that when people say that, they are really thinking something else and just not being specific.

          If what you are really suggesting is that our bodies need cholesterol and that the only way to get it is by eating it or that we have to supplement what our bodies make by eating it, then Toxins already answered that point. Our bodies make all of the cholesterol that we need. No worries there.

          If you are suggesting that our bodies need cholesterol and therefore there is no way to have too much of it, then I would point out an analogy for you: Our bodies also need water. But too much of it can kill you. To think that our bodies can have unlimited amounts of cholesterol without there ever being a problem (that cholesterol is more special than water) is against all common sense. I’m not saying you believe this. I’m just making a point.

          So, there is a limit/line above which too much of the stuff in our veins would be a problem. The question is: where is that line? We know that when total cholesterol is below 150 and LDL below 70, people don’t get heart attacks. Above that, people get heart attacks. Unsafe cholesterol (ie, above 150) is not a guarantee that a person will get a heart attack, but the risk goes way up compared to having safe cholesterol levels.

          This gets us back to our original points: You stated that 50% of the people who get heart attacks have low (or normal?) cholesterol. And I explained how the traditional definition of “low” is has been perverted in a society where “normal” is too high to be safe. Ie, where normal is to die of heart disease.

          Hope that explanation clarifies my point.

          1. Sure, it does. But see a human body holistically. You don’t want more cholesterol than 150 because from your point of view it is dangerous for heart attack. And what about your brain, and the production of vitamin D, and other hormones? If you are happy, lower your cholesterol below 100, it is your choice. Perhaps you will never have a heart attack and that’s great but what about your brain and other hormones and probably sth else that we have not discovered yet?

            1. RicardoRichard: The thing is, the healthiest people on the planet, the ones who have sharp minds at 100+ and live long healthy lives, generally have cholesterol below 150 and primarily eat a whole foods plant based diet. (You can do research on the “blue zone” populations if you want.) So the specific problems, plus general worries you list (ie: “… and probably sth else that we have not discovered yet?”) are not an issue in practice.

              In theory, your concern could be a valid one: If someone can have cholesterol that is too high, can we also have cholesterol that is too low? Zero cholesterol is too low. But where is the line? I’m not aware of anyone, baring some genetic deficiency, whose body isn’t able to make ***all of the cholesterol that they need.*** And that’s the point. If you have all that you need, then you have all that you need. Ie, Not just low enough to avoid heart disease, but high enough to be healthy. The entire point of is to figure out the diet that is most likely to lead to optimum health/disease prevention. Baring some terrible problem where a person’s body doesn’t make all of the cholesterol that they need, we don’t have to worry about cholesterol going too low. Our bodies make what we need. Once that idea really sinks in, the concerns you raise disappear. Here is some evidence to back up this point (click “sources cited” for details if interested):

              1. Thea, you see, I am very “allergic” to people who are “mono”. I mean, who ar4e specialists in only the right toe of the left foot or who love only one type of music or who talk only about one subject and those who are vegetarian or only meat-eaters or only fish-eaters, or only speak one language, etc etc.

                A human being must try to develop their full potentiality and nobody will convince me that eating only meat is the best or eating only vegetables is the best and they usually try to support their arguments from their own yard. Try to see why being a vegetarian is wrong. There is plenty of material (not only in English) instead of convincing yourself of your being right using arguments taken from your like-minded people.

                I have forgotten before to add that my example of eating eggs is not the only one. There are far more omnivore people than vegetarians or vegans, although it is not a scientific argument to prove you wrong. Besides I am far away to convince anybody.

                For vegetarians cholesterol was a red rag to a bull and therefore they turned vegetarian (others did it for other reasons, for instance animal-lovers), but the whole problem with cholesterol is a hoax.

                Your argument that the body produces sufficient cholesterol is taken from the air. The same we may say that the body produces enough vitamin C (it does not produce any) or that it produces enough CoQ10 or enough hormones.

                As we know nothing is static and with age there are changes in the level of hormones, etc, etc. So why are you sure that our bodies produce sufficient amount of cholesterol in this case? Perhaps it doesn’t.

                Last but not least I think our life is too short so that we should try (at least this is my philosophy of life) and find plenitude in every aspect of our lives to enrich our experience in order to live fully. Why should I limit myself to eating only plants? Is it healthy. You say so and your sympathizers, because there is no strong scientific argument that this is true. There is no agreement among doctors and researchers on the issue. Fortunately there is still food for us on our planet. We must use it sparingly but taking advantage of everything.

                How can I “go into nothingness” without drinking different kinds of alcohol, without experiencing hunger or unhappiness? Without experiencing love and happiness? Without eating meat, poultry, fish and eggs, vegetables and fruits?

              1. Great , Toxins. my advice is you should strive to lower your cholesterol below 10 and you will lead perfectly healthy life. Be happy.

                1. My point being the “cholesterol is necessary” argument for eating cholesterol is faulty on many levels. I would encourage you to watch the plant positive video I linked if you are truly interested in the evidence.

                  1. As in my comparison somewhere here, motor vehicles are necessary, but scrap them leaving only 100 in the entire US and so many lives will be spared every year.

        3. RicardoRichard: re: “Please tell me why the French have on average 250 cholesterol level?”
          I don’t know what the average French cholesterol level is, but I’m willing to accept your number for the moment for the sake of argument. I am aware that the French (as least historically and maybe still today) have lower CVD than say Americans. So, let’s say this is the “French Paradox”: ie, that their cholesterol levels are pretty darn high, but that they have relatively low rates of CVD. So, I think you are asking: How do we explain this apparent “paradox”?

          For this, I would refer you to the “Asian Paradox”: On one hand, we have a bazillion and one studies showing that smoking causes or greatly increases our risk of cancer. On the other hand, we have some Asian countries who smoke way more than America does, and yet has way less lung cancer. How do we explain that? Does that mean that smoking doesn’t really cause cancer? No, smoking really is bad for us. Smoking really does greatly increase our risk of getting cancer. What the data means, is that there is another factor at play in the Asian countries. As we have seen on NutritionFacts, we are starting to learn what that confounding factor is – by eating a mostly whole food plant based diet, people can do a lot to lower their risk of various cancers, even when they smoke. We do not know the answer to the paradox for sure, but we definitely have enough information about smoking to know that smoking is indeed bad for us, regardless of what happens in some Asian countries.

          The French Paradox is likely the same situation, with a third factor mitigating their risk. Why would I believe that the French Paradox is anything like the Asian Paradox? Because like the issue of smoking, we have a bazillion and one studies showing that high cholesterol is a big risk factor for heart disease.

          Something to think about.

          1. You try hard enough to always slant your explanation to a plant based diet. Now I have caught you or rather you have led yourself to the dead-end street. Whereas you were lucky to explain the Asian Paradox with the plant based diet, you are not so lucky to account for the French Paradox by using the same method. This time you did not dare to use the same argument… because it was too risky.

            Frankly speaking are you really convinced that a plant based diet slows down or reduces substantially harmful effects of smoking? If so should take worries off the minds of the smokers in the Western World as long as they follow a healthy (in your understanding) diet. Logically thinking it is good idea, isn’t it?

            As far as I am concerned I think that there are other factors (not necessarily a plant-based die)t that will account for that Asian paradox. But one thing is certain – in case of the French as it was not convenient for you, you prefered to abstain from mentioning resveratrol, a phytonutrient found in red wine that is THE “culprit”. Obviously you couldn’t mention it, because wine is terribly destructive or even poison according to your way of thinking.

            1. RicardoRichard: There is no great problem here. I didn’t speculate because I have no evidence on the confounding factors behind the French Paradox. Very simple. I stick to the evidence as best I can. I’m sorry you don’t understand the point I was making.

              1. Thea, I did understand, I am afraid. Do you call evidence, your explanation of the Asian paradox? We may call it only a hypothesis not the evidence. You couldn’t find that evidence in case of the French, because you can’t account for it using vegetarianism or veganism.

                1. RicardoRichard: To clarify: 1) no I did not attempt to explain the Asian paradox with strong evidence. What I said is that we are *starting* to understand the why (with some good evidence). What I didn’t say explicitly, but will now is: the “why” is irrelevant. I didn’t have to mention the potential “why”, except that it is so interesting. The main *point* was: “What the data means, is that there is another factor at play in the Asian countries.” That’s the point. Even if we don’t know the details, we do know that smoking is bad for us. Do you really want to argue this point?

                  2) re: “You couldn’t find…” Again, you mistake my meaning. I haven’t even looked for evidence regarding the case of the French Paradox. I just don’t care. Because what we know is that there *are* one or more confounding factors regarding the French for the reasons I explained above. In other words, just because the French may have higher cholesterol and lower heart attacks does not mean that the French situation wipes out all of the extremely strong science we have linking high cholesterol to heart disease. Just like the existence of cancer free, smoking Asians do not wipe out all of the very strong evidence that we have linking smoking to cancer. *That’s* the point. That is the answer to what I had believed was an honest question about the French.

                  1. ad 1 No, I don’t think that smoking is a good and healthy thing. I simply tried to show you how funny your argumentation was.

                    ad 2 You didn’t even try to look for the evidence because it would sound really funny to use the same kind of arguments. It looks
                    that you cannot see the world around outside the vegetarian/vegan diet, which is a “mono” attitude (I explained that before). The world is wider than healthy nutrition.

                    Cholesterol accumulating in the arteries is a consequence of the inflammation – without cholesterol the the sore spot of the damaged endothelium cannot be properly covered and protected. Total cholesterol is meaningless. There could have some meaningful indications of the problem if you use a spectracell test, because the so-called LDL is not a devil as it is painted.One should devide LDL into small and dense particles. – the latter are really dangerous because they are highly inflammatory. Please read more if you can take the information outside your health encyclopedia.

                    It is the same as saying that motor vehicles are to be blame for all road accidents. Scrap the vehicles or leave only 100 in the entire US and the problem will be solved. And you have solved your problem with cholesterol by lowering it to 150.

            2. re: “…wine is terribly destructive or even poison according to your way of thinking.” I don’t know why you think that. I don’t remember every saying any such thing. I certainly don’t think it. Do you have me confused with another poster? Or are you making assumptions?

              1. Sinply because wine is not in the prescription at, your health-nutrition encyclopedia. I was disappointed not to see your reply to my argument on the French paradox, which in point of fact is no paradox at all.

        4. RicardoRichard: re: “That “eggs-eater” should have been dead long ago if cholesterol were not a myth.”

          This is a strawman argument. The issue under discussion is risks/probabilities. Not guarantees. In other words: No one says that high cholesterol *will* give you a heart attack. It just raises your risk dramatically. Similarly, no one says that smoking *will* give you cancer. It just raises the risk dramatically.

          Everyone has heard about this or that 100 year old who smokes a pack a day every day for the last 80 years and never got cancer. So, when you smoke, you takes your changes. Who knows, you may be that lucky one. Similarly, there are people who eat 3 eggs a day every day for 80 years and low and behold, no heart attacks, no diabetes, etc. That’s great for them. But the majority of people were not so lucky… That’s the point.

          re: “I should have been dead as well.” I’m glad you are still alive to have this conversation. :-) Lucky person! With all my best wishes, I hope your luck continues.

          1. Thea, thank you for wishing me well. I am not a doctor but I have been reading a lot what clinical practice of cardiologists says and especially those who link their research with their practice and I am only repeating their argument. But those who have closed mind don’t want to hear that. That’s the point. Even a probability does not enter into play, because the root problem is not cholesterol but inflammation and cholesterol only helps to patch up the hurt part of the endothelium.
            All the best to yuou as well.

      1. Oh yah! I forgot about that one. There is just so much great info on this site, I can’t keep it all in my head. Thanks for that link. If nothing else, I appreciate it. :-)

    2. I just wanted to correct the claim that Dr. Greger is not familiar with the Mediterranean diet and inflammation factors and their effects on heart attack risk. Witness this video from 2003 or so that I think predates the Nutrition Facts website.

      Note that Greger is actually a proponent of the idea that inflammation can be harmful as you can see from a variety of videos on this site, and his quote in the video above concerning the “recommended diet” vs the Mediterranean diet in the post heart attack study is interesting.

      1. Hello, sf-jeff. What I meant was Dr Greger’s comments on the latest study done in Spain in 2012 I believe.

        Thanks for the video. Somehow it had passed me by. I like all his videos, his excellent research and his lively way of presentation except that he is prejudiced against everything which is not vegan/vegetarian (talking about nutrition). He never said a pleasant word in relation to meat-eaters and even fish-eaters. They are a total disaster. He uses their achievements to correct vegan/vegetarian diet. This is not an honest and detached attitude required of a researcher.

        As for inflammation, he is not consequent. Saturated fats are not inflammatory. They do not go rancid even in room temperature. (it does not mean we must stuff our face with it, bnut consuming from time to time will not send you to an early grave). Dr Sinatra and the growing numbers of doctors do not reject meat. And the Mediterranean diet is ALSO MEAT (not only fish and vegetables and olive oil) Although the video you advised me to watch is from 2003 but Dr Greger remains unyielding today. Still the same blames on cholesterl, etc. See some Dr Sinatra’s videos on the topic.

        It is true that milk does not contain proper calcium for humans, but look, for the last 300? 400? years babies have been fed on milk. Only for the last 50 yeasrs when pasteurization became a common practice – milk has lost its qualities. And it is not a scientific argument used not only by Dr Greger, namely that it is a strange case that only humans drink other animal’s milk. (It is not true, because cats and dogs drink also cow’s milk, not to mention pigs).
        What’s wrong in drinking goat’s milk? Now returning to raw milk will probably put a human evolution back on the right track.

        Take the example of the French and Swiss concerning cheese. They should be dropping dead like flies because of high cholesterol and saturated fat.

        Concerning other things, most probably already updated by Dr Greger, canola is a hydrogenated rape seed oil, which means it is an artificial trans fat – according to Dr Ribeiro. Besides 400 iu of vitamin D should be updated to 4 or 5 thousand. Meat-eaters don’t have to worry about B12 supplements because of homocysteine levels. I was surprised that he did not mention magnesium or CoQ10 even in 2003.

        1. I will probably refrain from commenting on the nutritional items you bring up, but I will say that it looks like we have quite a different view on evolution.

          Some people think of evolution as a ladder, with humans at the top of the ladder. I prefer to think of evolution as a Bush, with species only become more extreme in one access because of greater variability and random chance. The most successful organism on the planet by far is undoubtedly either the Bacteria or Viruses. They will be around long after humans are gone. We are enormously inefficient by comparison, with just a small fraction of our energies going into creating the next generation.

          Based on this worldview I don’t really see any meaning in the following:

          “Now returning to raw milk will probably put a human evolution back on the right track.”

          1. Please read my word “evolution” as development. What I meant was that if we started to drink cow’s milk some 300? or 200? years ago, we must have accepted this development and adapted it into our evolution in a micro-scale. Pasteurization upset our apple-cart for some 50 years roughly speaking (problems with allergies, etc) and those serious tendencies towards drinking raw milk, I called them putting a human development back on the right track, ie to resume what had been stopped. I still remember there was fresh milk widely available in Europe in the 1970s and 1980s. If you left it outside a fridge, it would get sour in 48 hours in the room temperature. Now it is milk + chemicals which don’t allow the milk to get sour And this must be the cause of allergies to milk and to dairy products.

            Personally I have never been fond of milk or cheese, so I am not defending my preferences. But I see what happens around me. Could you imagine babies not drinking cow’s milk in post-industrial countries even this milk full of chemicals?

            If you are more into Evolution, please don’t tell me that human being never ate meat and meat consumption is the invention of the consumer society. As far as I know, man never stopped consuming meat from other animals. And if that has any pejorative connotations (by analogy to millk consumption), perhaps we should call for cannibalism – it will be healthier… Do you really think that man started off with a plant diet? So I don’t understand where the problem lies. According to Dr Brian Clement cancer and CVD were little known 120 years ago. And suddenly these diseases fell on us because of meat and cholesterol? Concerning simple carbs, yes, I do agree – they contributed tremendously.Suddenly meat and poultry and eggs are the culprit of our bad nutrition?

            1. Evolution only gets one vote on your entire genotype per generation. This means “bad” genes can stick around for thousands of generations. Think of the problem we have in the voting box where we choose between 1 democrat and 1 republican times a thousand. Evolution can’t solve lactose intolerance in a thousand years any more than we can change page 47 of the Trans Pacific Partnership treaty in the voting booth. Many of our genes are here not because they in any way help us in modern times, but rather because they helped us (well, some of us) survive the last ice age.

              I honestly don’t know whether meat eating was healthy 10,000 years ago, but it’s kind of an exaggeration to say that eating chicken, pig, or cow today is the same as eating meat 10000 years ago. Here are a couple links:



              1. If lactose intolerance is innate so far as human beings are concerned, I am not human. Besides, I know a person who is now in her mid-50s and she drinks 1l of milk every day. And she has been doing that all her life and has been healthy all the time. Her first visit to a dentist happened when she was… in her mid-30s!!! Probably she is not human either… Moreover – my kids drank more or less the same amount each until they were in their late teens without any major or minor health issues, because of my stupidity – I simply did not know about a serious problem of lactose intolerance. I did not hear of sth like that in my surrounding. Today I would not let them do it if they had been born again.

                I don’t argue your theoretical knowledge of evolution you have brought forward. But what are the practical results? Take the Meditarreanean diet. Problems start when you overeat stuffing yourself with meat every day. But if you eat two or three meat meals a week (with lots of vegetables and flushing it with a glass or two of red wine, nothing will happen. What is wrong is that in Spain/Portugal they have such a meal sometimes at 11 pm or at midnight – they usually don’t have breakfast except for an expresso.. No wonder they still feel full when they wake up next day. And cvd and obesity is on the rise there as well but that is due to the abuse of meat and they love over-eating.

                1. “If lactose intolerance is innate so far as human beings are concerned, I am not human.”

                  What point are you trying to make? I was making the point that evolution doesn’t have precise control over genotypes. A lot of what we have today is just dumb luck. You sound as if I am attacking your diet with the above comments when I was doing no such thing.

                  “Take the Meditarreanean diet. Problems start when you overeat stuffing yourself with meat every day. But if you eat two or three meat meals a week (with lots of vegetables and flushing it with a glass or two of red wine, nothing will happen.”

                  I don’t see a problem with that. If you look at the links I provided above, chicken has far more fat and salt in it today than it did 100 years ago, and can potentially have higher fat levels than Ice Cream (although I really should second source that claim), but if you eat a healthy diet, then small amounts of things that are “bad for you” can be good for you because of the variety and balance that they add.

                  1. Precicely – “variety and balance” your golden words. At last we are at one! I even have a hamburger once a year. And I love it! I did not think you were attacking me. Why should I? By the way, what is a healthy diet? In Dr Greger’s opinion, my diet is NOT healthy.

  10. I do love gogi berries and they would rank high on my daily berry list if not for this one fact: consuming them at the rate I need, is too low an ROI – Return on Investment, due to the high level of mold in retail-purchased gogi berries. I have tried upwards of a dozen sources, from high-end to the top online suppliers, and none are free of visible mold. The only way I can eliminate this high dose of mold from gogi (and other berries, nuts, and some whole roots and mushrooms) so that I can use it in a medicine drink for example, is to put every gogi berry through my boiling water flash bath, friction, and wipe-down. This is why I am not able to utilize gogi along with the other dozen or so berries I use every day for my medicine drink made in blender with hemp or almond milk. The next time you see gogi berries in the bin at your local bulk supply store, you might want to examine them very closely. And if you switch to online suppliers for your gogi, and find one that does not pass off highly moldy gogi, please let us know! It appears that gogi is another of the Must Have medicine foods we might have to put into the Grow Your Own category!

  11. Tried 2 different brands of goji berries, but cannot digest them (gas, stomach discomfort).
    Read a great many people have the same issue with goji berries. Any way around this?

    1. I’ve never heard of that issue. I guess the best way to avoid any discomfort is to not eat them. Plenty of other foods that contain eye-protecting nutrients.

  12. I am desperate for advice I am 72 years old. Very active walking, Sailing, Gardening . I have been a vegan for 2 years during which time I have lost a small amount of weight. I am 5ft 1.5 inches tall and weigh 7 st 7 ozs. My blood pressure has decreased significantly although at present I am still taking 5mg amlodipine daily .I recently went to the optician and was told ,to my horror ,that I have macular degeneration. This was not mentioned 2 years ago at my last test. Can sun and glare cause this? What is happening ? I must be overflowing with antioxidants.

  13. I have early dry macular degeneration. I have been WFPB no added oil for 2.5 years. I eat greens 3 times a day, and orange pepper daily. My retinal ophthalmologist strongly suggests I take AREDS2 supplements. The formula is Vitamn C 500mg, vitamin E 400IU, Zinc 25-80 mg as zinc oxide, 2 mg copper as cupric oxide, Lutein 10 mg and Zeaxanthin 2mg. I acquiesced to purchasing them. I told the doctor that vitamin pills are not as effective as well balanced WFPB diet. He disagreed and said I was not getting the full range of AREDS2 formula on my WFPB diet. Is there an alternative to the AREDS2 formula in WFPB foods. It is likely I am getting sufficient Lutein and Zeazanthin from greens and orange peoppers but perhaps I am not getting sufficient Vitamin C and E , Zinc, Copper. I eat a lot of berries. Is there a recommended list of foods to ensure all these vitamins are taken in sufficient amounts?

  14. The recommended list you are searching is here’
    I am glad that you are working with your doctor and monitoring the macular degeneration closely. While you are eating admirably to obtain the nutrients you need it’s clear your opthamologist and you disagree on if WFPB diet is sufficient. You can certainly continue with your diet and for your eye and all other body organs, I hope you do but you may determine either to seek medical advice on the need for those supplements with other specialists (many opthamologist do recommend the AREDS) .or take the AREDS while continuing your WFPB approach then requesting close monitoring and perhaps going off AREDS down the road in an experiment to see if the dietary approach alone might work.

  15. Thank you for the welcome info. I use gogi berry juice as well as Gogi berries. Both are widely available at my local independent health store. I am glad to hear of corn and spinach being useful. My husband loves corn and I rotate my greens to include spinach along with kale, arugula. Eating the rainbow is always good advice.

  16. Hi NutritionFacts,

    I was hoping you could shed some light on a couple more foods for Macular Degeneration – bilberries & Ginkgo biloba.

    The former seems to crop up a lot in eye supplements and i found this study showing how bilberry helps to prevent AMD & cataracts in rats – (I know it’s not people but it’s a start) Should i be eating bilberries and do you have any more info regarding them?

    That’s not my real concern though as helpful or not, there’s no negative side-effects from eating bilberries, so regardless of if helps or not, it at least won’t hurt me.

    The second is my real question – Ginkgo biloba. I’ve found another study suggesting it could help with my condition, but the NHS (i’m in the UK), says that it could increase my stroke risk ( Should i supplement with Ginkgo biloba or is the risk / reward ratio skewed towards an unacceptable level of risk?

    Any help would be appreciated.

  17. Hi, Richard Slater! I agree that bilberry is safe to try, but was surprised to see the article you linked suggesting an increased stroke risk with gingko biloba, as this herb is known for blood thinning properties, and has been traditionally used to prevent or treat stroke. I have seen warnings regarding increased bleeding risk with gingko biloba. Gingko biloba has not been covered here on NutritionFacts. Due to possible risks associated with its use, you should consult your doctor before taking it. This study found, “The question as to whether people with AMD should take Ginkgo biloba extract to prevent progression of the disease has not been answered by research to date.”
    Both AMD and cataracts are related to free radical formation, and a healthy, plant-based diet as modeled by the Daily Dozen is antioxidant-rich.
    Meanwhile, you can find everything on this site related to AMD here: I hope that helps!

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