How to Prevent a Stroke

How to Prevent a Stroke
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Insufficient intake of fiber-rich foods may lead to the stiffening of our arteries associated with risk of having a stroke.

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High dietary fiber intake may prevent strokes. The belief that dietary fiber intake is protectively associated with some diseases was postulated 40 years ago, and then enormously fueled and kept alive by a great body of science since. Today, it is therefore generally believed that eating lots of fiber helps prevent obesity, diabetes, and cardiovascular diseases such as stroke. Strokes are the second most common cause of death worldwide. Moreover, stroke is a leading cause of disability, and so preventing strokes in the first place–what’s called primary prevention–should therefore be a key public health priority. All best studies to date found that fiber appears to significantly protect against the risk of stroke. Different strokes for different folks, depending, evidently, on how much fiber they ate. Notably, increasing fiber just seven grams a day was associated with a significant 7% reduction in stroke risk. And seven grams is easy, like a small serving of whole grain pasta with tomato sauce, and an apple.

What’s the mechanism? Well, fiber helps lower cholesterol and blood sugar levels. Or could just be we’re just eating more vegetables, or fewer calories, or less meat and fat, or improving digestion, slimming us down, lowering our blood pressure and the amount of inflammation within our bodies. Does it really matter though? As Dr. Burkitt commented on the biblical passage that reads, “A man scatters seed on the land—the seed sprouts and opens—how, he does not know.” But, he doesn’t wait to find out. Had the farmer postponed his sowing until he understood seed germination, he would not have lasted very long. So yes, let’s keep trying to figure out why fiber is protective, but in the meanwhile we should be increasing our intake of fiber, which is to say whole plant foods.

And it’s never too early. Strokes are one of many complications of arterial stiffness. Though our first stroke might not happen until our 50s, our arteries may have been already stiffening for decades leading up to it. Hundreds of kids were followed for 24 years, from age 13 in junior high through age 36, and they found that the lower intake of fiber during young age is associated with stiffening of the arteries leading up to the brain, and so we need to promote consumption of fiber-rich foods among the young. In fact, even by age 13 they could see differences in arterial stiffness depending on diet. This emphasizes the view that increases in fiber intake should be pursued already among young children.

And again, it doesn’t take much. One extra apple a day, or an extra quarter cup of broccoli, might translate to meaningful differences in arterial stiffness in adulthood. But if you really don’t want a stroke, we should try to get 25 grams a day of soluble fiber, which is found in beans, oats, nuts, and berries, and 47 grams a day of insoluble fiber, found primarily in whole grains. One would have to eat an extraordinarily healthy diet to get that much, yet these cut-off values could be considered as the minimum recommended daily intake of soluble and insoluble fiber, to prevent stroke. They admit these are higher than those commonly and arbitrarily proposed as “adequate” levels by scientific societies, but do we want to be patronized as to what authorities think is practical, or do we want them to just tell us what the science says, like the researchers did here?

Someone funded by Kellogg’s wrote in to complain that in practice such fiber intakes are unachievable. Rather the message should just be the more, the better, ya know, just have a bowl of cereal or something. Wink, wink.

The real Dr. Kellogg, who was actually one of our most famous physicians, credited for being one of the first to sound the alarm about smoking, may have been the first American physician to have recognized the field of nutrition as a science, and would today be rolling in his grave if he knew what his company had become.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to ML Cohen via Flickr.

High dietary fiber intake may prevent strokes. The belief that dietary fiber intake is protectively associated with some diseases was postulated 40 years ago, and then enormously fueled and kept alive by a great body of science since. Today, it is therefore generally believed that eating lots of fiber helps prevent obesity, diabetes, and cardiovascular diseases such as stroke. Strokes are the second most common cause of death worldwide. Moreover, stroke is a leading cause of disability, and so preventing strokes in the first place–what’s called primary prevention–should therefore be a key public health priority. All best studies to date found that fiber appears to significantly protect against the risk of stroke. Different strokes for different folks, depending, evidently, on how much fiber they ate. Notably, increasing fiber just seven grams a day was associated with a significant 7% reduction in stroke risk. And seven grams is easy, like a small serving of whole grain pasta with tomato sauce, and an apple.

What’s the mechanism? Well, fiber helps lower cholesterol and blood sugar levels. Or could just be we’re just eating more vegetables, or fewer calories, or less meat and fat, or improving digestion, slimming us down, lowering our blood pressure and the amount of inflammation within our bodies. Does it really matter though? As Dr. Burkitt commented on the biblical passage that reads, “A man scatters seed on the land—the seed sprouts and opens—how, he does not know.” But, he doesn’t wait to find out. Had the farmer postponed his sowing until he understood seed germination, he would not have lasted very long. So yes, let’s keep trying to figure out why fiber is protective, but in the meanwhile we should be increasing our intake of fiber, which is to say whole plant foods.

And it’s never too early. Strokes are one of many complications of arterial stiffness. Though our first stroke might not happen until our 50s, our arteries may have been already stiffening for decades leading up to it. Hundreds of kids were followed for 24 years, from age 13 in junior high through age 36, and they found that the lower intake of fiber during young age is associated with stiffening of the arteries leading up to the brain, and so we need to promote consumption of fiber-rich foods among the young. In fact, even by age 13 they could see differences in arterial stiffness depending on diet. This emphasizes the view that increases in fiber intake should be pursued already among young children.

And again, it doesn’t take much. One extra apple a day, or an extra quarter cup of broccoli, might translate to meaningful differences in arterial stiffness in adulthood. But if you really don’t want a stroke, we should try to get 25 grams a day of soluble fiber, which is found in beans, oats, nuts, and berries, and 47 grams a day of insoluble fiber, found primarily in whole grains. One would have to eat an extraordinarily healthy diet to get that much, yet these cut-off values could be considered as the minimum recommended daily intake of soluble and insoluble fiber, to prevent stroke. They admit these are higher than those commonly and arbitrarily proposed as “adequate” levels by scientific societies, but do we want to be patronized as to what authorities think is practical, or do we want them to just tell us what the science says, like the researchers did here?

Someone funded by Kellogg’s wrote in to complain that in practice such fiber intakes are unachievable. Rather the message should just be the more, the better, ya know, just have a bowl of cereal or something. Wink, wink.

The real Dr. Kellogg, who was actually one of our most famous physicians, credited for being one of the first to sound the alarm about smoking, may have been the first American physician to have recognized the field of nutrition as a science, and would today be rolling in his grave if he knew what his company had become.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to ML Cohen via Flickr.

Doctor's Note

This may sound familiar—an abridged version was included in my latest year-in-review live presentation (From Table to Able: Combating Disabling Diseases with Food). More on preventing strokes can be found here:

More on the wonders of fiber in:

It really is never too early to start eating healthier. See, for example, Heart Disease Starts in Childhood and How to Prevent Prediabetes in Children.

If you haven't yet, you can subscribe to my videos for free by clicking here.

78 responses to “How to Prevent a Stroke

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  1. How important is the ratio of soluble to insoluble? I average about 82g of fiber per day with many higher, and some less but I haven’t ever really looked at soluble vs insoluble before.




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    1. Hi Mike, I shared some sources in my other comment that you can use to estimate your soluble intake. If you’re getting 82 g total, I’d estimate you’re easily getting 20-25 g soluble.




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    2. Hey Mike. That is a lot of fiber! Fiber needs for adult men (38g) and women (25g) are measured as “total fiber” (both insoluble and soluble) . i think it’s good to have both in your diet, but if you’re eating so much fiber (from the sound of it you have no problem there) from a variety of whole-plant foods you really shouldn’t have to worry about soluble vs insoluble. Dr. Greger mentions guidelines on fiber recommendations here, and points out how this is just the minimum, which unfortunately many Americans do not meet.




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      1. Thanks, for the link. Yes, lots of fiber on a high carb whole foods plant based diet. And no problems personally. Certainly more regular than in my past on a standard American diet.




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    1. Absolutely!

      “Just as food is the prime cause of our culture’s heart-disease woes, it is also, ironically, the answer to them. Dr. Esselstyn’s program eliminates the food-based substances that wreak havoc on your endothelium, replacing them with healthful, plant-based foods. Freed from the toxicity of fats, animal proteins and processed carbs, your body’s inner workings change for the better. Here’s what happens: Your endothelium (that magic carpet of cells that lines your arteries) begins pumping out nitric oxide again; your blood vessels regain their flexibility, and the sludge lining your arteries dissolves and clears out, all allowing unimpeded blood flow to your heart. Participants in Dr. Esselstyn’s study showed these amazing reversals and, by continuing to follow a plant-based diet on an ongoing basis, remained free of symptoms — without further high-cost surgical interventions!”
      http://www.clevelandclinicwellness.com/conditions/CoronaryArteryDisease/Pages/Detox-Your-Diet-and-Heart-Attack-Proof-Your-Life.aspx#

      Highly recommend “Prevent & Reverse Heart Disease” by Dr. Caldwell Esselstyn:
      http://www.amazon.com/Prevent-Reverse-Heart-Disease-Nutrition-Based/dp/1583333002




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      1. Hi RD. I agree with B00mer. Dr. Esselstyn published research showing how a plant-based diet can be “A way to reverse CAD?”. Meat can cause inflammation and saturated fat appears to have other deleterious effects such as increasing the risk of heart disease. “A nutritionally poor dietary pattern, characterized by a high meat and alcohol consumption and low micronutrients intake, is related to an increased stiffening of large arteries.” Other foods that may help arterial stiffness are turmeric and coffee. Hope this helps.




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  2. “in practice such fiber intakes are unachievable” Like so many things …unless you’re on a whole foods vegan diet.

    If anyone’s interested, a few sources useful for estimating soluble fiber intake in particular, the data for which is a bit more elusive than total fiber:

    http://www.globalrph.com/fiber_content_soluble.htm
    http://www.ars.usda.gov/SP2UserFiles/Place/80400525/Articles/jfca15_715-723.pdf
    http://ocw.tufts.edu/data/47/531408.pdf
    http://www.dietitians.ca/getattachment/3bb6330f-0ab2-48fc-9d24-1303ad70003d/Factsheet-Food-Sources-of-Soluble-Fibre.pdf.aspx
    https://www.prebiotin.com/resources/fiber-content-of-foods/




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      1. I don’t know how people can function on a bowl of cereal in the morning! A couple, like Grape Nuts have some substance to them, but most are like cotton candy.




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    1. Thank you for the links. I noticed something surprising in the paper in the second link: Even soft white bread, purportedly the nutritionally worst kind of bread, has a lot of insoluble fiber.




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      1. Hi Ben, regarding the white bread, I looked at a couple calorie counters, and it does appear that some reduced calorie white breads have a couple grams of (added) fiber per slice, with each slice only weighing about 20 – 25 g, which would indeed give a value of about 8 – 9 g total fiber per 100 g as the paper says. These equate to about 0.035 g fiber per Calorie.

        However if you notice, the regular soft or firm white breads are only 1.5 – 2.6 g total fiber per 100 g, so these breads, which are what most people are thinking about when they hear “white bread” only average about 0.4 – 0.7 g total fiber per slice. These equate to about six-fold lower fiber content by calorie (0.0056 g fiber/Cal).

        All the whole wheat breads I looked at had at least as much as the reduced calorie white breads or more. Complicating this matter however is their use of “wheat bread” instead of “whole wheat bread” in several entries. Among those I looked at, whole wheat breads appear to average about 0.4 g per Calorie.

        So for fiber, Wonder Bread is still not a good source as we all most likely intuitively knew. However reduced calorie fiber supplemented white breads appear to be similar to some whole wheat breads in total fiber content. However this is pretty much like taking a fiber supplement, so if one wants their fiber from whole food sources, whole wheat bread would still be the answer.




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  3. In reality, John Harvey Kellogg would not be surprised at all by the sugary tack the Kellogg’s Company has taken.

    Sugar as an ingredient in his corn flake invention was the reason his brother Will Keith Kellogg broke ranks with John Harvey and founded the Battle Creek Toasted Corn Flake Company on February 19, 1906, now our present-day Kellogg’s multinational corporation.

    BTW Kellogg’s also owns Gardenburger and Morningstar.




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    1. I was just about to comment this, but was unaware if someone else had mentioned it previously, sooo I looked. I concur after investigating/watching documentaries about the Kellogg brothers. They were like night and day, or realistically, evil and good. A benevolent brother opposed to the corrupt, greedy, health-sacrificing ways of his brother, and the other brother only concerned with money and capitalism most despicable aspect—the lack of interest in it’s population’s health….

      Very sad to see the good guy lose. Welcome to Amurica.




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  4. Stroke is actually the worst manifestation of CVD. Heart attack kills you or leave you with angina, which can be treated through dietary intervention, medication or surgery. On the other hand stroke leaves you with paralysis, afasia, emotional incontinence and cognitive problems – and if you are lucky you will also get epilepsy. The consequences are permanent. Doctors will prescribe a lot of medication to prevent an other stroke – but it is too late!!! Stroke is reason enough to do everything you can to prevent CVD – go plant strong !!!




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      1. You are right. I have previously worked at a stroke unit and partial recovery is possible with intensive training through months. I have seen patients getting their second and third stroke, and I have seen patients with big infarcts in one hemisphere getting their second stroke in the other hemisphere leaving them with tetraparesis. Prevention is so important. I have also seen patients deeply unconscious with oedema in one hemisphere (CT scan), suggesting huge media infarction, walking around the next day without any symptom at all! The brain is fantastic!




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        1. Yes, of course, the critical piece is prevention. And, yes, the brain is an incredible organ (like all of the other amazing organs in our bodies!)




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    1. My husband and I were junk food vegans for many years. Then he had a stroke four years ago. Every word you say is true. Strokes are devastating. I wouldn’t wish one on my worst enemy.




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  5. Hi

    What’s your opinion of the ideas of these two books?

    1) Grain Brain

    2) Wheat belly:
    Lose the Wheat, Lose the Weight, and Find Your Path Back to Health

    Thanks




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    1. Most people on this list will probably hate both books. I think we have to think that the goal of Dr. Greger/Fuhrman/Barnard is different than the goal of Perlmutter/Mercola/WEston Price/Paleos. Greger et al emphasize CVD, while Perlmutter et al emphasize alzheimer’s, gluten inflammation, and diabetes. PErlmutter grudgingly admits that he eats more vegetables than meat and that high fat with high carb is disastrous for everything. For first group, the solution is low fat, all carb ok. Second group is low carb, all fat ok. I eat almost completely whole plant foods, with some coconut and olive oil, and a bit of free range organic eggs, butter and I eat meat about once a month. That’s what works best for me so far.
      John S




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    2. These books join a long list of books that sell alot of books but don’t contribute very much to improved health. It could be argued that they are detrimental. My patients over the last 40 years have often asked me what I think about this diet or that diet. The science keeps coming and we are learning more and more so we keep getting these books that focus on the latest simple solution or they push specific foods like my industry is guilty of pushing specific drugs. In my opinion you need to focus on the science and pay attention to credible sources without commercial interests. The ones I most frequently recommend are NutritionFacts.org, Dr. John McDougall and the Physicians Committee for Responsible Medicine. There are others as well… VegSource comes to mind. The good news for me is that the science over the last 40 years have provided the basis for good recommendations for patients. Fat loss is about calorie density and exercise and pursuing the ad libitum diet (eat when you are hungry just eat the right foods). Dementia is looking like a nutritional disease with some metals thrown in plus some lifestyle issues such as sleep, exercise and cognitive activities… good reference is Neal Barnard’s Power Foods for Your Brain. When you realize that fat cells and muscle cells produce over 100 substances that interact with every cell in our body you get an idea for how complex our biological system is. As Dr. Campbell points out in his book, Whole, there are limits to reductionistic science. I think it is important for patients to be given the best options and supported in their efforts. Good luck in your journey to improved health.




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        1. I am not aware of any specific studies. That said most intracerebral bleeds are due to the effects of blood pressure over time… higher makes for higher risk. Whole food plant based diets are associated with lower blood pressures. Of course strokes come in several varieties… thrombotic, hemmorhagic or embolic so the devil is in the details. Overall current science supports a proper plant based diet lowers risk across all of them… not to mention avoiding alot of other chronic conditions leading to disability and earlier death.




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          1. Thank you for your quick reply. This is the article I read: http://img2.timg.co.il/forums/1_155647027.pdf
            “Despite the remarkably versatile protection afforded by a vegan diet, such a diet may not be an unalloyed blessing. Asian and Hawaiian epidemiology indicates that low serum cholesterol and low intakes of animal protein and fat are risk factors for hemorrhagic stroke (299–302). (Age-adjusted incidence appears to be increased, so this is not merely a trivial consequence of preventing other pathologies.) Presumably, increased fragility of small cerebral arteries may mediate this effect (302,303).”
            299. Tanaka H., Ueda Y., Hayashi M. et al. Risk factors for cerebral
            hemorrhage and cerebral infarction in a Japanese rural
            community. Stroke 1982; 13: 62–73.
            300. Yamori Y., Kihara M., Fujikawa J. et al. Dietary risk factors of
            stroke and hypertension in Japan. Jpn Cric J 1982;
            46: 944–947.
            301. Yano K., Reed D. M., MacLean C. J. Serum cholesterol and
            hemorrhagic stroke in the Honolulu Heart Program. Stroke
            1989; 20: 1460–1465.
            302. Reed D. M. The paradox of high risk of stroke in populations
            with low risk of coronary heart disease. Am J Epidemiol 1990; 131: 579–588.
            303. Yamori Y. Experimental intervention of hypertension and cardiovascular diseases. Clin Exp Hypertension 1990; A12: 939–952.




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              1. Thanks very much Dr. Forrester for taking an interest in this outlier. I have only recently become a member of nutritionfacts, but I have watched ALL of the videos (and read the comments) since the website first launched, and I check every day for new ones. :-)




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    3. Am in medical school now and have read all of these books. Those two mentioned books don’t have any real science behind them and don’t have the weight of peer-reviewed studies to back their assertions. I would recommend reading Dr. McDougall and Dr. Esselstyn’s books if you want to read diet books that have real medical evidence behind them.




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  6. I tracked my fiber in take on a standard plant diet for several months and easily consumed over 85 grams of fiber per day. That’s almost three times the recommended sufficient level of 25-30 grams and almost six times what my neighbors are eating. Among the later, there must be quite a few getting on the low end of that average range, 5-10 per day.




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  7. I’m glad to report I usually have an intake of at least 80g of fiber :)
    I always find it funny when people think I must have diarrhea all the time because of my intake, while bowel movements have never been better.

    The recommended intakes seem to be spot on the intakes you’d get on a WFPB diet. I wonder why.. ;)




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    1. That’s what completely misguided and malnourished people think about fiber, that it only has to do with bowel movements. It’s a shame our society is so purposely ignorant.




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  8. The good news is that probably 80% of strokes are caused by modifiable risk factors – hypertension, obesity, diabetes, hyperhomocysteinemia, (smoking, physical inactivity)), low fiber intake – all modifiable through optimizing dietary habits. Again epidemiology shows that immigrants rapidly acquire the increased incidence for stroke of their host country – Again: Dont blame your genes! Low plasma concentration of antioxidants are associated with increased risk of stroke. You mother is right! Eat your vegetables! The outcome after stroke may also be improved by an antioxidant rich diet. Again: Prevention and treatment through a mainly plant based diet. Interesting polyphenols are resveratrol – beneficial effects on the cardiovascular system are well known – but resveratrol might also have neuroprotective actions and curcumin (again) may offer neuroprotection in stroke.




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      1. Hi veganrunner. You know I think that you live in paradise!
        You find resveratrol in red wine, grapes, blueberries, peanuts and cocoa.
        Resveratrol is actually a very interesting pharmaco active molecule. If you must utilize resveratrol as a “natural” drug it has to be as a supplement due to the small content in plants. That said I think you are better of with a mostly plant based diet including a little red wine, berries, nuts and so on, than a not so optimal diet and 250 mg resveratrol as a supplement. Data suggests that supplementing with resveratrol decrease cardiovascular disease risk. Animal data suggests prevention of various cancers, data suggests that resveratrol can reduce hypertension, improve insulin sensitivity and there is evidence that resveratrol can mimic the effect of calorie restriction, but I think that the latter is considered controversial. I think that longterm safety studies are lacking, so as with any supplementation you have to be a little carefull and consult an “openminded” physician before you start – If you can find one! Bottom line: Resvertrol as a supplement is not an alternativ to a healthy diet (plantbased).




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        1. I’ve noticed that supplements get a thumbs down from Dr. G sorta universally. It seems that because some studies have shown some supplements/vitamins caused harm (like the endlessly quoted Finnish carotene lung cancer horror) therefore all supplements are bad. That is poor reasoning. Take for example phytosterol. Very difficult to get the 2 gram or higher effective dose eating plants. I took a gel cap and immediately saw my cholesterol dip. but I kept hearing the negatives about supplements so I stopped….Back up to 5 mM cholesterol in short order.

          So maybe…just possibly there is one supplement or even two or three that can do some good?




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          1. Good question! There are some interesting supplements out there. I think that one problem is that in general long term safety studies are lacking. If a supplement really is active you have to regard it as a “medical” drug – then you need to know about optimal dose, interactions, toxicity, long term safety, side effects, half-life, enzyme induction and so on. On the other hand it could be interesting to compare how many people has died or got seriously injured from prescription drugs vs supplements. The answer could be surprising…. I never recommend supplements to anyone, but if a person by themselves choose to take a supplement I would recommend to do some research first and preferably work with an “open minded” physician in the process




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            1. Here is some loose adverse reaction info from a group battling regulation assault on supplements.

              http://www.anh-usa.org/ags-take-their-assault-on-supplements-to-congress/
              “The testing regimens which the supplement industry are held to under cGMPs are one reason that supplements have such a proven track record of safety—more so than food, not to mention FDA-approved pharmaceuticals. One report
              from the Government Accountability Office found that there were an
              average of 1,575 adverse event reports (AERs) related to supplements per
              year between 2008 and 2011. When you factor in that about half of Americans
              (157 million people) take supplements every day, this means that only
              one-hundredth of one percent of all supplement users ever experience any
              problems at all. It is also worth noting that AERs are not concrete
              evidence of supplements being a factor in an adverse event, but simply a
              possible correlation. By contrast, in 2008, there were 526,527 AERs from pharmaceuticals—488 times more than the number of supplement AERs. Our counterparts at ANH-Europe found that UK residents were about as likely to get struck by lightning as die from taking dietary supplements.”




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            2. I am a huge fan of yours. According to Dr. Hoffer, there has not been a single case of vitamin overdose related death in the past 25 years. This is interesting because men are told that iron is so bad for them. Even if you have vegan patients, I would not be surprised if deficiencies of things such as tin, chromium, valadinium abound in them, like they do in most people. You have most people in agreement. Except I don’t think most people are able to take the bus to buy the fruits and vegetables recommended with their current situation. This site is very useful to the 47 million Americans on foodstamps who want to do better by their families.




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          2. Good point. Perhaps it depends on diagnoses? Of course we love your comments and suggestions. If you ever come across any research please share with us! Thanks, Gregor.




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          3. Thank you for your post. If you compare this site with orthomolecular medicine it seems these are two groups of people who are saying similar things but are being ignored by almost anyone who is paying attention. I heard preaching to the choir is a good thing. Except the poor organist needs to see the people in the cheering section.




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  9. How many grams are in these 2 tbsp of flax seeds? I hate keeping up with numbers, but thought this would be a good place to mention how easy it is to add flax seeds to anything.




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      1. Thanks for the reply. I’ve found flax seed to be wonderful and simply eat one to three tablespoons daily. Even found local source.




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  10. Oh gosh. NPR’s “The Salt” http://www.npr.org/templates/reg/login.php?returnUrl=%2Fblogs%2Fthesalt%2F2015%2F04%2F11%2F398325030%2Feating-to-break-100-longevity-diet-tips-from-the-blue-zones%23commentBlock

    From the title I thought they finally wrote a decent nutrition artlcle. NOPE. The article is based on the scientific analysis of “Blue Zones” (places where folks live 100 or more years) to find the common factors in their diets and lifestyle. But instead the article focuses on the things that are unique, such as a “high omega-3 cheese” in one area or #putaneggonit in another. Some eat up to a fish a day. BUT THE COMMON FEATURES WERE PLANT-BASED WHOLE FOODS. The article gives a nod to this fact but the message is so garbled you’d think you should eat fish, eggs, dairy to get that healthy mix right. did anyone else get this impression? What do I know? I’m just a beetle living on crumbs.

    Hey Thea, miss you :)




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    1. Hi Gregor,
      Where is Thea? Anyhow did you read The Blue Zone? Didn’t you get the impression that the people are eating mainly WFPB? I did. Animal yes. But not that often.
      Sphincter slammed shut. Funny.




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      1. Not yet, I was referring to the NPR article that reviewed it. My point was the article totally missed the point and instead focused on what we know are bad parts of the diet. I should have made it clear that I was troubled by the reporting….heres some references that make the point better than i can’

        1. B. Goldacre, Bad Science: Quacks, Hacks, and

        Big Pharma Flacks (Faber & Faber, London, 2010).

        2 B. Goldacre, Bad Pharma: How Drug Companies

        Mislead Doctors and Harm Patients (Faber & Faber,

        London, 2012).

        These were reviewed in Science 6 Feb 2015




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  11. I was just wondering, if there was any scientific basis to the theory that too much salt can also cause strokes?
    My grandmother , her brother, and my aunt from my father’s side all ended up with strokes , although not until they were in their
    80s and 90s. They had no cardiac symptoms or obesity issues and otherwise healthy.




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      1. Thank you ! This video (Mediterranean diet) and the video on “Aspirin levels in plant foods” you mentioned below was very helpful. Reducing salt is quite hard to do being a Savory – person but recently I’ve started trying adding lemon juice instead and it actually tastes better.




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  12. It is a known fact now and was on CNN, NBC, National Geographic and so forth, that the groups of people in America that has the greatest longevity are the Seventh Day Adventists in Loma Linda, California, and they are among the top 3 groups in the entire World. They live on average 10 years longer than the rest of the population and are Vegetarians who believe in having a balanced diet of whole grains, legumes, nuts, vegetables and fruits. Dr John Harvey Kellogg was a Seventh Day Adventist. Look up ‘Dan Buettner: How to live to be 100+’ on YouTube.




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    1. Hey GoogGut. Did you not post this same question below? Dr. Forrester mentioned he would look, please await his reply. A quick search and only one study I found in the journal Medical hypotheses
      Only a theory that vegans could suffer more stoke. The abstract concludes “Nonetheless, vegans have the potential to achieve a truly exceptional ‘healthspan’ if they face this problem forthrightly by restricting salt intake and taking other practical measures that promote cerebrovascular health.” A case-control study study
      finds saturated fat boosting risk, especially in people with hypertension. If interested, here is more on information on stokes from Dr. Greger. Thanks for your comment.




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      1. Hello, yes, Dr. Forrester has already replied to me below. I posted the above question first a few days ago. Then I figured I would have a better chance receiving an answer if I asked one of the doctors in the comments. I received a very quick reply from Dr. Forrester the same day I posted, but I was unable to delete my first post, which you see above. Thank you for your reply, and for the information, I will read through it.
        *** ha, I’ve just found the delete and edit buttons***




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      2. What’s the risk, if any, of eating too much dietary fiber foods? I eat 95%+ whole plant-based foods. Generally fruits in the morning. Often I can sit down and eat 2-3 lbs. of skinned and oil free baked potatoes for lunch and/or dinner. Or 3-4 cups of rice with 1+ cup of beans. I train 5-6x per week burning 1100-2500+ kcal per session, so my appetite can be insane. Sometimes I feel like I can’t get full. Unfortunately, this sometimes leads to multiple 3-5x a day mud like stool, stomach rumbling, minor cramping and gas. If I have a massive salad, it often appears to go straight through me. I’ve read that too much fiber can cause nutrition absorption issues. Lots of confusing articles out there. Thoughts??




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      3. So, there is no evidence that higher risk for stroke is because of low IGF-1 activity, just a hypothesis? Could it be because of B12 deficiency? Or lower Omega-3 intake? Do other studies on urban vegans who supplement with B12 show higher risk for stroke?
        I don’t want to believe that low IGF-1 or low cholesterol are reasons for higher risk for stroke.




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  14. This is a little off topic but speaking of fiber, it was amazing how the arthritis-like pain in my hands which started to develop quite early disappeared completely, when I increased the amount of green leafy vegetables in my diet. If I had not read about it at this site I probably would be on medication and still suffering from it. Thank you Dr Greger and team !




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  15. 100 grams of fiber a day would be 100 preventative against death. That is what you said. But who can eat 100 grams of plants a day? I thought you had ALS. I think a cure for you would be raw jello (possibly made with caregeen) and Hibisucs tea brewed in the refrigerator. 100 grams of plants is like 2.5 pounds a day. I love this site. I still say I don’t want to eat as much as it would take to make me a true vegan. Is Vitamin C Iron? Did you know that they humans make a hormone from the sunlight that is tougher than diamonds to make because it is has never been completely made. I say you should make nude sunbathing legal on all private property. Did you know that? The sun could still give you skin cancer. Most people are wasting all their food benefit from food stamps on meat. It is prossible that fruits and nuts are cheaper and more nutritous. Go to any landfill. It is filled with raw rotten meat. The study of how they lowered the federal funds rate for too long.




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    1. Non-clinical, my personal experience and opinion (from the last 90 days of changed diet and intensive studies): Skinning those potatoes is vastly reducing the value of eating potatoes. I’m not back training yet, but am quite pleased with my diet now, mostly WFPB, plus b12 (and d3 when trapped indoors too long), PLUS one or two teaspoons of fresh-ground flaxseed. I sprinkle it over other foods, make bread with it, eat it straight out of the blender-amazing how it helps the stool and prostate. One or two movements daily, sometimes three-and generally perfect on the “stool scale” as discussed somewhere on here.




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  16. I am a long-term, committed vegan and NutritionFacts.org fan, and am wondering if you can answer my question? When people who a standard diet (meat / dairy) and who are slim pass away from a stroke, doesn’t it seem highly likely that they were low in B12, causing high homocysteine, a strong factor in heart disease? I think you reported that animal products also raise homocysteine, but I’m wondering why sometimes slim meat eaters are sometimes affected before overweight ones.




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  17. I am a long-term, committed vegan and NutritionFacts.org fan, and grateful if you can answer my question. When slim people on a standard diet (meat / dairy) pass away from a stroke, doesn’t it seem highly likely that they were low in B12, causing high homocysteine, a strong factor in heart disease?
    I think you reported that animal products also raise homocysteine, but I’m wondering why slim meat eaters are sometimes affected before overweight ones.




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  18. i have doubt, my aunt since few year have micro strokes in the brain (at least is whats doctors believe) the brain damage have increase considerable during last years.
    she was vegan, but with some over weight, and not a health vegan. eating little fiber and salt
    she have migraines where the blood pressure went app or vice versa. one curiosity of her case es that she had cholesterol under 40 .. and i found that very low cholesterol is correlated with Risk of strokes..
    now my aunt is going wfpbd focusing on lower her blood pressure (that normally is 12 – 7 but have high pics ).. but im worry about the low levels of cholesterol and this risks for new strokes that can incapacitate her.
    of course she is follow by a doctor and they are doing all the studyes but diet is not include.. so witch do you think that may be the best for her health taking in account this cholesterol thing..




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