Low Carb Diets and Coronary Blood Flow

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Low Carb Diets Found to Feed Heart Disease

People going on low carb diets may not see a rise in their cholesterol levels. How is that possible? Because weight loss by any means can drop our cholesterol. We could go on an all-Twinkie diet and lower our cholesterol as long as we didn’t eat too many. A good cocaine habit could do it. Anything that drops our weight can drop our cholesterol, but the goal isn’t to fit into a skinnier casket; the reason we care about cardiovascular risk factors like cholesterol is because we care about cardiovascular risk, the health of our arteries.

Now we have studies that measure the impact of low carb diets on arteries directly, and a review of all the best studies to date found that low-carb diets impair arterial function, as evidenced by a decrease in flow-mediated dilation, meaning low-carb diets effectively stiffen people’s arteries. And since that meta-analysis was published, a new study found the same thing: “A dietary pattern characterized by high protein and fat, but low carbohydrate was associated with poorer peripheral small artery function,” again measuring blood flow into people’s limbs. But peripheral circulation is not as important as the circulation in the coronary arteries that feed our heart.

There has only been one study ever done measuring actual blood flow to the heart muscles of people eating low-carb diets. Dr. Richard Fleming, an accomplished nuclear cardiologist, enrolled 26 people into a comprehensive study of the effects of diet on cardiac function using the latest in nuclear imaging technology–so-called SPECT scans, enabling him to actually directly measure the blood flow within the coronary arteries.

He then put them all on a healthy vegetarian diet, and a year later the scans were repeated. By that time, however, ten of the patients had jumped ship onto the low carb bandwagon. At first I bet he was disappointed, but surely soon realized he had an unparalleled research opportunity dropped into his lap. Here he had extensive imaging of ten people before and after following a low carb diet and 16 following a high carb diet. What would their hearts look like at the end of the year? We can talk about risk factors all we want, but compared to the veg group, did the coronary heart disease of the patients following the Atkins-like diets improve, worsen, or stay the same?

Those sticking to the vegetarian diet showed a reversal of their heart disease as expected. Their partially clogged arteries literally got cleaned out. They had 20% less atherosclerotic plaque in their arteries at the end of the year than at the beginning. What happened to those who abandoned the treatment diet, and switched over to the low-carb diet? Their condition significantly worsened. 40% to 50% more artery clogging at the end of the year.  In heart scans of the patients, as seen in my video, Low Carb Diets and Coronary Blood Flow, the yellow and particularly red areas represent blood flow through the coronary arteries to the heart muscle. The scan of one of the patients who went on a plant-based diet, shows how their arteries opened right up increasing the blood flow. Another person, however, started out with good flow, but after a year on a low-carb diet, they significantly clogged down their arterial blood flow.

So this is the best science we have, demonstrating the threat of low-carb diets, not just measuring risk factors, but actual blood flow in people’s hearts on different diets. Of course the reason we care about cardiac blood flow, is we don’t want to die. Another meta-analysis was recently published that finally went ahead and measured the ultimate end-point, death, and low-carb diets were associated with a significantly higher risk of all-cause mortality, meaning living a significantly shorter lifespan.

The reason I have so few videos about low-carb diets is that I already wrote a book about it. Carbophobia is now available free online full-text at AtkinsFacts.org. Atkins’ lawyers threatened to sue, leading to a heated exchange you’re sure to enjoy that I reprint in the book. I did touch on it Atkins Diet: Trouble Keeping it Up, though low carb diets don’t necessarily have to be that unhealthy (see my video Plant-Based Atkins Diet).

Here are some videos I’ve done on conquering our #1 killer:

-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.

213 responses to “Low Carb Diets Found to Feed Heart Disease

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    1. I second that Aneta. This has to be the most revolutionary site on health ever created!! It is my #1 go-to source… my Health Bible! I refer videos to friends and acquaintances with tumors and cancer. Humanity deserves this knowledge. .. After that it’s up to each individual whether they will follow it or not!!!

      1. It’s been stated lower down but worth nothing here that on the 26-participant study, the 10 who went to low-carb diets did not adhere to those diets. Further, those diets were not all the same low-carb diet. The study notes that those participants repeatedly regressed to their original eating habits.

        So it would be improper to conclude that the low-carb diets caused decreased blood flow, because no one actually committed to a low-carb diet.

        Here is a link to the full text of the study for anyone who wants to decide for themselves.

        1. Greger cherry picked data? Big surprise! lol like every single blog post and YouTube he has EVER done. Greger is a joke and will always be a joke.

          He often misquotes studies that litterally show the exact opposite of what he states.

          It’s pathetic and his vegan agenda just keeps going and going…

          1. Bring on the bacon, baby! My ketogenic diet is what took my weight off and reversed my pre-diabetes and high blood pressure. With all these self-proclaimed diet doctors and gurus in a constant tug of war over which is healthier-a plant based or animal based diet— it’s no wonder Americans are confused, frustrated, and getting fatter and sicker every year.

            If you wish to believe that the world is flat, I’m sure you can find some nut job on the Internet who will assure you that you are correct and the rest of the world is wrong.

            1. I also tried the ketogenic diet. I have varicose veins and when I was on the ketogenic diet it caused my veins to itch and bleed. Then when I went back on Whole Food plant-based the problem resolved. I think it’s because my blood went fatty. I don’t doubt that you know is good for weight loss but I don’t think it’s a good long-term solution. I worked at a pizza place for many years and it caused me to be very dysfunctional if you know what I mean. Plant-based really does help reverse that but keto does not.

                1. I was just about to make that point when I saw your comment. I’m sure he’ll eventually do a video on how vegan keto is miraculous compared to regular keto.

        2. The article confused me.

          A study of people who were on a vegetarian diet … people bailed and went to low carb …

          Can’t I be low carb AND vegetarian. I’m really looking for data that tells us what the impacts of eating a ton of sugar is. THAT really seems to be the data that the heart health industry seems to try to mislead us on.

        3. Totally AGREE … also it is important to note the kinds of fats taken in while on a low carb or even a keto diet…. the right kinds of fats are very very important….. this article is BS…..been on keto for over 9 months and my labs have improved dramatically as well as my weight is down over 46lbs and my blood pressure is no longer a problem!

          1. The studies clearly show that people on an animal based keto diet are at higher risk of premature death. No point in winning the lab numbers game if we’re dead. Also, the animal based keto diet is not sustainable, so as soon as anyone goes off it, they gain all their weight back.

            Dr. Ben

            1. The meta analysis on Low carb is centred on low carb HIGH PROTEIN not low carb HIGH FAT so its a little unfair to cite and tarnish all these approaches with one brush. Do you have links to studies on LCHF and LCHF plant based

              1. Dr G has reviewed these at least one vid that I don’t have handy at the moment (1AM here in Hawaii).
                Keep in mind that all free fat, especially animal fat, universally destroys Flow Mediate Dilation which has an extreme correlation with cardiovascular events.
                Please also keep in mind this isn’t about being fair or keeping score or a debating to see who wins. This is your life we’re talking about. Hoping that carbs is what triggers fat to decrease Flow Mediated Dilation to the point that eating high fat low carb is assumed to be protective has never been shown to be true as far as I’ve seen, so you’re taking an extreme risk that ties in with increased mortality seen on animal based low carb diets (again, as reviewed by Dr. G). If I’m wrong, oh well, you’re alive and missed out on a fatty meal. If I’m right….well, I think you get the picture. I keep being reminded of Pascal’s Wager.

                Dr. Ben



                1. I am afraid you have mis read my post. I am talking about high fat lowish protein especially low or no animal products with the exception of fish which universally improves mortality. I am talking plant based mainly with fats like nuts, avocados etc I am not talking Atkins here

                  It seems to me that the best approach given all evidence is to eat fish, mainly plant based and low or zero simple carbs with lots of healthy fats

                  1. Fish decreases mortality as compared to SAD, but compared to plant based?
                    I haven’t seen any data on this. I personally think of fish as a weekend “cheat” when I have some sushi, but the rest of the time I eat plant based.
                    As Dr. G points out, fish is quite laden with toxins and cholesterol so in the absence of definitive data comparing unprocessed plant based to the same diet including fish? I’d like to know. The data is very clear on the hazards of dietary cholesterol and Dr. G has highlighted the very high rates of T2 diabetes in fish eater. Dr. G has also pointed out the research that “Eco Atkins” (plant based high fat low carb) decreases mortality as well. The highest rates of longevity are seen in unprocessed plant eaters though which is low fat high carb.

                    Dr. Ben



                    1. Many studies show that, but vegetarians eat dairy and eggs which is nothing but toxic waste, and vegans often eat nothing but processed carbohydrates and fats like cookies, potato chips and french fries (obviously not good).
                      Those that clearly eat unprocessed plants, like the pre 1960 Okinawans and Tarahumaras, are consistently the longest lived.



                    2. There is nothing to suggest that the Pescitarians were not eating their own fair share of junk along with the pure vegitarians and vegans in the study.
                      It is at times like this that I feel that the site is really Veganfacts.org rather than Nutritionfacts

    2. The present cross-sectional study included 247 patients. Diet was evaluated by a 3-d food-intake register and reduced to a novel low-carbohydrate diet score (LCDS), this is what the meta-analysis study reads. This is important to understand. You see that Low-Carbohydrate Diet SCORE, that means that when they fill out a questionnaire of what they’re diet persist of, they are scored on the percentage of calories coming from fat and protein, versus carbohydrates, and those with 60 to 70% of calories coming from Fat and Protein and placed in the category of low-carbohydrates. My father would’ve fallen into that category with a diet that persisted of Fish, mussels, shrimp (cooked and dipped in butter), steak, pork chops, ham and chicken, with skin, and this equaled about 70% of his calories, the rest of his calories came from juice, beer, cakes, and other low fat foods (the occasional vegetable here or there). He had high blood pressure, high cholesterol, diabetes, and cancer. We put him on a Plant Based diet for 4 months until he had an adverse reaction to the chemo which seemingly caused the cancer to grow. He didn’t get off blood pressure, high cholesterol or diabetes medication in those 4 months, and he hated the diet every day. Then We put him on a low carb diet, where we avoided all his refined carbs and yeast beverages, and where the Doctors said he had a couple months left to live, he lived for 2 1/2 years, in the first 3 months, every medication was cut in half, six months before he died, he was off all his medications for the first time since he was 30 years old. When his cancer was treated with a steroidal treatment, he suddenly had carb cravings unlike anything my mother or I had ever witnessed and in 6 months of reintroducing easily digestible carbs like pancakes, toast, pastries, beer and juice back into his diet he was dead from the cancer. He died healthier (but for the cancer) than he was since he was 30. So excuse me if I don’t look at your studies a bit critically and examine them for what they’re really saying.

      You cannot equate people that are eating a high fat diet, because Meat and Potatoes will kill you and make you fat, a trip to Mcdonalds every day where you get a burger and fries will make you fat, drinking juices and other refined carbohydrates will make you fat while you’re eating a high caloric diet of fatty foods, and it will clog your arteries.

      A High Protein diet is not a high fat diet and so I’m curious why he put his focus on that. Too much protein will cause your insulin levels to rise to certain levels (less than carbohydrates) but rise none the less. Most low carb diets promote 60 to 70% of calories coming from fat and 20 to 30% of calories coming from protein, and 10% of calories coming from carbs. There is no way to mistake this for a high protein diet, since, this is the standard proportion of the USDA amount of protein. So, I’m already suspect on what their eating plan was that he referred to their diet as High Protein, rather than High Fat, and what percentage of calories came from protein vs. fat. The fact is that this study is already questionable and is probably why most people don’t use it in their arguments unless they have a solely negative stance.

      Sorry, your studies are misconstruing the actual promoted plan by using what usually falls in some standard American diet. I’m on a diet of about 70% carbohydrates (based solely on vegetables, carrots, spinach, broccoli and Cauliflower) and 15% fat and 15% protein. I’m not a proponent of low carb diets, but I’m an attacker of bad science, bad thinking, and bad information.

  1. I’m curious if there are any studies comparing vegetarian/ vegan diets to low carb/normal protein/high fat, as this is the diet currently touted by the Paleo crowd. It seems that the high fat diets in the study were Atkins diets, high in both animal protein and fat. What about moderate animal protein/high fat?

    1. No no no, Paleo does not mean “high fat”. Paleo and Atkins, or at least the old Atkins, are not the same at all. Most Plaeo advocates define their diet as high in low starch veggies, small amount of low fat protein, small “healthy” fats (avocado, olive oil, monounsaturated fats) some seeds & nuts, no processed foods, no added sugars, legumes or processed wheat, and a small amount of fruit.

      1. Sounds pretty healthy, but why would a Paleo diet have extracted oils? I was at Whole Foods the other day and saw the ingredient list for a Paleo item and it also had olive oil.

        1. Well, I guess there are no hard & stringent rules to what “Paleo” actually is. But you’re correct, any extracted oil shouldn’t be Paleo, nor should any processed foods/meats such as bacon, jerky, etc., but some say it is. The term Paleo used by many to define a diet is pretty much a misnomer, and admittingly, I’m not an expert.

    2. Dr. David Jenkins helped invent the glycemic index. He developed a portfolio diet for lowering cholesterol. One study he was part of looked at the difference between a vegan and omnivorous low-carb diet, as seen in this video. I do not necessarily recommend it because I have seen excellent clinical results from a strict plant based diet higher in carbohydrates and lower in fat, but still this ‘eco-atkins’ type of diet shows that perhaps animal fat is very different from plant fat.

    3. There is – sort of.


      While not a true veg diet, it was close in that is was a low fat calorie restricted with fat being only 30% of calories and saturated fat 10%. That arm of the trial had women and men eating 1500 or 1800 calories, respectively. So that means for a man only 180 calories would come from sat fat which would be only 20 grams. So that would have precluded eating very much meat or dairy. the other arms were the Mediterranean and low carb diets.

      In all measures the low carb beat the mediterrranean which beat the low fat.

      There are other studies as well but not as rigourous, but pretty much every diet tested against a low fat diet wins.

      The best part of this study is that food was provided to the participants at noon (the main meal of the day in Isreal), it lasted 2 years and there was a very high complaince rate (95 % year 1 and 84% year 2).

      BTW, low carb diets, such as Atkins, are not high protein.The are high fat (60-80%) with very low carb and modearte protein.

      The paleo diet that was origianlly developed to mimic what our ancestors ate for millions of years has sort of morphed into a low fat no wheat or sugar type of diet.

      They tend to be higher in protein with the suggestion being to eat only lean meats, I suspect because of the lingering fear of fat. So the claim that his diet is what out ancestors ate for million of years calearly is not correct. For as we know from indigenous peoples such as the Inuit and others, who routinley eat meat that had the most fat first and then the rest and then feed to leanest meats to the dogs. Also if we look at all carnivorous animals, we find that after the kill the first thing they go for are the viscera often leaving the the muscular parts to the vultures.

      Also with the current paleo idea as to what we ate, it’s hard to imagine how our ancestors survived on tubers and plants, etc for example in the norther hemispher fot the 6 months or so when you couldn’t grow anything. And as for olive oil and other oils, they are realtively recent inclusions to our diet. For example, read about the myth of olive oil having been consume for centuries.

  2. Dr. Greger, I’d be thrilled to see some data and suggestions on increasing blood flow to the brain for those who have had TBI/concussions, especially for young adults with history of concussions from sports. Apparently the increased blood flow to brain helps damaged brain tissue heal. Sure, one could cut back on fat and add berries. But your data is fun!

  3. Does low carb necessarily mean high meat-based protein and high fat? What I’m asking is what did these people on the low carb diet actually eat? If they ate veggies and fruits instead of starches, then this study would be astonishing. But if they ate lots of meat-based protein and fat, then this study doesn’t tell us anything new at all.

    1. Good points. It is hard to say what the low-carb diet consisted of. I’ll look deeper into this. You can too by checking out the actual study. Dr. mentions how the diet was supposed to be a healthy vegetarian diet, but then 10 folks went on a low-carb diet. From the methods: “Each patient was advised to consume a diet consisting of 10 kCal/pound/day. On the basis of
      caloric calculations, patients were instructed to consume 15% of their daily calories in protein, 70% in carbohydrate (principally complex carbohydrates), and 15% in fat with a 2:1 ratio of nonsaturated (polyunsaturated, monosaturated) to saturated fat intake. For example, a 170-pound person would be instructed to eat 1,700 calories per day, including 255 calories from protein (64 grams), 1,190 calories from carbohydrates (297 grams) from a variety of (mostly complex) carbohydrates, and 255 calories fat (28 grams), of which no more than 9 grams could be saturated.” At any rate, this dietary pattern seemed to trump the low-carb diet.

      1. “It is hard to say what the low-carb diet consisted of.”
        Yet earlier it was stated, “26 people into a comprehensive study.”

        Do you even know the definition of the word “comprehensive”? The study only had 26 people added to the fact that the author and yourself can’t even find out what they specifically ate, yet you two are still endeavoring to draw fallacious conclusions based off of incomplete evidence. You should be ashamed of yourselves, pseudo-intellectual sellouts.

    2. Here’s a link to the new study which found an association between low carb and poorer peripheral small artery function. http://journals.cambridge.org/download.php?file=%2FBJN%2FBJN109_07%2FS0007114512003091a.pdf&code=3b0134193b14a1741e3a1a9fe14560df The study was conducted in Spain, but the study authors noted that “the diet consumed by the present study population was similar to the diet of a corresponding American population with equally high CV risk”. It was based on a 3-day food intake evaluation and reduced to a low-carbohydrate score. Guess they weren’t following the Mediterranean diet, but instead the good’ol American SAD.

      A newer review http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418418/ questioned whether low-carb diets have a favorable or detrimental impact on endothelial function, or is it the quality of the carbs which matters. They commented that high carbohydrate diets which cause hyperglycemia have been demonstrated to worsen the efficacy of the endothelial system and are associated with an increased CVD risk. A limitation to the studies analyzing low carb diets is that the carbs must be replaced by fats and protein, and it can be “challenging to differentiate the effect of carbohydrate restriction from the effects due to alterations in other macronutrients”. They observed that low-carb diets are associated with decreased intake of fiber, fruit or root vegetables, and increased consumption of meat and dairy, which may contribute to the adverse vascular outcomes. This review concluded that emphasizing the quality and GI index of foods may be a more promising approach to preserving vascular function than low-carb.

      However, the Eco-Atkins diet, which is low-carb vegan, has been shown to be associated with lower all-cause and cardiovascular disease mortality rates. David Jenkins published this study http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418418/ which used nuts as a replacement for carbs. The full-nut dose of 73 g/day (2.6 oz) reduced A1c, LDL, and ApoB with good compliance among the participants with the diet. This is the diet I follow which has helped me drop my A1c to 5.0, total cholesterol to 145, LDL particles down to 668, inflammation markers low, and BMI fine. I think my success with this low-carb plan is from using high quality, whole plant foods and low GI carbs.

  4. What about those of us vegans who eat a lot of nuts, avocados, seeds, and tofu, but virtually no carbs and zero animal products? My diet is about 40% fat, but only the veggie kind. So far, no heart or vascular disease, low homocysteine and CRP. The reason for low-carbs? Unfortunately, I’m pre-diabetic and even whole grains raise my glucose excessively (even though I’m quite thin).

    1. Hey Russell, a high carb plant diet does not cause diabetes, in fact Dr. Neal Barnard’s patients managed to reverse their Type-2 diabetes by eating as much as they cared for of fruits, veggies, grains, legumes etc. Diabetes is a disease of fat toxicity as Dr. Gregor has taught us in previous videos. I would recommend cutting your fat intake WAY down to no more than 10% of your calories. Try to aim for 80-10-10 for optimal health. (carbs-protein-fat). Use Cronometer.com for an excellent look into your diets macro/micro nutrient breakdown. Raw till 4 high-carb, low fat for the win!!

      1. People who do not have this problem are always quick to recommend this sort of thing. I also note that the doctors pushing this approach do not have such problems themselves — if I am wrong here please direct me to one who does. Unfortunately, I also suffer from carb sensitivity due to a medical mistake and the fact is that, like others with blood sugar regulation issues, too many carbs dangerously elevates my post-prandial glucose levels. Intelligent use of supplements, exercise, and a moderately low carb diet have kept me from slipping into any diagnosed disease — in fact, most doctors would now laugh at my concerns based simply on fasting blood sugars — but I work hard. I would love to reduce fat content and eat more carbs but given my observations based upon extensive blood monitoring I do not see how it could possibly work.

        One problem with these studies is the confounding of animal products with “low carb” and, as the doctor points out, at least one study showed that a vegan low carb diet (Eco Atkins) can be healthy (though it was a bit high in processed soy for my taste). And BTW, I do support a vegan diet approach so I am on his side in that respect.

        Finally, while I cannot claim to have read every study on fat metabolism and diabetes, every one I have read involves obese patients. So I always have the question about how this applies to fit folks who otherwise appear to have normal fat metabolism. I am pretty fit and can eat nearly 4,000 calories a day on a lower carb diet without gaining weight at a certain point. That is on a diet of approximately 60% fat.

        1. Steven, thanks for the comments. We have similar issues, and I’m up to 60% plant-based fats on some days as well. Like Steve Bozic above, who clearly means well, there is a lot of ignorance in the community about what thin vegan diabetics or pre-diabetics should do. It’s also frustraging to see so much conflation between low-carb animal diets and low-carb plant-based diets. There are extremely different!! (Yes, have seen Jenkins’ excellent work supporting plant-based fats, and higher fat levels in general).

          For that reason, three of us from Nutrition Facts have taken our conversations off-line and we compare notes and send around interesting studies and articles on a weekly basis. Feel free to join us if you want. I’m at russelllong@me.com. Yes, we are all basically Eco-Atkins.

          I’ve had a few emails with Caroline Trapp who runs the diabetes program for Dr. Neal Barnard, and she finally admitted that there is virtually no data on thin diabetics, and recognizes that it presents a different set of problems since we don’t have insulin resistance and instead appear to have insulin production problems, And you need a lot of insulin to metabolize carbs, whole grain or otherwise. (Not so much for veggie fats or protein.)

          Here’s the question regarding Eco-Atkins: at higher veggie fat intakes, I find my LDL can climb to 138. At the lowest fat intake that I can get to while still keeping A1c under 5.5, I get about 35% of calories from fat and my LDL drops to 95. But wow, at those lower levels, its hard to stay over 140 lbs,, and I’m 5’10”. Finding the middle ground between getting too skinny and having excessive LDL is very challenging.

        2. I am happy to find yours and Russels comments! I thought I was alone in this and maybe having some issue.

          I so agree. So many health professionals tend to universalise their recommendations based solely on observational studies and their own experience, but they forget that there are outliers and individuals with specific issues, needs and treatment. In other words, the treatment that works mostly does not necessarily work for everyone.

          I would love to make HCLF vegan diet, clinically “the optimal diet”, work for me, but I just can’t. Just a little bit of oatmeal or fruit sends my insulin through the roof and my blood sugars crash, I feel tired and crave sweets. I developed anemia, probably due to iron malabsorption. I have very low blood pressure, probably partially due to no salt intake.

          I increased my avocado, nuts and seeds intake, added a bit of salt and eliminated all sweet fruit. Now I finally feel human again! For a first time in a long time, I am able to go without food for more than 3 hours. I have more stable energy and no cravings. I know this is not optimal for health, but I was not able to make anything else work for me.

      2. Steve, not sure if you saw my response below, and I appreciate the comments. I actually do use Cronometer. I briefly got my fat to 10%, while compensating for the lost calories with brown rice, whole oats, etc., but my glucose went crazy and the docs were threatening to put me on insulin. Unfortunately, Greger/Barnard’s approach just doesn’t work for thin people with diabetic-type issues. We’re clearly in the minority though, and heavier people should definitely go with the Greger program.

        Anyway, my A1c is happily under 5.5 now, and the docs are not concerned about my glucose so long as I keep it there.

        1. Well, heavy or thin, it just doesnt work for some. I cannot get weight down while concentrating on carbs. It doesnt matter if its mostly complex..the insulin resistance may play a part.
          contrary to popular belief..we can be very active people, but carbs of any kind wreak havoc

          1. Hey Becky. Have you tried a Raw Till 4pm high fruit diet yet? It will reverse Insulin Resistance. Here’s what I eat in a day – What I eat in a day –
            My smoothie recipe: Approx. 2500cal (gets me to approx 4pm daily). Macronutrient breakdown of roughly 80% Carbs / 10% Protein / 10% Fat. (Which is ideal for optimal health)

            250ml of soy/almond chocolate milk (almost all brands B12 fortified)
            20 Pitted dates
            Handful or two of Spinach (or kale)
            1 teaspoon of “Ceylon” Cinnamon (not the common kind found in most stores)
            1.5 tablespoons of Chia Powder
            1.5 tablespoons of Hemp seeds
            Optional 1 fresh Indian Gooseberry (left in the fridge to soak over night in water)
            1 Apple
            2 Kiwis (if available)
            1 Handful of Dried or fresh cranberries (if available) OR
            1 Handful of dried or fresh Figs (if available)
            1 tablespoon Coconut sugar (optional for taste)
            6-8 Bananas depending on size (super ripe with tons of brown spots if possible)
            Fill blender rest of the way with water

            (I’ll also sometimes sprout Broccoli seeds and throw a handful in)

            Then for dinner it’s a cooked carb rotation between Pasta/Potatoes/Rice/Quinoa with mixed Veggies (mainly Broccoli) and tomato sauce.

            This daily diet when checked on Cronometer.com meets all of the Vitamin/Mineral as well as Fat/Protein/Carb requirements for optimal health.

            1. Wow. No, thats way more than I eat. Any addition of fruit or veg, besides, besides s bit of ight salad fare, seem to count as sugar. Kale (strange) even gave me a couple lbs.
              when I review how those with insulin resistance seem to have all go to fat storage if not used right away, it sees accurate. I am active, eat clean for the most part, and rarely consume over 2000 kcal in a day. The oy way I have evet lost weight was by extreme exercise ( zumba-way fun!) And eliminating most carb.
              Because so many are as confused, as I am, I am now studying nutrition.
              lower carb rates can cause troble with memory and other issues with the brain. When I put more carbs back in my diet (mostly vegetable, but some fruit), I felt more awake, just as the RD tlod me. By no means am I a young pup, so a little brain fog (and with heart and muscle conditions as well…I’m complicated. Im only told to gind a way to lose weight. No direction gor me, except my new RD. I cant imagine all that fruit would help me.
              I do add chia and flax seed, alternating, fish oil and vit D (mine was a little low). Yes, the Ceylon cinnamon is used often, as is garlic and turmeric…yes, right in my greek yogurt! Savory, and quite tasty with some homemade balsamic vinegrette! I eat some berry every day too.
              somehow, my blood sugars have been low, but I still gain. Doesnt help that I needed a steroid treatment to get my legs going last fall.

              1. If your issue is that you have insulin resistance the only real cure is to cut out all animal foods as the saturated fat and cholesterol in them is causing your disease. Yours is a disease of “Fat Toxicity” as Dr. Gregor has done a few videos on in the past few months. Once you cut out all animal foods (meat, dairy and eggs) as well as oils, and other overtly fatty foods and replace them with an abundance of fruits daily then and only then will you cure yourself of the insulin resistance issues you are troubled with. You should use Chronometer.com to make sure you are meeting all of your micronutrient requirements as well. Potassium is the key to weight loss. Not sure if you know this but 98% of Americans do NOT get enough Potassium daily.

        2. Hey Russell. Here’s the key. Long term results. I know you’ve got your issues under control now eating that much plant based fat but have you tried to go “fruit-based” “Raw till 4pm” Freelee the Banana girl style yet? It’s been super successful for most even slim, active people that are at risk for type-2 diabetes. I say give it a shot for a few weeks at least. Smash in the bananas brah. Peace and love.

          1. I can eat about two bites or banana before my glucose exceeds the speed limit. Or about a quarter of an apple. I wish it could work… I love fruit but other than a strawberry or two sometimes, they’re off my list.

            1. I second Russell’s comments. For instance, you frequently see recommendations to eat berries as a “low glycemic” fruit but my experience as been that even small amounts (like picking blackberries as you walk through the woods here in the PNW) elevate my glucose, and it sounds like Russell has much bigger problems than I do. I’ll stick with emphasizing the vegetables.

              Russell. I saw your earlier response and am interested – I will contact you soon.

              Interesting conversation, at any rate!

            2. I have similar reactions but could probably manage 1 banana and an apple and no more.
              I also find coffee has a negative effect , after about 30mins-1hr. When I used to eat biscuits before going Plant based Whole food, anything containing golden syrup or corn syrup also gave me problems, similar to the effects of MSG in some processed food.

      3. I’m type 2 diabetic. Was on injected insulin until I went low carb high fat. In a month I was off insulin and now off metformin. Regular blood glucose of around 5. My calorie ratios per day are approx: 20% protein: 70% fats: 10% carbs. I’m well, have better blood lipids than ever, off statins, off kidney meds, blood pressure great, liver much improved and kidneys great. The studies cited in the article were not what they purported to be.

        1. What are your sources of fat Lorna? Are they plant based or animal ? Not sure if you read my comments above regarding what causes insulin resistance but it’s definitely not carbohydrates from whole plant foods. It’s saturated fat and cholesterol. Now you may be seeing the benefits of caloric restriction right now as your results seem to indicate that due to eating less calories your body has been able to recover from some of its fat toxicity. However long term high saturated fat diets always fail and can cause heart disease / stroke / diabetes/ cancer et all. Please read Dr. Neal Barnard’s work on this issue as its life saving stuff.

      4. This is the most insane thing I have read. Are you really trying to suggest that someone pre-diabetic could eat high-glycemic fruits, bananas, sugar, mangos, as long as they didn’t eat fat and be completely fine? Absurd!

        1. Hi Randeep. If you watch the recent videos on Diabetes from a week ago on this web site you will see clearly that sugar doesn’t cause diabetes and in fact eating a low carb diet leads to insulin resistance. Do your homework and you will find that you have been lied to about glycemic index meaning something. What really matters is the Insulin Index of Foods.

      5. Diabetes is a disease of fat toxicity? Do you know what the main fat storage hormone is in the body Steve?


        Do you know what causes Insulin to rise? Carbs and sugar. So you eat carbs and sugar which makes your insulin rise, and if you don’t use all that for energy, it gets stored as fat. So if you are using all the energy, sure you may be fine. If you don’t, you’re going to gain weight.

        You know what else? Which of the following is not an essential nutrient? AKA which one can afford not to eat any of and still live? Its Carbs buddy. You see our body can make glucose (gluconeogenesis) and we can also break down protein for sugar. Additionally, if we needed to we can use ketones for energy (esp the brain) which is what happens for those truly in nutritional ketosis.

        I’ll tell you something else. All this cholesterol hype is crazy. You know what we use cholesterol for? Pretty much all of our hormones. You know how much of that comes from our diet? Like 20%.

        Higher carbs MAY be ok if its all plant based and slowly digestible, but you can do a high fat low carb 20-30% protein diet that is mostly plant based and be very healthy. Check out the Virtahealth study going on related to high fat low carb. Amazing results.

        And by the way, you can’t use Gregor as evidence of anything when the comments are calling him out for shady reporting of evidence. Im all about mostly plant based diets, but there really isn’t any GOOD evidence against cholesterol and fat (not including trans fats obviously). The study he describes of what, 36 participants? If you know anything about what makes a study good or not, and what can be used as evidence for the larger population, 36 participants is laughable. LAUGHABLE. I just hope you aren’t a nutritionist giving people advice.

    2. Hey Russell, a high carb plant diet does not cause diabetes, in fact Dr. Neal Barnard’s patients managed to reverse their Type-2 diabetes by eating as much as they cared for of fruits, veggies, grains, legumes etc. Diabetes is a disease of fat toxicity as Dr. Gregor has taught us in previous videos. I would recommend cutting your fat intake WAY down to no more than 10% of your calories. Try to aim for 80-10-10 for optimal health. (carbs-protein-fat). Use Cronometer.com for an excellent look into your diets macro/micro nutrient breakdown. Raw till 4 high-carb, low fat for the win!!

    3. Good question. You may want to check out some of Dr. Jenkins’s work. Dr. David Jenkins helped invent the glycemic index. He developed a portfolio diet for lowering cholesterol. Here are 38 citations about diet and disease with this one showing tree nuts help improve glycemic control. Nuts and seeds appear helpful for those with diabetes. Vegans on a low-carb diet ate nuts/seeds and seemed to do okay, as seen in this video on a low-carb plant-based diet. Click “source cited” to find the actual study, if interested. I do not necessarily recommend it because I have seen excellent clinical results from a strict plant based diet higher in carbohydrates and lower in fat, but still this ‘eco-atkins’ type of diet shows that perhaps animal fat is very different from plant fat.

      1. Thanks Dr. Gonzales. I am aware of some of the research on nuts but not all and will follow up these links. It is clear from many sources, including Dr. Gregor’s videos, that walnuts may be the best attested “super food” out there. In any event, I eat a fairly large amount of nuts and seeds and they have been key to making it work for me.

      2. Please see Russell’s response to me above. I always thought that blood sugar spikes were fine and of no threat to the organs as long as the levels were brought down to a safe level within a few hours. Mine can spike up 175 after a bowl of fruit, but as long as I move around and exercise it comes down 2 or 3 hours later. I always was told this was safe, but the studies Russel posted claim otherwise. Your thoughts?

    4. When you say “whole grains raise my glucose excessively” what are you considering a high glucose reading? How long does it stay that high? Does it eventually come down a few hours later? Thank you for clarity, this might help me.

      1. Studies show that above 140, organ damage can begin to occur. I try always to stay below 140. Unfortunately that means that if I have a half cup of oatmeal, I exceed that number by quite a bit and will stay above 140 for 2-3 hours unless I go for a walk right away. Instead I substantially reduce my oatmeal amount and add flaxseed, almond butter, hemp seeds. These reduce the peak considerably and also taste great!

        1. Thanks for the studies. But I am confused and now curious about something…as you claim that if you go for a walk after eating the oatmeal then the blood sugar issue is no longer an issue, as this obviously keeps your blood reading at a safe level, of no harm, but you instead you add nuts and seeds in place of the oatmeal, and this, I am to assume, allows you not to have to go for the walk. Why not just eat the oatmeal and exercise? It seems so natural, like the “human” thing to do, to be on our feet, active before and after exercise. Am I understanding this correctly?

          1. It would take a one hour walk to hold glucose down to sub 140. I just don’t have the time and need to get to work. But you are on the right track; if one has time for extended walks after each meal every day, some carbs can definitely be added.

  5. I eat meat so can distinguish between low cabo and high protean.

    the experiment does not mean low carbo no good.. It just means high protean no good.

    1. I believe Dr. Greger has reviewed studies comparing animal protein to plant protein and plant protein doesn’t have the same negative effects as animal.

    1. Hi Susanna. You can read for free from the printer friendly version (the link Mike gave below). We’re working on fixing the PDF link. Thanks!

  6. Lies. Big Vegetable Oil Companies producing “research”. Dr. Atkins Diet has helped scores of patients, to lose weight and reduce cholesterol, and triglycerides. Low fat and high carb diets have proven to increase weight, and to promote diabetes.

        1. Read Carbophobia.

          Here is a excerpt:

          There is nothing new or revolutionary about Dr. Atkins New Diet Revolution. Various high-fat diet fads like Atkins have been masquerading under different names for over a hundred years, starting in 1864 when an English undertaker and coffin maker by the name of William Banting wrote a book called Letter on Corpulence.[24] Based on what we know now about these diets, Banting’s book may very well have added to Banting’s business.

          1. 2tsaybow, it really is a great read, isn’t it? :) Who else but our Dr. G. could find the humor in death and diet?

    1. LOL. Atkins died from heart disease he kept hidden from his public, you have got to be joking! I got rid of my diabetes and tons of other health issues after switching to that low fat, high complex carb, whole food diet…where do you get this antiquated nonsense from?

      1. Dr. Atkins feel on a slick icy sidewalk and hit his head, and died from it. He didn’t die from heart disease. That’s why your brain isn’t fully working. Saturated fat is needed for brain functioning. And carbs t shoot up your blood sugar. Low fat diets cause heart disease, and cancer. You never had diabetes to begin with.

        1. Is it true that Atkins as reported at the time was seriously overweight when he died? If so, perhaps that made some people sceptical about his diet programme. I have no idea if his approach to diet is correct or not but suspect that part of the key may be in sticking to three small meals a day and not snacking. I’m not totally convinced that demonising fresh fruit is correct or sensible though.

    1. Hi, Really. I don’t think so. Dr. Greger has multiple hyperlinks in this blog post with all the research available in “sources cited” – check it out! Also, he mentions at the end of the article why he doesn’t have tons of information on low-carb diets because he wrote an entire book about it called “Carbophobia.”

      For ease. These citations are from the video low-carb diets and coronary blood flow. Hope this helps.

      H. Noto, A. Goto, T. Tsujimoto, M. Noda. Low-carbohydrate diets and all-cause mortality: A systematic review and meta-analysis of observational studies. PLoS ONE 2013 8(1):e55030.

      J. Merino, R. Kones, R. Ferré, N. Plana, J. Girona, G. Aragonés, D. Ibarretxe, M. Heras, L. Masana. Negative effect of a low-carbohydrate, high-protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk. Br. J. Nutr. 2013 109(7):1241-1247.

      R. M. Fleming, K. Ketchum, D. M. Fleming, R. Gaede. Treating hyperlipidemia in the elderly. Angiology 1995 46(12):1075-1083.

      R. M. Fleming, L. B. Boyd. The effect of high-protein diets on coronary blood flow. Angiology 2000 51(10):817-826.

      F. L. Santos, S. S. Esteves, A. da Costa Pereira, W. S. Yancy Jr, J. P. L. Nunes. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev 2012 13(11):1048-1066.

      L. Schwingshackl, G. Hoffmann. Low-carbohydrate diets impair flow-mediated dilatation: Evidence from a systematic review and meta-analysis. Br. J. Nutr. 2013 110(5):969-970.

      R. M. Fleming. Reversing heart disease in the new millennium–the Fleming unified theory. Angiology 2000 51(8):617-629.

        1. Oh this is so exciting! It reminds me of my first philosophy class, Logic. I had to go back to my old book to determine whether of not the fallacy in your argument is Argumentum ad hominem or if its a Moralistic fallacy.
          I love it – “outrageous referencing a felon..”
          He didn’t make money off people eating plants.
          There is no money in having people eat a whole food plant based diet, just the opportunity for good health.

          There is a lot of money to be made if Americans eat a Standard American Diet. Who makes the money? The beef industry, the dairy industry, big poultry, big pharma, big agriculture (corn fructose, yum!), and all those medical professionals making all that money by performing surgeries that would not be needed if their patients just ate beans and veggies instead of meat.

          1. “He didn’t make money off people eating plants.” —-http://cnsnews.com/news/article/doctor-who-got-atkins-death-report-selling-his-own-diet-book

            “There is no money in having people eat a whole food plant based diet….” LOL

  7. This comment is a bit off topic : )
    Below is a paragraph from an email sent by the owners of PEERtrainer about the benefits of Nicotinamide Riboside(NR), and a product they are promoting called NiaCel, made by Thorne Research.The PEERtrainer owners claim “When cell fuel increases, so does your energy, and nearly every aspect of your health improves. There isn’t an advanced MD we have come across recently who a) does not recommend this and b) take it themselves every day.”

    I’m very curious to know what Dr. Greger has to say about it. He’s one of the few people I trust for honest, unbiased nutrition information. Here’s the paragraph:

    “Nicotinamide Riboside (NR): Sometimes referred to as the “Miracle Molecule” or “Hidden Vitamin,” NR is found naturally in trace amounts in milk and other foods and is a more potent, no flush vitamin B3 (Niacin)derivative.

    Published research has shown that NR is perhaps the most effective NAD+ booster, an essential metabolite found in all cells. NAD+ is arguably the most important cellular cofactor for improvement of mitochondrial performance and energy metabolism.

    Mitochondria are the powerhouse of the cell where macronutrients are converted to energy the cell can use. Mitochondria also play an important part in the aging process. It is hoped that by stimulating mitochondrial function with the NR molecule scientists will see increased longevity as well as other health improvements.

    Researchers worldwide continue seminal discoveries characterizing the unique properties of NR in a wide range of health benefits. These include increasing mitochondrial health, increasing muscle endurance, neuroprotection, sirtuin activation, protection against weight gain on a high fat diet, protection against oxidative stress, improvement of blood glucose, and insulin sensitivity to maintain blood sugar levels within the normal range

    Findings from a recent study by Weill Cornell Medical College and the Ecole Polytechnique Federale de Lausanne, Switzerland researchers showed that mice on a high fat diet that were fed NR gained 60 percent less weight than mice eating the same high fat diet without NR.

    Moreover, unlike the mice that were not fed NR, none of the NR treated mice had indications they were developing diabetes and they had improved energy and lower cholesterol levels, all without side effects. The Swiss researchers were quoted as saying the effects of NR on metabolism “are nothing short of astonishing.”

    A study by researchers from Harvard Medical School in conjunction with the National Institute on Aging, published in December 2013 in CELL, demonstrated that mitochondrial dysfunction (a hallmark of aging) in aging mice is due to a disruption in sirtuin1 dependent nuclear mitochondrial communication.

    They further showed that a reduction in NAD+ levels is responsible for this disruption. They also showed this mitochondrial dysfunction was readily reversible by administration of a NAD+ precursor. The authors found that “one week of treatment with a compound that boosts NAD+ levels is sufficient to restore the mitochondrial homeostasis and key biochemical markers of muscle health in a 22 month old mouse to levels similar to a 6 month old mouse.

    NiaCel, from Thorne is a single ingredient product that is designed to boost NAD+ levels. Essentially this product produces “cell fuel” or ATP. When you make more cell fuel you help to support:

    Weight Managment by promoting THERMOGENESIS
    Greater Endurance for both athletes and tired people
    Fat Metabolism
    Nerve Function
    Insulin Sensitivity
    Brain Function
    Healthy Aging.”

    1. I am not sure this is a good place for advertising. Consumption of supplements in not encouraged here unless it is B-12 of Vitamin D.

    2. Thanks for sharing, Leslie. I don’t see any links to your comments so not sure exactly what the study is, at any rate looks like animal data so it is hard to based day-to-day choices off animal studies. I agree with 2tsaybow’s comment that the only main supplement needed are B12 and Vitamin D. B12 is super important. Check out Dr. Greger’s Optimal Nutrition Recommendations for more information, if interested.

      Thanks again,

    1. Hey, broken1. We do not conduct clinical trials but you can always share your stories, what works for you, what didn’t, what foods you feel give you the best boost of energy, etc, etc! That would be great and super helpful for others who may be trying to eat more plant-based.


      1. Hey thanks Joseph for your reply and time. I do relate to others I talk with at my grocery store about eating a plant base diet. And many people respond positively. My produce friend call me the organic vegan guy. They know my name, but I like the nickname. I guess I should keep a journal. Maybe one day my kids will benefit from it. Namaste.

  8. Sure is confusing when you have people like Dr. Permultter and Dr. Wahls advocating paelo/grain free and even ketogenic disease for those with autoimmune, neurological, and other serious diseases based on their own experience or treating patients.

    1. Selma, Agree, there are a lot of conflicting opinions out there, which is why for me, as a sciencey-person, I always come back to not opinions, but the evidence (here’s a fave video about that). Who’s published their results? Who’s citing evidence rather than their opinions? One thing I love about NutritionFacts.org (and why I volunteer for the site) is that it’s not-for-profit and all references are listed (under “Sources Cited” tab).

      I failed to find any clinical studies published by Dr. Perlmutter but found one published study by Dr. Wahls-to the contrary of what I thought I knew about her work, her study showed the positive effects of veggies on the fatigue associated with MS. Also, the effect of a diet that is helpful is usually evident to the person eating it within 1-3 weeks. That’s pretty quick. So we should not be afraid to do our own experiments and find what makes us feel best :)

      1. Exactly what I planned on doing…for just a month, trying out a WFPB diet over 5 years ago. In 3 weeks no more diabetes, high blood pressure, high cholesterol, arthritis, on and on. Needless to say, I never looked back. There would be NO controversy if people would just give the diet in question a fair trial. I also eventually lost half my body weight too, but the original goal was to nix another round of pharmaceuticals and stop disease progression, I was already taking 12 meds and hadn’t even reached 60 yet. Needless to say, they are all history now, including narcotics for severe arthritis, fibromyalgia. and back issues. I never did have to get the knee or hip replacement they were scheduling me for either. I am soooo thankful I finally learned the truth and the ADA should be ashamed of themselves, seriously. Their “healthy diet” is a sham for diabetics…it may maintain the disease in a “better” way, but it didn’t come close to eliminating or reversing it like a WFPB diet did!

  9. People are having a hard time with round up poisoned wheat that is GMO garbage. It is ruinous. So many people on paleo (not atkins or soth beach) are much healthier with no allergies and no diabetic problems. Doctors besides the few like DR OZ, now being harassed for his honesty, are concerned with the money they get from pharmas and not our health.

  10. So I posted this question yesterday and can’t see it anymore? I hope it wasn’t deleted because as a vegan, I’d like an answer and since this website is science-based I would hope open discussion is allowed. I have a friend with severe digestive issues who’s been experimenting with a zero-carb diet and she used to be vegan but it didn’t help her digestive issues and I shared this post with her and asked if she was going to get a scan and shared these links with me that I’d like your thoughts on:




  11. Having looked at the abstract for the source article, I am unclear about what seems to me to be a significant point. Dr. Greger wrote, “[Fleming] He then put them all on a healthy vegetarian diet”; later he (Dr. Greger) refers to “the veg group.” So what exactly was the diet of the Treatment Group? A ‘vegetarian diet”–even a “healthy” one–is usually defined as one that excludes flesh foods but not dairy &/or eggs. Is *that* what the treatment group ate? If so, that’s different than what Dr. Greger recommends and what many of us follow–specifically, a vegan diet. Could someone with access to the full article (hint, hint, Joseph!) clarify what the Treatment Group’s diet comprised? Thanks.

    1. I may have spoke to this further down in the thread. If you cannot find please let me know. Thanks, throrn324

    1. If that is something you want to try I suggest checking out the Eco-Atkins diet by Dr. David Jenkins. Dr. Greger shows a video about low-carb plant-based diets. I do not necessarily recommend it because I have seen excellent clinical results from a strict plant based diet: A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study.

      Good luck whatever you choose! Let me know if you want more info. Dr. Greger explains in his book, “Carbophobia”, the importance and healthfulness of carbohydrates (unrefined whole grains). I highly recommend skimming through the resources on this blog they are super helpful! Thanks again for your post.

    1. Hey Justin. It looks like there are no available citations so I am not sure. our site offers all citations and information free of charge. Let me know if you have other questions.

      Best regards,

      1. Thanks doctor! I follow the Weston A Price Foundation for nutritional and lifestyle advise for most things, everyone has their own hobbies and likes for things though. I eat lots of grass fed beef, organic chicken, and takes fermented cod liver oil and high vitamin butter oil everyday! Along with lots of butter from kerrygold. I also drink raw milk, eat raw cheese, raw pastured egg yolks and cooked egg whites. I have a total cholesterol of 241 HDL of 104 LDL of 128 VLDL of 9 and TRIGLYCERIDES of 43 which is outstanding ratios and numbers. I have recently wanted to go low carb but am scared to now but my HbA1C was 5.6 and my glucose was 83 all the tests listed above were from over a year and a half ago now. Haven’t wanted to go back to get tested!

        1. Hi Justin, you might want to look into the studies that are being done by nutritional scientists. This website is a good starting point. There is also the Physicians Committee for Responsible Medicine website. Its is PCRM.org.

          I am not a registered dietitian like Joseph but when I began having problems with my blood sugar I started to rethink my day to day diet and I’ve found that a whole food plant based diet really made be feel better. I hope you spend some time here and watch many of the videos that Dr. Greger has made. My favorite ones are his annual presentations. If you have a chance watch From Table to Able: Combating Disabling Diseased with Food. I think it is the best one.

          Good luck and good health

  12. I know of a person who religiously follows Dr. Mercola. Joe is very well known for what he does, but it now seems that he is at opposite ends of the spectrum that Michael is touting. I will stay with Dr. Greger and the science that he so generously gives us. But, what about Mercola and this article? It’s entitled: They Just Made This Stuff Up and Most of Us Believe It


    1. Hi John. I am not sure about Mercola I do not know him if you have any questions related to the research we provide here (or have some of your own you’d found) let’s discuss! I could spend hours reading nutrition articles and giving you my “take” but I’d rather focus on the research :-) Sounds ok?

  13. Dr Greger, I’m a 30-year Type I diabetic on Dr Bernstein’s lowcarb diet for glycemic control – my HbAic is 5.3%. However, my coronary artery calcium score is zero. My doc tries hard to persuade me I’m digging my grave with my teeth, just like you, but my experience suggests you are gravely misguided. Were I to embrace your advice, my HbA1c would return to near 8% as it was on the ADA low fat diet and I would once more be at extreme risk of diabetic complications.

    1. Hey Jonathan. Please eat what you feel is best. I will say that the ADA diet is useful, as well as a strict plant based diet for lowering A1c. From Dr. Barnard’s research, study participants received either a low-fat vegan diet or a typical diet for diabetes and found significant changes in weight loss and insulin levels. Dr. Greger presents the study in this video. Good luck with your diet I commend you for lowering your A1c.

  14. I am trying to find Carbophobia that is now available online full-text at AtkinsFacts.org. Unable to locate it. Help please.

  15. Interesting –

    So you quote a single old study from 15 years ago on 26 patients using SPECT , the limitations of that era that we are all aware of. How is it that no one has have done a follow up to see if the results could be replicated? Or have they and just never published because they didn’t? One will never know since there is no way of checking. But with the popularity of low carb diets since 2000, one would clearly have expected this to have been done many times over since it would bypass all of those risk markers such as LDL,HDL,,LDL particle size, CRP, etc. and get right at the “heart” of the question.

    Then you point out more recent sutuidies that dramatically show a low carb diet causes heart disease to progress. From the alarm of them one would expect people on low carb diets to be dropping like flies due to their CAD.

    And then to further show how bad low carb diets really are you reference a study that shows overall mortality is increased (RR 1.3) in those on a low carb diet . Of course RR is a pretty slippery statisitic. For example, statins are advertised to reduce risk by 33% but if you look at the package insert of any of them and look at the data upon which that number is based you will find that the absolute risk reduction is just 1% over 3 years (i.e. in the treated group of people at high risk for vascular diasease only 2 out of 100 had an event while in the placebo group 3 out of a 100 had). So that means out of every 100 people taking a statin for 3 years, 99 of them will not have had any benefit.

    But the main concern I have is that you fail to point out that in that very large meta analysis (272,216 patients) that the mortality and incidence of CAD was not statistically different. And to me those are the real hard end points in any study.

    So on the one hand you are using data from various imaging studies to prove that low carb diets cause CAD to either devlop or progress, but ont the other the study that shows the real hard endpoint, ie. incidence or mortality from CAD does not.

    1. new science says cholesterol is not a bad thing at all. Our bodies NEED it, our brains NEED it, that is why our bodies make it. Giving up sugar is what helped me…and sugar is grains too.

      1. ” that is why our bodies make it.” … that is why you don’t need to get cholesterol from the diet. We also need water but consuming too much can kill you. These simplistic arguments about cholesterol which you have found are half truths at best and seriously misleading at worst. Be very cautious about people claiming there is “new science” on nutrition and health which real scientists, researchers and physicians are unaware of … two and two still make four whatever the diet book infomercials and promoters may say.

  16. I have had issues with carbohydrate addiction for a long time. I am morbidly overweight at this point. When I fast for a day or two…I detox from the carbs and I feel extremely better. I am also able to control my carb intake. In my experience now and in the past (I lost more that 50 pounds twice in my lifetime) I find reducing my starchy and sugary carbs helps me to take control of my weigh loss. I have other issues to deal with also…such as motivation, exercise, chronic health issues, etc..

    1. Good for you keep it up! if you want more information about how whole grains and other healthful carbohydrates let me know. Motivation is hard to find for everyone! We must find what we love doing in regards to physical activity and perhaps look for that “greater purpose in life” to help build our self esteem. Social support is also key. Best to you.

  17. I agree some people may have carbophobina. But what about cholesterolophobia?

    Namely, cholesterol does not cause heart disease. Never did.

    And secondly, even if it did (but 50 % of people who get heart attack have normal or even low cholesterol levels which shows that it does not matter what your cholesterol level is), it is not ingesting (dietary) cholesterol that raises your (blood) cholesterol. It is ingesting sugar, too many carbs and inflammatory foods. So even if you go out of your way to stretch the truth and interpret it the way you set out to interpret it, i.e., distorted, LC diets do not cause heart disease, at least they didn’t cause it those 5-6 million years when humans were eating mostly meat and fats.

    Meanwhile, there hasn’t been one single vegan society in the whole human history. Not one, ever. And there isn’t one now. because without animal fats, you can’t procreate. This is what happens when you pretend to be smarter than Mother nature.

    1. Is there a study showing that without animal fats you cannot procreate? Interesting! Please eat what you feel is best we do not promote one diet over another. Based on the research cholesterol does not appear to have a lower limit so I am not following that logic. Anyway, we many be in a bit of a disagreement about optimal cholesterol levels but that doesn’t mean we cannot have a civil conversation about the research. Thanks for you comments, Tomorrow.

      1. Yes, I’m in correspondence with many who have successfully followed this approach. I however question any diet that requires supplementation and/or requirement of specialized non-local foods to sustain health. Most animal species get along just fine without any specialized supplementation. If they were unable to do so, they would have long since become extinct.

  18. Total non-sense. Reduced blood flow ? Of course, the lowering of sugar, not the increase of protein or fat, causes a settling and leveling of your entire body.
    Eat some sugar its like adding gas to the BBQ
    Stop being a vegan activities , We can all see how sickly our vegan friends are .

  19. My name is Diana, I am here to give my testimony about a doctor who helped me in my life. I was infected with CORONARY ARTERY DISEASE in 2010, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution out so that my body can be okay. One day I was in the river side thinking where I can go to get solution. so a lady walked to me telling me why am I so sad and i open up all to her telling her my problem, she told me that she can help me out, she introduce me to a doctor who uses herbal medication to cure CORONARY ARTERY DISEASE and gave me his email, so i mail him. He told me all the things I need to do and also give me instructions to take, which I followed properly. Before I knew what is happening after four weeks the CORONARY ARTERY DISEASE that was in my body got cured . so if you are also heart broken and also need a help, you can also email him at ogboduherbalhivcure@gmail.com OR ogboduspellhome@gmail.com OR ogboduherbalhome@hotmail.com

  20. After seeing the article on plant based atkins, I did 6 days straight on it, using nuts and seeds and greens and 6 oz of berries, the results were spectacular. Lost 12 lbs. It had the added benefit of lowering my overnight blood sugar from 140 to 102 with in 3 days. The problem is it is boring and I had very little energy. However, my goal was to burn out the ceramides that had accumulated in the muscles by forcing my body to become a fat burner. Once the ceramides that blocked the absorption of sugar into them were cleaned out, it was possible to convert to a high carb low fat vegan diet. Ceramides are formed when you consume fats – mainly palmitic acid in a high insulin environment. Eating too much fructose even from fruit – usually more for women- can cause issues. If your liver’s glycogen stores are already full, then the fructose will be converted to fat which can then form ceramides in a high insulin environment. Banana girl suggesting women should be smashing in 1000 calories smoothies, have led many women including my daughter and daughter in law to gain weight. And when it happens, banana girl said it is from past metabolic damage. No it is just they are exceeding their liver’s storage and creating ceramides. My daughter and daughter in law continued to have issues after quitting the diet, but after putting them on the plant based atkins diet for six days to burn out the ceramides, they are now able to drop weight eating normally. In summation, before starting any hclf diet, I recommend that everyone do a plant based atkins to burn out the ceramides first and also only eat fruit on an empty stomach and limit fruit consumption at any one time to 500 calories for women and 800 for men.

  21. You wrote this article in 2015. Your most compelling cite comes from “Dr. Richard Fleming, an accomplished nuclear cardiologist”. Yet you fail to note for your audience that he was convicted of fraud in 2009 and stripped of his license to practice by the Iowa Board of Medicine in 2012. (google his name in conjunction with “FBI” or “Iowa Board of Medicine”) Doesn’t that make the citation somewhat less credible? Even if you believe the science is good, doesn’t your audience deserve to know?

  22. Gee, I wonder how humans survived on a low carb diet for hundreds of thousands of years. Who funded those studies? Because there are many studies that show the exact opposite. Not only that, but the Twinkie statement at the beginning of the article is ridiculous.

      1. Pre-agricultural hunter-gatherers would’ve subsisted primarily on meat, berries, and nuts. The book Guns, Germs, and Steel is a good resource on this point. It took a long time for grains to be domesticated and agriculture to be developed.

      2. Get out of your computer chair and experience the great outdoors; then maybe you’ll find out. P.S. when you’re out there… good luck finding “sugar”.

  23. Wow this study was amazing probably got the kid a b in his middle school science fair. If it was a legit study they would have had a control, they didnt, it would have had hard rules ,I didn’t. So to make any assumptions off this pathetic waste of space is to believe in aliens, big foot and every other mystical creature. In fact if you put stock in this study I have lots available on Mars for sale……. wish sites used intelligence when posting garbage studies

  24. The first study had carbs at 45% and 29% of diet, versus a truly low carb diet of 5%. There are several studies that clearly show ketogenic diets are beneficial for cardio vascular disease. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/ When I did a high carb low fat diet, my fasting blood sugar kept rising, and when you consider that some people who have fewer copies of amylase genes, may actually do better on a high fat low carb diet. Your real argument against meat consumption is large amount of toxins in the animal products as well as bad bacteria, inflammation, . And yes, eating animal products without restricting carbs substantially at the same time, can lead to heart disease. After 2 years of watching your videos, I am hesitant to consume animal products, however, I am doing a cyclical ketogenic diet where I eat vegan 5 days a week and the other day I have some trout raised to spring water. Also on the trout days, I consume garlic (antibacterial), shredded red cabbage (sulforaphane), turmeric and black pepper(anti-imflammatory) nuts, (cholestrol remover), and over 80g of fiber (increase flow thru colon).

  25. I had a heart surgery in 2009. Ever since 1998 I have been on cholesterol lowering drugs. I gained too much weight, so I am thinking of the low carb diet. How the bad side of this diet correlates with the statins?

  26. His bio belies his bias. There is no way this man came at his opinion objectively. There are now literally decades of studies and research to prove a proper low-carb lifestyle is far, far healthier than a carb-loaded, grain-fed diet.

    1. That is wishful thinking at its worst. Or perhaps just parroting wishful thinking found on crank websites. Low carb diets are associated with increased mortality and greater whole grain condition with lower mortality

      1. Are you mad? What is causing diabetes – steak or bread? Have you read on this subject at all? I mean, from sources other than these quack sites?

        1. His Eminence: We know what causes diabetes. You can learn about this basic information right here: What Causes Diabetes: http://nutritionfacts.org/video/what-causes-diabetes/ The science clearly shows that if you had to pick between steak or bread (neither of which is an ideal food) and you cared greatly about diabetes, then you would pick the bread.

          I encourage you watch the video. If you would like an in depth look at the clinical research regarding type 2 diabetes, then check out Dr. Barnard’s book on reversing diabetes. Dr. Barnard’s diet is *clinically proven* to be 3 times more effective than the ADA diet, and he found that it is the fat in the steak that is what causes diabetes.

            1. His Eminence: I understand your confusion. You are confusing symptoms with causes, and it is no wonder. That’s what you have probably been told by sources you think are valid. Based on your reply, I would guess that you did not actually watch the video so that you could understand what *causes* type 2 diabetes. You will learn that it isn’t “us people”. It’s the science…
              There isn’t much discussion you and I can have until you take the time to educate yourself on what type 2 diabetes *is* and what *causes* it. Good luck.

        2. Quack sites? You mean like
          1. Harvard?
          “The HSPH investigators, led by professor of epidemiology Frank Hu and research fellow An Pan, analyzed data from three longitudinal studies of male and female healthcare professionals who were followed for 14 to 28 years. After adjusting for other risk factors, the researchers found that a daily serving of red meat no larger than a deck of cards increased the risk of adult-onset diabetes by 19 percent. Processed red meat proved much worse: a daily serving half that size—one hot dog, or two slices of bacon, for example—was associated with a 51 percent increase in risk.”

          2. The US National Evidence Library?
          “Strong evidence indicates that dietary saturated fatty acids (SFA) are positively associated with intermediate markers and end-point health outcomes for two distinct metabolic pathways: 1) increased serum total cholesterol (TC) and LDL cholesterol (LDL-C) and increased risk of cardiovascular disease (CVD) and 2) increased markers of insulin resistance and increased risk of type 2 diabetes (T2D). Conversely, decreased SFA intake improves measures of both CVD and T2D risk.”

          3. The American Diabetes Association?
          “Our data indicate that higher consumption of total red meat, especially various processed meats, may increase risk of developing type 2 diabetes in women.”

          and so on.

          I have a strong suspicion that your views are derived from what you call quack sites – sites run by people selling fad diet books and telling people what they want to hear eg you can eat all the steak, cheese and butter you want and still be healthy.

  27. So many health professionals tend to universalise their
    recommendations based solely on observational studies and their own
    experience, but they forget that there are outliers and individuals with
    specific issues, needs and treatment. In other words, the treatment
    that works mostly does not necessarily work for everyone.

    I would love to make HCLF vegan diet, clinically “the optimal diet”, work for
    me, but I just can’t. Just a little bit of oatmeal or fruit sends my
    insulin through the roof and my blood sugars crash, I feel tired and
    crave sweets. I developed anemia, probably due to iron malabsorption. I
    have very low blood pressure, probably partially due to no salt intake.

    I increased my avocado, nuts and seeds intake, added a bit of salt and
    eliminated all sweet fruit. Now I finally feel human again! For a first
    time in a long time, I am able to go without food for more than 3 hours.
    I have more stable energy and no cravings. I know this is not optimal
    for health, but I was not able to make anything else work for me.

  28. The diets you cited do not in any way represent a ketogenic diet. A ketogenic diet is ultra-low carb, moderate protein, and high fat. (C5%-P15-20%-F75%-80%) The positive effects of a ketogenic diet are seen after several months on the diet and not a few days. Very poorly done studies showing bogus results. In the 1970’s when Ancel Keys got his way and people ate more carbs the incidence of heart disease and cancer skyrocketed. If you are going to cite studies then at least pick well done studies that span more than a few weeks. Honestly get real.

    1. This is simply untrue.
      Do some fact checking and you will find that Americans are eating fewer carbs now than before WW1 and that cardiovascular death rates began to decline after the 1970s. The people who make these claims on the internet, that you repeat here, just do not tell the truth.

  29. The 10 patients that jumped ship in this study were reportedly following a high protein diet, not a atkins-like diet! The meta-analysis you cited specifically says that makers of CVD were not impacted by low-carbs diets! Your article is dishonest at best, Dr Greger.

  30. The first study you mentioned was “Negative effect of a low-carbohydrate, high-protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk.” Okay, this was low carb, HIGH protein, high fat. In the Abstract it states the Quartiles used were: Q1, 45 % carbohydrate; 20 % protein; 32 % fat: Q4, 29 % carbohydrate, 24 % protein, 40 % fat; It only shows the extreme quartiles, but neither of these are what I would consider low carb or high fat. The second study you cite is: The effect of high-protein diets on coronary blood flow. Again, not looking at low carb high fat diets. So neither of the studies you mentioned actually cover the topic of this article. This kind of negates anything you actually say.

    1. Lorna Brighurst: You wrote that you do not consider 29-45% carbohydrates to be low nor 32-40% fat to be high. Determining whether these percentages are high or low should be done not based on feeling, but on some good solid evidence. My favorite evidence is looking at the diet of populations who are known to be extra healthy and live extra long lives compared to other populations. The traditional Okinawans were one such population. If memory serves, they ate 85% carbs and 6% fat. http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/ Another example is the Tarahumara Indians of Mexico. Their carbs are 75-80% with 12% fat.
      The point is: In light of what counts as a healthy human diet, those studies you looked at were indeed low carb and high fat. Quite a bit so.

      1. However, since those figures do not equate with what would be considered a low carb high fat diet in the modern world, which is moderate protein not high protein, the results would differ. On LCHF my ratios of calories are 20% protein, 70% fat, 10% carbs. I stay under 25g net carbs a day. Some would consider 100g low carb and that’s fine for some, But with carb intolerance would be too much for some. By equating the results in the papers cited it gives a false impression of LCHF diets.

        1. Lorna Brighurst: “modern world” I read your post multiple times until I could find some meaning in it. I hear you saying that: people who typically follow a diet that they label as LCHF would define that diet not according to science, but according to an arbitrary understanding that a group of people have decided upon.
          I don’t consider that a valid argument in regards to a scientific paper which gives you the percentages they used to define the diet. However, I can understand why you personally would object to the characterization of such a study.
          What this conversation has shown me is that we really, really need to do some education on what counts as healthy macro percentages so that people can objectively define what is high vs low.

      2. Regarding Okinawan diet:

        Regarding Tarahumara indians (yeah malnutrition due to poverty, or could it be their diet):
        In this very remote region of Mexico, Miller sought out the Tarahumara Indians, who have impressively low blood sugar and cholesterol levels. After studying their traditional diet, experts found that Tarahumara benefited from a diet that emphasizes slow-release foods, sending sugar into the bloodstream at a much slower rate than other foods. Their staples include whole corn, beans, squash, jicama and cumin. While the Tarahumara have struggled with poverty-related malnutrition, the slow-releasing carbohydrates help prevent an overproduction of insulin and aid in maintaining blood sugar levels.

  31. Thank you Dr. Greger. You, Dr. Fuhrman, Dr. Esselstyn and the like are true heroes. Thank you for dispensing the truth. I am 41 y.o. and I’ve been on a vegetarian diet since February 2016 that focuses on high nutrient foods such as the GBOMBS acronym created by Dr. Fuhrman. Needless to say my weight decreased from 255 pounds as of 2/15/16 to 217 pounds as of today 9/22/16. My cholesterol went from 255 to 190 (tested in May). I feel great and I don’t miss meat at all. My goal is to drop my weight down to 185. For the first time in a long time I feel that my goal is achievable. Thank you –

  32. At 14 YOA I had open heart surgery… 9 years ago I had a stent job… I am looking at the Keto Genics Diet… Please advise pro’s and conn’s… all my best…

  33. I have been on the vegetarian diet since January and have lost 60 LBS… 240 to 180… I am trying to get to 165 but have been stuck here for near a month… My doctor tells me that I read too much but introduced me to your book and here I am since January… my last blood work floored him and he asked what I had been doing and I reminded him that he got me started with your book, videos and e-mails…(he was not aware of your web site or e-mail video’s) But recently I was turned onto this Keto Genetics, here is a video link… file:///C:/Users/Owner/Desktop/A_Prof.%20Ken%20Sikaris%20-%20’Does%20LCHF%20Improve%20Your%20Blood%20Tests%20’%20-%20YouTube.htm (scroll down and you will see a number of very interesting video’s that talk about how cancer is fed by sugar but starved by fat, so it is suggesting that a high fat LOW protein low carb diet is most useful in extending life… 75% fat, 20% protein, 5 percent carbs… the MD from Australia explains it well as do many others including a researcher in Miami named Dr D’Angeotino… I have been studying this for days now and have found it very interesting>>>

  34. This MD in Australia talks about cholesterol and the fact that the way it is tested today is incomplete and does not tell the whole story when you just look at A1c, LDL, HDL, and Triglycerides, this diet raises your cholesterol but there is a small dense LDL that is not accepted by the liver for servicing but rejected and ends up in your arteries as plaque… and this is what needs to be included in a Lipid panel because this diet pre-diet shows a lipid panel that is not to bad but when you look at the SDLDL it is at 20 which is very high, and when on this diet for 6 or more weeks your lipid panel is higher but the SDLDL is 0 Zero… so your doctor flips out and yells at you but in fact you are much less prone to heart failure…

    1. Sorry Bill but this is outdated and dangerous nonsense that is still promulgated by saturated fat proponents.trying to sell high fat diet books and related stuff to the public. And repeated by thousands of deluded souls on the internet who believe them. Don’t be taken in by these people – your doctor is absolutely right.

      The particle size idea, implying certain LDL cholesterol particles of particular sizes are harmless, that you mention was effectively disproved years ago………
      “Previous studies showing that smaller low-density lipoprotein (LDL) size is associated with greater atherosclerotic risk did not adequately control for small and large LDL particle correlation. …….. Both LDL subclasses were significantly associated with subclinical atherosclerosis, with small LDL confounding the association of large LDL with atherosclerosis.”

      This subject has been extensively studied over the years. A major review in 2008 found “In summary, only LDL particle concentration, as measured by NMR, was consistently found to be associated with incident CVD after adjustment for lipids (and other risk factors). Other specific measures have been found to be associated with incidence or progression of CVD by only a minority of studies.”

      and “Limited evidence suggested that LDL subfraction analysis is not a consistently strong predictor of CVD compared to other known risk factors”

      More recently, Dr Greger has produced a good video on the topic also which refers to relevant research since 2008:

      This video is also worth watching:

  35. I will be staying on this vegetarian diet until this year ends and may try this Keto Genic diet for the first quarter of next year… I understand that it takes 3 months to clean your blood so I may go on for two quarters… I will never leave this site and have recommended it to so many because there is no doubt in my mind that through your guidance I have vastly improved my ability to manage my health in my retirement years… But like my doctor said I read(and experiment) too much… So I will continue to read and learn and possibly experiment… all my best… Bill

  36. Vegetables and limited fruit are free on this Keto Genic so it is only different that it wants you to eat fat… I can choose healthy fats like coconut, olive, avacardo’ fish, and the like as opposed to bacon, processed meats, Saturated fats and all her friends… it also likes to have fasting for weight loss…

    1. Just because they call these fats “healthy”does not mean that they are’

      There is no evidence that these diets promote healthy longevity and quite a lot oe evidence that low carb diets in general increase mortality eg

      I am not aware of any very long-term studies of human beings adopting a high fat, low carb diet. However, I see that a Brazilian team published a study in 2013 using a mice model for the diet which provides some clues as to the likely outcome. Its results make disturbing reading:

      “C57BL/6J mice were fed with a HF diet (60% kcal/fat) or control diets (15% kcal/fat) for 27 months. One-half of the mice on the HF diet developed obesity (diet-induced obese (DIO) mice), whereas the remaining mice were diet resistant (DR). At 8 months of age, both DIO and DR groups had increased hyperglycemic response during a glucose tolerance test, which was normalized in 16-month-old mice. At this latter time point, all groups presented similar performance in cognitive tests (Morris water maze and inhibitory avoidance). The survival curves of the HF and control diet groups started to diverge at 15 months of age and, after 27 months, the survival rate of mice in the DIO and DR groups was 40%, whereas in the control diet group it was 75%.”
      Source: “High saturated fat and low carbohydrate diet decreases lifespan independent of body weight in mice”

  37. MD means medical doctor who is not BS, cannot do surgery. Do not trust MD who do not do any research on cell but merely on theory collections and selling books! Doctors often could not live longer because they only believe in themselves. We should listen to 100 years old bioscience professor who advises us to eat egg, clean meat. https://healthimpactnews.com/2014/ldl-bad-cholesterol-indicates-an-amino-acid-deficiency-99-year-old-researcher-says/

  38. Unfortunately, SPECT is quack science. Last hydrostatic test, I was 8.5% body fat. I perform human flags, one handed pullups, and back levers. I eat beef daily, chicken daily, eggs daily, also organic vegetables (broccoli and carrots) grilled or fried in organic coconut oil. I juice organic carrots, but I seldom eat fruit, other than a monthly smoothie. My main source of simple carbohydrate is basmati rice. I avoid sugar and processed food. I do not do well on bread or whole grains, but I will bake an occasional pizza from time to time. Liquor yes, beer yes. Bourbon spikes my HDL levels, so 24 hours prior to a blood test, I abstain from that.

  39. I think this info may be misleading if intended to refer to ketogenic diets which are designed to be high fat moderate protein and low carb; calorie wise this could be 70%-20%-10%. Just now I was listening to professor and researcher of nutritional ketosis, Dominic D’Agnostino [I highly recommend listening to interviews with his re ketogenic diet] and he recommended the following book which is mandatory for his students [he is an assistant professor at a medical college at So. FLA University. His info may astound you; but this book required reading for his students is “THE ART AND SCIENCE OF LOW CARBOHYDRATE LIVING” [I believe the author’s surname is Jeff Volek

    The benefits are enormous for the brain mitochondria & heart and the diet is markedly protective against neurological disorders, isquite possibly a best tx for epilepsy, is protective against Diabetes type 2 and against cancer. He does not mention it but other researchers have revealed that the human body is best adapted for utilizing fats, broken down to ketones for energy; and not glucose. Dominion of carbohydrates [-glucose] as energy source in human diets began with the advent of agriculture 11,000 years ago but for some millions of years prior to that, fats [presumably animal but it need not be]

    were what the human body was using and adapted to. Glucose requires insulin for transport into the cells and ketones do not and ketones are more efficient and provide more energy without ROS damage to mitochondria. Cancer requires ever greater amounts of glucose and insulin which are maintained at low levels in the blood in a state of nutritional ketosis. It starves cancer and makes the environment inhospitable for cancer growth. A low carb high protein diet is something different and presumably that is what the article above addressed. So does D’Agnostino in one interview I heard. The definitive book on this that the professor D’Agnostino requires for his students is probably a good place for in depth comprehensive data as, per the professor, it provides all the science source references for the material presented. Per comments below, Paleo is not a well defined term for diet and can mean almost anything so the user needs to define it. I mention here Dominic D’Agnostino as he is actively engaged in very relevant research involving nutritional ketosis with funding from various sources including the US Navy for matters relating to Navy Seals; and presumably it is not top secret.Plus he is a continuous state of nutritional ketosis and often will mention aspects of his own experience with being on a ketogenic diet. Also, to mention the Atkins diet, in the book I read, the diet begins with a two week very low carb diet [20 grams of carbo perday] in order to transition the body into a state of nutritional ketosis , using ketones not glucose/insulin for energy generation; however, it is not intended to be a permanent such state but rather for the dieter to gradually add in carbs; however, is one added in only up to the limit, which varies from person to person, of carbs to just below the lvel that would transition out of ketosis, then Atkins would work with that in mind and requiring monitoring for blood or urine ketone levels and must needs be high fat, ,moderate protein, and low carbs

  40. The problem with the good doctor’s opinions is that they conveniently ignore the realities of endocrinology and scientific facts inconvenient to his crusade.

    The fact is that the high-carb, low-protein (especially animal-products protein), low-fat diet correlates directly with hypertension, obesity, Type II diabetes and heart disease. Any professor of endocrinology must agree that increases in bloodstream glucose must be accompanied by increased production of insulin, and that long-term elevated insulin levels are undesirable.

    More and more cardiologists recommend cutting back on the cereal-based carbs — the very grains this man is telling us should be a core component of our diets — because the omega-6 fatty acids they have in abundance abrade the arterial walls and create the perfect environment for triglycerides to pile up.

    We have millions of years of evolutionary history supporting the idea we should eat an animal-product based diet, augmented by leafy greens and berries and nuts, and that foods that reduce to glucose in the bloodstream should be taken in moderation.

    Were it not so, the diet recommended by the medical community and the government for the last half-century wouldn’t perfectly coincide with corresponding increases in those dread diseases: hypertension, obesity, Type II diabetes and heart disease.

  41. This is intentionally deceptive. I don’t know how else to look at it.

    One of the quoted studies explicitly looked at the effect of a low carb, high fat & high protein diet on people with existing cardiovascular problems. It’s apples to oranges. The study did not look at the effect on healthy people and the way it is quoted above seems to indicated that the findings apply to a healthy population.

    Another study referenced as looking at low carb diets was in fact looking at high protein diets, which are definitely not the same thing. It also had an incredibly small sample size. But I’m most concerned about how the study was completely misrepresented here.

    If you’re making a valid claim that is actually supported by science then you shouldn’t have any need to be this deceptive. Where is the evidence that keeping carbs low specifically causes heart or arterial problems?

  42. You need to relabel this post “Low Carb, High Protein, High Fat Diet…” because that’s the criteria you address here. Low Carb, High Fat, moderate protein diets do not feed heart disease. Just look at what’s been happening in Sweden the last few years. The key is reducing insulin.

  43. Dr. Greger here cites one study by Richard Fleming, a vegan extremist affiliated to PCRM, who is notoriously known for having a long career as an Atkins rival trying to dispel the low-carb phenomenon. A doctor who actually went out of his way to acquire Atkins’ death certificate in order to assist his anti-low-carb agenda. I am not advocating Atkins or any diet in particular. But one must have pause with the amount of agendas that exist, even in the medical world.

    Dr. Fleming’s credibility is also damaged by an insurance fraud indictment. Which brings into question his own study echoing his agenda as a glaring case for one can only one deduct as confirmation bias marring his research. We must also be careful to not cherry pick studies and omitting studies that have found the opposite result. Such as:

    New research published in the POS One Journal

    Sidney Diet Heart Study

    Malmo Diet and Cancer Study

    Siri-Tarino meta analysis

    Low-Carbohydrate Diets and All-Cause Mortality: A Systematic Review and Meta-Analysis of Observational Studies

  44. Calling a study of 26, down to 16 people isn’t comprehensive. It’s amazing you come to such a quick conclusion to such a measly “study.”

  45. Well damn. I wonder if the sugar industry is funding this research and giving free reign grants to the doctors and scientists whom perform them.

  46. Why is it that when anyone mentions low carb diets people immediately assume we are taking Atkins ?. You can go low carb plant based and you will get the benefits of low carb (removal of all simple carbs) and the benefit of plants. Assuming that low carb means Atkins results in the public never really getting hold of the benefit of low carb.

  47. Thanks “Doc”. I just wasted several precious minutes of my life reading this rubbish. Oh, and the Tom Goff commenting here is either a bonehead or an internet troll (or related to the deceptive jerk Ancel Keys).

  48. I was vegan and vegetarian for years and developed PCOS had large tumors. I became vegan and vegetarian to prevent illness.

    I developed more health problems and had low energy being vegetarian and vegan.

    Every single person on the planet is different if not then cancer treatments would work for all patients the same but as we know some become violently ill with treatments and others no symptoms with treatments.

    Why can’t we all just agree on this…no one lives forever!!! Eat what each person wants according to how they feel and what they think is right for them.

    My grandmother and her sister were 10 years apart in age. My aunt ate a vegetarian diet was tiny weak and had bad bone density and jogged daily until her 80’s. My grandmother ate any thing she wanted but ate pretty healthy on average and never workout but was just active in her garden and house etc.

    My grandmother passed at 86 sick for only 30 days prior to dying. My aunt the vegetarian lived to 96 but was down for 8 years and in the nursing home before passing suffering a broken hip.

    Point she only had 2 1/2 years of active life more than my grandmother….hmmm.

    Also she told me at 90 no one should want to live to be this old because quality of life is just not the same. She was a very happy person but quality is what she craved.

    My grandmother could walk right up until her 30 days prior to death and lived at home! My aunt couldn’t walk for years and suffered in a nursing home.

    Also my grandmother had no heart problems. I also think stress plays a huge part in people’s health too.

    Which life would you want?

    Stop! Eat mostly healthy real foods, walk, breathe, enjoy life. No one gets out alive.

    There is no way to do a proper study because every single person is different and every morsel of food reacts differently when we eat it.

    I eat organic slow cooked oatmeal with or without protein I get so sleepy I can’t stay awake 20 to 30 mins after consuming it. But most doctors say eat it, it’s healthy, clearly not for me! I eat 2 organic eggs, 3 slices of uncured bacon and I feel great and not hungry for 6 hours. I don’t eat bacon everyday all day. I eat salmon, many sources of lean protein and all green vegetables.

    We are all different no reason to fight over who’s right and who’s wrong because there is no right or wrong for every single person.

    One thing I do notice is doctors who spend their whole life trying to figure out the healthy thing always look old and unhealthy. And even if they look healthier or are healthier they too will die one day.

  49. The mistake that Dr. Greger is making is that he is equating a low carb diet with a high animal protein diet. There is a gigantic difference between high fat, low carb, low protein compared to the Atkins diet that is high fat, high animal protein, and low carb. The cardiovascular problems he describes are related to eating too much protein and to much adulterated fats like hydrogenated oils and high omega-6 oils like soy bean oil, cottonseed oil, corn oil, canola oil, etc. His approach is very one dimensional since two people can both be low carb and have dramatically different diets. There are an increasing number of people who need a heart bypass operation who are able to avoid it by going low carb, low protein, and high natural fats.

  50. Fleming was done for medicare billing fraud and falsifying data for research for a soy product company. This does not mean that this particular piece of research is dammed but it would be worrying. Long term studies on LCHF and CVD and health are a bit thin on the ground.

    This study seems to be the best I can come up with so far


    It suggests a significant increase in overall mortality for LCHF and no significant increased risk for death from CVD or incidence of CVD. Interestingly though the risk ratios for CVD are a tad over 1.0 which would possibly add weight to the argument that setting out in life on LCHF is not particularly going to kill you from CVD, it is either neutral or at worse so marginally negative that something else is going to get you first. However perhaps in the battle to reverse heart disease (if you accept that this can be achieved) you need some protocol that can improve on neutral.

  51. I think this is good information. We often rush towards diet plans for weight loss but we tend to ignore health. These popular diets, especially low carb diets have become a rage. But now we can see that there can be heavy impacts of these. Thanks for sharing the information.

  52. I think it should be done with extreme caution. What is good for one person is not good for everyone. My dad was put on the keto diet by a new doctor he had only a few months and (coincidentally?) died suddenly just shy of 60 years old after 3 months on the diet. He was type 2 diabetic and the doctor was focused on reversing his diabetes. He lost 36 lbs (which I now know is more than what is recommended by nutritionists in that time frame). The cause of death was coronary artery disease. I have no doubt that this diet was the cause or at the least a contributing factor that pushed him over the edge. So exercise caution when deciding about an extreme diet. Carbs are not necessarily the enemy.

  53. Thank you so much Dr. Greger for all of your research and information you provide!! My wife and I have been eating a whole food plant based diet for about 8 months now and would never go back. After reading your book How Not to Die, it has opened up our eyes to what food really does to you and what it can do for you. Plant based for life!!

  54. I am confused as the conclusion drawn from the very first study cited in this video:
    Low-carbohydrate diets and cardiovascular risk factors. Schwingshackl L, Hoffmann G.
    with this link with no summary:
    Dr Greger summarizes it as:
    “Now we have studies that measure the impact of low carb diets on arteries directly, and a review of all the best studies to date found that low-carb diets impair arterial function, as evidenced by a decrease in flow-mediated dilation, meaning low-carb diets effectively stiffen people’s arteries.”

    But when you search for the actual content of “meta-analysis” it’s here https://www.ncbi.nlm.nih.gov/pubmed/24613757
    With this conclusion “Recent randomized controlled trials document that low-carbohydrate diets not only decrease body weight but also improve cardiovascular risk factors. In light of this evidence from randomized controlled trials, dietary guidelines should be re-visited advocating a healthy low carbohydrate dietary pattern as an alternative dietary strategy for the prevention of obesity and cardiovascular disease risk factors.”

    What am I missing here? I realize the conclusion of the 2nd study :
    does indeed back up his overall conclusions but the 1st seems to be in direct conflict.

  55. Hello Noel, and thank you for your question. I am a family doctor with a private practice focused on WFPB nutrition. I recommend that you read the following editorial, which points out that many meta-analyses, especially in the field of nutrition are not properly done:

    This link shows only the first page of the editorial, but their main points are on this first page. They point out that meta-analyses often combine together studies which shouldn’t be combined. For example, in the meta-analysis which you cite as showing that low-carb diets improves cardiovascular risk factors, the authors gave a lot of “weight” to the very large Malmo Diet and Cancer cohort study, in which saturated fat intake ranged from 13% to over 22% of total calories — i.e. there were NO patients who actually consumed a low enough percent of saturated fat (less than 6%) to meet the AHA guidelines. So, in the range of 13 to 22%, there was no association between saturated fat intake and risk of cardiovascular events. Using that study diluted out the findings of other studies which showed clearly that patients with high saturated fat intake had much higher risk of cardiac events, as compared with patients who ate a diet that was truly low in saturated fat.

    So, we need to be careful about believing meta-analyses. The authors of this editorial point out that sometimes there are conflicts of interest, i.e. a meta-analysis may be sponsored by industry.

    I hope this helps some. I encourage you to read the entire editorial, which was published in JAMA on 10/17/2017.
    Dr. Jon
    Health support volunteer for NutritionFacts.org

  56. The problem is that how one “feels” is not necessarily an objective measurement of health. Also keep in mind that while “routine blood tests” may improve, the low carb with high animal protein/fat diet increases the risk of early death from all causes by 30%. The improved blood tests numbers won’t do anyone any good if they’re dead.

    Dr. Ben

  57. I clicked. The link to the study. Your summary is misleading. You state the results came from a low carb diet but the study didn’t state that. It says they were on a high protein diet. It doesn’t say anything regarding their fat or carb intakes. A ketogenic diet is not a high protein diet. It is a high fat moderate protein diet. Big difference. A high protein low carb diet might as well be a standard carb diet because it is still a primary glucose burning diet with the body converting protein to blood sugar. High fat moderate protein and low carbs create a keto state.

  58. The discussion of this paper makes it very apparent that 1. The study discussed can’t prove causality – there are too many confounders here to draw any meaningful conclusion – a glaring example would be – people inclined to drop the prescribed diet are also more likely to follow other negative health decisions and practices – perhaps these are what caused the heart disease progression?
    2. Long term, actually well performed/structured, studies are needed to adequately evaluate the long term risks of specific low carb diets (as Atkins is not the same as ‘low carb’ or ketogenic or paleo etc- each have their own nuances)

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