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Moderation Kills

What if we don’t want just low risk for a heart attack, but no risk? One great stumbling block has been that government and national health organizations appear to have taken the patronizing view that the public can’t handle the truth and would rather the science be watered down.

However, as Dr. Esselstyn wrote in the Cleveland Clinic Journal of Medicine, in regard to cholesterol lowering, moderation kills. “Even if all Americans kept their total cholesterol below 200 mg/dL, as recommended by the American Heart Association, millions would develop coronary artery disease.” Strong evidence shows we need to keep our total cholesterol under 150 mg/dL in order to stem the American epidemic of coronary artery disease, our number-one killer. What kind of evidence? In many cultures, coronary artery disease is practically unheard of when total serum cholesterol levels are under 150 mg/dL. In the United States, the famous Framingham Heart Study demonstrated that few of those with levels below 150 mg/dL developed heart disease, and none died from it.

In my video Everything in Moderation? Even Heart Disease? you can see the data from a 26-year follow-up of the Framingham Heart Study comparing the cholesterol levels of people who get heart attacks and the cholesterol levels of those who don’t. The study suggests that because we now know that 35% of heart attacks occur in people with total cholesterol levels of 150-200 mg/dL, a target level of only 200 mg/dL guarantees that millions of U.S. citizens will die from coronary artery disease.

Dr. Esselstyn states, “We cannot continue to have public and private organizations on the forefront of health leadership recommend to the public a dietary plan that guarantees that millions will perish from the very disease the guidelines were supposed to prevent. With its lack of fiber and antioxidants, and its emphasis on animal protein, fat, and extreme free-radical production, the US diet is largely responsible for our bitter harvest of [chronic] diseases….” He continues, “If the coronary artery disease epidemic is seen as a raging fire, and cholesterol and fats as the fuels, the AHA [American Heart Association] has merely recommended cutting the flow of fuel. The only tenable solution is to cut off the fuel supply altogether—by reducing cholesterol levels to those proven to prevent coronary artery disease.”

It’s worth closely examining the Framingham data. At first, it seems those who get heart disease and those who don’t have very similar cholesterol levels, but that’s only at “normal” levels. To get an Optimal Cholesterol Level, one has to eat an exceedingly healthy diet. It’s worth it, though, since we’re not just talking life and death with heart disease, but life and the number-one cause of death.

What’s so bad about having high cholesterol? Well, it’s not only involved in the formation of atherosclerotic plaque, as I discuss in my video, Cholesterol Crystals May Tear Through Our Artery Lining. What about fluffy versus dense cholesterol? I cover that in Does Cholesterol Size Matter?. But can’t you just take cholesterol-lowering statin drugs? I encourage you to see The Actual Benefit of Diet vs. Drugs. When should we start monitoring cholesterol? As it turns out, Heart Disease May Start in the Womb.

For more on this concept of being at normal risk and dying from all the normal diseases, watch my video, When Low Risk Means High Risk. I continue questioning the patronizing paternalism of authorities in Optimal Diet: Just Give It To Me Straight, Doc. Finally, check out my latest heart disease overview, How Not to Die from Heart Disease.

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:


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.

236 responses to “Moderation Kills

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      1. The L. A. Times is not a medical journal. Why are we looking at that? The authors are not M.D.’s nor are they dieticians. Again, why are we looking at this article?

        1. The LA Times just reported what the experts who are not tools of the FDA, have been saying for years. And there are billions of people in the world to prove what they said. Just look at France for example, or the true Chinese in the past and not the ones as described in a fantasy novel.

          1. Afraid your post is the usual “fantasy” post trying to discredit proven results made by real physicians who are actually NOT part of the mainstream BS.

            1. The mainstream doctors are at the heart of our biggest health disaster of the century. They are tools of Big Pharma and Big Foods and the FDA and CDC.

          2. Dr. Greger is hardly a “tool of the FDA.” Or of the USDA, which promulgates the USA Dietary Guidelines — subject to and heavily modified by intense lobbying from the meat, dairy, and poultry industries. (e.g., and Recommending a whole foods plant based diet seems more like a lone voice in the wilderness to me. Which is a darn shame.

          3. Those people aren’t experts . They are two journalists who make money selling books that misrepresent the science so they can tell people what they want to hear – ti’s healthy to eat foods high in saturated fat. It ‘s a formula that made Atkins rich, Taubes certainly isn’t short of a penny or two and Teicholz is now more famous than she could ever have dreamed.
            You must have heard of journalists Jerry – people who never let the facts get in the way of a good story.

            Yeah and I am pretty sure that the World Health Organization, national governments around the world and professional medical associations all around the planet are not “tools of the FDA” . The idea that the FDA in any case is engaged in some evil plot to persuade Americans to eat unhealthy foods land hide the “fact” that high saturated fat animal foods are “healthy” is a ridiculous conspiracy theory that makes no sense whatsoever (and let’s not even mention the total lack of evidence for such loony beliefs).

            Then you mention your fantasies about France and China, I am pretty sure that the French and Chinese know a lot more about this topic than you do. The French are quite clear that they need to “Limit the consumption of total fat and particularly of saturated fat;”

            And the idea that the Chinese traditionally ate diets rich in saturated fat and cholesterol is just too absurd for words, As is your idiotic claim that the China study conducted by the Chinese Academy of Preventive Medicine, Oxford University and Cornell University is merely a ‘novel”.

            1. Yeah we know that you believe in the WHO, FDA and CDC and it is not surprising that you fried your own liver and kidney based on their advices.

              And while you have been to Asia and know exactly what people there eat, you continue to distort the reality to justify and protect your former employers at the WHO, FDA and CDC. What a loyal employee you are except that you are causing o much harm to your fellow human beings bu literally lieing and deceiving.

              Read the following article and see what they said – I bet that you will say that it was not written by an MD despite the very logical analysis and numerous references at the end of the article.


              “One of the biggest changes that has occurred is the shift from eating foods rich in saturated fat and cholesterol, to eating low-fat, and low-cholesterol foods. Since the 1970s we have been in a low-fat craze. Saturated fat and cholesterol have been purged from the diet. We’ve switched from eating whole foods rich in natural fats to low-fat and non-fat milks and cheeses, lean cuts of meat, yolkless egg whites, skinless chicken, low-fat this and no-cholesterol that. Everywhere you go, you are offered low-fat food options. Total fat consumption has dropped from about 40 percent of total calories in the 1960s to about 30 percent now. Dietary fat has been demonized so severely that out of fear many people restrict their total fat intake to less than 20 percent. As a result, we have become a fat deficient society.”

              1. Poor Jerry. Your delusions are simply getting worse.

                The paper you refer to is not by an MD despite your claim. It is by the professional clown called Dr Dropo who earns his living promoting coconut oil and other coconut products. Yes, he calls himself “Dr” Fife now and claims to possess a doctorate in naturopathy.. He may be right although he doesn’t say where he obtained. Perhaps he bought it from a diploma mill or found it in a fortune cookie. Who knows. In any case, from the extract you posted here, it is quite clear that he is making false claims. But hey it sells coconut oil, so who cares?

                I did not fry my liver and kidney and, no, I did not and do not work for the WHO, FDA or CDC. They are nevertheless a lot more credible as sources of information than Dr Dropo or any of the other obvious hucksters you believe in. Only crackpots believe something so utterly ludicrous

                Little wonder that people laugh at conspiracy nuts who think clowns are superior sources of information on nutrition and health than the WHO etc Why on Earth do you choose to believe such obvious rubbish?

          4. Jerry,

            Not once, in your hundreds of posts here, have I seen you directly address a study cited by Dr Greger. Whenever I can afford to, time & money wise, I read the studies for myself. Scores of them so far, as critically as I can, checking for the journal for peer-review, and the study for profit motives, the structure of the trial, methodology, confounding factors, whether the data match the conclusions. I have yet to catch Dr Greger in a conclusion not supported by the research he cites, or citing industry-tainted research.

            I have read a few of the sources you link to and I definitely can’t say the same. The sources are not high quality, and very often linked to industry profit motives. When they are clinical science at all, which they often are not.

            And that’s the whole point of your approach, right? “FUD”… fear, uncertainty, and doubt. Distract from the high quality clinical science , for motivations the rest of us can only guess at. Because you can’t refute the clinical science directly.

            1. Re: once, in your hundreds of posts here, have I seen you directly address a study cited by Dr Greger.

              Because the only thing I can quote is article about eating WFPB which we all agree and know, including myself. But it is hard to find an article by Dr G talking about WFPB alone without a mentioning of the 70 year old cholesterol and saturated fat bad theories plus distorted view of anything related to animal food. So unless this is a vegan site, and even if it is so, then there is no reason to have to resort to trashing one type of food that causes no harm while promoting eating plant foods. It’s not a case of one or the other and not both.

              And all articles that I posted have a long list of references down below plus very logical analysis such as this one.


              “A lack of adequate fat and cholesterol in the diet can have a pronounced effect on the health of every cell in the body and particularly on the neurons – the brain cells. The fat we eat influences the amount of fat and cholesterol available to the brain. Our diet can have a pronounced influence on our mental health. Cholesterol, for instance, is essential for the transmission of nerve impulses and for the storing and retrieving of memories. The synapses – the highly specialized junctions between the brain cells – depend on cholesterol in order to transmit signals from one neuron to another.2 Any interference with normal cholesterol synthesis can impair nerve tissue maintenance and repair, leading to neuron degeneration.3 Even a small depletion of cholesterol – less than 10 percent – has been shown to be enough to inhibit nerve transmission.4 When this happens memory and cognitive skills decline.5

              A number of studies have shown that the amount of cholesterol circulating in the blood influences brain function. Low blood cholesterol is associated with poor cognitive performance. Higher cholesterol levels appear to improve memory and cognitive skills and protect against neurodegenerative diseases such as Alzheimer’s.

              For example, researchers at Johns Hopkins University monitored a group of 392 subjects for 18 years. All of the subjects were 70 years of age at the beginning of the study. Every few years the investigators measured their cholesterol levels and conducted cognitive tests. The study revealed that those people with the highest blood cholesterol levels scored the highest on cognitive tests.6”

                1. I heart that it is always a comfort zone where everybody pat on each other shoulder and say that we are very healthy and we will live to 130 year old. It’s also a worship place where they revere a God.

                2. Looks like a few of the bone broth, high cholesterol & meat/dairy addicts are keen to stick around with the “mutual admiration society”. I wonder why!

                3. Oh, come on, he keeps quoting an artcle by a professional clown to support his ridiculous.

                  Of course, your own views seem a little naive themselves.

              1. Because the only thing I can quote is article about eating WFPB which we all agree and know, including myself.

                And yet you advocate against WFPB eating in your many posts. For example, you promote coconut oil, which is not a whole food.

                But it is hard to find an article by Dr G talking about WFPB alone without a mentioning of the 70 year old cholesterol and saturated fat bad theories plus distorted view of anything related to animal food.

                I don’t believe the age of evidence automatically invalidates it — and neither do you! You very often cite your impressions (valid or not) of what ancient cultures did as evidence.

                The Framingham study is the real deal. It’s so significant is has it’s own Wikipedia page. Yes, as a longitudinal study it started years ago but neither the data nor the theories are stuck in 1948. Here are the key scientific discoveries by Framingham so far (warning, it’s a pretty astounding list).

                As for your link… an article by a nutritionist. Typical of the junk science you seem to favor.

                And as for the Johns Hopkins research, I can’t find the source article you quoted because you didn’t provide a link to it. (You never link to pubmed or the publishing journal, do you?)

                I did find this meta analysis of 18 studies following about 30,000 patients over 3 to 20 years. It shows a strong association between total cholesterol (TC) at midlife and increased risk of any form of dementia and Alzheimer disease (AD). A specific form, Vascular dementia (VaD), wasn’t affected by total cholesterol at midlife.

                Consistent associations between high midlife TC and increased risk of AD, and high midlife TC and increased risk of any dementia were found. There was no evidence supporting an association between late-life TC and AD, or between late-life TC and any dementia. No study reported a significant association between TC (measured in midlife or late-life) and VaD. An association between high midlife TC and cognitive impairment was found but there was only weak evidence for an association between TC and cognitive decline. Two of seven studies reporting data on the interaction between TC and apolipoprotein e4-allele had significant effects. Results suggest the effect of TC on dementia risk occurs in midlife but not late-life, and that there may be different cardiovascular risk factor profiles for AD and VaD.

                The bottom line seems to be that high cholesterol influences the onset of Alzeimer’s and dementia long before the diseases manifest. Of course many additional factors are involved, including genetics.

                1. Re: And yet you advocate against WFPB eating in your many posts. For example, you promote coconut oil, which is not a whole food.

                  Hmm??? If I can climb a tree to pick and eat coconut, I will do, But since I live in the city then I have to get as close to whole food as possible such as using virgin coconut oil. Just like I consume olive oil for my salad, or nut in a package that does not look like the original nut from the tree, or flax, chia seed, rice, tea. etc. that are processed, or …

                  Talking with Suzan is a lot of fun, because she starts to make long rambling posts like TG without getting angry like him.

      2. I looked at the data referenced in the LA Times article.
        It says that Americans are eating less than the recommended amounts of fruits, vegetables and dairy, and eating more than the recommended amounts of protein foods, grains, added sugar, and added fats and oils. I suspect that the increased grain consumption is in products processed with added sugar and fats/oils.
        But the article just says that people have been following the guidelines to increase grain, fruit and vegetables and the obesity and diabetes is going up. The data seemed to indicate that people are not actually following the recommendations. They’re eating too much processed grains with added sugar and fat and too much protein.
        And the article says that type 2 diabetes can be reversed with a ketogenic diet.
        Um, type 2 diabetes has been reversed by many people on a WFPB diet, which is much healthier long-term than a ketogenic diet.

        1. April, a type 2 diabetic, caused by obesity and insulin resistance, can indeed be reversed with a typical WFPB diet.
          But the 20% or so type 2’s who do not make enough insulin have to be on a very low carb diet. Usually no more than 20 or so carbs, very low glycemic ones, per meal.
          Can it be WFPB? Absolutely, what I tell them to do.
          But the diet of many people here, eating grains and high carb vegetables, like root vegetables, cannot be eaten by them if they want to control their sugars.
          I just sent one of my clients a recipe for 8carb per serving pancakes made with almond flour and ground flaxseed, topped with a strawberry sauce.
          So it can be done, but the typical person who says they are eating WFPB eats way too many carbs for type 2’s, and of course for type 1’s.

          1. Marilyn –
            Is there a book that describes in some detail, a low carb, high fat WFPB diet for that 20% (which I think are the same as the so-called type 1.5’s who have an autoimmune disease)? Or the names of some doctors who use low carb, high fat WFPB diets to reverse T2D?

            My daughter, who has T2D and had had gestational diabetes, might fall into that class as she claims even intact whole grains raise her blood sugar too high, and I’d like to be able to help her get beyond the standard treatment model, which seems not to be working.

            Do you know if there’s a link between gestational T2D and type 1.5?

            1. David, I’ve not been able to find a doctor who does this.
              I use Dr. Bernstein’s book (Diabetes Solution) for guidelines to teach people how to monitor their sugars. But he is not even vegetarian. But he is the best authority on diabetics as a disease.

              So I have had to basically teach them how to swap animal protein for vegetable protein. I have had to resort to some keto recipes for things like the pancakes I mentioned.
              I agree with Dr. Bernstein that diabetics can have normal blood sugars. But, unless they are overweight, they will have to swap carbs with fats.
              I do think he recommends too much protein. But that is mainly for type 1’s.
              Dr. mark Hyman, in his Advanced Plan for diabetics addresses it some.
              But he isn’t vegetarian either.
              I think most doctors think all adult diabetics are just insulin resistant. That is in spite of research dating back 20 years showing genetic causes in at least 20% of them. As I said, it’s been proven, many diabetics cannot make enough insulin to have normal sugars.

              I agree with your daughter, that you cannot be a healthy diabetic using most ADA or similar type guidelines. And the Epic-Norfolk Cancer Study, (which I can no longer give you access to, unfortunately, have to pay for it), showed that the biggest risk factor for all cause mortality, including heart disease, was A1c.
              She is right about ‘healthy whole grains’. Only a very few mild type 2’s can eat them.
              And yes, according to studies women who have gestational diabetes are very likely to go to MODY, or type 1.5.

              1. Thanks, Marilyn!
                I’ll read his book.

                It seems to me the first order of business is to lose weight, typically a lot of weight (as Dr. Greger has pointed out in some video) to see where the person really lies on the type 1, type 1.5, type 2 scale, and the method used is less important (ignoring bariatric sugery!). One viable approach seems to me to be to follow the 5:2 fasting plan (5 days normal amount of cals, 2 nonsuccessive days ~500-800 cals).

                Have you had much experience with the 5:2 fasting approach (5 days regular calorie intake, 2 nonsuccessive days ~500-800 cals) or similar approaches?

                1. David, yes, I have recommended a fasting diet such as you describe when someone is overweight, and for women with PCOS. Generally Glucophage helps the latter quite a bit, and is a decent drug if you supplement with B12.
                  For those who do not want to fast at 500-600 calories for the 2 days, some prefer to cut hours when food is consumed, cut out a meal, do 2, 400 calories meals a day etc. I try to work with what the individual can handle without being miserable.
                  Of course, on these diets you need to lower both fast acting carbs and fats.
                  I find upping food volume (veg soups, veg oil-free stir fries, salads) so they can feel satisfied, and some protein with each meal helps. Tofu works great for all of these uses.

            2. There is a definite link between diabetes when pregnant and Type II diabetes. Generally it is a precursor to later disease. Your daughter needs to guard against being over weight or eating a high fat diet. In that way she can most likely avoid diabetes in the future. Eating a low fat WFPBNO diet is a good life style for her as it is for everyone.

              1. Thanks, Donna.

                But the issue I am most concerned about is whether she has true T2D, which I believe can be reversed with a high carb, low fat WFP diet (as Barnard as shown in published results) or type 1.5.

                It seems common to call anyone not actually type 1 “type 2”, but I find that muddies the murky waters since unlike “true” T2’s (who have sufficient beta cells), type 1.5’s do not have enough beta cells to produce sufficient insulin to metabolize lots of carbs, and so would be predicted not to do well on a high carb diet, at least as I understand things (my knowledge is admittedly wanting). And this results in unproductive debates about which diet is best for reversing T2D, since there would be no one such diet..

                1. Btw David, I looked into the details of that Barnard study.
                  The ‘placebo’ group was on the ADA diet.
                  The Barnard group lowered their A1c’s, long term, about .3%, from around 8 to 7.7. A bit better than the ADA, but anything above 6, (average reading round the clock of 125), is really unacceptable. That’s the number where, long term, you get heart disease, retinopathy, neuropathy etc.
                  A Swiss study done with continuous glucose monitoring showed normal people after a high carb meal average 125 at their peak, and come down to 85 or so in less than 2 hours. Even the high outliers in the study didn’t go above 140, and came down to 100 or so.

                  1. Marilyn,
                    Thanks. I looked at two papers – the 2006 22 week study (reported larger reductions) and the 2009 74 week study “A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial, which is the one I think you are referring to.

                    Clearly, these results are very modest and I’d guess not really clinically significant. What strikes me is that in this study and the earlier 22 week study, the reductions in A1c seems to be mostly a consequence of weight reduction. I noted that neither group seemed to lose much weight and on average their BMI was started and remained over 30. I’d speculate that much larger weight loss would result in much better drops in A1c. Both studies reaffirm my belief that weight reduction per se, assuming any “reasonable” diet is the key.

                2. I have not heard of gestational diabetes being type 1.5.
                  You know more than I if you have heard it could be. I think type 1.5 would not look like gestational but I may be wrong.

                  1. Donna,
                    Thanks. I’m just a novice information seeker :-). I have not found any literature associating gestational with T2 diabetes. And you are right, as I found, that they present differently. I found the descriptions of different types in this article very helpful. If interested, take a look at the figure.

                    1. Thank you.  My information is based on the fact that people usually progress to Type II years after gestational Diabetes.    It is the same kind of factoid that I retained when I was in nursing school.  Like 5 years is the life expectancy of a person who has had a limb amputation due to Diabetes.  The five years after gestational diabetes is average for developing type II.We are very fragile in some areas.  Eating an unhealthy diet is deadly in many ways.  

            3. David

              You could check out Jenkins’ “eco-Atkins” diet. The article below describes the diet used.

              The Atkins site also describes such a diet

              I personally have my doubts about the long term health effects of low carb diets, even this one, but that’s another matter. Anyone going down this road would certainly need to address the ratio of unsaturated fats to saturated fats, and omega 3 to omega 6 fats, as well as the usual matters of supplementing with B12 etc.


            1. Charmaine, it is a pretty high calorie recipe. I substituted the flour and oil in a typical pancake recipe with a combination of almond flour (1/4 cup), 1 tablespoon flaxseed, which you measure before grinding in a coffee or nut grinder, (so it’s not rancid), a teaspoon or so of grated coconut for sweetness instead of sugar. Add 1/8 tsp aluminum free baking powder. Mix.
              Then mix 1 vegan egg, (not the high carb type), a bit of vanilla, and about 1-2 tablespoons of soy milk, or other liquid ( I use Westbrae unsweetened soymilk because it is the only one I can find without phosphates added which cause kidney damage).
              Add wet ingredients to dry, let sit for about 10 min to let baking powder work. Need nonstick pan, or lightly grease. Makes 4-5 small pancakes.
              Top with berries simmered till thickened.
              Serve with at 2-3 servings of veggies on the side for a complete meal.
              Low carb, low calorie ones like summer squash, cauliflower, water-sautéed greens, etc.

          2. I don’t think that it can be “reversed” on a ketogenic diet as such It is just that the overt symptoms will not be present. Those people still have diabetes as would be evident if they ever went back to eating healthy foods. That’s my understanding at least.

            That said, it is complicated. To the extent that a ketogenic diet (or any other diet for that matter), delivers substantial weight loss, this may itself reverse diabetes. But that would be a function of the weight loss not ketogenic eating specifically.

            1. Tom,
              I agree that weight loss seems to be the key. However, some people said to have T2D, in fact have too few beta cells to metabolize lots of carbs, irrespective of weight, the so-called T1.5’s (apparently around 20% of those said to have T2D).

              I suspect a lot of the debate occurs simply because these two types are not differentiated in many discussions. That is, true T2D can be reversed with weight loss and a typical low(ish) fat, high(ish) carb WF diet, but T1.5 cannot be – it really cannot be reversed completely, just like T1 cannot be, although there situation can be drastically improved. And for true T2Ds, there is no merit in a ketogenic diet or even a low carb diet, once the weight issue has been resolved. Admittedly, I am no expert and welcome corrections for anyone who is.

              1. Thanks David.

                Yes, I think you are correct. A couple of years ago there were 3 or 4 people here who appeared to have type 1.5 or LADA and exchanged ideas and knowledge in the comments section of several videos. Not sure if they are still commenting though

                You could look through the comment threads here (if you have a lot of time!)

            2. Tom, type 1’s, MODY and LADA do not need to lose weight!
              They cannot be ‘cured’ unless someone can figure out how to cause them to produce more insulin.
              Often the way they are diagnosed is because they are losing weight very rapidly because they cannot use the carbs they are eating. The kidneys try to dump all that excess sugar, and they are losing fat and muscle.
              Not everyone who has diabetes is overweight or has insulin resistance.
              But even type 1’s will become insulin resistant if their sugars are high.
              Then they need more and more injected insulin, and insulin itself causes damage to the body.
              The fix is to eat less carbs.

              1. Marilyn,
                Ok, but isn’t it also true or possible for some T1.5’s that they have sufficient in principle working beta cells so that were they to become slim enough, i.e. pull excess fat from muscle cells and the liver, they’d become more insulin sensitive and so be able to eat more carbs?

                I am not suggesting they’d be cured, only that they occupy a mid-ground between T1 and true T2.

                How can T1.5 be diagnosed?


                1. Yes, David, because then they are minimizing insulin resistance by losing any excess weight. Most 1.5 people who don’t stop stressing the pancreas by eating too high carb will lose more function. Important to lower carb so sugars are normal especially because weight loss will raise triglycerides. (The body burning fat).
                  Study showed about 1/2 of people can stop loss of pancreatic function over time, but there was no data why. My belief is that those that continued to have high sugars further damaged the pancreas.
                  And there is a test to see what insulin function is left. Called C Peptide.
                  But test must be done after a meal, the lab might tell you to fast, but that is wrong. Then you are only testing basel function. You want to see what happens after a standard meal.
                  Normal person will have highest insulin and C Peptide numbers about 45 min after -Starting- a high carb meal.
                  In people with gastroparesis, unfortunately there is no way to tell when they are actually digesting their food.

          3. Since even type one diabetics can lower their insulin requirements with a low fat diet maybe 1.5s should be treated like type 1 and use insulin. What is causing the pancreatic issues in whole Food vegan? Could it be the amla?

      3. What the LA Times reports is what I have found in the type 2 diabetics I work with. Low carb intake is what gets diabetics in normal fasting glucose and A1c range.
        So they are not MD’s, does that mean you shouldn’t at least consider the information?
        Do you have to eat animal food? Absolutely not! But, if they are normal weight, they need healthy fats, avocados, nut, seeds, soybeans, etc. or they will lose too much weight.
        We start with them planning 3 servings per meal of low carb veggies, then a serving of protein, which can be soybeans, black soybeans, nuts, almond flour, etc. (Till they get their sugars down, most other beans are too high in carbs.)

        Test sugars at 1, 2 hours, or till they come down. Adjust diet as necessary.
        People who need to lose weight, will lose it on this diet.
        What everyone seems to forget, is that insulin is a storing hormone. You can’t burn fat while your insulin levels are high. So, if people are insulin resistant, they won’t lose weight on a high carb diet.
        And it will raise triglycerides of course, and in some, ldl.

        1. Re: You can’t burn fat while your insulin levels are high. So, if people are insulin resistant, they won’t lose weight on a high carb diet.

          Marilyn, this is totally counter intuitive to a lot of people. When people eat fat, they don’t need sugar and carb as much and it will fix their insulin resistance problem and therefore they will burn more fat. Furthermore their metabolism will be higher and they are more active and the metabolism even burns fat during their sleep.

          Like you said, this can be all done with plant foods. Eating fat does not equate eating animal foods.

          Now the obsession with cholesterol and saturated fat will prevent people from eating fat like this. If they eat healthy fat and their LDL or triglycerides go up slightly, albeit a very low amount, they will panic and said oh my God, what I have done? And then they pop statin pills into their mouth which causes a lot more of damages to the body, including weaken the heart muscle which will cause heart disease, something that people tried to avoid in the first place.

          So it is very harmful to people to publish a hard number, like your LDL has to be below 80 and TC below 150. This will cause people to panic and do the wrong thing, such as taking statin avoiding fat and eating carb and sugar, when their cholesterol is above that number.

          This 70 year old bad theory has created so much damage to our country and the world.

          For people who trash the LA Times article, they are merely possum and they hurt themselves by not reading the content which the paper merely reports what they saw from some other researches. Take for instance the ketogenic diet, it as been around since 1920 to cure epilepsy and so this is not new.

          1. Jerry, for many of them their cholesterol numbers go down, because triglycerides are reduced, and inflammation goes down with a high vegetable diet.

            1. Marilyn, my HDL goes up. my triglycerides go down and my LDL goes slightly up, and the net is my TC goes up. I am guessing that the good part of my LDL goes up while the bad part goes down, since my triglycerides go down.

              I thought that I read from you or from somebody else that after consuming coconut oil, the LDL goes down (mine is slightly up).

              My point is that whether TC is up or down, it does not mean much and you have to take other things into consideration such as CRP result (mine is close to zero). It is what it is and you have to eat what is necessary for your nutrition and necessary fat intake, and not worry about what the cholesterol will be.

        2. This isn’t aimed particularly at Marilyn but it is pertinent to the thread. Has anyone checked out They deal with all diabetics from type 1 all the way to insulin resistant. Their approach is low fat, high carb and it seems to work for a bunch of people. Perhaps the differences in what works for some and not for others is genetic? If anyone has attended a genetic summit it becomes quite clear that things like nutrition, medication and excercise is a very personal approach for each individual.

          1. Yes Charmaine, low fat, high carb works for some who lower caloric intake and lose weight. Then they are eating the amount of food their bodies can metabolize in a healthy way. They are the true type 2’s.
            In them it can indeed be reversed.
            Diabetes is not such a simple disease as most people assume it is.
            So each person must be treated as an individual.

        3. I lost 50 pounds on a high carbohydrate diet and reduced my A1c while doing it. It is true that some people are more sensitive to carbs but cutting out the highly processed carbs are most important. Eating whole food starches is a big improvement over highly processed foods that are made from flour and have added oils which are the biggest problem. Potatoes are the solution to this problem. Just don’t pile them up with high fat or processed toppings.

          1. Donna, good for you! You obviously did what was right for your body type.
            You will encourage others who just need to lose weight.

    1. Consumption of cholesterol in the absence of sugar (or processed grain) does not cause coronary heart disease. INFLAMMATION is the root cause of ALL chronic non-infectious disease, and sugar (especially when combined with fat) is a primary cause.

      Fat is necessary for cellular life; all cells produce it (yes, even plant cells.)

          1. Demographic studies “prove” nothing. Neither does “arithmetic”.

            Especially when con artists and loons compare health and nutrition in wealthy Western countries with excellent public health and medical care systems, with health and nutrition in poor countries without those things.

            You need to look at experimental studies and mechanisms of action to get a complete picture. demographics and arithmetic are too often the weapons of charlatans delling snake oil health solutions and the deluded individuals who believe them.

              1. Yes, Corpsman, look at the way numbers are used in the saturated fat epidemiological studies

                Or the way in which certain people quote the cholesterol levels of people in hospital who had had heart attacks to say that many of them had low to “normal” cholesterol. Yet these self-proclaimed cholesterol experts never ever mention that heart attacks cause cholesterol to decline. So does heart surgery for that matter. Why? Ignorance or an intent to mislead people about the relevance of high cholesterol to heart attack risk?

                So yes arithmetic and epidemiological data are often used by snake oil sellers to deceive. Heck, the dreaded Big Pharma uses arithmetic in a similar way for that matter. For example, when it only refers to relative risk reduction and fails to mention absolute risk reduction.

                Arithmetic may not lie but in the wrong hands it frequently deceives hence the expression lies, damned lies and statistics.

      1. Just because fat is used in every cell doesn’t mean that we’re required to ingest it. The only required fats in our diet are omega 3 fatty acids. Our bodies can and will make the rest that we need as long as we’re consuming enough calories from a variety of sources =D

  1. What about the patient with high cholesterol on a vegan diet? My husband eats a perfect vegan diet of beans and vegetables and very little gluten. He has always had high cholesterol since his 30’s. He is 55 now and is becoming very discouraged that no one can help him without statins. He exercises, is thin and in good shape. Little stress and very active. What about the patient that none of these studies or comments ever talk about?

          1. Mark, I hope that you are still young and can change your diet before it is too late. The kind of numbers that you listed will lead to all kind of diseases down he line including Alzheimer’s. I hope that you can remember what I said if you can remember.

        1. “needs to be put in jail for terrorism” You realize you’re talking about a man who won a gold medal in the 1956 Olympics for the USA when he rowed for Yale. And a man who won a bronze star as a battlefield surgeon during the Vietnam War. A man who, as a surgeon at the Cleveland Clinic, demonstrated to the world that his WFPB diet could reverse heart disease. You realize you are calling an American hero “a terrorist”? We’ve tolerated your nonsense for a long time, but now you’ve gone too far.

            1. Dr. Esselstyn proved that he could cure his patients’ heart disease. You obviously have not read his book Prevent and Reverse Heart Disease. Or his subsequent studies that confirmed his results. No one but a fool would advocate putting a man like that “in jail for terrorism.” End of story.

              1. Any diet better than the SAD diet can cure diseases and so there is nothing to brag about. Even a rice diet by Kemper which is obviously deficient, can cure diseases.

                1. LoL now you’re arguing against yourself. I’m glad you recognize the power of going animal-free and how once INTRAMYOCELLULAR LIPOTOXICITY is dealt with on a low-fat diet such as the Rice Diet, patients with Kidney and Pancreatic disorders could get back on track.

                  I’m sure you also realize Kempner’s goal was not to create a long-term dietary program with the Rice Diet.

                  1. Arguing against myself????

                    Vegans often associate any meat eaters with SAD eaters and they think they eat te most healthy diet. LOL. For a start, I eat more plant foods than most vegans and especially you.

                    1. Jerry Lewis –
                      The vegans on this forum are generally quite aware that there are junk food vegan diets, and are generally concerned with a healthful diet. That’s why they come here.

                      Why do you insist on dealing in vague generalities, and distorting pretty much any discussion to the point that it makes no sense?

                    2. Re: If I’m vegan, then my diet is 100% plants. How can you claim that a meat eating diet somehow has more plants?

                      I am saying that healthy meat eaters eat more plant foods (on top of a small amount of animal foods) than most vegans.

                      Btw, this is what the Okinawans and traditional Chinese people and Mediterranean people used to eat (not as described by some novelist).



      1. All cells produce fat, even those in rabbit food. It is necessary for life itself.

        Fat is necessary for brain and nervous system health – dementia has been associated with lack of fat in the brain/nervous system cells.

        1. >>Fat is necessary for brain and nervous system health –
          Who doubts that?

          Alzheimer’s disease is associated with lipid dysregulation among other things in the brain but the etiology is unclear.

    1. @Kristy
      My husband was the same. He’s 66 and struggled with same issue most of his life until he tweaked his diet to be not just vegan but whole food plant based – which I’m sure yours is as well. But he after Dr G’s videos came out about nuts – raw he added them back, along with avocado, pumpkin seeds for zinc (prostate) etc.;minimized processed carbs and sugar. He also makes sure to sleep enough and not stress over life as much…including his diet. A new GP helped as well. He looks ten years younger, has healthy hormone levels, and takes no meds. These are only suggestions. Never give up. It can take time to find what works. If you haven’t already look into Hypercholesterolemia.

    2. Kristy, some people have cholesterol of 350 and they are perfectly healthy. You have to look at the whole picture. Just for a start, have your husband take the CRP test; it’s a measurement of inflammation and it should be close to 0.

      Similarly, we are also obsessed about high BP while in Germany they think that having low BP is sick, and so they will give you drug to boost your BP if it is below let say 100. Taking drug is never recommended for almost any reason, but the point is that German doctors think that low BP will make you sick.

      1. You are attempting to mislead people again, Jerry.

        They may have a peculiar view of hypotension in Germany but that does not mean that they think that high blood pressure is harmless eg


        “Hypertension is a major risk factor for cardiovascular and renal disease (1), is highly prevalent (2) and can be both prevented and treated (3). Blood pressure (BP) has been named by the WHO the number one risk factor for population health worldwide.”

        It would be highly misleading to suggest that in Germany they are unconcerned with high BP levels. I understand that they use the European standards there which identify a relationship with cardiovascular disease

        ” The relationship with BP extends from high BP levels to relatively low values of 110–115 mmHg for SBP and 70–75 mmHg for diastolic BP (DBP).”

        You might consider 110/70 low Jerry. I don’t know. In Germany though they recognise that BP needs to be below that to ensure that there is no increased cardiovascular disease risk

        That said, declining blood pressure for no apparent reason – weight loss, adoption of healthy diet and lifestyle for example – can possibly be a pre-clinical indicator of disease, especially in the elderly. So, of course, can weight loss and declining cholesterol.

        This below is particularly relevant and mirrors a similar phenomenon in cholesterol levels in the elderly

        “BP decline was correlated with: a number of years before dementia onset [3,4], high initial BP level [5], shorter survival [6-8], cognitive decline [9,10] and dementia [11-14]”

        High blood pressure and high cholesterol levels remain predictive for dementia. However, levels that decline for no apparent reason may be infdicative of disease.

      1. Jerry, I like your comments and ask that you do not give in to the narrow focus of most people. The following are general comments – 1. High cholesterol may, and I stress may, be an indicator for an individual to change eating habits. 2. You are arguing against the FDA and all concerned. 3. People generally believe Big Pharmas (the salesman’s) advice – the same ones that bribe doctors. 4. You should never look at cholesterol levels in isolation. 5. Logically if everything else (mainly blood vessels) is in very good condition then cholesterol will do no harm and this is what people (and doctors) should be focussing on – cholesterol may be likened to the flotsam floating down a stream that build up around a narrow opening and causes problems – the narrow opening was the problem not the flotsam. 6. The human body did not evolve to rely on chemicals (statins) to survive.

        1. Peter, you summarize so well like you are reading my mind :)

          To clarify further on what I said, I never said and no health doctor / healthy people ever said that we should consume fat as much as we want like eating kale. But at the same time, we should not fear it and either avoid some beneficial foods that happen to contain saturated fat or cholesterol (coconut, bone broth, etc.) or take drug to lower cholesterol or blood pressure. I am not a doctor and I don’t know the exact threshold but a total cholesterol of 300 and blood pressure of 250-300 may be OK for some people. A CRP test will be more useful.

          On a different subject, there is an article today in the NY Times that talks about a gene mutation that can cause heart disease and stroke despite people having low cholesterol and low blood pressure. The only symptom is inflammation, which is not detected via cholesterol test or BP test, but it can be detected through a CRP test.

          Google for the following title and you may need to open an incognito window (for Google Chrome) to see it without a subscription.

          Google for: Bone-Deep Risk for Heart Disease

          Few doctors, and even fewer patients, have heard of CHIP. But it is emerging as a major cause of heart attacks and stroke, as deadly as high blood pressure or cholesterol.

          By GINA KOLATAJAN. 29, 2018

          It’s been one of the vexing questions in medicine: Why is it that most people who have heart attacks or strokes have few or no conventional risk factors?

          These are patients with normal levels of cholesterol and blood pressure, no history of smoking or diabetes, and no family history of cardiovascular disease. Why aren’t they spared?

          1. By GINA KOLATAJAN. 29, 2018

            GINA WHO?

            It’s been one of the vexing questions in medicine: Why is it that most people who have heart attacks or strokes have few or no conventional risk factors?

            What the…. where do you get this rubbish?
            Dude, lay off the drugs.

            These are patients with normal levels of cholesterol and blood pressure, no history of smoking or diabetes, and no family history of cardiovascular disease. Why aren’t they spared?

            “Normal” as we keep trying to explain to you is TBC “under 200”. Again, FRAMINGHAM study. Go check it out already.

            Family history of CVD is rubbish. You should know that. You mean Family history as in “diet and lifestyle”?

              1. Dude, stop ignoring medical and scientific literature. Accept the Framingham study. 150TBC or less makes you “heart attack proof”.

                Only Esselstyn and Ornish have published REAL results of reversing heart disease. Once you accept it you’ll feel a lot better about yourself and end the trolling.

        2. Peter, you may want to watch the following video:

          So let’s take some simple example. You get a cut on your finger and then you get an infection and your finger may swell. That is a good sign that your finger swells because that’s what the body is trying to repair the wound,. Usually in a few days, the swelling, i.e. inflammation, will go away. But when inflammation goes out of control inside your body that you have a problem (which you prevent and cure via nutrition).

          Similarly, cholesterol and high blood pressure are the mechanisms for which the body uses to repair itself, and so why do we suppress it with drugs? Now if those indications are high then you will eat beneficial foods that are antioxidant and antiinflammatory. But if those indications remain high for some reason then you take the CRP test, and if it is low (close to zero) then there is nothing to worry about. If CRP is high then you have to find out what you eat that causes it, such as too much carb that gets converted to sugar. But at no point that you take statin or blood pressure drugs.

          This is where the bad cholesterol theory causes people to panic and take poison.

      2. If you want to know about cholesterol, don’t watch YouTube videos by people like Bowden who bought his “PhD” from a diploma mill or Bergman, a chiropractor. Get advice from experts not dangerous snake oil sellers who target the naive and the ignorant.

        “Consistent evidence from numerous and multiple different types of clinical and genetic studies unequivocally establishes that LDL causes ASCVD.”

    3. Hi Kristy,

      I was advised that being overweight even while eating a WFPBD can make the LDL cholesterol stay elevated. I was struggling with mine. So my focus is to stay in a healthy BMI and see what happens. I am high of “norm” with LDL, but I want it lower. I am on no meds.

      A real trap for me was my consumption of processed gluten free products. They are pure sugar to the insulin regulation system and cause fat accumulation – I was underestimating that. Even whole grain wheat bread was a problem for me, so I stick to less calorically dense food for my carbs.

      Just some thoughts and all the best to your husband on his wellness journey.

      A healthy and strong monthly supporter of

      1. The “whole foods” of whole foods plant based eating means “unprocessed,” as much as possible. When I met my husband 10 years ago, he was overweight and gaining. He kept food diaries, so I could see that he did not eat much. But what he did eat was highly processed: he was a widower with no inclination to cook. And I actually wondered: Could his weight gain be due to processed food? Um, well, yes, it could and probably was! When he started eating my cooking — vegetarian — he lost 30 pounds over about 18 months. Since we switched to wfpb a bit ago, our weight is drifting down even more. And he takes no meds, and seems to me, at age 75 fairly hale and hearty. He bounds up and down the stairs — and today shoveled all the walks and drive.

        Oh, I love my electric pressure cooker (I have an Instant Pot), and we are now eating more whole grains and beans. So many delicious recipes!

    4. I also knew a guy who ate super healthy and exercised plenty, but couldn’t get his cholesterol down. Some people have a genetic condition where their bodies just over-produce cholesterol.

      1. Or they could also be over absorbers. This can be found out through a blood test, and it should be done before people just dive in and start taking statins because if you’re an over absorber, statins are just masking the problem. Better to take a cholesterol blocker or load up on psyllium and fiber-rich foods.

          1. It’s a blood test that’s done by Boston Heart. You have to find a doctor that draws blood for Boston Heart. They do a super in-depth analysis of all the lipids, size of cholesterol, inflammation, tolerance for statins, over producer, over absorber, etc. It’s also not covered by insurance, but Boston Heart partners with certain doctors to obtain and analyze cholesterol to present to insurances companies, so the cost gets written off. ($3200!!)

          1. Charmaine,

            Supposedly, an overabsorber is someone who absorbs most of the cholesterol that their body produces. And I’m not so sure this is even a bad thing since the body needs cholesterol, and studies have shown that most people who live to old age have higher cholesterol levels than people who don’t.


            1. Suzanne

              Most (old) people in Western countries have cholesterol that is too high.

              So what causes old people in Western countries to have low cholesterol?

              It’s not usually a healthy WFPB diet, genetics or regular exercise that is the cause of low cholesterol in older people.

              It is normally because they are sick. Old people are more prone to sickness and loss of appetite than younger people.

              Dementia causes cholesterol to decline, so does malnutrition, so do certain cancers, liver diseases and infections generally. That is why there appears to be an association between mortality and low cholesterol. Low cholesterol doesn’t cause illness and premature death – illness (and injury) cause cholesterol to decline.

    5. Exactly! This is why it seems that cholesterol and heart disease aren’t necessarily related. My grandma who lived to be 99 had super high cholesterol and never did anything about it. I have it too, no matter how I eat, but what I think people should be focusing on is whether or not one’s high cholesterol is affecting them. With a simple carotid artery screening that costs around $40, one can see if there is any build-up, and for a little bit more money (but totally worth it!) the screening of the small arteries around the heart can be done at the same time. Has your husband had any of these tests done?

      As an aside, my grandma’s tests at the age of 88 showed zero buildup. (Same with me, so far.) This helps fuel my belief that doctors should be focusing on something else other than lowering peoples’ cholesterol. Inflammation, maybe? And why is it that people who have perfectly normal or even low cholesterol numbers have heart attacks? Again, I think we should look at inflammation markers.

      1. Suz, I agree Inflammation markers need to be checked, along with HgA1c, homocysteine, omega 3-6 ratio. It’s not all about cholesterol.
        We got to this point of only considering cholesterol because of big pharma who wants to put statins in your water.
        Just follow the money trail!
        Do you need to consider ldl levels, yes, but there are other markers that are very important that are being ignored because they aren’t making anyone money.

        1. It’s not all about Cholesterol, BUT the sooner people accept the 26 years of Framingham data and the magic number of 150TBC, the sooner we’ll stop having heart attacks.

          Keep in mind, the only way to naturally get your TBC below 150 is on a plant based diet. It doesn’t have to be a Fuhrman style diet either. I eat more of a McDougall/Fuhrman combo, and achieve 140’s consistently.

          Once that’s achieved, all other metrics (CRP, A1C, etc) follow suit.

          The fact that someone’s relative escaped a heart attack or cancer after years of SAD and smoking is irrelevant. That’s the exception not the norm. Most of these people, including my family members, benefit from years of meds which often delay the inevitable.

          1. Caspr,
            I’m glad you distinguished lowering cholesterol by eating a sound WFPB diet and by using statins. In other discussions, it seemed to me this key point was inflated.

            In particular, some were claiming that a TC of less than 150 is associated with or even cause Alzheimer’s disease without any supporting evidence. My belief is that there’s no evidence that a low TC achieved, as Fuhrman says, by nutritional excellence would be implicated in any kind of dementia.

            1. Quite right but DECLINING cholesterol – not as a result of adopting a healthy diet and/or lifestyle – may be a marker for Alzheimer’s.

              Cholesterol levels in men with dementia and, in particular, those with Alzheimer disease had declined at least 15 years before the diagnosis and remained lower than cholesterol levels in men without dementia throughout that period. The difference in slopes was robust to adjustment for potential confounding factors, including vascular risk factors, weight change, alcohol intake, and use of lipid-lowering agents.

              A decline in serum total cholesterol levels may be associated with early stages in the development of dementia.”

            1. Oh come on Jerry. Neither “Dr” Bruce Fife previously known as Dr Dropo when he made his living as a clown before deciding that telling stories about and selling coconut oil was more profitable, nor the famously nutty Stephanie Seneff are medical doctors or real experts on fats, cholesterol or statins..

              That is a ridiculous and downright dangerous recommendation of yours.


            2. Jerry: Have you heard of Vascular Dementia? Caused by the same thing that’s at the root of Strokes and Heart Attacks. I can assure you it’s not plant foods.

          2. I would agree on the exception escapees. I too had a grandmother that seemed bullit proof and lived to 93 but the rest of the family have had no such luck. I find your comment interesting Casper. Could you please explain how you combine Fuhrman/mcDougal?

            1. Sure, Charmaine.

              Well, I’ve gotten the most in-depth knowledge from Dr. Greger. But aside from Dr. G’s Daily Dozen, and the fact that he’s all about phytonutrient intake, if I were to classify my dietary approach it would be along the lines of McDougall (since I’m primarily a Starchivore), with the inclusion of phytonutrient-dense foods in the style of Fuhrman. Make sense?

          1. Yeah, a YouTube video by unqualified crank selling dodgy health products on the internet, talking to a bunch of other cranks. Not at all credible, Jerry.

        2. Marilyn

          I thought that I was old and cynical!

          We got to this point because there is lots of credible evidence that lowering LDL cholesterol with statins or lifestyles changes reduces the number of adverse events.

          There is no such evidence that altering other indicators like eg HDL or even CRP would reduce the number of adverse events. They have altered HDL levels and found no effect on outcomes. I don’t think any trials have been done with CRP but I agree with you that it is an important indicator. Whether is a causal or simply a marker for other processes is I think still being debated.

          If there was money to be made from developing drugs that affected things other than LDL and there was evidence that altering those other things affected outcomes, I am sure that the pharmaceutical companies would be delighted to oblige.

      2. >>>screening of the small arteries around the heart
        Can that be done with ultrasound or does it require radiation or contrast MRI?

        1. Hi David. My ophthalmologist was actually the one who saw artherosclerosis in my eyes when my physician didn’t have a clue. I make sure I do regular eye visits since he has picked up issues in the early stages before. A good opthomologist/ Optrician is worth their weight in gold.

    6. Try this. The cholesterol comes out of the body every day but it is reabsorbed. In order to block it from reentering, add phytosterols (vegetable oil) to your diet.

      “Sterols and stanols complement a healthy diet low in saturated fat and
      cholesterol and high in fruits, vegetable and whole grains. Studies show daily
      intake of 2-3 g sterols and/or stanols lowers LDL cholesterol levels by 10%
      and likely lowers CHD risk by 12-20% in the first 5 years and by 20% over a

    7. I am also one of those whose cholesterol is high but follows a strict vegan diet and exercises. I am 65 and still won’t go on a statin. I believe at some point I will have to. :(

      1. Hi Kathy- I just posted a longer reply on the same thread, so check that out as well. It’s important to know the pattern of your high cholesterol, and the level of LDL (bad) cholesterol. There are many variations of vegan eating, and the one that lowers LDL the most is a whole foods, plant based, very low fat (no saturated and less than 10% total) approach. When the LDL cholesterol remains much above 70 eating in this way (no oil, whole food, plant based), it may be that the person has an inherited form of high cholesterol. That generally needs a healthy lifestyle plus medication. The majority of people will have a normalized cholesterol with whole food, plant based, no oil eating, though.

        It you’d like to determine your risk of heart disease over the next ten years (a scale used to advise a statin drug, but which really should prompt us to review diet then statin only if this isn’t enough), you may use this calculator:

        -Dr Anderson, Health Support Volunteer

    8. I want to know the answer to this question as well! My husband struggling with the same issues. We eat no oil nor fat…but wait…we eat a small quantity of nuts and avocado. I love olives. No olives either? What about Chia seeds as a pudding? Is it as Dr. Essestein says…absolutely no fat, no oil and no nuts despite what the studies shows about nut consumption? For some, like my dear husband, for ever? There are so many questions. I need to revisit Dr Esselstein.

    9. I was one of those patients until I heard the talk by Dr. Lim on calorie density at Dr. McDougal’s program. I was eating bread, larabars, raisins, nuts, etc. You can eat a strict vegan diet and be very unhealthy. No nuts, no oil, no dried fruit, no pasta, no popcorn, and no processed food (flour). If you are really following the plan, the results will come. I am proof.

      1. Tyler, I don’t eat foods like larabars (I had to look them up, and they look processed), but I do eat bread — home baked whole grain sourdough (I grind the grains myself) — raisins, nuts, etc. But in measured amounts. We also eat lots of other whole grains and beans, veggies and fruits. The food is great!

        1. Good morning Dr J. I believe a WFPB approach relies on the food you are eating to be in it’s whole form as it comes from the plant or tree. Bread, however coursely milled, is still processed and very calorie dense pound for pound with leafy greens for instance. I’m assuming if all markers including weight are optimal then foods like bread and pasta in their least processed forms may be consumed as an amber light food and more like a condiment than a whole meal. Susan Pierce Thompson of Bright Lines (PHD) however has her own ideas on food addiction and approaches flour and sugar from a totally different and interesting perspective.

    10. Kristy, it’s very frustrating. I never hear the gurus address this issue of what to do when you have an inherited cholesterol issue and yet you are faithful to the WFPB diet. It’s always posed as a black-and-white, simplistic solution: eat WFPB
      and everything will be just fine. But it isn’t for some of us. I have never bothered to mention this issue on the blog because someone always comes back with “well take a teaspoon of that“ or
      “Drink 10 cups of this kind of tea“ etc. etc. i’m tired of adding new things to my diet. So many of this and that and I have to drink a smoothie every morning just to pour it all in. Plus, I do 20 miles on my bike each week and three hours of weightlifting at the gym. I saw a cardiologist recently who of course quizzed me about my diet. After I told him, he said “you mean you don’t eat dairy? I couldn’t go without my ice cream.” And I looked around his office and saw all these models of stents, etc. I knew he was an interventionist. I’d like to be able to find a preventive cardiologist but there are none that I know of in New England. Tell your husband there are many more of him out there. We just don’t fit the mold.

      1. Absolutely. Add two more to that list! I did listen to the last summit on genetic profiling and it was quite clear that each of us is in all the ways that count toward our wellbeing and longevity, unique. Our nutrition, medication and excercise for instance is very personal. The genetic experts say the future of medicine is genetics. The only way to really know who you are and what you should eat is too have your profile done.

    11. Kristy,

      Have you heard much about the human microbiome? I’m new to the subject and am fascinated and hopeful. check out this company:

      Additionally, I empathize with your husband’s situation as I have the same struggle: high serum LDL in the face of being a vegetarian, exercising regularly, maintaining fitness and healthy weight level, don’t smoke, don’t drink, very little stress if any, etc. Last year, however, I managed to stun myself and my doctor by lowering my LDL 38 points in 4 months.
      Here is what I did:
      Oatmeal 5 x week
      Flax seed, ground, on above 1-2 Tbsp
      Dried prunes 2 per day
      Oyster mushrooms, some 1-2 x week
      Brazil nut 3-4 per week
      Dried apple rings, unsulphered 1-1.5 apple equivalent each day
      Garlic caps Daily
      Cut back cheese to once every two weeks
      Cut way back on refined sugar
      Perhaps this combination may help him as well?

    12. Hi Kristy,
      Dr Greger has a video on why vegans may have similar heart disease risk to omnivores. I found this very interesting as lots of information would suggest it should be much much lower. Spoiler alert – involves omega 3 fatty acids and vitamin B12

    13. Get him a Coronary Calcium test and determine his score. That will tell whether his cholesterol is sticking to any inflammatory response in his blood vessels. Does he have any.symptoms such as Peripheral Arterial Disease, erectile dysfunction or ever had an angiogram? My grandmother was extremely careful about added fats after her husband had 2 heart attacks and 2 bypass surgeries. Her own level was 370! When they did an angiogram, it showed none of it was, “sticking.” Coronary Calcium Score tells what those levels are doing. Best Wishes!

    14. Krisy-
      Please try plant medicines like Hawthorn, Turmeric, Amla, Gum Guggul,Goji Berries, Ginger, Milk Thistle, Fenugreek, Cordyceps mushroom, Hibiscus. All backed up by science…lots of science. Plus they all have various side effects that are positive. From good nutrition to better circulation to better digestion.


    15. My arteries are clean and smooth per measuring my endothelial lining of my blood vessels. My cholesterol has always been above 300. Some of us have bodies that make a lot of cholesterol. I have been on Dr McDougall’s recommended diet for over 5 years. I am not worried about my high numbers since my blood vessels are clean. If he follows a low fat WFPBNO diet he will probably be safe from blood vessel disease evidenced by deposits on the walls of his vessels.
      He can have this measured. Ask his doctor for a prescription for the test.

    16. Check out the work of Dr. John McDougall. There is considerable information on his web-site. He also personally will respond to questions.

    17. Hey Kristy- This can be very frustrating for patients. I am a cardiologist who treats high cholesterol, first with a whole food, plant based, very low fat diet, then with statins or other medications when needed. I find (and this correlates with published data) that the bad (LDL) cholesterol drops about 30% with changing from a Western diet to a whole food, plant based diet, and drops further with eliminating added oils, and still further if fatty plant foods are limited to no more than a very small handful of nuts like almonds a day. Assuming your husband takes in the foods that specifically lower LDL (soy protein, plenty of fiber) and is normal weight for height, and that he does not take in added oils/any saturated fat, if his LDL cholesterol remains much above 70, he could have a form of inherited high cholesterol. In my patients in this situation, I often prescribe a statin medication. Some folks with severe inherited high cholesterol need other, very expensive, injectable medications to lower the bad cholesterol. Still a smaller group needs their blood filtered (plasmapheresis)! These are uncommon needs, though, and most people, with careful attention to the details of the diet, assuring no saturated fat in a whole food, plant based diet, can get their LDL sufficiently low to avoid medical or other therapies. I’d suggest you find a plant based doctor who can get into the weeds of his lifestyle and also explore the possibility of inherited high cholesterol. Here’s a helpful resource: -Dr Anderson, Health Support Volunteer

  2. Our economy is built on a “Bitter Harvest”. Maybe we could pay people to stay healthy instead of getting their money’s worth back from insurance companies $s paid in the form of sickening pharmaceuticals and needless surgeries. Rebates for staying or becoming HEALTHY!

  3. Fake new again, and again and again. It will go on for another century if not forever.

    Total cholesterol of 150 is just insane.

    Just do the math: TC = HDL + LDL + Triglycerides / 3.

    So if HDL = 60-90, LDL = 100 and triglycerides = 80. then you exceed 150 immediately and you are sick according to the doctor while you are actually very very healthy.

    This fake theory will drive people to take statin drug and kill their internal organs like a certain professor on this board had done, plus you are going to develop alzheimer’s / dementia, heart disease, cancer, etc. with this low cholesterol. And then people have no energy and will have to eat sugar and therefore get fat in the process, and the vicious circle will start.

    Eat low fat –> no metabolism –> get fat –> heart disease + cancer + Alzheimer’s + etc.

    Take statin drug –> destroy liver, kidney, heart muscle –> heart disease, liver / kidney failure

    1. I fail to see your point. many people have lower than 150 and so of course have lower numbers adding up to the total. Also, define “healthy”. One could argue that they gave plaque in their arteries and are still healthy if they have no symptoms, that is until some of it breaks loose. BTW my cholesterol has been below 150 on a diet that doesn’t feel like anything special, just WFPB. I don’t see associated insanity.

    2. Sounds like Jerry has ‘high cholesterol’. Probably ‘high blood pressure’, ‘high body fat’, and a high ‘resting heart rate’ as well.

    3. Jerry

      You just prefer the claims of charlatans and cranks to what the evidence shows.

      You simply refuse to let the facts get in the way of your opinions. That’s bad enough but pretending to other people that your anti-factual beliefs are true is utterly reprehensible.

  4. In Esselstyn’s Wikipedia info it states “. . . is the author of Prevent and Reverse Heart Disease, in which he argued for a low-fat, whole foods, plant-based diet that avoids all animal products and oils, as well as reducing or avoiding soybeans, nuts and avocados.”

    From the large number of dr. greger talks and content I’ve read/watched I was under the impression that eating legumes [ beans and nuts ] along with other whole food plant based [wfpb] fats like those that exist in an cut up avocado or olives [ vs olive oil ] was a good thing. All of these are things I daily pile onto my wfpb salad dinner which I viewed as a recommended practice.

    So how is one to interpret this Esselstyn position on things that would have us avoiding wfpb sources of fats and oils?

    1. Hi myusrn, I have been doing exactly the same thing. On another site I was told the other day, when I submitted an article for comment, that if I am looking for consistency I will surely go mad. I was told to pick a bus to hop on. The discrepancies are maddening. What do you believe…who do you believe?? I’m wondering if the only true path will be genetic profiling?!

      1. Better testing to find out what will help You! Ask your doctor to do some less popular tests.
        It is Not one size fits all, look at the studies, a certain percent of people improve when you do ‘X’. What about the others?
        Typically, about 20% of my clients have genetics that make standard answers not work for them. I won’t even consider a client who hasn’t had a Crp, A1c, fasting glucose, homocysteine to start.

    2. That comment is the Dr’s advice for people with existing heart disease who are trying to reverse it. He does allow for nuts and avocado for people without heart disease and have their cholesterol under control.

      This is from the FAQ on Dr. Esselstyn’s website. The question is it OK to eat nuts.

      “As nuts are a rich source of saturated fats, my preference is no nuts for heart disease patients. That also eliminates peanuts and peanut butter even though peanuts are officially a legume. For those with established heart disease to add more saturated fat that is in nuts is inappropriate. For people with no heart disease who want to eat nuts and avocado and are able to achieve a cholesterol of 150 and LDL of 80 or under without cholesterol lowering drugs, some nuts and avocado are acceptable. Chestnuts are the one nut, very low in fat, it is ok to eat.”

    3. The strict Esselstyn diet was designed for people with serious, established heart disease.

      However, in general terms, he appears to accept that these can be included in the diet but nuts and seeds should be eaten as condiments not as a significant source of calories. Note also that he argues that total fat intake should be between 10 and 15 per cent. This in turn will determine how many olives, avocadoes and high fat soy beans/products can be consumed.

      I suspect that many of us go overboard on the high fat stuff – olives, nuts, seeds, tofu etc. I know that I do if I am not disciplined. On Brazil nuts, I seem to recall Dr Greger saying that the benefits come from just 4 per month so I am not sure that there is that much discrepancy between the WFPB people (or mainstream advice for that matter).

  5. I prefer new video every day than video every other day and new between these days. In the papers dr Greger repeat things from old videos.

    1. Reads like a very subjective based opinions article. where are the “put it to the test” references she has read in detail and based the assertions she is making on?

      Calling out b12 and vitD deficiencies just tells us she didn’t bother to review / dr. greger talks discussing the need to supplement wfpb nutrition with b12 and vitD supplements.

    2. Greg, interesting link. I’d like to see Dr. Greger respond. What about the retinol issue – is that something to be concerned about if you are a true WFPB person?

    3. Harcombe makes her living selling fad diet books and plans. She is just another high fat low carb promoter. and media hog. Of course she is going to criticise Dr Greger just as she criticises (misrepresents) conventional nutritional advice.

      I can’t see any reason why Dr Greger would waste his time responding to somebody like this

  6. Dr. Caldwell Esselstyn’s great father-in-law (his wife’s grandfather), Dr George Crile Sr. was first surgeon to succeed in a direct blood transfusion, early contribution to blood pressure and co-founded the Cleaveland Clinic (highly rated for cardiac care incl preventive.) His grand-son Dr George Crile Jr. had an early influence on breast cancer treatment. Found out during good podcast with Rip Esselstyn. Another great example of WFPB.

    1. I did not know this about the Criles. My mother was a patient of Dr. Crile Jr in the early 60s (breast cancer diagnosed in her late 30s) — thank goodness! No radical Halsted surgery for her (which severely disfigured and disabled women), just simple mastectomies. She lived to age 93. And I believe that the doctor’s wife (first wife?) died of breast cancer.

  7. Re: Infant diet… I was told by pediatrician to give 3 cups of milk daily to my 1 year old child for brain development nutrition. I would like very much to ulitize whole-plant based foods. What would be a solution to provide for the fats that cow’s milk supplies???

    1. Omg another doctor that should be jailed in Cambodia. This is sick. RUN fast. Do not poison your precious baby. Test out some nuts, maybe blend in water and serve. How much fat do you really want to give to the kid? Be careful.

        1. And why is that? The child is 1 year old.

          According to a recent recommendation from the American Academy of Allergy, Asthma and Immunology, highly allergenic foods like nuts can be introduced into infants’ diets as early as six months.

          Like i said, you could test out some nuts. Peanuts, which tend to be the most allergenic, are Legumes.

          Introducing the child to different nuts at a younger age will benefit him later in life.

          1. Milk will supply Bovine Leukemia Virus, and Bovine Growth Hormones, and, Pus Cells, and who knows what else! It has to be pasteurized by law because from what organisms we know not…

    2. Ron Knepper
      Do not listen to the free advice given on here as you can see they themselves have a multitude of health concerns trust your doctor and if the baby can’t take regular milk ask your doctor if you can use goat milk .

      1. Why would you blindly trust your Doctor who is recommending DAIRY, which is possibly the most harmful food group on the planet and will wreak havoc on this kid’s body setting him up for all sorts of health issues later in life including cancer. SMH

      2. Re: if the baby can’t take regular milk ask your doctor if you can use goat milk .

        Very often, milk found at supermarket is damaged by the heavy processing by homogenization (to get rid of the ugly fat deposit), or the low fat or no fat processing due to the low fat bad theory. On top of that, milk comes from cow fed with grain and hormones. If you have no choice but to use that milk then it’s better to skip milk altogether. It is not the milk that is bad but the way that it is processed that makes it bad.

        Like Buster suggested above. use goat milk because goat is mostly fed with grass, and goat is not popular and not injected with hormone yet. It is like a niche market and so it is safe for now. The goat milk that is sold at Trader Joe is non homogenized. One of the cow milk at Whole Foods comes from grass fed cow and pasteurized at low temperature and non homogenized.

        Grass fed cow milk has CLA which is an antioxidant. Best of all, it comes from cows that are raised humanely. And non homogenized and pasteurized milk at low temperature, has all the enzymes for digestion and is as close to raw milk without the dangers.

        Likewise, Dr G had a video a short while ago talking about a beneficial bacteria that helps the digestion of soybean. That’s where the differences lay between the Asians who consume soybean and have no problem, and us who get a lot of problems digesting soybean because we lack the bacteria.

        By the same token, milk from grass fed cow that is not destroyed by high heat, has all the enzymes for digestion.

      3. Ron Knepper

        Buster has previously told us that he is employed by a dairy company to promote dairy products in online for like this. It’s probably best to ignore his advice.

        These articles may help you decide

        You can buy vegetarian milk powders specially formulated for toddlers. You should be able to get them online even if they are not available in your local supermarkets. Here in the Philippines I can get eg from iherb

        1. Tg already knows what the truth is , in Wrench’s book the Wheel of Health which is available to read online for free at under the farm library heading is that entire book plus lots others , another book there talks about fiber with an introduction from Burkit no less .Robert Mccarrison spent 7 years in Hunza as their doctor and he was amazed to find none of the people there had any disease’s that were so common back in England .What did these longest lived people live on ? Grains mainly wheat , milk , fruits and vegetables in that order according to the book . TG has the book . Robert Mccarrison was knighted and became the doctor to the king of England in 1935 .I wonder why there are no reports about the longest living people on earth at NFO?
          Anyways the question was about milk . Here are some of the things in milk . compared to baby formula .
          B-lymphocytes active
          Macrophages active
          Neutrophils active
          Lymphocytes active
          IgA /IgG antibodies active
          B12 Binding Protein active
          Bifidus Factor active
          Medium Chain Fatty Acids active
          Fibronectin active
          Gamma Interferon active
          Lactoferrin active
          Lysozyme active
          Mucin A oligosaccharides active

          Hormones and Growth Factors active

          These are all active and present in fresh milk or human breast milk none are active in plant based formulas according to the Lancet .

          Maybe that is why the Queen of England makes sure her family has fresh milk .

          1. Great stuff Buster. Unverified claims about what the Queen does, accompanied by vague statements about what a 1938 book says, aren’t really that believable. And no links to your alleged sources. Is this really the best you can do to justify dairy consumption?

            The claim that these Hunza were the world’s longest lived people – who made this claim? You perhaps? It is not backed by credible documentary sources recording birth and death dates (unlike eg in Okinawa). So we really don’t know if they were or weren’t.

            In any case, Wrench in his book clearly reported (page 10) that the main distinguishing feature of the Hunza diet was the very high level of fruit consumption – fresh in Summer and dried when fresh was not available.

            “The most conspicuous feature of the Hunza diet is the large quantity of fruit they eat,
            fresh in the summer and at other times dried, either alone or in wheatencakes. There is so
            much fruit in Hunza that “even the animals,” said Durand, “take the fruit diet, and you see
            donkeys, cows and goats eating the fallen mulberries. The very dogs feed on them, and
            our foxterriers took to the fruit regimen most kindly and became quite connoisseurs.”
            The daily eating is given by Schomberg as: nothing before going out in the early
            morning to the fields; after two or threee hours of work, bread, pulses and vegetables
            with milk; at midday, fresh fruit or dried apricots kneaded with water; in the evening
            these same foods, with meat on rare occasions.”

            Sounds suspiciously like a WFPB diet to me to me not a dairy based diet ,even if it includes some milk.

            As for milk, yes it has lots of things in it. So do most foods including vegetarian baby formulas and they are less likely to predispose a child to heart disease in later life

            As for Jerry’s goat milk recommendation
            “Goat’s milk is not recommended for infants.29
            Goat’s milk contains inadequate quantities of
            iron, folate, vitamins C and D, thiamin, niacin,
            vitamin B6, and pantothenic acid to meet an
            infant’s nutritional needs. Some brands of goat’s
            milk are fortified with vitamin D and folate, but
            other brands may not be fortified. This milk also
            has a higher renal solute load compared to cow’s
            milk and can place stress on an infant’s kidneys.
            This milk has been found to cause a dangerous
            condition called metabolic acidosis when fed to
            infants in the first month of life.”

            1. Why TG comes on here to lie is puzzling ? he has the book , read it for yourselves , Mccarrison clearly states the diet of the Hunza is wheat , milk ,fruit and vegetables in that order . Read the book . As for the age of the Hunza population there have been a number of people who have investigated and yes 120 years old are common . Read John Tobes book he had some verification in the 60’s . So what if there isn’t a birth certificate , I am believing Mccarrison when he says they are the longest lived and healthiest people .
              Whats in milk is a article from the Lancet Nov 18 1984 .
              As for the Okinawan’s there is one study in 1949 compared to Mccarrison’s study , being a doctor for 7 years . Hardly comparable . To top that off Okie’s study was done shortly after a major war which saw 140 thousand civilians die and as many soldiers

          2. “RESULTS:
            During the follow-up period, 770 cancer registrations or cancer deaths occurred. High childhood total dairy intake was associated with a near-tripling in the odds of colorectal cancer [multivariate odds ratio: 2.90 (95% CI: 1.26, 6.65); 2-sided P for trend = 0.005] compared with low intake, independent of meat, fruit, and vegetable intakes and socioeconomic indicators. Milk intake showed a similar association with colorectal cancer risk. High milk intake was weakly inversely associated with prostate cancer risk (P for trend = 0.11). Childhood dairy intake was not associated with breast and stomach cancer risk; a positive association with lung cancer risk was confounded by smoking behavior during adulthood.”

    3. Coconut fat or nut fat are fats that you can give to your infant for fat, but it is not a substitution for cow milk fat because it has all the protein and other nutrients. But you can combine plant based fat with soybean milk which is a complete protein.

      Alternatively, you can grind all kind of vegetables and cooked bean, rice, etc. into a puree because the infant is already one year old.

      Just google for coconut milk and homemade infant food recipes,

    4. Rob,
      Please take a look at this video
      The saturated fat in cow’s milk is contributing to heart disease starting in childhood. Since the Dairy board has such a stronghold among governing agencies that publish dietary recommendations, unfortunately most doctors are misinformed (even many dietitians). Often they just go by these published guidelines rather that looking at the science for themselves. I recommend that you take some of the sources cited to your physician. If he/she is willing to take a look, hopefully better advice will be given in the future.

  8. I had a stroke and couldn’t move my right side at age 48. I was a cyclist and in relatively good shape but eating garbage which I define as anything that comes from a restaurant or out of a box or can. My weight was 210 at 6’1″ and total cholesterol was 153. Medical Doc said with my “healthy lifestyle and good stats, keep doing what you’re doing”. I visited with a Quack Doc who said to eat raw plants and juice. Going to all raw plants is a tough change & I’ve settled on both raw and cooked plants except for once in a while when we go out and I’m tempted with …. garbage (usually salmon). Weight is 175-180 and total cholesterol is ~110.

    Sixteen years later outsiders can’t see any remnants of the stroke but strangely, blood pressure has crept up. I’ve chased every rabbit …plants, flax seed, beets, etc & it’s still up to 150/90 unmedicated. any other ideas?

    1. Maybe chemical? I have the same situation with my BP. I think my system is constantly in a low level of “flight or fight.” My pulse has risen over the years from 60 to now around 82 even though BMI is 21 and I am in pretty good shape.

      1. My resting pulse drops with drops with activity. It’s 36-40 after a 400 mi ride consisting of 5 80 mi days. It increases 10 beats during the off season when I’m only taking 45 minute spin classes. None of this seems to be reducing BP but I don’t know what it would be if I were to quit the cardio. Caffeine seems to add a few points to BP.

      2. Ron

        I’m no physician but have you ever had a full cardiovascular work-up?

        There was a study last year that suggested that increases in heart rate may indicate an underlying health issue.

        That all sounds a bit scary but your latest number still appears OK and the problem particularly concerns people with certain diagnosed conditions. Harvard has some advice on this

      1. It’s the BP that’s an issue. Cholesterol in in the 110 range. I remember my mom worked for the endocrinology department at the University of Chicago in the 60s. They were just starting to test cholesterol and hers was naturally low but the reasons and interpretation were unknown – sort of like early nuke researchers used to handle radioactivity with their hands.

    2. Bob, it probably goes without saying that you are checking your own blood pressure, about 2 to 3 times a week. I have white coat blood pressure and every time a doctor gets ready to shove a prescription at me, I whip out my little tablet and show him what my blood pressure really is at home. I’m not a medical person, but since higher blood pressure may be a symptom of another issue,you might consider having a cardiac calcium scan. Insurance won’t pay, but it is worth it. If the numbers are not so good, the doctor will have you do a stress test which will be covered.

    3. Meditation and yoga? Breathing exercises? Are you sure you don’t have kidney stones, adrenal tumors, etc? Try out that rice diet for a week or so and see what happens?

    4. Hi Bob- Stroke at a young age can be caused by several things: abnormal rhythms leading to blood clot, dissection of blood vessels, or bleeding related to very high blood pressure. There are sometimes inherited artery problems or blood clotting disorders can that predispose people to stroke as well. I’m sure you had an extensive evaluation for these things. Unfortunately, sometimes we don’t find the answer.

      Meanwhile, your dietary changes have been great. Your weight is healthy, as is your total cholesterol. With that at 110, it’s likely your LDL (bad) cholesterol is below 70, which would be great.

      I’m also assuming your high BPs are recurrent, repeated in doctor’s office, happen at rest, and are not right at or after peak exercise.

      When folks follow a good diet, have a healthy weight, yet still have high BP, I ask about alcohol intake (some people are very sensitive to alcohol raising BP), sleep apnea (even those with normal weight can have this condition, which blocks the airway during sleep and raises BP), and salty foods (your avoidance of processed and restaurant foods makes me suspect this is not the case for you).

      If your BP is high despite no clear risk factors, your doctor may want to do an evaluation for “secondary” hypertension, caused by hormonal or blood vessel abnormalities, or other rare conditions. An ultrasound of the heart to look for thickening or other cardiac problems that could cause or result from high blood pressure would also be reasonable.

      Best to you! -Dr Anderson, Health Support Volunteer

  9. Man, it’s tiring. Gary Taubes and others just can’t accept the fact that high Fat, animal Protein and Cholesterol is a recipe for disaster. Just because these awfully sick people “improved” a little doesn’t give credence to these careless diets that only Lazy people care to follow. A 7 year old could even draw the conclusion that our hospitals are filled with these people and not with the 1% Plant-Based population. Use common sense. You really think Plant-Based dieters are dying of Heart Disease?

    It’s easy to stay below 150TBC Jerry, maybe you could follow this math:

    The problem with the HFHP diets are the PEOPLE going on them… they are already sick to begin with, and sometimes see positive results during the first few months. They often see TG levels drop (classic Atkins), but they never improve health long term.

    All we’re asking is to use common sense. Do you honestly believe PLANTS cause atherosclerosis?? Do you really think even consuming excessive SUGAR creates arterial plaque? BTW there’s not one PB doctor in the past 50 years that has ever recommended eating lots of sugar. Excessive Sugar mixed into a diet loaded with lots of animal foods is a recipe for accelerating the development of T2DM.

    CRP could never be low on a HFHP diet. It’s impossible. And Jerry’s reference to getting it close to Zero is laughable. Not only is that not possible on the superior Plant-Based diet, but low-CRP shouldn’t even be mentioned in the world of HFHP community.

    Finally, something that these clowns like Gary Taubes and William Davis always cleverly ignore is the fact that there is NO (ZERO) research in the scientific and medical literature that has EVER shown that a diet rich in Animal Foods prevents and/or REVERSES diseases of ANY type. You will never, ever see proof from any of these Low-Carb clowns. All they do is get gullible victims to buy into their nonsense and end up sicker while they line their Pockets. And twenty years from now, when William Davis is finally deemed one of the most dangerous doctors of this century, it’ll be too late. Millions more will be dead. And he’ll be dead too, so it won’t matter to him either.

    Get this straight Jerry : a WPBD is the ONLY diet that has been shown to REVERSE disease. That’s it. Just accept it.

    1. I had chronic pain for nearly 20 years. After 6 months of WFPB, and not 100% at that, I am able to move again, BP DOWN and heart rate cut nearly in half. HALF. I don’t care to go back. But that is just me!

    2. Casper, While I agree with much you have said, I hope your statement that even eating excessive sugar is merely hyperbole and not encouraging anyone to do that.
      Sugar is definitely not WFPB, and is a great problem in the world today.

      And, btw, I have clients, diabetics on low carb, whose Crp numbers are so low the lab noted they couldn’t give a value.

      1. Marilyn Kay,

        I’m saying that although excessive sugar is bad, it does not create plaque. I said this because animal food supporters seem to always point to sugar as causing their atherosclerosis and refuse to accept that saturated fat is the culprit.

        The other point often overlooked by the animal eating crowd is the fact that TMAO drives plaque into the arterial walls. And as we now know, TMAO is a result of their bad bacteria munching on Carnitine and Choline.

        I’d love to see these clients of yours who are low-carb and have low CRP levels. Really trying to get my head around that. What foods are they consuming to mitigate the inflammation cause by the animal foods they consume?

        1. Casper, I said Nothing about animal foods! Nothing about high protein! They are eating high healthy fats and tons of low carb veggies with some berries.

    3. Casper, I don’t know how to get this through your thick skull but cholesterol number means nothing in the first place. For one thing, your body will produce or not produce cholesterol based on its need. Secondly, there is no hard number and cholesterol measurement is just one biomarker, albeit a very lousy one. So the fact that your cholesterol is below 150 does not mean that you are healthy if let say your CRP is through the roof, and conversely if your TC is above 150 then you are sick.

      The same thing goes with a lot of measurements such as the BMI. I can be considered “obese” if I have a lot of bone and muscle and I weigh a lot, or I am considered skinny if my BMI is low, but I have a beer belly and you know that this will lead to heart disease among other diseases (or you don’t even know).

      I bet that Casper has a TC of 100 and a CRP of 10 and a BMI of 18 and has a beer belly. And he is very healthy (not). And he drinks the Kool Aid by claiming that he eats WFPB.

      1. Dude, you’re missing the point.

        If you NATURALLY (NO MEDS) achieve a TBC of 150, then all other metrics will look great. You’re not going to have inflammation issues causing an elevated CRP result.

        You continue to ignore one of the most important studies of past 100 years, the FHS, which showed the world that when you achieve TBC under 150 you’re basically heart attack proof.

        You wouldn’t achieve a TBC under 150 if you’re loading up on processed carbs (which could spark a rise in CRP). So I know where you’re tying to go with this, but your reasoning is flawed.

        Good luck bro.

  10. Dr. Greger, will you please do an analysis of the views contrary to the cholesterol-heart disease link espoused by Dr. Cowan, as in these links?:
    His book and references are here:
    What he says doesn’t seem to disagree with anything you’re saying, since he supports a plant based diet. My mother has congestive heart failure and I’m wondering if she should be taking the supplement he suggests.
    Thank you! Linda Hart, PhD

  11. I am humbled by all of the information and links in that list above. Dr. Greger, you are a hard working educator and I am trying to be as hard working as a student, but the amount of information you put out every week is genuinely humbling.

    Over my whole life, I have found all of the contradictory information and misinformation in the area of diet and nutrition and health daunting, but I feel like I am finally learning things, which are genuinely things I can live with for the rest of my life, even if I don’t do the process perfectly, I finally at least know where to aim.

    I have had those thoughts before – because there has been so much spin on so many theories, but then, I hear the opposite and it has been a literal war inside of my mind about which direction to go, but that war is starting to die down. The ducks are starting to line up in a row.

    Thank you for that.

  12. Can your cholesterol level be too low? My total cholesterol has been tested at 100. I’ve been told (by an MD) that this can cause anxiety because cholesterol is needed to produce the myelin sheaths around your nerves. Is that true? Thanks!

      1. Hi,

        Thanks for responding. I’m not taking any medication. My cholesterol before going plant based (5/16) was:

        Total – 107
        HDL – 33
        LDL – 58
        TRIG – 82

        Since going plant based (10/16), my numbers this month are –
        Total – 127
        HDL – 31
        LDL – 73
        TRIG – 155

        I just got these numbers back today. So my plant based numbers are considerably worse. I haven’t been carefully eating WFPB. But still. I’m wondering both about my overall low cholesterol. But also the fact that my numbers have gotten so much worse. I’ve never had high triglycerides in my life until now. Thanks for your thoughts!

        1. That’s shocking. 107 TBC? No meds, and not plant based? Wow. No comment on that.

          Are you eating lots of processed carbs? Seems off to see 155 TG level on a sound PBD.

          Could you explain the big changes you’ve made?

          What did you Add? What did you Remove?

          How much Fiber do you consume a day?

          1. Yeah, I know. It’s just genetic low cholesterol I think, plus the protective effect of estrogen. I’ve always wondered if it was unhealthy somehow. As far as dietary changes, I eliminated processed meats I was eating quite a bit of. I used to eat quite a bit of canned tuna. I ate meat of some kind every day, including red meat. But I wasn’t a frequent eater of whole eggs or cheese. I ate wheat toast with butter pretty frequently. Now I do eat earth balance sometimes but I’m more likely to eat 2 ingredient peanut butter. I’ve added processed soy “meat” products that I didn’t eat before. I’ve definitely eaten some french bread with earth balance in the past month or so (like during the holidays). I added tofu regularly. And I do roast vegetables with olive oil, as I always have. But I definitely wouldn’t say my diet has gotten more unhealthy since I made the switch. I eat lots more vegetables and fruit than I did, lots more beans, lots more whole grains. I used to eat white pasta and white rice. Now I eat whole wheat pasta and brown rice. Lots of homemade vegetable soups. Lots more nuts than before – cashew cream included. I have indulged in some coconut products from time to time, but that’s not a regular part of my diet. I’ve eaten more whole grain tortilla chips than before, which is not ideal. I’ve added some supplements (whole turmeric spice in capsules, ground cloves in capsules, amla powder, bladderwrack powder, and powdered ginger). I’m worried about those, too, because one of my liver enzymes is now elevated. I don’t count my fiber grams, but it’s definitely a lot more than before. I’m eating about the same amount of sugar as before, I think.

            I don’t know what the heck to think. My plan is to go fully whole foods with no more white flour at all, no processed soy, no sugar and no oil and see what happens. But I’m obviously pretty disappointed by making such a big change and seeing worse results.

            1. I’m obviously not a doctor, but I’d look into your original numbers further …. has your physician had concerns over the very low numbers you originally reported? You say your numbers have gotten worse, but I’m thinking your numbers have improved a bit (except the TG is high). Too low of a TBC is often regarded as sign of something else of concern. But one possible explanation of low HDL could be Tangier Disease a familial alpha lipoprotein deficiency.

              107TBC is extremely low IMHO. I’d follow that up with genetic tests etc. if I were you.

              1. Thanks. I really appreciate the help. I don’t have Tangiers but I do have a blood antibody that probably causes it, now that I think about it. I’m going to see a lipid expert and sort it all out. Thanks for your help!

    1. Hi I’m a Health Support Volunteer with Thanks for your great question.

      That is your total cholesterol that is 100? I’d be interested to know the breakdown of your cholesterol-
      HDL (“good”) vs. LDL (“bad”). There isn’t a good consensus in the medical community on what is too low of the LDL or “bad cholesterol”. According to Mayo Clinic, it may be around 40 for LDL. Is your LDL below 40?
      You might want to look at this video of Dr. Greger’s if you haven’t yet:

      If it is your HDL, or good cholesterol is low, this is typically increased with exercise. However, there are very healthy populations who eat plant based diets with very low rates of disease who have very low HDL, or good cholesterol. Dr. McDougall, who was a mentor to Dr. Greger, has a really great article about HDL, or good cholesterol your might find helpful:

      I hope that helps.
      Health Support Volunteer.
      The information on is designed to complement, not replace, the relationship between a patient and his/her own physician and is for informational purposes only.

      1. Hi,

        Thanks very much for contacting me! I’m not taking any medication. My cholesterol before going plant based (5/16) was: Total – 107 HDL – 33 LDL – 58 TRIG – 82

        High sensitivity CRP – 2.4 (worrisome)

        Since going plant based (10/16), my numbers now are – Total – 127 HDL – 31 LDL – 73 TRIG – 155

        My high sensitivity CRP is now 1.8 (normal).

        I’m realizing that since going plant-based, I’ve been eating more hydrogenated fats than I used to (without realizing it), because we’ve been trying out a bunch of vegan “replacement” foods and eating more tortillas. We haven’t been eating enough whole foods (although way more than before). That said, my results have me concerned and also thinking about my historically low HDL (which may not be a problem necessarily). I’m going to see a lipidologist MD about all of it.

        Any thoughts you have would be awesome too. I will check out the resources you sent as well.

  13. Of course you need to take everything with a grain of salt but this last video of the vaccine series has some interesting tidbits. In particular the push to mandate vaccination of the entire country including adults (they can force through various way such as insurance companies won’t ensure you unless you vaccinate). and Homeoprophylaxis which is being used in India, Cuba, etc. Now again, I am just a messenger and have not researched the subject thoroughly myself. But this free video will go away at the end of today and so watch it if you are interested to learn.

  14. Thanks for responding. I’m not taking any medication. My cholesterol before going plant based (5/16) was:

    Total – 107
    HDL – 33
    LDL – 58
    TRIG – 82

    Since going plant based (10/16), my numbers this month are –
    Total – 127
    HDL – 31
    LDL – 73
    TRIG – 155

    I just got these numbers back today. So my plant based numbers are considerably worse. I haven’t been carefully eating WFPB. But still. I’m wondering both about my overall low cholesterol. But also the fact that my numbers have gotten so much worse. I’ve never had high triglycerides in my life until now. Thanks for your thoughts!

  15. Hi Kimberly and thanks for your question – It would be difficult to comment on the worsening of your lipid panel without knowing what you are eating. Keeping a food journal to identify items that are not consistent with a whole food plant based diet, including processed/packaged foods, added oils, or other added fats in excess such as more than one to two servings per day of nuts or nut butters, would be helpful to determine the dietary cause. I would agree that improvement of the TG’s and HDL would be of benefit. The total cholesterol and LDL are basically on target.

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