Four Ways to Improve on the Mediterranean Diet

Image Credit: Sally Plank

Four Ways to Improve on the Mediterranean Diet

The traditional Mediterranean diet can be considered mainly, but not exclusively, as a plant-based diet, and certainly not a whole foods, plant-based diet. Olive oil and wine can be considered essentially fruit juices. Even if one is eating a “vegiterranean diet,” an entirely plant-based version, there are a number of problematic nutritional aspects that are rarely talked about. For example, the Mediterranean diet includes lots of white bread, white pasta and not a lot of whole grains.

In an anatomy of the health effects of the Mediterranean diet, the single most important component was the high consumption of plant foods. In contrast, high cereal consumption, meaning high grain consumption, did not appear to help. This may be because most grains that modern Mediterranean dieters eat are refined, like white bread, whereas the traditional Mediterranean diet was characterized by unprocessed cereals—in other words, whole grains. And while whole grains have been associated with lower risk of diabetes, heart disease, and cancer, refined grain may increase the risk of diabetes, obesity, heart disease, and other chronic diseases. In the PREDIMED study, those who ate the most white bread—but not whole grain bread—gained significant weight.

Alcohol may also be a problem. As a plant-centered diet, adherence to a Mediterranean diet is associated with lower cancer risk, but does not appear to lower breast cancer risk. With all the fruits, veggies, nuts, seeds, beans, and low saturated fat content, you’d assume there would be lower breast cancer risk, but alcohol is a known breast carcinogen, even in moderate amounts. When researchers created a special adapted version of the Mediterranean diet score that excluded alcohol, the diet does indeed appear to reduce breast cancer risk. 

The wonderful grape phytonutrients in red wine can improve our arterial function such that if you drink nonalcoholic red wine (wine with the alcohol removed), you get a significant boost in endothelial function—the ability of our arteries to relax and dilate normally, increasing blood flow. If you drink the same red wine with alcohol, it abolishes the beneficial effect and counteracts the benefit of the grape phytonutrients. So, it would be better just to eat grapes. You can find more information about this in my video Improving on the Mediterranean Diet.

Similarly, there are components of extra virgin olive oil—the antioxidant phytonutrients, that may help endothelial function, but when consumed as oil, (even extra virgin olive oil), it may impair arterial function. So, even if white bread dipped in olive oil is the very symbol of the Mediterranean diet, we can modernize it by removing oils and refined grains.

Another important, albeit frequently ignored, issue in the modern Mediterranean diet is sodium intake. Despite evidence linking salt intake to high blood pressure, heart disease, and strokes, dietary salt intake in the U.S. is on the rise. Right now, Americans get about seven to ten grams a day, mostly from processed foods. If we were to decrease that just by three grams every year, we could possibly save tens of thousands of people from having a heart attack, prevent tens of thousands of strokes, and tens of thousands of deaths. There is a common misperception that only certain people should reduce their salt intake and that for the vast majority of the population, salt reduction is unnecessary, but in reality, the opposite is true.

There is much we can learn from the traditional Mediterranean diet. An abundance of plant foods is a defining characteristic of the Mediterranean diet, but recognition of the importance of this characteristic seems to have fallen by the wayside. No main Mediterranean meal is complete without lots of greens, a key part of not only a good Mediterranean diet, but of any good diet.

Here are some of my previous videos on the Mediterranean diet:

I touch more on whole grains in How Many Meet the Simple Seven? and Whole Grains May Work As Well As Drugs.

More on breast cancer and alcohol in Breast Cancer and Alcohol: How Much Is Safe?, Preventing Skin Cancer From the Inside Out, and Breast Cancer Risk: Red Wine v. White Wine.

I’ve touched on olive oil in the other videos in this Mediterranean diet series, but also have an older video Extra Virgin Olive Oil vs. Nuts and more recently, Olive Oil & Artery Function.

More on sodium in Dietary Guidelines: With a Grain of Big Salt, Big Salt – Getting to the Meat of the Matter, and Can Diet Protect Against Kidney Cancer? But what if without salt everything tastes like cardboard? Not to worry! See Changing Our Taste Buds.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

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.


125 responses to “Four Ways to Improve on the Mediterranean Diet

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  1. Ah, XV olive oil again. So here’s my question once again.

    It’s clear that XV olive oil does not help arterial function – it hinders it. No argument here.

    But, is this arterial function hindering temporary? And, most importantly, does it decrease life-span and general health over time?

    I suspect the answer depends on how much XV oil is consumed. I use about 1 tablespoon a day. This has raised some eyebrows. However, does the research show that I’ll be pushing up daisies prematurely because of my consumption?

    My understanding of the PREDIMED study implies that the answer is no.

    Inquiring minds want to know.

    1. Thanks for your question Richard.

      I would have to say that it depends on what a person is consuming other than olive oil, as in, what the overall dietary pattern and choice of foods. In my opinion, consuming a plant based diet or a typical Western diet on top of olive oil, as well as other lifestyle factors will more likely to determine the outcome.

      Hope this answer helps.

      1. And thank you for your answer. I’ve been a faithful follower of a healthful plants-only lifestyle for the past 3 years. I’m not overweight but am considered pre-diabetic. Hmmm. Maybe there’s my answer.

        1. Thanks for your question Iain, it is clear that consuming balsamic vinegar is regarded as healthy (see here). However, given that there are negative effects of olive oil (see here), I would not assume that consuming both would have a neutral effect, it is possible, but I am not sure.

          Hope this answer helps.

    2. I remember an article about arterial function using the ultrasound brachial artery tourniquet test. It evaluated the damage done to blood vessels after ingestion of olive oil.. It did mention the recovery time of the artery but for the life of me I can’t find the article..

      1. Because its delicious! Fat is very satisfying. The thought of my pantry w/out EVOO is unacceptable. Of course we use it sparingly.

        1. That’s funny. I ate the SAD for decades. And I loved that high fat food at the time. But now, after eating WFPB and very, very low fat for just over a year, I find the thought of eating pure fat repulsive. What you “like” is simply what you’re used to eating.

          1. Blair,

            Funny you should make this comment. In medical school I recall a study that gave 2 and 3 year olds choices of either sweet or salty foods, without restrictions. Those who had been eating a low sugar diet consistently….no surprise here….ate low sugar went for those items and likewise with the salt. I’ll try to find this fascinating study. And the kids also changed their preference when fed a diet low in sugar and salt….so yes you can influence your 2 year old.

            Keep up the great work….nice to see and feel the change.

            Dr. Alan Kadish moderator for Dr. Greger

            1. Remarkable that somebody actually did a study demonstrating this. But not at all surprising when you consider that up until recently, there was huge variation in the diets of people in different parts of the world. And I’m sure they all enjoyed their food equally. Taste is just an opinion that’s conditioned by someone’s usual diet. One anecdote I remember is this. Before the 1800’s, the diet of the arctic native Inuit consisted solely of fish, seal, and an occasional polar bear. When the British arrived searching for the northwest passage, they gave candy to the Inuit who were repulsed by the sweet taste having never eaten sugar before.

          2. That’s a fair statement. I’m not sure I’ve ever eaten totally SAD. Being an amutuer athlete /skier / biker / runner /body builder/ power lifter starting at 19, we were always concerned about the quality and quantity of food we ate. Fat and sugar was always avoided. But I did have the same experience with milk a long time ago. I used to eat a whole grain cereal with skim milk, never drank milk per say. Afterward, the taste of whole milk was unpalatable. No more milk for a long time, but I still eat non fat Greek yogurt. The same for me is true with salt and sugar, I just don’t care for either. Suffice to say, we pretty much all agree your taste can be trained to some degree.

            1. I have also done sports my entire life and continue to do so. I never ate as much sugar as some other people but enough. As far as fat and animal products go, it was “the more the merrier” for me. I’m sure my arteries still have some repair work to be done after what I put them through. If you haven’t been on this website for too long, I will summarize and say that about the best thing you can do for your health is to eliminate dairy.

    3. I am vegan and follow a mostly oil free WFPB diet. I recently visited a naturopathic oncologist that promotes a mostly plant based mediterranean diet. He suggests I add 2 tbsp of olive oil per day for its cancer fighting properties. It contains oleocanthal which is supposedly good at killing cancer cells. I don’t think it is found in any other foods. I was conflicted by this information as I have been avoiding oil as much as possible with the understanding that it is always bad for you. Any advice?

      1. Evidence does not support advising the addition of processed oil of any kind to a whole food plant based diet. Like many foods, olive oil has some health promoting effects, but these are offset by other, illness promoting effects. For example, any processed oil worsens endothelial function in the short term. Chronic exposure can damage the endothelium (the lining of the blood vessels) and contribute to blocked arteries.

        Here’s another of several videos by Dr Greger on olive oil pros and cons. In summary, whole food sources of healthy fats, like a small amount of nuts, maintain the health benefits of plant fats without the health detriments.

        https://nutritionfacts.org/video/extra-virgin-olive-oil/

        Dr Anderson, Health Support Volunteer

  2. I have several times traveled to Greece, Spain and Italy and the diet options – at least as a tourist – I will consider as junk food – probably to satisfy the tourist palate. French fries with every meal, fried fish, lots of meat, lots of oil (probably not even olive oil), lots of cheese, white bread and a salad on the side. This is far from a healthy diet and far from the traditional Mediterranean diet. And then you read in the newspaper that a Mediterranean diet is healthy…

      1. Probably.
        The point I tried to make was that going to these places, eat the food served, or read about it in magazines, and then hear that the Mediterranean diet is healthy, will make you choose poorly, when you return to home. Unless you know that the true Mediterranean diet was the diet from the post WW2 islands of greece, where the population was poor and they couldnt afford meat and had to eat beans, vegetables, fruit, grains and so on.

  3. I don’t get it: NOW evoo is BAD for you!? This contradicts the most recent studies that show women who consume 3-4tablespoons of evoo REDUCE their risk of breast cancer by something like 40%! I know you spoke about arterie function, but come on! Is there ANY consistent “expert” info out there? The public is weary of contradicting info even by so-called experts.

      1. Actually what I’d like to know is what is the fact of the matter for someone on a WFPB diet who has no weight issues. For instance, in the abstract of

        https://www.ncbi.nlm.nih.gov/pubmed/26148926

        it is claimed that:
        “Recent epidemiological research has shown that regular consumption of olive oil is associated with increased longevity. This benefit is partly due to the olive oil’s unequivocal cardio-protective role. There is converging evidence on the benefits of olive oil for preventing several CVD risk factors, including diabetes, MetS and obesity. Olive oil is also implicated in preventing certain cancers, with the most promising findings for breast and digestive tract cancers, although the data are still not entirely consistent and mainly from case-control studies. These health benefits are ***supported by strong mechanistic evidence from experimental studies, demonstrating that specific components of olive oil have antihypertensive, antithrombotic, antioxidant, antiinflammatory and anticarcinogenic action.***”

        I’ve read several articles that make similar claims, including as I recall that it OO can have an anti-arrhythmia effect, which for some of us would be of interest. It’s not clear to me that the only benefit derives from replacing a worse fat with a better one.

        1. My question then is what exactly is in olive oil that makes it beneficial considering the nutrition label shows a bunch of zeroes besides the concentrated calories.

          1. It is just better than animal fat. The rest is all hype. Remember the olive oil and wine lakes? A solution was needed, desperately. Hey presto, olive oil and red wine are good for you. It is like green washing, health washing. It is a brilliant marketing tool and it is used to everywhere. So just be aware of where the financial interests rest when you read all these placed pieces.

              1. It’s OK David, I know how it reads but I don’t mean this one we are all commenting on and I do believe that if you are going to use oil occasionally it is better to use good olive oil and coconut oil than other options (and there is Campbell’s 5% rule that most substances at this percentage of a day’s intake do not harm you and might (like poisons in homeopathy) actually do you some good, Same applies to meat and dairy.)

          2. The claim is that various micronutrients are beneficial e.g. oleuropein and hydroxytyrosol, which of course would not show up on labels.

            But I should add that I found the comment below by Gatherer re: the atherogenic properties of MUFA, the main oil in OO, a sound argument against its use in other than very small quantities (not to mention the atherogenic properties of the SF palmitic acid).

            1. Again David, everyone with a product to sell can dredge up some selling point to suck us in, but getting whatever beneficial ingredients that are in oil would be much better accomplished getting it from the whole food in it’s original balanced form, the way nature made it, and we co-evolved with. isolating and concentrating components of plants for consumption always has downsides, whether it is vitamins, pharmaceuticals, or oils.

              1. Olives are inedible without processing. To get EVOO, there is no heating or chemicals, it’s a very simple process of crushing the olives and filtering out the inedible solids, its truly a minimally processed food. On the other hand, to make whole olives edible, they must be cured, this is either done with sodium (resulting in a high sodium end product) or chemicals, the curing process also destroys much of the beneficial polyphenols, and whole olives have a very limited shelf life (2 months) before most of the polyphenols are depleted (compared to high poly EVOO which is good for a year).

            2. I’ve seen several comments almost stating as fact that EVOO is atherogenic. PREDIMED proved this idea wrong, (7,447 subjects at high risk for cardiovascular disease), no progression of carotid intima thickness on high polyphenol extra virgin olive oil. Now it didn’t reverse progression like nuts did, so nuts clearly “win”, but high poly EVOO has other beneficial properties like preventing LDL oxidation and neuroprotective effects (also protects against strokes), it also has numerous cardiovascular system benefits, I posted links to studies showing this in comments below. Based on the science, I’m fairly confident it’s not a good idea to skip the high poly EVOO and get most of your fats from nuts, seeds, and avocados only… I’ve also noticed many eating a plant based diet seem to consume a lot of sugar, some even talk about being pre-diabetic including one person right in these comments above. I think getting more calories from plant based fats may help prevent consuming excess sugar for a lot of people, as I feel like they are mainly doing this because their body says “I need more calories” and sweets are the easy answer to that. 240 calories from EVOO (2 tbsp) with a big plant based meal will prevent 240 calories being eaten an hour or two after a meal when the plant based eater has cravings because their plant based meal wasn’t calorie dense enough. On the other hand, if you are trying to lose weight, EVOO may not be a good idea.

            1. Minimal and a poor source…on a list of the top 100, it barely sneaks in, and you would have to consume gross quantities to make a dent with a mere 60 units compared to even peppermint at over 15,000. There are many far better sources with other quality nutrients, ditto for the other points. Other than good marketing propaganda and people acquiring a taste for it, I fail to see how oil could be considered as anything of value when it is just the fat left over after wasting the fiber and majority of nutrients in processing. Somehow I don’t think our evolution necessitated that Grog spend his days trying to squeeze oil from plants, or carrying around a cruet to garnish his greens, when he could just eat the whole plant and get so much more benefit. That hasn’t changed. As oils go it may be the least harmful, but that doesn’t make it good.

              1. Olives have thousands of years of reputation for being health promoting, we smash all sorts of things for the “inside contents” like coconuts or oranges. While I agree that the absolute number of phenols in EVOO is low, that’s kind of a meaningless statement, it takes only 5mg of one particular phenol in EVOO to prevent LDL oxidation (which in turn is linked to heart disease). Every phenol is a completely different chemical compound with different effects on the human body, some are more potent than others. See: Elevated Circulating LDL Phenol Levels in Men Who Consumed Virgin Rather Than Refined Olive Oil Are Associated with Less Oxidation of Plasma LDL
                http://jn.nutrition.org/content/140/3/501.long

                Olive Oil Polyphenols Decrease Blood Pressure and Improve Endothelial Function in Young Women with Mild Hypertension
                https://academic.oup.com/ajh/article/25/12/1299/231681/Olive-Oil-Polyphenols-Decrease-Blood-Pressure-and

                Or this report: Olive oil as medicine: the effect on blood lipids and lipoproteins
                https://1.oliveoiltimes.com/library/ucd-olive-oil-medicine.pdf

    1. Yes, there are specific components of olive oil that have beneficial properties, but those components are in relatively low abundance compared to the “bad components” of olive oil.

      Olive oil is 100% fat, 0% protein, 0% carbohydrate and contains no fiber.
      1 tablespoon (13.5 g) contains 119 calories. Making up those calories there are:
      1.86 g of saturated fat (82% palmitic).
      9.85 g of monounsaturated fat (98% oleic).
      1.42 g of polyunsaturated fat.
      Thus, 83% of olive oil fat is atherogenic.
      Further, the omega-6:omega-3 ratio is 13.2, which is not beneficial.

      In your example, Noelle, if a person ate 4 tablespoons (60 ml) of olive oil a day that would be 476 calories. Do you really think it is a good idea for 25% of your daily calories to come from oil?

      1. You could do the same thing with the nutrition facts from a container of deluxe mixed nuts (one of the healthiest things you can eat!)
        https://www.fatsecret.com/calories-nutrition/food/mixed-nuts/fat
        Per Serving:
        Total Fat 15.96g 25%
        Saturated Fat 2.494g 12%
        Polyunsaturated Fat 3.665g
        Monounsaturated Fat 9.067g

        Lets be science minded here. PREDIMED (and other reputable studies) have essentially proven that at least high polyphonol extra virgin olive oil (EVOO) is NOT atherogenic (7,447 subjects at high risk for cardiovascular disease), no progression of carotid intima thickness on a very high dose of EVOO for years! Now it didn’t reverse progression like nuts did, so nuts clearly “win”, but high poly EVOO has other beneficial properties like preventing LDL oxidation and neuroprotective effects (also protects against strokes), it also has numerous cardiovascular system benefits, I posted links to studies showing this in other comments below. Based on the science, I’m fairly confident it’s not a good idea to skip the high poly EVOO and get most of your fats from nuts, seeds, and avocados only… I’ve also noticed many eating a plant based diet seem to consume a lot of sugar, some even talk about being pre-diabetic including one person right in these comments above. I think getting more calories from plant based fats may help prevent consuming excess sugar for a lot of people, as I feel like they are mainly doing this because their body says “I need more calories” and sweets are the easy answer to that. 240 calories from EVOO (2 tbsp) with a big plant based meal will prevent 240 calories being eaten an hour or two after a meal when the plant based eater has cravings because their plant based meal wasn’t calorie dense enough. On the other hand, if you are trying to lose weight, EVOO may not be a good idea. Personally I think its challenging to always eat 100% plant based whole food, even Dr. Greger has been candid about this in interviews where he admits he doesn’t always stick to the plant based whole food diet. EVOO could very well be part of an answer to this problem.

        1. Regarding the PREDIMED trial and its weakness …
          Melinda Wenner Moyer, a science journalist, wrote a “hit piece” on Dr Dean Ornish for Scientific American back in June of 2015. Dr Ornish was allowed to write a short rebuttal, and not surprisingly Sci Am allowed Moyer to pen the final response.
          https://www.scientificamerican.com/article/why-almost-everything-dean-ornish-says-about-nutrition-is-wrong/

          In her article Melinda Wenner Moyer extols the virtues of olive oil:
          “The recent multicenter PREDIMED trial also supports the notion that fat can be good rather than bad. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. (All groups consumed about the same amount of protein.)”

          Dean Ornish wrote in response:
          “Below is my letter to the editor of The New England Journal of Medicine that they published about this study:”

          The PREDIMED study is highly flawed. The control group did not follow a low-fat diet. This is not surprising, since researchers gave the control group little support in following this diet during much of the study. In the “low-fat” control group, total fat consumption decreased insignificantly from 39 to 37 percent (Table S7 in the Supplementary Appendix, available with the full text of the article by Estruch et al. at NEJM.org). This level of consumption is much higher than the level recommended in American Heart Association guidelines for a low-fat diet (<30 percent fat) or a diet that can reverse coronary heart disease (<10 percent fat). There was no significant reduction in the rates of heart attack, death from cardiovascular causes or death from any cause. The only significant reduction was in the rate of death from stroke (see Table 3 of the article).

          The conclusion of the study should be, ‘We found a significant reduction in the rate of stroke among those consuming a Mediterranean diet as compared with those who were not making any substantial changes in their diet.’ A Mediterranean diet is better than what most people are consuming; even better is a diet based on whole foods and plants that is low in fat (especially saturated and trans fat) and in refined carbohydrates while allowing for sufficient consumption of n-3 fatty acids.

          1. I’m a big proponent of and follower of a plant based whole food diet, but both of these writers have some valid points and both seem good at picking out problems with the other but maybe not so much inclined to correct their own mistakes. The Ornish “low fat” idea is not science based, and nothing Dean Ornish wrote contradicts that conclusion, like he himself says, there are good fats and bad fats (just like good protein/bad protein, and good carb/bad carb). And like Moyer says, his studies never showed this, its also kind of sad but true that his studies never isolated a single variable. Dr. Greger himself starkly contrasts from Dean Ornish on this point, Dr. G does not promote “low fat”, he promotes “healthy fat” and has even made a video urging people to make sure they consume fats with their vegetables. Furthermore, Ornish mentions above “or a diet that can reverse coronary heart disease (<10 percent fat)" when in fact the PREDIMED study he is responding to showed that a high fat diet where much of the fat comes from nuts actually does reverse heart disease. While the extra virgin olive oil group had no increase in artery blockage over almost 5 years, and did result in a significant reduction in strokes. The results were so strong for the EVOO and nut interventions that they had to cut the study short as it was deemed unethical to allow the controls to continue without the interventions. More analysis on PREDIMED here:
            https://www.crsociety.org/topic/11719-olive-oil-healthy-or-not/#entry17306

            My only point is that there is a mountain of scientific evidence showing that high phenol extra virgin olive oil is beneficial to health in many different ways, and is not atherogenic. I like to spread out my phenols in a very wide net, benefiting from them all. I agree strongly with Moyer's point that healthy fats are a good way for an average person to REDUCE otherwise unhealthy food choices.

      2. This is why I think cold expeller pressed canola oil is superior to olive oil:
        (from Nutritionfacts.com)

        Total Fat: 14.0g
        Saturated Fat: 1.0g
        Monounsaturated Fat: 8.9g
        Polyunsaturated Fat: 3.9g
        Total trans fatty acids: 0.1g
        Total trans-monoenoic fatty acids: 0.0g
        Total trans-polyenoic fatty acids: 0.1g
        Total Omega-3 fatty acids: 1279mg
        Total Omega-6 fatty acids: 2610mg

    2. Hi Noelle,

      The sources that Dr Greger has used as “evidence” to support his claims that EVOO is bad for you are poor. Firstly, the studies are 10-20 years old and secondly, the cohort used is significantly small and bias. The duration of the study spans over two days…. to observe any significant and evidently side effects, the study needs to be performed over a long-term basis (6 months to years). No mice model was used either.

      Thirdly, one of the studies used deep-frying conditions as an atherogenic which is correct due to thermo-oxidation…. It’s a given that deep fried foods aren’t healthy and can cause heart disease. Thermo-oxidation occurs around 200C; olive oil has a smoke point 210C. If you lightly fry or grill your food, that temperature is around 150 to 180C. Significantly lower which means thermo-oxidation should not occur. A good quality olive oil will have a good smoking point. Quality over quantity.

      When seeing health claims like the aforementioned one, be mindful, do your research and see if the “evidence” is plausible. In the case of “Four ways to improve the mediterranean diet”, the evidence is not plausible and does not stack up. EVOO is once again safe in your cupboard.

      I hope this helps! I have an article on the extra benefits of EVOO from real evidence based studies.

      Remember, everything in moderation and enjoy life!

      Kathryn
      (Medical scientist, Nutritionist, Scientific writer)

  4. I’d be very grateful if anyone could tell me whether there is any scientific research out there on ‘will power’? I’m really keen to find out proven methods that I might be able to follow to increase my resolve and chances that I’ll stick to this kind of healthy eating. I’m two weeks into following Dr. Greger’s advice and it’s going well so far…..

    1. This is wonderful news, Rachel C! I don’t know of any studies on willpower, but I can tell you about the experience of my partner and me. It took only a few weeks for us to lose the craving for foods that I used to consider must-haves (parmesan, feta, anchovies, yoghurt, omelets …). Four years in now, not only do we not crave those foods anymore, but they no longer smell good to us. I just can’t imagine eating them anymore. That’s something we absolutely would not have predicted before we went WFPB. I have wondered if this change in taste might have something to do with the change in gut flora that comes with the new diet; maybe those critters have some way of communicating their own preferences, as it were, through chemical signals. Whatever the case, it’s a happy circumstance. This may not be everyone’s experience, but I know my partner and I are not alone in finding our tastes changed so dramatically—no willpower required!

      1. At TrueNorth Health Center, where they specialize in restoring health through water-only fasting and WFPB eating with no SOS, they find that even a short fast sharpens the taste buds so people taste many flavors in foods that were previously masked by salt, sugar and oil.

        But you may also be onto something about our little gut critters demanding the food they thrive on, once they change places from the meat-eaters’ bacteria to the veggie-loving bacteria.

        1. Thank you very much Rebecca Cody, Veg4life, Maureen Okun and ToBeAlive for your helpful responses. I love a good TED Talk and will check out The Willpower Instinct. I caught the back end of one of those TV programmes last night that was road testing various diets and it was discussing a scientist who was in the process of developing a brain training app that with repeated use would gradually help strengthen your ability to resist temptation and steer you away from junk foods. It sounded just what I need to help breech that critical gap between my old SAD ways and my hopefully re-educated future veggie craving tastebuds helping me stay ‘on the wagon’.

          1. It gets easier as long as you don’t keep challenging yourself with “just a taste” of what you know you should avoid. You can eventually get away with it, but in the beginning, let your tastebuds adapt! Best of luck, it is well worth the journey!

        2. I’ve just finished watching your great recommendation – I’m definitely at stage IV in the pleasure trap! It was very helpful. Thank you.

    2. …by not over-stretching your will power muscle: I loaded up my then-kindergartener with smoothies and nuts before birthday parties; she was not much tempted by their junkfood.

      Plan ahead.

    3. Results are always more motivating, and setting firm boundaries is much easier that counting on ‘willpower’. For example, don’t buy or bring anything into the house you know you shouldn’t eat, because willpower WILL fail if it’s there. You are making this positive change to benefit YOU, think of the positives and refuse to sabotage yourself. Easier said than done, but replacing bad choices with good ones gets to be a habit you’ll succeed with. Keep it simple and don’t stress. Tastes do change!

    4. There is one lesson you can take from macrobiotics and it is that consuming/imbibing at either extreme of the yin yang food/drink spectrum tends to generate a craving for a balance from the other extreme. Move closer to the centre in terms of food and drink choices and you will find cravings for things like coffee, sugar, meat and dairy just disappear. This does to mean that I am advocating other doctrinal elements of macrobiotics.

      1. Ryan: Great article. I was so sad to see the body-position-creates-emotions on that list, because it makes a lot of sense to me and it seems I’ve read about a lot of other similar research which backs it up. I felt better as I read more details from the article. Either way, it really is an important point and article. Thanks for sharing.

  5. I feel like Dr. Greger is not giving balanced consideration to the scientific evidence & published research around high polyphenol extra virgin olive oil (EVOO). First of all, true EVOO is a very minimally processed product. Second, he has said “just eat olives” – I have researched this, and while I haven’t found a whole lot of scientific studies on it, from what I’ve read olives, especially high phoenol olives, are completely inedible right off the tree. Allowing them to ripen further, greatly reduces the beneficial polyphenols, but they still have to be CURED before eating, this curing process from what I’ve read, wipes out most of the polyphenols, also the shelf life of olives is very short. In sum, olives are NOT equivalent to EVOO. Now how about reputable, large, studies on EVOO itself? Please see: https://www.crsociety.org/topic/11719-olive-oil-healthy-or-not/#entry17306
    (19 citations at the bottom of the post)
    Moreover, I feel like increasing the intake of “healthy fats” causes the healthy eater to reduce intake of sugar (they will get calories from somewhere), and the lower overall sugar intake likely improves health outcomes. Sure you could eat more nuts and avocados instead, but high phenol EVOO shouldn’t be ruled out as an additional option (perhaps 1-2 TBSP a day).

    1. Thanks for sharing that Gordo. It’s always great to see research on both sides of an argument.

      I think taking the bulk of evidence though, it’s still wise to avoid processed oils of any kind. To quote Gatherer further up in the comments “Olive oil is 100% fat, 0% protein, 0% carbohydrate and contains no fiber.
      1 tablespoon (13.5 g) contains 119 calories. Making up those calories there are: 1.86 g of saturated fat (82% palmitic).
      9.85 g of monounsaturated fat (98% oleic).
      1.42 g of polyunsaturated fat.
      Thus, 83% of olive oil fat is atherogenic.”

      Studies that David J linked to https://disq.us/url?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F7489230%3A8cObM5soyI1b6W5vD3IDj1jr0ls&cuid=1365650
      https://disq.us/url?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F12544660%3AvmhMuPOyNGKpip0mdkd4WyEEc-I&cuid=1365650
      And a study that Gatherer linked to: https://disq.us/url?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2674687%2F%3A2tOyPNCeWEnFjeFUR6ua6-gnoSU&cuid=1365650

      So what’s the big deal with that? Heart disease is our number one killer so it should be a major priority if not the highest priority when planning our diets. Heart disease won’t progress if atherosclerosis is kept from progressing.

      Not to mention that atherosclerosis leads to thinks like erectile dysfunction http://nutritionfacts.org/video/survival-of-the-firmest-erectile-dysfunction-and-death/, chronic back pain http://nutritionfacts.org/video/back-in-circulation-sciatica-and-cholesterol/, and a litany of other issues. Plus most of the research I’ve seen tends to agree that “healthy fats” in oils are usually only healthy in that they’re replacing animal fats in people’s diets. So while high polyphenol EVOO has its benefits, it’s most likely better for your health overall to stick to whole plant foods.

      1. OK, but what about all of the scientific evidence that high phenol EVOO prevents heart disease? What about PREDIMED (described in detail in the link I provided)? There are countless studies showing that high-phenolic EVOO reduces multiple risk factors for chronic disease, many of them related to CVD or CHD specifically, whereas low-phenolic EVOO or refined olive oil (which has no phenolic compounds, and which is what you get if you buy either “pure olive oil” or “olive oil” with no specification in the store) has lesser or no effect.

        Here’s a small sampling of studies:
        1.
        Consumption of extra-virgin olive oil rich in phenolic compounds improves metabolic control in patients with type 2 diabetes mellitus: a possible involvement of reduced levels of circulating visfatin.
        Santangelo C, Filesi C, Varì R, Scazzocchio B, Filardi T, Fogliano V, D’Archivio M, Giovannini C, Lenzi A, Morano S, Masella R.
        J Endocrinol Invest. 2016 Nov;39(11):1295-1301.
        PMID: 27344308
        Similar articles
        Select item 27443526
        2.
        Extra Virgin Olive Oil Improves Oxidative Stress, Functional Capacity, and Health-Related Psychological Status in Patients With Fibromyalgia: A Preliminary Study.
        Rus A, Molina F, Ramos MM, Martínez-Ramírez MJ, Del Moral ML.
        Biol Res Nurs. 2016 Jul 21. pii: 1099800416659370. [Epub ahead of print]
        PMID: 27443526
        Similar articles
        Select item 27422371
        3.
        Genes and miRNA expression signatures in peripheral blood mononuclear cells in healthy subjects and patients with metabolic syndrome after acute intake of extra virgin olive oil.
        D’Amore S, Vacca M, Cariello M, Graziano G, D’Orazio A, Salvia R, Sasso RC, Sabbà C, Palasciano G, Moschetta A.
        Biochim Biophys Acta. 2016 Nov;1861(11):1671-1680. doi: 10.1016/j.bbalip.2016.07.003.
        PMID: 27422371
        Similar articles
        Select item 26658900
        4.
        Effect of olive oil phenolic compounds on the expression of blood pressure-related genes in healthy individuals.
        Martín-Peláez S, Castañer O, Konstantinidou V, Subirana I, Muñoz-Aguayo D, Blanchart G, Gaixas S, de la Torre R, Farré M, Sáez GT, Nyyssönen K, Zunft HJ, Covas MI, Fitó M.
        Eur J Nutr. 2015 Dec 12. [Epub ahead of print]
        PMID: 26658900
        Similar articles
        Select item 26136585
        5.
        Olive Oil Polyphenols Decrease LDL Concentrations and LDL Atherogenicity in Men in a Randomized Controlled Trial.
        Hernáez Á, Remaley AT, Farràs M, Fernández-Castillejo S, Subirana I, Schröder H, Fernández-Mampel M, Muñoz-Aguayo D, Sampson M, Solà R, Farré M, de la Torre R, López-Sabater MC, Nyyssönen K, Zunft HJ, Covas MI, Fitó M.
        J Nutr. 2015 Aug;145(8):1692-7. doi: 10.3945/jn.115.211557.
        PMID: 26136585 Free PMC Article
        Similar articles
        Select item 23333095
        6.
        Olive oil polyphenols enhance the expression of cholesterol efflux related genes in vivo in humans. A randomized controlled trial.
        Farràs M, Valls RM, Fernández-Castillejo S, Giralt M, Solà R, Subirana I, Motilva MJ, Konstantinidou V, Covas MI, Fitó M.
        J Nutr Biochem. 2013 Jul;24(7):1334-9. doi: 10.1016/j.jnutbio.2012.10.008.
        PMID: 23333095
        Similar articles
        Select item 22914255
        7.
        Olive oil polyphenols decrease blood pressure and improve endothelial function in young women with mild hypertension.
        Moreno-Luna R, Muñoz-Hernandez R, Miranda ML, Costa AF, Jimenez-Jimenez L, Vallejo-Vaz AJ, Muriana FJ, Villar J, Stiefel P.
        Am J Hypertens. 2012 Dec;25(12):1299-304. doi: 10.1038/ajh.2012.128.
        PMID: 22914255
        Similar articles
        Select item 22872323
        8.
        Beneficial effects of polyphenol-rich olive oil in patients with early atherosclerosis.
        Widmer RJ, Freund MA, Flammer AJ, Sexton J, Lennon R, Romani A, Mulinacci N, Vinceri FF, Lerman LO, Lerman A.
        Eur J Nutr. 2013 Apr;52(3):1223-31. doi: 10.1007/s00394-012-0433-2.
        PMID: 22872323 Free PMC Article
        Similar articles
        Select item 22440854
        9.
        Protection of LDL from oxidation by olive oil polyphenols is associated with a downregulation of CD40-ligand expression and its downstream products in vivo in humans.
        Castañer O, Covas MI, Khymenets O, Nyyssonen K, Konstantinidou V, Zunft HF, de la Torre R, Muñoz-Aguayo D, Vila J, Fitó M.
        Am J Clin Nutr. 2012 May;95(5):1238-44. doi: 10.3945/ajcn.111.029207.
        PMID: 22440854 Free Article
        Similar articles
        Select item 22349682
        10.
        Polyphenol-rich foods in the Mediterranean diet are associated with better cognitive function in elderly subjects at high cardiovascular risk.
        Valls-Pedret C, Lamuela-Raventós RM, Medina-Remón A, Quintana M, Corella D, Pintó X, Martínez-González MÁ, Estruch R, Ros E.
        J Alzheimers Dis. 2012;29(4):773-82. doi: 10.3233/JAD-2012-111799.
        PMID: 22349682
        Similar articles
        Select item 21421296
        11.
        Crossover study of diets enriched with virgin olive oil, walnuts or almonds. Effects on lipids and other cardiovascular risk markers.
        Damasceno NR, Pérez-Heras A, Serra M, Cofán M, Sala-Vila A, Salas-Salvadó J, Ros E.
        Nutr Metab Cardiovasc Dis. 2011 Jun;21 Suppl 1:S14-20. doi: 10.1016/j.numecd.2010.12.006.
        PMID: 21421296
        Similar articles
        Select item 21376434
        12.
        The effect of olive oil polyphenols on antibodies against oxidized LDL. A randomized clinical trial.
        Castañer O, Fitó M, López-Sabater MC, Poulsen HE, Nyyssönen K, Schröder H, Salonen JT, De la Torre-Carbot K, Zunft HF, De la Torre R, Bäumler H, Gaddi AV, Saez GT, Tomás M, Covas MI; EUROLIVE Study Group..
        Clin Nutr. 2011 Aug;30(4):490-3. doi: 10.1016/j.clnu.2011.01.013.
        PMID: 21376434
        Similar articles
        Select item 21216542
        13.
        Olive oil in the primary prevention of cardiovascular disease.
        Ruiz-Canela M, Martínez-González MA.
        Maturitas. 2011 Mar;68(3):245-50. doi: 10.1016/j.maturitas.2010.12.002. Review.
        PMID: 21216542
        Similar articles
        Select item 20934731
        14.
        Olive oil phenols modulate the triacylglycerol molecular species of human very low-density lipoprotein. A randomized, crossover, controlled trial.
        Perona JS, Fitó M, Covas MI, Garcia M, Ruiz-Gutierrez V.
        Metabolism. 2011 Jun;60(6):893-9. doi: 10.1016/j.metabol.2010.08.010.
        PMID: 20934731
        Similar articles
        Select item 20682710
        15.
        Inhibition of hypoxia inducible factor-1alpha by dihydroxyphenylethanol, a product from olive oil, blocks microsomal prostaglandin-E synthase-1/vascular endothelial growth factor expression and reduces tumor angiogenesis.
        Terzuoli E, Donnini S, Giachetti A, Iñiguez MA, Fresno M, Melillo G, Ziche M.
        Clin Cancer Res. 2010 Aug 15;16(16):4207-16. doi: 10.1158/1078-0432.CCR-10-0156.
        PMID: 20682710 Free Article
        Similar articles
        Select item 20406432
        16.
        Gene expression changes in mononuclear cells in patients with metabolic syndrome after acute intake of phenol-rich virgin olive oil.
        Camargo A, Ruano J, Fernandez JM, Parnell LD, Jimenez A, Santos-Gonzalez M, Marin C, Perez-Martinez P, Uceda M, Lopez-Miranda J, Perez-Jimenez F.
        BMC Genomics. 2010 Apr 20;11:253. doi: 10.1186/1471-2164-11-253.
        PMID: 20406432 Free PMC Article
        Similar articles
        Select item 20179144
        17.
        In vivo nutrigenomic effects of virgin olive oil polyphenols within the frame of the Mediterranean diet: a randomized controlled trial.
        Konstantinidou V, Covas MI, Muñoz-Aguayo D, Khymenets O, de la Torre R, Saez G, Tormos Mdel C, Toledo E, Marti A, Ruiz-Gutiérrez V, Ruiz Mendez MV, Fito M.
        FASEB J. 2010 Jul;24(7):2546-57. doi: 10.1096/fj.09-148452.
        PMID: 20179144 Free Article
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        Select item 20089783
        18.
        Elevated circulating LDL phenol levels in men who consumed virgin rather than refined olive oil are associated with less oxidation of plasma LDL.
        de la Torre-Carbot K, Chávez-Servín JL, Jaúregui O, Castellote AI, Lamuela-Raventós RM, Nurmi T, Poulsen HE, Gaddi AV, Kaikkonen J, Zunft HF, Kiesewetter H, Fitó M, Covas MI, López-Sabater MC.
        J Nutr. 2010 Mar;140(3):501-8. doi: 10.3945/jn.109.112912.
        PMID: 20089783 Free Article
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        Select item 20070918
        19.
        Effects of dietary extra-virgin olive oil on behaviour and brain biochemical parameters in ageing rats.
        Pitozzi V, Jacomelli M, Zaid M, Luceri C, Bigagli E, Lodovici M, Ghelardini C, Vivoli E, Norcini M, Gianfriddo M, Esposto S, Servili M, Morozzi G, Baldi E, Bucherelli C, Dolara P, Giovannelli L.
        Br J Nutr. 2010 Jun;103(11):1674-83. doi: 10.1017/S0007114509993655.
        PMID: 20070918
        Similar articles
        Select item 19712933
        20.
        Effect of Mediterranean diet on the expression of pro-atherogenic genes in a population at high cardiovascular risk.
        Llorente-Cortés V, Estruch R, Mena MP, Ros E, González MA, Fitó M, Lamuela-Raventós RM, Badimon L.
        Atherosclerosis. 2010 Feb;208(2):442-50. doi: 10.1016/j.atherosclerosis.2009.08.004.
        PMID: 19712933

    2. Here are two articles on Extra Virgin Olive Oil from Dr. Mary Flynn, PhD, RD, Associate Professor of Clinical Medicine at Brown University’s Alpert Medical School. She teaches nutrition at Brown University and lectures on nutrition in the medical school. She answers the question “How solid is the science surrounding olive oil?” She promotes a PLANT BASED DIET by the way and has found her patients consume far more vegetables when using EVOO for the reasons described:

      http://www.truthinoliveoil.com/2013/10/science-cooking-olive-oil
      http://www.truthinoliveoil.com/2013/04/truth-on-olive-oil-health

      Here are the citations she makes:

      1. Covas MI, Nyyssonen K, Poulsen HE, et al. The effect of polyphenols in olive oil on heart disease risk factors: a randomized trial. Ann Intern Med 2006;145:333-41.
      2. Salvini S, Sera F, Caruso D, et al. Daily consumption of a high-phenol extra-virgin olive oil reduces oxidative DNA damage in postmenopausal women. Br J Nutr 2006;95:742-51.
      3. Madigan C, Ryan M, Owens D, Collins P, Tomkin GH. Dietary unsaturated fatty acids in type 2 diabetes: higher levels of postprandial lipoprotein on a linoleic acid-rich sunflower oil diet compared with an oleic acid-rich olive oil diet. Diabetes Care 2000;23:1472-7.
      4. Ferrara LA, Raimondi AS, d’Episcopo L, Guida L, Dello Russo A, Marotta T. Olive oil and reduced need for antihypertensive medications. Arch Intern Med 2000;160:837-42.
      5. Fito M, Cladellas M, de la Torre R, et al. Antioxidant effect of virgin olive oil in patients with stable coronary heart disease: a randomized, crossover, controlled, clinical trial. Atherosclerosis 2005;181:149-58.
      6. Ruano J, Lopez-Miranda J, de la Torre R, et al. Intake of phenol-rich virgin olive oil improves the postprandial prothrombotic profile in hypercholesterolemic patients. Am J Clin Nutr 2007;86:341-6.
      7. Beauchamp GK, Keast RS, Morel D, et al. Phytochemistry: ibuprofen-like activity in extra-virgin olive oil. Nature 2005;437:45-6.
      8. Kim MK, Park JH. Conference on “Multidisciplinary approaches to nutritional problems”. Symposium on “Nutrition and health”. Cruciferous vegetable intake and the risk of human cancer: epidemiological evidence. Proc Nutr Soc 2009;68:103-10.
      9. Fowke JH, Longcope C, Hebert JR. Brassica vegetable consumption shifts estrogen metabolism in healthy postmenopausal women. Cancer Epidemiol Biomarkers Prev 2000;9:773-9.
      10. Flynn MM, Schiff AR. A Six-week Cooking Program of Plant-based Recipes Improves Food Security, Body Weight, and Food Purchases for Food Pantry Clients. Journal of Hunger & Environmental Nutrition 2013;1.
      11. Flynn MM, Reinert SE. Comparing an olive oil-enriched diet to a standard lower-fat diet for weight loss in breast cancer survivors: a pilot study. J Womens Health (Larchmt);19:1155-61.
      12. Rickman JC BC, Barrett DM. Nutritional comparison of fresh, frozen, and canned fruits and vegetables II. Vitamin A and carotenoids, vitamin C, minerals and fiber. Journal of the Science of Food and Agriculture 2007;87:1185-1196.
      13. Rickman JC BD, Bruhn CM. Nutritional comparison of fresh, frozen and canned fruits and vegetables. Part 1. Vitamins C and B and phenolic compounds. Journal of the Science of Food and Agriculture 2007;87:930-944.
      14. Burdge GC, Jones AE, Wootton SA. Eicosapentaenoic and docosapentaenoic acids are the principal products of alpha-linolenic acid metabolism in young men*. Br J Nutr 2002;88:355-63.
      15. Burdge GC, Wootton SA. Conversion of alpha-linolenic acid to eicosapentaenoic, docosapentaenoic and docosahexaenoic acids in young women. Br J Nutr 2002;88:411-20.
      16. Bastida SS-M, FJ. Thermal oxidation of olive oil, sunflower oil and a mix of both oils during forty continuous domestic fryings of different foods. Food Sci Tech Int 2001;7:15-21.
      17. Gennaro L, Piccioli Bocca, A, Modesti, D, Masella, R, Coni, E. Effect of biophenols on olive oil stability evaluated by thermogravimetric analysis. Journal of Agricultural and Food Chemistry 1998;46:4465-4469.
      18. Allouche Y, Jimenez A, Gaforio JJ, Uceda M, Beltran G. How heating affects extra virgin olive oil quality indexes and chemical composition. J Agric Food Chem 2007;55:9646-54.
      19. Cicerale S, Conlan XA, Barnett NW, Sinclair AJ, Keast RS. Influence of heat on biological activity and concentration of oleocanthal–a natural anti-inflammatory agent in virgin olive oil. J Agric Food Chem 2009;57:1326-30.
      20. Garcia JM, Yousfi K, Mateos R, Olmo M, Cert A. Reduction of oil bitterness by heating of olive (Olea europaea) fruits. J Agric Food Chem 2001;49:4231-5.
      21. Brenes M, Garcia A, Dobarganes MC, Velasco J, Romero C. Influence of thermal treatments simulating cooking processes on the polyphenol content in virgin olive oil. J Agric Food Chem 2002;50:5962-7.

  6. I’ve started doing “whole foods” after failing on the Med diet and am having great success since the 1/2/17 losing 12 pounds and not really feeling hungry except every once in a while before morning breakfast. If I am not hungry and there is no other underlying cause for the weight loss, is it possible I am losing weight too fast? I started with a BMI of 30.2 6’3″ 251. I figure I need to get to at least 190. I am in no rush to get there, but I don’t want to just eat because I like to eat and can eat compulsively if I let myself. I’m thinking my body will tell me if I am hungry and I eat additionally if need be. Any thoughts?

    1. I wouldn’t worry about it, the weight loss will happen fast at first, and just let your appetite dictate how much to eat, and that will determine how fast you will continue to drop lbs. I was so amazed I could eat so much and still lose weight, for the first time ever.

      1. Vege-tater, I had the same experience–miraculously dropping 30 lbs without being hungry and then 5 more when I eliminated oil/fat. Now I’m stuck on the high end of the “overweight” BMI and can’t seem to budge any further. If you have any ideas/thoughts, please let me know.

        1. Liisa: I have some ideas for you that come from the experts I follow. I’m sure Vege-tater will get back to you, but I thought that you might want to see this information too.
          .
          The nice thing about your situation is that you already understand half the battle. I’m guessing from your post that you already understand about the importance of a whole plant food diet and have at least a sense of how to implement it. That’s half the learning curve. The other half is understanding the concept of calorie density and how to apply it to weight loss so that you don’t get hungry and you still get all the nutrients you need.
          .
          Dr. Greger covers calorie density (http://nutritionfacts.org/video/eating-more-to-weigh-less/ ), but not in enough detail in my opinion for someone who wants to apply it for the first time. Doug Lisle, one of the experts in the Forks Over Knives documentary, gives a great ‘calorie density 101’ talk officially called: How To Lose Weight Without Losing Your Mind. I have watched the following talk from Doug Lisle several times and think very highly of it. And it’s free!!! And it’s entertaining! https://www.youtube.com/watch?v=xAdqLB6bTuQ
          .
          As good as Doug Lisle’s talk is, it pretty much just gives you a solid understanding of the concept, but not enough practical information in my opinion. For starting to get the practical information, I recommend a talk from Jeff Novick,Calorie Density: “How to Eat More, Weigh Less, and Live Longer,” http://www.jeffnovick.com/RD/Calorie_Density.html If talks aren’t your thing, the following article from Jeff covers a lot of the same information: http://www.jeffnovick.com/RD/Articles/Entries/2012/5/20_A_Common_Sense_Approach_To_Sound_Nutrition.html
          Be sure to pay attention to the charts.
          .
          Chef AJ tells people who want to lose weight to eat “left of the red line”, where I believe the red line is on a diagram of hers representing is about 650 (or so) calories per pound. And “left of the red line” is all the whole plant foods which are below 650 calories per pound. The above article from Jeff Novick gives you a good sense of which foods are “left of the red line” by food category. But if you want to look up the calorie density of specific foods, you can find many foods on the following site: http://nutritiondata.self.com/ Most foods on that site have the option of choose an ‘ounce’ as a size. Then you can multiply by 16 to get the calories per pound.
          .
          It would be perfectly respectable if you are one of those people who are just not interested in the theory. You just want to dive right in and want straight how-to information. If you would rather not think about any of that (or start with the theory and then move onto this step), I have one more suggestion that Dr. Greger also recommends in his book, How Not To Die. Consider going through the free program from PCRM (Physician’s Committee For Responsible Medicine) called 21 Day Kickstart. The program will “hold your hand” for 21 days, including meal plans, recipes, videos, inspirational messages, and a forum (moderated by a very respected RD) where you can ask questions.
          http://www.pcrm.org/kickstartHome/
          (Click the green “Register Now” button.)
          At the end of the program, you will have a very good practical knowledge about how to eat with healthy and “low” (normal for most people) calorie density.
          .
          Another recommendation that Dr. Greger and I share is to get Jeff Novick’s Fast Food videos for tasty, affordable, fast and healthy calorie density recipes. Also, on-line and free is a YouTube series of recipes/cooking shows called something like Chef AJ and The Dietician. I know that Chef AJ will not steer you wrong in terms of weight loss and providing accurate nutrition information.
          .
          How’s that for some tips? If you give these ideas a try, please report back and let us know how it went.

          1. Thea, your list is really excellent. Most of it is recognizable to me. Here’s something I found particularly helpful: “But if you want to look up the calorie density of specific foods, you can find many foods on the following site: http://nutritiondata.self.com/ Most foods on that site have the option of choose an ‘ounce’ as a size. Then you can multiply by 16 to get the calories per pound.” I did that and now am eliminating DATES from my life!

            There are general calorie lists giving general categories to avoid/use, etc. These lists don’t give specific “don’t use XXX” that I need–Such as, for example, “dates.” (I was thinking to myself: is a date a dried fruit? They’re sort of moist–and I really don’t know; I have my suspicions, but I don’t really know. Now I do because of the link you provided.)

            Understanding the concept of calorie density is pretty easy. The problem is that most of the books/articles about whole foods incorporate sugar, (e.g. maple syrup, date sugar, dates,) avocados, nuts, seeds, etc., and it’s hard to incorporate this into a way of life if I want to lose those remaining stubborn pounds. (Is anyone listening out there? This is an idea for a cookbook/food lists for those of us who are still working on the last stubborn pounds!)

            So what cookbooks would provide practical help/guidance? While PlantPure Nation and “The China Study” got me started, I need the next step. Those associated cookbooks, including Fuhrman’s and Esselstyn’s seem to use the high calorie foods in abundance. What am I missing here?

            1. Liisa: Glad I could be of some help!
              .
              You might want to check out Chef Del’s Better Than Vegan cookbook. Chef Del underwent quite a weight loss experience. You can read his story at the front of the book. His cookbook uses pureed cauliflower in a lot of recipes, which is lower calorie density than beans and nuts which are often used in other vegan books for creaminess. And of course, the book is oil-free.
              .
              You might also check out Jeff Novicks Fast Food DVDs. If you read that article or watched the talk by Jeff Novick, you know that he really understands the concept of calorie density and his recipes follow that concept. The recipes in the Starch Solution from McDougall also seem to be a good overall calorie density to me.
              .
              Good luck!

              1. Thank you for these additional recommendations. I appreciate your mentoring–because you really do help people on this site.

                And what a coincidence! I just made some roasted cauliflower for a lesson on rouxbe.com–excellent cooking class, btw. I made soup with the cooked cauliflower in my Vitamix and added a little Parma (1.5 tsp.) They call for oil in the lesson I’m taking, which is a plant-based course, but I substituted some low sodium broth for the oil and am waiting for the teacher to comment. (It’s an online course and I told him what I did.) Personally, Thea, I think much of my problem is that I really miss fat/salt flavors if I don’t use them. I’ve been pretty low-salt and low fat for awhile now, but I still severely crave them. I know you’re not supposed to after a month, but I’m like an alcoholic in this regard. When I go out, about 1-2 times a week, I am all over the vegetarian options on a Chinese menu, for example. So possibly I have to stop eating out; it’s not the act of eating out–it’s “the food” as McDougall says…. :( :( :(

                I’ve seen Jeff Novicks’ DVDs–all except the one that is not in our local library.

                I’ll pay more attention to Chef Del’s recipes/cookbooks, and look for McDougall’s starch solution book. When I looked at McDougall’s recipes sometime previously, my impression was that he uses a lot of flour and even some sugar. I’m nearly 70, so I’ve been pretty hard on myself trying to eat better since I was “bad” for most of my life–about 65 years(?) or so…. I think this is part of the reason I’m finding it difficult to find help; I’m pretty fussy.

                1. what nobody is telling you , fat loss or weight gain is all about Protein plus carbs . If you make sure your protein is really low , like eating rice , potatoes ,most vegetables and some fruits , most grains, beans , animal products would be to high in protein . You will lose weight quickly even if there is some fat in your diet . Dr. Mcdougall says “the fat you eat is the fat you wear” I wish he would put that to the test , simply put a few people on his potato diet, some with a little oil or butter , some with none. What are the results? The good doc would be surprised.

                    1. Good talk . Wasn’t too surprised . She lost weight when she kept her protein intake down while eating a lot of carbs. did she really prove the fat was what was making her overweight ? After all nuts and grains are fairly high in protein as well.
                      If it works that’s all that matters and the video was quite good . thank you.

                    2. Ignatius: I don’t know if Chef AJ proved that it was “fat” per say that helped her to lose the weight in the end. I think the point is that she cut out high-fatty foods which are also very calorie dense. It’s been a while since I watched that talk, but if memory serves, she had to cut out foods like avocado and nuts, both very high-fat, high calorie-dense foods. Chef AJ went from eating a whole food plant based diet that was pretty much what Dr. McDougall already recommended, but also included some nuts and avocados, etc. It wasn’t until she cut out the calorie dense foods (that are very high fat) that she lost the last bit of weight.
                      .
                      I don’t remember Chef AJ saying that she cut out whole, intact grains. (If I’m remembering correctly. You have now seen the talk more recently than I.) I have a magnet from Chef AJ that shows which foods she recommends . If memory serves (the magnet is at home and I’m not…), whole grains, beans, etc are all on the OK list. She just has people eat foods that are 700? calories per pound or less.
                      .
                      Glad you liked the talk! It’s pretty moving I think.

                    3. Yes , she says she eats whole grains , however I have watched a couple other vids where she swaps out oatmeal in favor of brussel sprouts or zucchini for breakfast , again low protein foods .

                    4. Ignatius: I really tried to let this go, but I just had to look up the claim that oatmeal has more protein than say brussel sprouts.
                      .
                      When I do the math, I come up with:
                      >>> oatmeal ~ 18% protein
                      >>> brussel sprouts = 40% protein.
                      .
                      Let me know if you think I got this wrong. The data is from NutritionSelf webite.
                      Oats: http://nutritiondata.self.com/facts/cereal-grains-and-pasta/5708/2
                      1 ounce of oats are 109 calories. 20 of those calories are protein (assuming 4 calories per gram of protein). So: 20/109 = ~18%. (If these are for raw instead of cooked oats, then these numbers would be off. I could not tell.)
                      Brussel Sprouts: http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2363/2
                      1 ounce of brussels is 10 calories. 4 of those calories are protein. So: 4/10 = 40%
                      .
                      Suppose Chef AJ had held the calories the same (ie: eaten the same amount of calories from brussels as from the oats after doing the food swap). In that case, then Chef AJ was getting more protein from the brussels.
                      .
                      On the other hand, suppose Chef AJ had not held the calories the same. Ie, suppose Chef AJ ate say 2 cups of brussels for one cup of oats. Even for a swap like that, Chef AJ would have been getting less calories overall from the brussels. She might have felt just as full because that’s a lot of volume of food. But she got less calories for that volume by eating a less calorie-dense food, which is the point that I was making. Yes, eating brussels over oats would have been less protein, but it would have been less everything : ie, less protein and less carbs and less fat. Eating less calories seems to me like it would be a key factor to losing weight. Why would you assume that for such a food swap, it was just the protein difference that mattered (if this food swap even happened as part of that final weight loss discussed in the video)?
                      .
                      You don’t have to answer. I just wanted to put this idea of protein amounts “out there” when it comes to grains vs greens. The following is one of my favorite sites for explaining protein. It has a nice bar graph showing protein amounts by food category: http://michaelbluejay.com/veg/protein.html As a category, veggies beat grains for protein. Really interesting stuff.

                    5. That chart is SO interesting, Thea!!! When I had hypoglycemia in my 20’s, a nutritionist told me to snack on cheese, nuts, or other protein–exactly what I should NOT have done to help my blood sugar, although I never became diabetic, knock on wood. This nutrition stuff really angers me–how the wrong information is still being disseminated. I am SO thankful for Dr. Greger, all the NF moderators, and all the intelligent commenters !!!

                    6. Liisa: I agree on both fronts. The problem is not that people got it wrong once upon a time, it’s that people in authority are STILL getting it wrong today, despite the irrefutable evidence.

                      The deliberate falsehoods combined with the resulting confusion makes the mission of this site all that more important. I’m proud to support NutritionFacts.

                      Glad you have joined us. :-)

        2. I wish I could, but stuck in the same bind! My whole family was fat and I had been struggling with it all my life, so I was ecstatic when I initially lost almost 150 lbs with maybe 30 more to lose, and without changing anything, it just stopped. The worst was it started creeping back up over time, despite never using oils or high fat foods. So ad libitum does not work for all of us and we still have to be acutely aware of caloric density, or deal with the consequences. Thea has some great info, (thanks Thea, I actually read your reply first!) and Doug Lisle is awesome! Jeff Novick and Chef AJ are great also! Whenever I start feeling sorry for myself that i can’t just be like everyone else after all the changes I made, I remind myself WHY I did, and put things into perspective!

    2. Congrats on your recent success! It’s possible to see quick results in the first few weeks of eating a whole-food, plant-based diet. A lot of the initial weight loss can be fluid related – especially if you’ve significantly cut your sodium intake. You may find that the rate of weight loss slows down over the next week or two. I’m also not surprised you’re not as hungry. A whole-food, plant-based diet is high in fiber, which can help you feel full for a longer period of time. What you’ve described seems normal and very similar what my own patients have experienced when making these dietary changes. If you’re still concerned, there’s no harm in checking in with your regular doctor to update them on your new lifestyle and meal plan. Hope this helps!

  7. How much salt do I save by not eating salt-laden meat, dairy (Is there salt in dairy?), poultry, eggs (fried, scrambled, or boiled w/salt), and pork?

    Is our salt consumption a victim of our carnage and our tastes?

    If we correct our flesh-eating habits and our taste for saltiness, will we use far less salt–the kind of measure Dr. Greger calls for?

  8. Before you wave away that steak consider this latest study which finds that red meat may not contribute to heart disease.

    Conventional beliefs hold that red meat is harmful to the heart, but this new review from Purdue University finds that consuming it in amounts above what is typically recommended does not affect short-term cardiovascular disease risk factors, such as blood pressure and blood cholesterol.

    “During the last 20 years, there have been recommendations to eat less red meat as part of a healthier diet, but our research supports that red meat can be incorporated into a healthier diet,” said Wayne Campbell, professor of nutrition science at the school, which is located in West Lafayette, Ind.

    “Red meat is a nutrient-rich food, not only as a source for protein but also bioavailable iron,” he adds.

    Traditional recommendations to limit red meat from the diet come mainly from studies that relate peoples’ eating habits to whether they have cardiovascular disease.

    While these studies suggest that red meat consumption is associated with a higher risk of cardiovascular disease, they are not designed to show that red meat is causing cardiovascular disease, adds Campbell.

    His team reviewed hundreds of studies, selecting 24 that met their criteria in terms of red meat consumption, evaluation of cardiovascular disease risk factors and study design.

    “We found that consuming more than half a serving per day of red meat, which is equivalent to a three-ounce ounce serving three times per week, did not worsen blood pressure and blood total cholesterol, HDL, LDL and triglyceride concentrations, which are commonly screened by health-care providers,” says Lauren O’Connor, a member of the research team.

    This research includes all types of red meat, mostly unprocessed beef and pork.

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    But more research is needed, Campbell acknowledged, noting that blood pressure and cholesterol are not the sole determinants for someone to develop cardiovascular disease. “It is also important to recognize that our findings are specific to selected indicators for cardiovascular disease risk,” he added

    “Comparable research is needed to assess other health risk factors from clinical trials, including inflammation and blood glucose control,” he adds of the findings, which appear in the American Journal of Clinical Nutrition.

      1. “Surely a meta analysis of 3,106 subjects is more telling?”
        No, a meta analysis is only as good as the studies chosen to include in the analysis. In general, studies that show a positive effect of olive oil on endothelial function have used ischemic reactive hyperemia (stop blood flow with a pressure cuff and then release the cuff and measure flow) to assess endothelial function. The problem is, it is not a reliable measure of endothelial function (for one example, it is independent of the vasodilators nitric oxide and COX products).

        In addition, the link you provided goes to the journal ‘Nutrients’, not a particularly well regarded journal. Further, the American Oil Chemists Society is affiliated with the journal. Does that seem like a conflict of interest?

    1. The bottom line is you are getting second hand protein and accumulated pollutants from the digestive processes of an animal that has to eat plants and die as your food, which you would be far better off getting straight from the earth yourself, also. I don’t think an occasional treat of any kind is going to be fatal if your diet is otherwise good, but occasional can mean twice a year, or once a day, depending on who is interpreting, and that is huge.

    2. I wonder if Campbell’s financial ties to the beef and pork industries have anything to do with the way this study is slanted or the wording of the media release.

      “Campbell received support for other research while this analysis was conducted from the American Egg Board-Egg Nutrition Center, Beef Checkoff, Coca-Cola Foundation, National Dairy Council, National Institutes of Health, Pork Checkoff and U.S. Department of Agriculture.”
      https://www.purdue.edu/newsroom/releases/2016/Q4/nutrition-data-review-shows-red-meat-has-neutral-effect-on-cardiovascular-disease-risk-factors.html

    3. They looked through hundreds of studies to choose less than a dozen… talk about cherry picking!

      And then they choose studies with people getting less than 3 servings of meat a week. That’s flexitarian levels of eating meat, practically vegetarian levels of meat consumption. If you’re eating that low a volume of meat, you are (probably) eating a lot of plants.

      We know that plants in high quantities tend to correct cholesterol and blood pressure issues so between that, them looking at only ‘short term’ outcomes, them only looking at tiny levels of meat consumption, and them looking at only a handful of studies they stacked the deck to make meat look safe. This study was setup to fail from the start.

  9. The word mediterranean should be replaced with the word ‘peasant’ and that will tell you everything you need to know. The dietary benefits of scarcity, consumption of natives greens including bitter leaves and roots, relatively unrefined food stuffs locally made/grown coupled with high levels of hard physical activity/poor access to medicines (to their great benefit)/low levels of pollutants to which we can add a genetic self selection/adaptation to local conditions, gives you a robust human community. Replicating that in any sense today…. well, there’s the challenge. It is not all about agonising over wine and olive oil.

  10. Why has NF.org closed comments on the 1-20-17 post by Dr. Greger? I sometimes find commenters opinions fascinating–such as the post of Doug Lisle’s Ted Talk below. Please keep comments open!

    1. Thank you for your comment, Liisa. I believe this was an error and appears to have since been reversed. I also greatly appreciate the discussions here. Thank you for letting us know!

    1. Thank you for your comment, Susan. I believe this was an error and appears to have since been reversed. I also greatly appreciate the discussions here. Thank you for letting us know!

  11. I have a vital video request, where would be the best place to post it? I would love to see a single video that lays out the plethora of reasons it’s best to avoid animal products….primarily for our health, but also with reference to their health and the planet’s health. Almost every time I try to run down the list I go brain dead and emotion gets in the way, especially when the cholesterol deniers start spouting the mantra of their gurus, as if there are no other issues, or how we have “always” eaten it! There are other videos out there but they are by vegans who tend to be righteous about the animals, so avoid the actual affects of consuming them by humans. It would be so nice to have a studious, level headed, Dr G video to share, that lays out the actual specifics of all the detriments and with mention made that grass fed or CAFO raised meat are BOTH muscle with health deficits, and the same ugly slaughter is involved, because I always get people saying they buy meat that is grass fed, or free range, or whatever phony acronym gets used, like that negates any issues, let alone is more “sustainable”! It would also help each of us to compile all the separate health issues like the detriments of ingesting foreign animal protein, fat, contamination, hormones, and so on, (including at least a mention of all the ones I always have to look up like IGF-1, Neu5Gc, and DNA damaging chemicals, endotoxins, neurotoxins, etc) into one convenient volume for our edification. Everyone I know is convinced that we are some kind of obligate omnivores and NEED meat to be healthy and not just survive, and you and I are some kind of radical “vegans” with an “agenda”… because it’s so much easier to slap a label on someone and shelve them, than to challenge your comfortable beliefs!

    1. Vege-tater: Being a site about nutrition, I don’t think we would be doing a video that lists the ethical and environmental reasons to avoid animal products. Plus, that would be a *very* long video.
      .
      I wonder if you would consider the topic page on the general category of ‘meat’ to be helpful? It lists many of the reasons to avoid meat from an individual human health perspective: http://nutritionfacts.org/topics/meat/ The page needs some paragraphs and organization, but it might be the place/page to at least partially meet your request. What do you think?

      1. Thanks, that will do I guess, but is geared for those already interested and willing to investigate, I was just hoping for a succinct video to share with the clueless who are very unlikely to bother. I didn’t expect him to expound of the ethical and environmental topics, just a mention to wrap it all up for contemplation.

    2. One of the strongest arguments is pretty simple to understand, the healthiest, longest lived, large people group ever studied, California Adventists, do not eat meat. So if you want good health and long life, you should probably do likewise. It is very well documented that a plant based whole food diet dramatically lowers heart disease risk, talk to anyone that got bloodwork done before and after, and you will find out about their big drop in LDL. That’s avoiding the NUMBER ONE killer of Americans, heart disease. How about cancer? It is very well documented now that phytonutrients help prevent cancer, phytonutrients come from eating plants, the more diverse and nutrient dense, the better. Meat on the other hand, fuels cancer by boosting IGF-1 (growth factors). It should be noted that refined sugar (and refined flour) is probably just as bad for your health as meat, and “vegans” often eat poor diets including junk food, refined sugar, and processed foods, which is one reason they don’t live dramatically longer than meat eaters. Dr. G never promotes “veganism” he promotes the plant based whole food diet.

  12. Surprised no mention of cheese in this article. My understanding is that cheese is consumed in the traditional Mediterranean diet. Which people love to offer as a reason to eat “a Greek salad with olives and feta cheese.” In fact, as Dr. Greger and other authorities point out, no dairy cheese is a healthy food choice. Eat the Greek salad with olives, but hold the feta (or any other dairy cheese) and olive oil dressing.

  13. Can someone fix the last sentence. It is written “No main Mediterranean meal is replete without lots of greens, a key part of not only a good Mediterranean diet, but of any good diet.” The word “replete” is incorrect and should be “complete”. If you want to use “replete” in the sentence you could say, “No main Mediterranean meal is COMPLETE unless it is REPLETE with greens, a key part of not only a good Mediterranean diet, but of any good diet.”

  14. Thank you for mentioning alcohol is a carcinogen, it is a pro-oxidant that is almost as dangerous as tobacco is. Except all we hear from certain groups is “tobacco is bad but alcohol and marijuana are good”, no hypocrisy there.

  15. Hi Dr. Greger,
    I was searching for information about ‘Lectins’ in your website and in your book “How not to Die” and there’s none. It seems that it’s pretty bad for the health and a lot of food that here appears as a healthy, ‘allegedly’ is not, because its amount of Lectins, as All grains. Nightshades including tomato, peppers, potato, and eggplant. Gluten from wheat, rye, barley, malt, and maybe oat. Legumes – All beans including soy and peanut. Dairy including milk, and milk products as cheese, cottage cheese, yogurt, and kefir. Yeast (except brewer’s and nutritional). All lot of fruits and vegetables… Would you please explain the ‘Lectin’ ‘thing’ in the aliments and if it’s toxic or not? Thank you!

  16. Though I respect and agree with most of Dr.Grieger’s info, and I am a practicing vegan, this is where we (and Dr. Neal Barnard, etc) part ways.
    Olive oil has been proven to be extremely therapeutic. As a personal anectode, it completely reversed my Herceptor Positive Breast Cancer within 4 months. (Based on an article I read at GreenMedInfo.com, I increased my olive oil intake significantly, rather than start “Herceptin”, the pharmaceutical drug.)
    In addition, this incredibly healthful, antioxidant, plant-based fat has been proven to be helpful for a variety of health imbalances, most notably, “inflammation”, which is basically the root of all disease processes.
    In the quest for health “perfection”, don’t get too carried away. “Perfection is the enemy of the Good.”
    Wisdom might be lost in the fervor to find perfection.

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