Image Credit: Kristina DeMuth. This image has been modified.

Reversing Massive Obesity with Diet

Dr. Walter Kempner introduced the first comprehensive dietary program to treat chronic kidney disease and, in doing so, also revolutionized the treatment of other disorders, including obesity. Kempner was Professor Emeritus of Medicine at Duke, where he came up with the so-called rice diet, which basically consisted of rice, sugar, fruit, and fruit juices, was extremely low in sodium and fat, and included no animal fat, no cholesterol, and no animal protein. The sugar was added as a source of calories so people wouldn’t lose too much weight. But some people need to lose weight, so he started treating obese patients with a lower calorie version of the diet, which I discuss in my Can Morbid Obesity Be Reversed Through Diet? video.

He published an analysis of 106 patients who each lost at least 100 pounds. Why 106? Kempner simply picked the last 100 people who lost more than 100 pounds, and, by the time he finished reviewing their charts, 6 more had joined the so-called century club. Average weight loss among them was 141 pounds. “This study demonstrates that massively obese persons can achieve marked weight reduction, even normalization of weight, without hospitalization, surgery, or pharmacologic intervention…[O]ne important fact to be gained from this study is that, despite the misconception to the contrary, massive obesity is not an uncorrectable malady. Weight loss can be achieved, massive obesity can be corrected, and it can be done without drastic intervention.”

Well, Kempner’s rice diet is pretty drastic, so definitely don’t try this at home. In fact, the rice diet is dangerous. It’s so restrictive that it may cause serious electrolyte imbalances, unless the patient is carefully medically supervised with frequent blood and urine lab testing. Dangerous? Says who? Said the world’s number-one advocate for the rice diet: Dr. Kempner himself.

The best, safe approximation of the diet, meaning low in sodium and without fat, protein, or cholesterol from animals, would be a vitamin B12-fortified diet centered around whole, unprocessed plant foods. However, even a medically supervised rice diet could be considered un-drastic compared to procedures like getting one’s internal organs stapled or rearranged, wiring someone’s jaws shut, or even undergoing brain surgery.

Attempts have been made to destroy the parts of the brain associated with the sensation of hunger, by irradiation or going in through the skull and burning them out. “It shows how ineffective most simpler forms of treatment are that anyone should think it reasonable to produce irreversible intracranial lesions in very obese patients.” The surgeons defended these procedures, however, explaining that their “justification in attempting the operation is, of course, the very poor results of conventional therapy in gross obesity, and the dark prognosis, mental and physical, of the uncorrected condition.” In reply, a critic countered, “Such strong feelings [about how dark the prognosis is] run the risk of being conveyed to the patient, to the effect of masking the operative dangers and steam-rolling the patient’s approval.” The surgeon replied, “If any ‘steamrolling’ is taking place, it comes rather from obese patients who sometimes threaten suicide unless they are accepted for experimental surgical treatment.”

As of 2013, the American Medical Association officially declared obesity a disease, by identifying the enormous humanitarian impact of obesity as requiring the medical care and attention of other diseases. Yet the way we treat diseases these days involves drugs and surgery. Anti-obesity drugs have been pulled from the market again and again after they started killing people—an unrelenting fall of the pharmacological treatment of obesity.

The same has happened with obesity surgeries. The procedure Kempner wrote about was discontinued because of the complication of causing irreversible cirrhosis of the liver. Current procedures include various reconfigurations of the digestive tract. Complications of surgery appear to occur in about 20 percent of patients, and nearly one in ten of which may be death. In one of the largest studies, 1.9 percent of patients died within a month of the surgery. “Even if surgery proves sustainably effective, the need to rely on the rearrangement of [our] anatomy as an alternative to better use of feet and forks [that is, diet and exercise] seems a societal travesty.”

For more on Kempner and his rice diet, see my videos:

Learn more on the surgical approach in Reversing Diabetes with Surgery and Stomach Stapling Kids.

And, for more on weight, see:

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.

60 responses to “Reversing Massive Obesity with Diet

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    1. YR, Hope he left a little dirt on some of the potatoes in order to get some Vit B12 ;-)

      And he would have been better off eating sweet potatoes. It’s hard to believe that sweet potatoes comprised 80% of the calories of the pre-WWII Okinawans, many of whom were healthy centenarians!

      That’s an interesting find … thanks for sharing.

        1. Yep, Dr Weil has a good summary. I do eat some form of sweet potatoes every day. I usually boil a batch with the cleaned skin then make different dishes with them. One interesting way of eating them is to blend them with a few spices to make a “hummus”. Tastes delicious and no need for added refined oil.

          1. Sweet potatoes. I eat them raw. When I saw how much my dogs loved them raw, I tried them and found them to be delicious. Also eat them cooked a couple times a week. The six basic food groups: potatoes, corn, beans, whole grains, oats, pumpkin.

            1. I would add greens to that list. We need the folate and vitamin K. I encourage everyone to eat a minimum of roughly 3 ounces of greens plus 1 cup of cruciferous veggies daily.
              I like to have a large salad, or cooked greens with some beans or nuts for breakfast. Berries for dessert.

        1. gengo, When they surveyed the populace, perhaps they didn’t include that one guy who lived on sweet potatoes for a year. If they had included that one guy, the percentage would be closer to 80% ;-)

            1. gengo, Seriously, when I used 80%, I was quickly going form memory rather than looking it up. I knew it was pretty high, but I think you are right and I was off by about 10%.

      1. While they didn’t have the longevity benefits of Okinawans due to widespread tobacco addiction, New Guinea highlanders subsisted on a diet of nearly 100% sweet potato (2 kg sweet potato + 200 g sweet potato greens) for centuries, with an evident absence of cardiovascular and metabolic disease

        Luyken et al, 1964. Nutrition studies in New Guinea. Am j clin nut, 14(1), pp.13-27.

  1. Once obesity, like so many other “conditions” such as alcohol, tobacco and drug abuse were classified as diseases, the “sick people” considered themselves not responsible for their life choices; after all, you are not sick by choice, correct? Sickness is external; it attacks the innocent preys. It also gave big pharma the go ahead to come up with all sorts of drugs to treat the diseases.

    When people do not own their choices, very little will they do to fix the problem their choices have brought upon them. They want a doctor or drug to cure them of the disease. It seems to me that nobody is responsible for anything they do anymore.

    Once, at a party, a woman asked a doctor sitting next to me what she could do to lose weight because she never “ate anything” but could not shed the extra pounds. He was quite blunt and said it was very simple: if you ingest more calories than you burn, you gain weight; if you burn more calories than you ingest, you lose weight. Quite simple, indeed, but it requires, God forbid, discipline and strong will.

    1. Carolina,

      Listening to Dr. Barnard and other doctors explaining food addiction and used to be a chocolate and soda addict myself, where I would crave chocolate and soda all day long and tried to break off of it so many times. It turned out that I was low in Magnesium and that Cacao is not addictive and I slingshotted from soda to 96 ounces of coffee (which was 80% milk) to 1 green tea latte and tea with no milk.

      I say it because people whose brain has not been hijacked don’t have any clue. I no longer have any food cravings. None.

      I have dear people in my life who are 400 pounds. I don’t think I know anyone who is over 500 pounds. But one of the 400 pound range persons had her stomach stapled but stomachs grow. She tried every diet and every thing possible, but couldn’t afford gastic bypass and couldn’t do it with will-power.

      She doesn’t know that if she could get over to the proper food, she probably wouldn’t even need self-control at all.

      But people who eat Whole Food Plant Based think that they have self-control.

      And people who aren’t addicted to opiates also think they have self-control.

      By God’s grace, may you never have your brain hijacked.

      1. I think most of food addiction is often a nutritional deficiency, combined with a food industry who use brain scans to figure out what to add to addict as many people’s brains as possible.

        I used to have zero self-control with chocolate and now I can have a dessert at Christmas and not even have a blip.

        When I watched the documentary on drug abuse, they said that the meds they have are ridiculously successful nowadays at getting rid of the brain cravings for drugs, but addicts can’t afford the meds.

        They get put in “self-control” and “12 step” programs and 90-something percent of them fail using that method where most of them succeed with the meds which take away cravings.

        1. Watching the show on drug addiction the most tragic part to me was a woman who had gotten off drugs easily using methadone, but she got behind in paying for methadone and couldn’t get it and ended up back on drugs and losing her child again.

          No mother loses her child without it cutting her soul to shreds, but she couldn’t do it with self-control. She needed the money to get the methadone.

          1. Last year, when I listened to the Food Revolution Summit, the woman who runs Bright Lines talked about how only 1% of obese people who tried to get to their ideal weight made it and of that 1%, 90% regain it within 5 years or something and that is NOT WFPB. That is eating foods designed to addict the brain and trying to get off of it all with will-power.

            I do not even want to claim to understand it. I just know that I used to have overwhelming food cravings and failed every time I tried to lose weight and hated myself for not having will-power and now, I don’t even think about those foods unless I see an ad and I don’t feel the need to buy a Reeses from seeing the add and if I have one at Christmas, I no longer have brain addiction.

            I can’t do that talk scientifically. I don’t know if I just have Magnesium now or whether I no longer have artificial sweeteners and artificial flavors causing a sweet tooth.

            All I know is that I am not doing this process through self-control now and I no longer have that self-hatred of the part of myself who ate the foods the industries spent billions trying to addict my brain with.

            Yes, it is a bit of a pet peeve. Mostly, I am watching people die without being able to get free.

            1. Also, I know “alcoholics” who did the whole “12 step” and learned that it was their fault and their responsibility and them not exercising self-control and they lost their jobs and relationships and went to jail and failed and blamed themselves and then, they just took a pill and never craved alcohol again and NOW they turn out to be these highly responsible people who exercise self-control fairly easily without drinking at all and with ZERO counseling and ZERO 12 steps programs and when I spoke to one of them he said, “I was surprised at how easy it was. I just never craved alcohol again.”

              It is such a bummer because he couldn’t get his job back and has a new girl friend and might get his driver’s licence back next year, but it was all such a waste of time and life and putting all of this blame on him didn’t help him at all. Getting rid of the brain craving helped him.

              1. Sorry to all of the professionals who may understand how simplistic I am about all of it.

                I grew up cutting myself and drank antifreeze and blamed things like abuse, but then got rid of inflammation and got nutrition or something like that and it was gone. All of it.

                Between WFPB and PEMF and Water fasting, I hate complicated explanations now.

                I think about what Dr. Lisle said about people believing obesity is related to trauma and it is correlated, but people in other places like Asia were getting abused and going through trauma and were not becoming obese or developing the health problems.

                I am clearly not a professional. I just know that I got rid of things like Diabetes and now I am using PEMF and already can see 3 D movies in 3D and lost night blindness.

                To me, the larger system is sooooooooooo far off and we don’t understand how to help people and just made up whole complicated systems of “What is wrong with them” and suddenly a child eats broccoli and some of them get healed of Autism.

                That tells me we made systems without ANY understanding AT ALL and THEN we professionalized things and passed laws about it all without understanding and the laws and education has made it so hard to change things.

        2. There is a free book on amazon called “Never Binge Again” it is different from 12 step which is a daily willpower thing. This is a matter of character, you wouldn’t eat dog, would you? Then why eat junk?

    2. That’s the beauty of a low fat WFPB diet. You don’t need discipline or willpower. You can eat as much as you want. I always eat to satiety, BMI < 20. When I ate SAD BMI 30.

      1. “That’s the beauty of a low fat WFPB diet. You don’t need discipline or willpower. You can eat as much as you want. I always eat to satiety, BMI < 20. When I ate SAD BMI 30."

        Blair, that's exactly what I did. Went from 224 lbs. to 150 lbs. in approximately 12 months time. Never looked back…easy peasy! Of course regular vigorous daily exercise is also an important ingredient. In the Blue Zones, DanB says that the average 'Blue Zoner' sweats between 5 to 10 hours a week.

    3. Carolina,

      That doctor didn’t understand what is known now. People who eat low fat plant based diets often eat more food than others and still lose weight effortlessly. Yes, that probably means they are eating fewer calories, but the way he said it also most likely means going hungry and never feeling very satisfied. Nobody is going to do that long enough to lose significant weight, and then maintain the loss.

      It is so freeing to be able to eat to satiety knowing that every bite contributes to health and makes the weight loss easy to maintain.

      1. Rebecca, I think they have known that a long time actually. Even back in the days of Weight Watchers they had lists of ‘unlimited foods’… non-starchy veggies basically. Trouble is, that most people don’t want to eat the things they are allowed to eat. Even Jean Neidich (spelling?) was said to say “just put down the damn fork”. WFPB is terrific for people that are ‘volume eaters’. I should say, it’s terrific for everyone, but like Blair says, it makes it easy when you can eat til you’re full and still lose weight.
        There are others like myself who struggle with food addictions daily … it isn’t a matter of getting enough to eat, or nutrients etc, the cravings remain :(

    1. BMI 40 or more, or 35 with obesity related health conditions.

      About 36% of the US population is obese (BMI over 30) compared to Japan’s ~4%. Average BMI in US is ~29% v. Japan’s 22%.

      And all this extravagant, health destroying eating along with the incredible food waste (~40% in the US I’ve read) contributes significantly to global warming.

      Just how stupid can humans be?

        1. Gengo, Yikes, males in the US rank at 9? And, I think, in general, males have worse health when overweight than women. Probably because the minimum amount of body fat women are supposed to have is higher.
          I had no idea that the whole world has gotten so heavy.
          Thanks for posting!

      1. Stupid enough to cause this climate breakdown emergency and not be aware of it. Stupid enough to eat as gluttonous and as fast as they can and not be aware of it. Stupid enough to not understand that the urban consumerist lifestyle is mostly responsible for all of the above

        1. John, much of the problem is that the truth about how to eat is kept from people. I’m a reasonably intelligent adult who was never aware until I happened to read “The China Study,” a book either my daughter or one of her college friends left out on our coffee table amongst a pile of other books. People do not learn this information in school and it should be taught. Even those training in the field of food cannot help but be influenced by industry input, as it is ubiquitous. When it appears in the news, much of it is highly conflicting (e.g., “Butter is back,” and the like.)

          1. I agree, Liisa. In my own case, it took a cancer diagnosis + a last minute viewing of FOK, to switch totally over to a plant based lifestyle, low in added oils, sugar and salt. I have friends with high blood pressure. After suggesting many ideas and factual evidence based truths, all I get is “I take a pill now”. The same for the climate emergency. By the time food becomes rationed or coastal stateside cities become swamped, the solutions will be moot. One of my friends recently had a stroke. He’s obese. He now cannot recall simple ideas and memories from the previous day, but, will not give up the eggs, butter, etc that produced the stroke. We cannot save everyone my dear.

  2. Does anyone know how long the people sited in Kempner’s Rice Diet were on the diet in order to lose 100 lbs??
    Thanks for the idea of sweet potato hummus — sounds wonderful!

    1. The pictures have months on them.

      The before and after shots all seem to be 9 months apart.

      That doesn’t mean that it took that long losing the weight.

      It just seems to be the length of the study itself.

      There were ones from different years and even those had a 9-month difference between before and after photos.

      So I guess, 9 months or less.

    2. I did a little digging and it seems the full study is somewhat elusive. You can find the abstract but doesn’t describe how long folks were on the diet. I found this article which seems to make the case that dieters stayed on the plan for varying times
      The Rice Diet: Weight-Loss Plan Helps Combat Obesity, Weight-Related Diseases “The first phase of the diet is detoxing. After this stage is over, dieters must stay on a 1,000-calorie diet every day until they achieve their targeted weight loss goal.”
      To get a more comprehensive look at weight loss I’d review these videos:
      Many experts suggest it is not safe to lose more than 2 lbs a week but many on a whole food plant based diet ESPECIALLY if oil nuts and seeds are eliminated have safely lost at a faster pace. Dr. Greger’s upcoming book How Not to Diet should give us some more answers as well. Hope this helps.

  3. I learned rice has higher levels of arsenic than other foods. I switched to beans/lentils and millet as staples for protein. Had to eliminate animal proteins to be healed of kidney stones and excess uric acid production Learned some foods are metabolized into alkaline end products to balance one’s system.

  4. Something not mentioned… dramatic caloric restriction over time slows metabolism dramatically! I was a yo yo dieter most of my life, and even now on a strict WFPB diet still have to watch what I eat because my caloric intake is under 1300 cal. before I will start gaining again. Chef AJ has it covered, and fasting helps too but still frustrating to hear people crow that you can’t be overweight on a whole food plant based diet devoid of oil, sugars and any processed food. Nuts, olives, avocados, any high fat, healthy whole foods are off limits or else the pounds happily creep back up.

    1. ‘Most high-fat plant foods (nuts, avocados, olives etc.) have an omega 6:3 fatty acid ratio greatly in excess of the suggested optimal ratio of 4:1 or less. Flaxseed, chia seed and hemp seeds are exceptionally high in omega 3’s and may be beneficial in small quantities (amounts compatible with a low fat diet). High intakes of omega 6’s provide more precursors for the production of inflammatory omega 6 mediators and inhibits the production of anti-inflammatory omega 3 mediators.

      Many of the plant foods that are considered to be ‘good fats’ are actually moderately high in saturated fats – 22% of calories in avocados for example. Even olive oil is 15% saturated fat. Saturated fats are damaging to the intestinal lining, raise cholesterol levels, have adverse effects on blood and endothelial cells and increase insulin resistance. To what degree other components of whole plant foods counter these effects is uncertain.’

    2. Same here Vegetater, I have to be very conscious of what/how much I eat. Though I am a regular and enthusiastic exerciser, I still have to stay under around 1450 cal. or less. Menopause doesn’t help either!

  5. Last night I viewed a YouTube video from VegSource pinning Dr. Joel Fuhrman to the ground through his false reporting on his own so-called Nutritarian diet plan. Now, T. Colin Campbell most noted for his part in The China Study has completely disassociated himself from this man. Fuhrman was supposedly a good guy until this. So much corruption, now even within our own ranks. Be careful.

      1. I don’t recall that which you state, as I watch every vid and read every blog addition. The Fuhrman debacle is huge and deserves its own response.

        1. This is quite disappointing for anyone like me who has benefited greatly from Dr. Fuhrman’s ideas and recommendations.

          However, there is a far more general, ultimately more important, point to be made.
          In his statement to the journal when requesting his name be removed from the published paper, Campbell points out that he had nothing to do with “organizing or conducting the research” and stated “Nor did I review the raw data for the statistical analysis. Like virtually all reviewers of manuscripts I simply accepted the tabulation of the data”. Dr. Fuhrman made essentially the same statement in his defense (and suggested that Campbell had more of a responsibility than he to review the statistical modeling, presumably because Campbell, and not Furhman, is an expert in those matters). The PhD researcher, the third author, took responsibility for the errors. This shows pretty clearly how shaky the research is **in general**. It is ridiculous that a paper could be published in which only one person reviewed the raw data and its tabulation. Mistakes are very easy to make and it is essential that the modeling be done correctly. So in my mind they are all to blame (and by the way, Campbell was not just a reviewer, he was an author). So while this is a case of “road to hell paved with good intentions” for Campbell, and it reflects extremely poorly on Fuhrman, the ***real problem*** is, accepting Campbell’s account, that research can get published with only one person being responsible for the data analysis. (Physicists are much more careful about this sort of thing.) This is one reason relying on any one study is ill advised. Caveat emptor — in general.

          1. But I should add that it was rejected from some first rate journals and then published in some other journal without Dr. Campell’s knowledge. The same general point remains, however.

        2. Hello John, and thank you for your link, above, to the YouTube video about Dr. Fuhrman,

          I am a family doctor with a private practice in lifestyle medicine and also volunteer for Dr. Greger on this website. Dr. Fuhrman’s book Eat to Live is one that I have recommended to several of my patients. I was not previously aware of this situation involving Dr. Fuhrman’s published research.

          However, I am aware that Dr. Fuhrman sells a whole line of vitamins and “Nutraceuticals”. I tell my patients to always beware of any healthcare provider who is making a profit from selling supplements they recommend. It is an inherent conflict of interest. The American College of Lifestyle Medicine, of which I am a member, has an ethics policy, and item #8 of that policy is as follows:

          “8) Members shall not prescribe or recommend products or services from which they profit without full and complete disclosure of their financial gain.”

          I also have a master’s degree in epidemiology from Harvard, and (assuming what I learned from the YouTube video is correct) I find it extremely disturbing to see the way in which the data in the Fuhrman study was “doctored” to make the results more favorable to him. There were major problems with which patients were included and which were excluded from analysis, in the way that “average weight loss” was calculated, and of course, with the completely unsubstantiated conclusions that were drawn. I plan to look into this further.

          There is already so much misinformation out there about nutrition. It is really sad when someone who has been trusted by so many of us who advocate for a WFPB diet is found to be part of the problem. We do indeed need to be careful about who and what we believe.

          Dr. Jon

          Health Support Volunteer for

          1. Dear Dr. Jon,

            Thank you so much for this very valuable comment to my initial post.

            All of this goes back further than Joel Fuhrman, whom I also used to recommend.

            If one looks at Joe Mercola, an ND and Osteopath, Joe was one of the initial people talking about nutrition on the net, he too is lost in a fog of products his site sells. What’s interesting, is that Joe interviewed Michael several years ago. hahaha Michael showed the vast divide still existent between academia and intelligentsia.

            Early last year, I published my own catharsis on this diet/lifestyle conundrum on my little viewed blog. As an animal species, we are complex due to our psychology and cultural imprinting. The latter point is what Dr. Bruce Lipton brings to this table; however, I’m unsure if he is solely a plant eater. hahaha We are evolving very slowly and may not make it, although the ‘fat’ lady hasn’t sung yet.

            I lived with PC for 9 years [blogging about that]. After my EBRT escapades, my oncologist discharged me as an active patient. I told him that prostate cancer was a disease of lifestyle through diet. He replied: “I’m beginning to see that now.” He is the chief oncologist in Halifax, NS, the province I reside in. Such is life.

            What Michael does is of enormous benefit to folks who will listen and take the free challenge. I must say that I met a prof from DAL who teaches nutrition, a plant eater, who told me that it’s easier for someone to change their religion than switch their diet. What a sorry bunch we are! hahaha



          2. Dr. Jon,

            Dr. F. certainly must be aware by now that there are many negative posts about him flooding the ‘net. Do you think he’ll record a “damage control” video in an attempt to defend himself? As we know, there are two sides to every story.

            1. He might admit to being a dirty rotten scoundrel and beg to be whipped with 50 kale leaves.

              Or maybe just the stalks. Tie a strong rubber band around ’em and yer good to go. *_^

            2. Indeed there are, YR. Here’s the link to Dr. Fuhrman’s side of the story.


              I think his response is sufficient. The error was that of the researcher responsible for the statistical analysis and results, as she acknowledged (see the letter posted in Fuhrman’s reply. Once the error was discovered, he quit using the wrong figures.

              Regarding Jeff Nelson (vegsource) – he has absolutely no training or other discernible expertise in nutrition or science more generally. He has 2 degrees in English and made movies for a living. Yet he had the chutzpah to state in the video denigrating Dr. Fuhrman that he has been his colleague for the past 15 years! His colleague?!

              Dr. Fuhrman had previously completely rebutted Nelson’s amateurish videos denigrating nuts/seeds.


              Dr. Fuhrman has been going against the deep seated biases of many WFPB doctors against higher fat vegan diets (Fuhrman maintains that fat content should be at least 15% of calories but even 30% is fine in some cases). I admire Dr. Fuhrman for having the courage to “fight the establishment” on this topic as I’ve always been skeptical of ultra low fat diets. (Note that recently both Campbell and Esselstyn have said that nut/seed eating in moderation is fine, if there are no counterindications e.g. obesity or diagnosed heart problems to be reversed.)

              Thanks for motivating me to look for Dr. Fuhrman’s replies to the attacks on him.

          3. Dr. Jon,
            As YR pointed out, there’s two sides to every story. Here’s Dr. Fuhrman’s reply.


            Regarding his supplement sales, I am happy he does provide some as I have more faith in the quality of his products then most others. My wife and I use his low dose, custom tailored Men’s/Women’s Daily multivitamin. Dr. Klapper has also revealed in a video that he uses his Men’s Daily multivitamin. He also provides a high quality, low dose vegan DHA/EPA product, which has the exact does recommended by Dr. Greger. I see nothing wrong with that, and I do not begrudge him making money.

  6. I hope Dr. Greger geeks out for a few episodes to introduce his science fan viewers to the hormone fibroblast growth factor-21 (FGF21), which in my opinion plays a large role in the metabolic benefits of the lysine deficient Kempner rice diet and plant based diets, generally.

    Key reviews and human studies:

    Mashili et al, 2011. Direct effects of FGF21 on glucose uptake in human skeletal muscle: implications for type 2 diabetes and obesity. Diabetes/metab res rev, 27(3), pp.286-297.
    De Sousa-Coelho et al, 2012. Activating transcription factor 4-dependent induction of FGF21 during amino acid deprivation. Biochem J, 443(1), pp.165-171.
    Kim et al, 2013. Acute exercise induces FGF21 expression in mice and in healthy humans. PloS one, 8(5), p.e63517.
    McCarty, 2014. GCN2 and FGF21 are likely mediators of the protection from cancer, autoimmunity, obesity, and diabetes afforded by vegan diets. Med hypotheses, 83(3), pp.365-371.
    Fazeli et al, 2015. FGF21 and the late adaptive response to starvation in humans. J clin inv, 125(12), pp.4601-4611.
    McCarty, 2015. Practical prospects for boosting hepatic production of the “pro-longevity” hormone FGF21. Hormone mol bio clin inv, 30(2).
    Gosby et al, 2016. Raised FGF-21 and triglycerides accompany increased energy intake driven by protein leverage in lean, healthy individuals: a randomised trial. PloS one, 11(8), p.e0161003.
    Fisher and Maratos-Flier, 2016. Understanding the physiology of FGF21. Ann rev physio, 78, pp.223-241.
    Cummings et al, 2018. Restoration of metabolic health by decreased consumption of branched‐chain amino acids. J physio, 596(4), pp.623-645.
    Hill et al, 2018. Homeostatic sensing of dietary protein restriction: a case for FGF21. Front neuroendocrin.
    Castaño-Martinez et al, 2019. Methionine restriction prevents onset of type 2 diabetes in NZO mice. FASEB J, includes a human trial with vegetarian diets

  7. Any chance that you could do a video on diet and lipedema and adipose tissue disorders? There’s some cool research coming out of The University of Arizona by Dr Herbst on these conditions and I’m wondering how nutrition can play a part in treating those conditions.


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