Q&A with Dr. Greger 13

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Did you ever wonder if certain foods have a direct effect on your health? Well, I’m here to solve that mystery since you are the foods you eat. Welcome to the Nutrition Facts Podcast. I’m your host, Dr. Michael Greger.

Today we answer a wide variety of your questions, like the best way to treat insomnia, or information on how to lower your cholesterol, and whether or not you can eat too many beans.

Hello, this is Dr. Michael Greger coming to you live from my stationary treadmill because so many people complained that I was making them seasick. I don’t want to make people sick—that’s kind of the antithesis of what I’m trying to do. Let’s get to your questions.

“First one up is nutritionally, for weight loss and longevity, are peanuts more like nuts or legumes? And which nuts have the highest concentration of plant sterols to bring down LDL?”

Nutritionally, peanuts are very similar to tree nuts. In terms of weight loss, they have a very similar caloric density. In terms of longevity, walnuts really beat all other tree nuts as well as peanuts. And I don’t think peanut butter works at all. Does silica prevent AGEs? No, not that I know of, nor would it boost collagen. I do have a webinar on collagen-boosting foods; check it out.

“Should the government tax high saturated fat foods?” Whether it should or whether it could—so, there was a… I do have videos talking about the Danish meat tax, which was so effective that the animal agriculture lobby made sure it did not last very long, but just as we were starting to see significant public health benefits, unfortunately, it was repealed.

“Any tips on repopulating my gut after a course of antibiotics?” Well, probiotics—taking probiotic supplements actually makes things worse. It actually delays the rebalancing of your gut flora, which is something that I discovered in researching How Not to Age. Check out my probiotics chapter. All we can do is just start feeding… I mean, there are certain antibiotics that absorb in the small intestine and don’t really affect much in the gut, but if you’re experiencing gastrointestinal symptoms, make sure to get lots of prebiotics to feed the stragglers. You know, we’re not sterilizing the gut; your gut microbes may just take a hit, so you feed them lots of good food, and they will be fruitful and multiply on their own.

“Are there any health benefits you can get from coffee but not from green tea?” Absolutely. So, coffee has chlorogenic acid, the autophagy-boosting antioxidant, which green tea does not have. Three cups of coffee a day decrease all-cause mortality by 13%, while three cups of tea a day decrease it by 24%, but by a different mechanism—actually, ironically, a pro-oxidant mechanism, rallying our antioxidant defenses in an interesting “that which doesn’t kill us makes us stronger” hormetic mechanism. Anyway, they both work through different mechanisms, so we would assume it would be an additive effect. So, eat both or drink both. I started out with coffee; now I’m drinking tea.

Next up, “any advice to help with sleep—not just falling asleep but staying asleep?” Absolutely. So, treating insomnia is all about sleep hygiene and sleep conditioning, and I think I’ve talked about five rules of each in the sleep chapter of How Not to Age, and I think the sleep chapter of How Not to Diet also has the same information. Also, warm baths—either foot baths or full-body baths or showers before going to bed, even just wearing warm socks at night—improve sleep through an interesting mechanism which I talk about in How Not to Age. Check it out—go to your local public library and check it out.

Okay, next up: “I’ve taken amla—amla’s dried Indian gooseberry powder—and it lowered cholesterol levels by about 10%.” That’s great! “What if there was one thing to lower high blood pressure? What would it be?” Hibiscus tea, probably, or ground flaxseed would be my two best bets. But less than a teaspoon a day of ground black sesame seeds also drops systolic blood pressure by about eight points. Sustaining that alone could decrease your risk of stroke by about a quarter. How exciting is that?

Okay, Phil Hampton says, “what are my thoughts on echinacea?” I talk about echinacea being useless in terms of upper respiratory infections. I’ve not heard of anything about group streptococcus and echinacea, but if it’s being—I mean, the thing that we thought had the greatest evidence base for it was upper respiratory infections, and it turns out it doesn’t even work for that.

Bonnie says, “how much fat should one have at each meal to get sufficient nutrition?” This questioner, what Bonnie is asking, is talking about the absorption of fat-soluble nutrients. So, if you eat a meal without any fat in it—like a salad with no nuts or seeds or avocado with a fat-free dressing—you are not going to maximally absorb all the fat-soluble phytonutrients, like all those carotenoid nutrients that are so beneficial, like the beta carotene in greens, etc. It does not take much; I have a video about that where I give exact values, but it was just a few—like a few walnuts or a quarter of an avocado, if I remember correctly. But check out that video. And yes, soybeans certainly—chickpeas are low in fat, but soybeans may have enough fat. But you know, you’ve got to sprinkle flaxseeds onto your food anyway—ground flaxseeds are part of my Daily Dozen—so that’s another great way to make sure you have just enough fat to boost the absorption of your fat-soluble nutrients.

“Sarcoma with paravertebral invasion—just got diagnosed with that.” That’s not good. So, sarcoma is a cancer of connective tissues. Oh, that’s a fantastic question. So, what can I actually do? That is the subject of what I hope is going to be my next book, if the publisher agrees—a book on cancer. So, I’ll be doing daily cancer protocols for all 16 or so cancers that kill 5,000 Americans or more. Although sarcoma may not actually make the list, fingers crossed. So, I just don’t know, but there certainly are foods that can improve survival for different types of cancer—different foods for different cancers. But sarcoma is not one I’ve looked into and may not look into for the book. I don’t think that actually made the list. I think the 16th was melanoma. So, cancers more rare than that, killing fewer Americans, will not make the list, unfortunately. Already it’s going to be a massive book with the Daily Dozen.

“I get all my vitamin needs except for one—I only get 300 milligrams of choline versus the RDA of 550. I can’t eat soy and don’t want to eat more broccoli. Should I supplement?” No, you shouldn’t supplement. Just type in “choline” on NutritionFacts.org and look at its effects on organ function. Choline is an essential nutrient, but you don’t want to get too much because bad bacteria can turn choline into trimethylamine, which is oxidized by the liver and wreaks havoc in the body. But you should be able to get all the choline you need from whole foods without taking supplements.

“Are there health issues associated with silicone cooking utensils?” Not that I’ve seen. It’s not something I’ve looked at particularly, but I did do a lot of videos on cooking utensils and pots and pans. I assume if something was bad, it would have popped up. But I have not seen anything offhand. If you do a PubMed search and something comes up, send it my way because I cook with silicone, so I’d want to know.

“My books are life-changing,” says Fernanda. Thank you! “Is a calcium supplement from algae better?” No, no, no, no, no. We should not be supplementing for calcium. It’s not particularly effective, it’s not safe, and regardless of what kind—it’s just a scam. And in this case, a dangerous scam, because you’re getting too much of a calcium spike in your bloodstream. Check out my videos for more.

Fernanda’s back—would I recommend statins for someone whose LDL was 190? Oh, Jesus. 90 is good. No, but 190 is way too high, especially with a high LP(a), which is largely genetically determined, so you need to get your LDL absolutely as low as possible, certainly under 70 for primary prevention. I would go on the Portfolio Diet, which is a plant-based diet with particular foods that lower LDL cholesterol. See how far you can take diet, and if you can’t get it down to target, then absolutely talk to your physician about prescribing drugs.

“People at Mastering Diabetes claim that dietary fat—not just any dietary fat, but particularly saturated fat—causes insulin resistance. In their diet, they restrict fat to 10-15%. Is that necessary?” Well, that certainly is more typical of how our species evolved—getting about 10% of calories from fat. But insulin resistance is really a problem with saturated fat in the context of excess calorie intake. But yeah, different fats are kind of a mixture of various fats, and so, for example, there’s some saturated fat in nuts, even though nuts have an overall benefit. That’s because of all the other wonderful things in nuts. But I think if you just restrict saturated fat, which is in meat, dairy, and junk food, you should be able to reverse your insulin resistance.

“Do I need to worry about pH value when making a DIY vitamin C serum?” Oh, you know, I wouldn’t mix the vitamin C and niacinamide together in a serum. I would do them separately just because… yeah, I don’t know what the vitamin C would be doing to the niacinamide.

“Fascinated by longevity research? Wild blueberry”—well, wild blueberry, you would like my new book. “What specific blood markers”—oh, interesting. Yeah, so there are all sorts of interesting measures of biological aging. There are lots of companies trying to fight it out to be the best. Probably the kind of following the epigenetic clock is the most well-validated, but I’m not sure what commercial tests are available. I know what tests are used in a laboratory setting, but not sure what’s available commercially.

“Hello,” says Niall. “I was wondering if I could get your insight on artificial sweeteners, like sucralose.” I’ve got videos on sucralose. Yes, there is a health concern—it has to do with causing dysbiosis in the gut. You know, sucralose manufacturers like to brag about how their artificial sweetener doesn’t get absorbed into the bloodstream, so therefore it’s safe. But guess what? If it doesn’t get absorbed into the bloodstream, what does it do? It ends up in the colon, where it mucks with our microbiome. So, don’t do it. If you want to see the science, just type in “sucralose” on NutritionFacts.org.

“Are puffed grains unhealthy?” Yeah, puffing, as well as kind of explosion-extrusion, and all sorts of things to make breakfast cereals—it’s just ways to kind of increase the glycemic index, which is not something we want. So yeah, I would avoid that, even if they’re whole grains. There are better ways to get your grains, like whole intact grains.

Victoria says her husband, 63, has been following a whole-food, plant-based diet for six years, but his total cholesterol is still high. Oh my God, LDL is way too high. Well, so, you know, a lot of people claim they’re on a whole-food, plant-based diet, but are eating vegan junk food that has tropical oils like coconut oil or something. That’d be the first thing to check. But if you really are eating whole foods and your LDL is that extraordinarily high, I would try the Portfolio Diet, as I talked about before. David Jenkins at the University of Toronto—that’s the best diet for maximally lowering cholesterol. But if you can’t get it down to target, then you need to figure out another way. There are lots of things you can take that also lower cholesterol, like amla and things like that. But again, if you can’t do it by diet, you have to get it down some way, and that can include drugs—higher-dose drugs, multiple drugs, whatever it takes to get your LDL down, which is a primary risk factor for the number one killer in women.

Wealthy says, “what do we think about Peter Rogers?” Never heard of him. A more radical version of me? How funny. Now I want to Google him—never heard of him.

“Can I roast nuts on low temperature to avoid forming acrylamides?” It’s not the acrylamides we worry about in nuts. Acrylamides are more of a concern with high-heat cooking of carbohydrates like crackers, French fries, and potato chips. The nut roasting causes the formation of advanced glycation end-products. I think it starts occurring at like 250°F, so it’s not really the roasting of nuts, but if you can keep your nuts under that temperature, you’ll likely keep your AGEs low.

I find them easier to chew than raw. Raw—I don’t know why raw nuts would be hard to chew, like raw walnuts—are they hard to chew?

“Can I eat too much protein from beans? I hear doctors say more than a cup a day of beans”—well, why can’t you eat more than a cup a day? In fact, I recommend in my Daily Dozen a cup and a half—right, three servings a day of legumes, with a serving being a half-cup. How many beans can we eat? Why would you be hurting your kidneys? Beans do not hurt your kidneys. In fact, the recommendation is to switch over to plant protein for protecting chronic kidney failure patients—to protect one’s kidneys by reducing animal protein intake. If you have extremely poor kidney function, then they may want to decrease your protein overall, but you need to talk to a renal dietitian, definitely.

Anthony ate a whole-food, plant-based diet for four months. Oh my God, lost 75 pounds—congratulations! But then, in four months, gained back 40 pounds. So, I talk about what is behind the stalling of weight loss and gaining back weight in How Not to Diet. Go to your local public library, get How Not to Diet, and go to that chapter. Sorry to hear that.

Isabelle says she’s a huge fan—that’s nice. Can I advise what a type 1 diabetic should eat to prevent diabetic bone disease? I don’t think of diabetes causing bone disease, but I mean, type 1 diabetes can be certainly serious. You know, the Defeating Diabetes or Mastering Diabetes folks know a lot about type 1 diabetes, so basically you’re trying to improve insulin resistance just to make your body more sensitive to the insulin that you are injecting. But you will be injecting, or your child will be injecting, insulin for their whole life—critically important to maintain… yeah, primarily to not bottom out and have life-threatening hypoglycemia. So yeah, it’s very important to work very closely with your medical professionals to make sure that they keep their blood sugar levels stable. We can do that by improving insulin sensitivity so you can get into a regular regimen of knowing exactly how much insulin you need every day.

“How long to microwave 1.5 ounces of mushrooms to make sure the polyphenol oxidase is gone?” This is such a high-level question—I love it! What is the optimum amount of mushrooms to eat every day? I hear too much is a waste. Huh, I don’t think so; I’ve certainly never heard that. No, no, eat as many mushrooms as you want! Oh, speaking of which, I just made some pasta sauce and totally forgot my maitake mushrooms—I’m totally going to add some. I did a long Q&A talking about polyphenol oxidases. Didn’t I talk about how much? Don’t quote me—go to the video where I actually show the data on how many seconds it takes—it does not take much.

What are my thoughts about the NIH report on a study saying spermidine can cause stroke? I’ve never heard of that. Alright, now you got me. I am typing it into PubMed as we speak… serum spermidine in relation to stroke… so it’s not talking about taking spermidine; it’s talking about serum spermidine. But serum spermidine is linked to lower all-cause mortality, which is the most important thing. It is the most predictive nutrient. Following hundreds of individuals between the ages of 45 and 64, they found 146 components of people’s diets, and spermidine was the single most associated with longevity. So, presumably, that would wash out any stroke effect if there even is a stroke effect. And they’re certainly not talking about taking it as a supplement, so there’s a possibility of reverse causation or whatever. But that is totally interesting—I’m going to look into that when I do my spermidine update. But so far, I would stick to my recommendation because of all-cause mortality—that’s the most important thing. But I will look into it—thank you so much for letting me know, that’s exciting!

How do I explain ApoB and how it compares to LDL for atherosclerosis risk? So, ApoB is a protein that’s kind of part of LDL, but it’s also a protein found in other kinds of lipoprotein conglomerates. But LDL continues to be recommended as the best marker. Testing companies are always trying to come up with fancy methods to test, but LDL is just so dirt cheap, they’re not making a lot of money on it. But it’s hard to really beat out LDL for predicting survival and cardiovascular disease risk. I would stick with LDL.

“If someone ate a pure carnivore diet, how long until they would develop scurvy, the vitamin C deficiency disease?” Well, it depends. If you ate raw meat—I don’t recommend eating raw meat, don’t recommend eating cooked meat either—but raw meat has some vitamin C. That’s how, you know, the Inuit could survive on eating whale carcasses without much plant food during the winter months. How long does it take to develop scurvy? I have videos about it—I think it just takes a couple of weeks. In fact, I talk about it in my fasting video. Anyway, it takes a while, but scurvy is not the reason why you don’t want to do the carnivore diet. You don’t want to do the carnivore diet because of the saturated fat intake, the cholesterol intake, etc.

“If you have elevated liver enzymes, can the liver heal if you drink non-alcoholic beer and wine?” Well, the reason your liver enzymes are high is because they’ve been suffering alcoholic damage from the alcohol. If you stop drinking alcohol, can your liver heal? Absolutely. Your liver has a remarkable ability to regenerate unless it’s really far along. So yes, stop drinking alcohol.

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