The Actual Benefit of Diet vs. Drugs

The Actual Benefit of Diet vs. Drugs
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The medical profession oversells the benefits of drugs for chronic disease since so few patients would apparently take them if doctors divulged the truth.


One of the reasons people may undervalue diet and lifestyle changes is an overconfidence in the ability of pills and procedures to prevent disease. For example, people tend to wildly overestimate the power of things, like mammograms and colonoscopies, to prevent deaths from breast and bowel cancer, or the power of drugs, like Fosamax, to prevent hip fractures, or the power of cholesterol-lowering drugs to prevent fatal heart attacks. Patients believe statin drugs, like Lipitor, are about a hundred times more effective than they actually are in preventing heart attacks. Most people wouldn’t take multiple blood pressure medications if they knew the truth, which raises a dilemma for doctors. Most patients want to be told the truth.  They want to be told what the chances are that the drugs will actually benefit them, but there is this tension between the patient’s right to know and the likely reduction in patients’ willingness to take the drug if they were so informed. If taking a cholesterol-lowering drug would reduce your risk of getting a heart attack over the next five years by 100%, then, of course, everyone would take it. Even if there were a 50% chance of benefiting, most would still want to take the drugs. But if the chance of benefit is just a few percent, hardly anyone would be willing to take the drugs every day for the rest of their lives. And that’s the actual benefit.

For most people the chance of benefit is normally less than 5% over five years for cholesterol, blood pressure, and blood-thinning drugs. It’s no wonder that doctors seldom share these figures with patients. So, even high risk patients have less than a 5% chance of benefit; whereas, patients don’t want to take drugs unless they have at least a 1 in 5 chance—even those who just had a heart attack. The study therefore suggests that informing patients of the percentage chance of benefit from preventive drug strategies will substantially reduce the uptake of such drugs. They recognize that for the individual, this is unlikely to be detrimental; after all there’s a 95% chance it won’t do anything for them, but for the population at large, it would make a difference; so, doctors and drug companies tend to oversell the benefits by conveniently not mentioning how tiny they actually are, knowing that most patients wouldn’t take them if doctors divulged the truth. To practice non-lifestyle medicine is to practice deceptive medicine.

The best cholesterol-lowering statin drugs can do here is an absolute risk reduction of 3.1% over six years. A whole foods plant-based diet has been shown to work twenty times better–an absolute risk reduction of 60% after less than four years. Overall, 99.4% of patients who stuck with the diet avoided major cardiac events, such as death from heart attack.

So, when we have to decide whether we want to go diet versus drugs, it’s not a choice between eating healthy to prevent a heart attack, or taking a pill to prevent a heart attack, because in 97% of cases the pills don’t do anything —we’re risking side effects for nothing, whereas if we treat the underlying root cause of the disease, by eating this healthy cholesterol-free diet, we may even reverse the progression of the disease. Stop eating an artery-clogging diet and our bodies can start dissolving that plaque away, opening up arteries, in some cases, without drugs and without surgery. This wasn’t an Ornish study; so, no exercise requirement, no meditation, no stress management, no yoga; just a healthy whole food plant-based diet may work twenty times better than drugs to combat our #1 killer. Now, that’s something doctors may want to tell their patients.

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 Derek Gavey via Flickr.

One of the reasons people may undervalue diet and lifestyle changes is an overconfidence in the ability of pills and procedures to prevent disease. For example, people tend to wildly overestimate the power of things, like mammograms and colonoscopies, to prevent deaths from breast and bowel cancer, or the power of drugs, like Fosamax, to prevent hip fractures, or the power of cholesterol-lowering drugs to prevent fatal heart attacks. Patients believe statin drugs, like Lipitor, are about a hundred times more effective than they actually are in preventing heart attacks. Most people wouldn’t take multiple blood pressure medications if they knew the truth, which raises a dilemma for doctors. Most patients want to be told the truth.  They want to be told what the chances are that the drugs will actually benefit them, but there is this tension between the patient’s right to know and the likely reduction in patients’ willingness to take the drug if they were so informed. If taking a cholesterol-lowering drug would reduce your risk of getting a heart attack over the next five years by 100%, then, of course, everyone would take it. Even if there were a 50% chance of benefiting, most would still want to take the drugs. But if the chance of benefit is just a few percent, hardly anyone would be willing to take the drugs every day for the rest of their lives. And that’s the actual benefit.

For most people the chance of benefit is normally less than 5% over five years for cholesterol, blood pressure, and blood-thinning drugs. It’s no wonder that doctors seldom share these figures with patients. So, even high risk patients have less than a 5% chance of benefit; whereas, patients don’t want to take drugs unless they have at least a 1 in 5 chance—even those who just had a heart attack. The study therefore suggests that informing patients of the percentage chance of benefit from preventive drug strategies will substantially reduce the uptake of such drugs. They recognize that for the individual, this is unlikely to be detrimental; after all there’s a 95% chance it won’t do anything for them, but for the population at large, it would make a difference; so, doctors and drug companies tend to oversell the benefits by conveniently not mentioning how tiny they actually are, knowing that most patients wouldn’t take them if doctors divulged the truth. To practice non-lifestyle medicine is to practice deceptive medicine.

The best cholesterol-lowering statin drugs can do here is an absolute risk reduction of 3.1% over six years. A whole foods plant-based diet has been shown to work twenty times better–an absolute risk reduction of 60% after less than four years. Overall, 99.4% of patients who stuck with the diet avoided major cardiac events, such as death from heart attack.

So, when we have to decide whether we want to go diet versus drugs, it’s not a choice between eating healthy to prevent a heart attack, or taking a pill to prevent a heart attack, because in 97% of cases the pills don’t do anything —we’re risking side effects for nothing, whereas if we treat the underlying root cause of the disease, by eating this healthy cholesterol-free diet, we may even reverse the progression of the disease. Stop eating an artery-clogging diet and our bodies can start dissolving that plaque away, opening up arteries, in some cases, without drugs and without surgery. This wasn’t an Ornish study; so, no exercise requirement, no meditation, no stress management, no yoga; just a healthy whole food plant-based diet may work twenty times better than drugs to combat our #1 killer. Now, that’s something doctors may want to tell their patients.

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 Derek Gavey via Flickr.

Doctor's Note

Yes, an ounce of prevention is worth a pound of cure, but a pound isn’t that heavy—why change our diet and lifestyle when we can just wait and let modern medicine fix us up? Turns out we overestimate the efficacy of treatment as well, the subject of my next video: Why Prevention is Worth a Ton of Cure.

Sometimes preventive medicine procedures can even be harmful. See Cancer Risk From CT Scan Radiation and Do Dental X-Rays Cause Brain Tumors?

I’ve previously noted how an honest physician-patient interaction might go in Fully Consensual Heart Disease Treatment. What should we be saying? See: What Diet Should Physician’s Recommend?

So why don’t more doctors do it? See Barriers to Heart Disease Prevention.

More on Dr. Esselstyn’s heart disease reversal study in: Evidence-Based Medicine or Evidence-Biased?

Of course, then there’s just the brute force method: Kempner Rice Diet: Whipping Us Into Shape

In 2018, I published a series that starts with What Is the Optimal Diet? Check it out!

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

179 responses to “The Actual Benefit of Diet vs. Drugs

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  1. I showed this video to my neighbour (he’s 71, he has prostate cancer and also takes statins – he’s 5,7″ tall and 17 stone) – he thinks it’s a load of rubbish – now matter how good the information, you can lead a horse to water etc etc……

    1. My dad’s the same way. He actually says he’s known that diet can cure his health problems for a long time. Then he adds, “Change my diet? Never!” Well, I’m going to do everything in my power to live out my days as painless and healthy as possible eating wholesome plants. Nothing tastes as good as being fit feels.

      1. I feel your pain – it’s like trying to herd cats….

        At least you can take some comfort from knowing that your father has made his own choice, whereas my neighbour takes his Dr’s word as gospel and refuses to accept any other opinion, as do so many others of his generation…….

        All we can do is keep trying……

    2. Yeah, trying to help others with this info can be so frustrating! My mom wants to believe that the meds she and my dad take are helping them. It upsets her world too much to even consider that her doctor is doing a disservice by not informing them that diet can be way more helpful and medication more toxic than they’ve been led to believe. She told me that she’d respect Dr. Greger more if he offered a broader picture, stating both the pros and the cons. Aargh!

      1. Yes, some people will accept the conclusions, others will not – and there are people like your parents that require additional proof in many different formats – c’est la vie….

      2. I hear you! You would not BELIEVE the pushback I get from everyone. It’s not that I’m aggressive about this or obnoxious, I just gently say to people with diabetes or heart disease that there are ways through diet to improve their health, and I’m an example. They immediately jump to the following defenses:
        It’s all genetic, so it doesn’t matter what you eat.
        Cholesterol is good for you, and you need fat in your diet.
        All the vegetarians I know are sickly looking.
        Sure, I know, we should cut down on red meat. I only it eat every other day now. Isn’t that great?
        And then there is all time favorite that I hear from everyone: If I can’t eat the foods that I like, I might as well be dead! Who cares if I die a few days sooner?

        I try to explain that chronic diseases like heart disease, hypertension, cancer and diabetes are expensive, debilitating, painful, and severely limit your ability to enjoy any life at all.

        I’ve learned that good health is more about the emotional and psychological aspects than the actual medicine.

      1. Coincidentally, love does have something to do with it – he’s a comfort eater, he loves his wife but she hates him (long story).

        He is the definitive example of a person displaying akrasiac behaviour – smoking, drinking, comfort eating (all the wrong processed foods – are there any right ones?), refuses to exercise, just sits on the sofa watching TV all day – and his cancer has metastasized to the bones…..

        I hope that I never find myself in a similar situation.

        1. I’d say loving wrong things and the lack of love (from others) are two great reasons why someone will never change. My dad knew about healing power of vegan, raw vegan food and fasting long before his gallbladder was taken out and long before he got colon cancer.

          No love = no motivation = no change. I too hope i will not end like this. Suffering and felling sorry for myself. In fact i will do more than just hope. I will do anything in my power to make myself and the world better.

          1. I share your enthusiasm for the future – I have told my neighbour that I will do my utmost to avoid finding myself in his position. To his credit he agrees, and says that if he had his time over again he wouldn’t make the same mistakes (we all must say this at some point in our lives), but now he feels he is too old for a lifestyle change. I don’t agree with this choice, you hear this type of comment all the time, and I interpret it as “I’m too lazy to change”, as there are a number of videos on NF that tell you it’s never too late, but then again I’m a few decades away from my 70’s, who knows whether I’ll live that long, and if I do, whether I become his clone……..

            1. You are your own creator ;) And you can’t change others. Maybe you can pinch someone … but still they have to become aware themselves.

    3. My grandfather was the same way. He refused to try anything new, even though he eventually came to admit that the statins weren’t actually helping. There isn’t much to do if the person in question isn’t willing to help themselves. It certainly reinforced my thoughts on the whole foods I eat everyday, however!

    4. It’s tough.

      It is pretty clear to me that a whole food plant based diet is great.

      But go back to when you weren’t vegan. You probably would be pretty uncomfortable with someone else trying to shit on your lifestyle. Maybe you would have a defensive reaction.

      It is important to remember that we as human beings don’t know reality, we just make “mental models’ for what reality can be. Your neighbor had probably lived his whole life having risky habits reinforced. You can expect a defensive reaction if you state something that challenges someone’s mental models.

      I am studying medicine and I am struggling with motivational interviewing… And when to wear the doctor hat and when to just listen.

      1. Encouraging change without eliciting defensive reactions is an art I hope to learn. Thanks for posting about motivational interviewing (just looked it up) as I’ve not yet studied these techniques. Good luck in your studies.

      2. Well I don’t have to go back far, and when I think about it, if I hadn’t stumbled across a comment on a bodybuilding forum re protein intake and “The China Study”, I would still be eating about 150-200gms of animal protein per day – maybe you can provide me with some motivational techniques for my neighbour – any involving chocolate, dairy, meat and lack of exercise should work……

        I hope you are spreading the NF word among your fellow students – reading what some of the other medical practitioners have written, I believe I’ve had more Health and Safety training on how to lift a box correctly, than you medical students have re nutrution – good luck with your studies.

        1. I would still consider myself mediocre at motivational interviewing.

          There are some videos on YouTube about it.

          But you could check out “the fifth discipline” by Peter Senge. I think it provides a philosophical framework for leveraging positive change.

        2. I was diagnosed with Prostate Cancer two and half years ago. In that time. I’ve had two shots to lower my testosterone. My number was at five yesterday and today I had bone scan that revealed that my bone’s are cancer free.. I refused the radiation and have had good success with managing the cancer thus far.

          In regards to some of you lamenting that you are unable to convince love one’s to change their life style? You may have to wait until you become that age to get your answer? Sometime , life is just life and one day is like the next and there is no real reason to just be , to just be. I think I understand that one more day or year is not all that important…

    5. For prostate cancer, this site recommends fenugreek, amla. strawberry. black raspberry, mushrooms. seaweed. flaxseed. matcha. walnuts. pecans, cranberry, lemonade, apples. rosemary, tumeric with pepper. ginger, garlic, cloves, beets. spinach. collards. broccoli, kale. chamolle. dandelion. hibiscus. Nuts, beans, matcha, cocoa, Whole grains, berries, fresh fruit, fresh veggies, and spices are recommended. I think when presented with data on how effective fenugreek, amla, and other advice from this site are on a long term battle with prostate cancer, you could be a real game changer.

      1. Although your list sounds daunting, it is amazing how many of those things are incorporated in Ayurvedic medicine. eg. a single product called Hingvastak contains:cumin, ajamoda, black cumin seed, black pepper, ginger, pippali (another type of pepper), asafoetida, and fenugreek. I dump it on my food and it is absolutely delicious. I also turn my green tea into super tea by adding Tulsi powder, another Ayervedic herb with extensive scientific evidence supporting it.

    6. I know…I am trying to get my GP to NOT prescribe drugs to my hubby. He has gone 90% vegetarian…he struggles some days, but his blood sugar is coming down and his weight is coming down…but they still want him to take statins and bloodpressure meds. Le sigh. If I tell him not to take them, my doctor thinks I am nuts.

      1. Try expanding your Dr’s nutrution knowledge by pointing him in the direction of NF – you could always consider changing your Dr (extreme – but if you feel so strongly about it, this it may be your only option).

        Good Luck…

      2. For hypertension, this site recommends beets, hibiscus tea, seaweed, grapefruit, beans, brazil nuts, whole grains, and flax seed meal. For high cholesterol, this site recommends nuts (particularly almonds), whole grains (like Cheerios), flax seed meal, kiwi, grapefruit, red yeast rice, dried apples, amla, and beans like chickpeas. For high blood sugar this site recommends hibiscus tea, cinnamon, flax seed meal, amla, and beans. Thule has produced another list of recommendations from this site for high blood sugar: Indian gooseberries (amla), coffee, soy, flaxseeds, green tea, pulses (dried beans), chamomile tea, purple potatoes, sprouts, whole grains, vinegar, and beans. Congratulations on your decision to be a vegetarian couple. One of the biggest sources of high blood pressure and rapid pulse is caffeine in the diet. You should be really prepared for heart disease. Dr. Greger in this site shows and states that lifestyle intervention should be front line or a main treatment and intervention for diseases that involve accumulated wear and tear on the bodies cellular machinery like heart disease. Intervention should be in one to two months, one year for full effect, based on Dr. Ornish’s results. Good luck to you and your family. In another video, Dr. Greger said that these medications have a low chance of working, below placebo effect, and have risk of side effects that could further hurt health. Lifestyle intervention is safe whether or not it works for you and you have already taken positive steps with it for health!

      3. Andrea…I had a similar thing happen to me as a Type 2 diabetic. However, there was a point where it became dangerous to KEEP taking meds because my blood sugar got too low. My doctor was amazed and took me off. Since then, I found a doctor here in Dallas that PROMOTES whole foods plant-based eating instead of meds. The Happy Herbivore has a list of doctors who support this way of eating. You might want to check it out!

      4. Hi Andrea. Your concern is so valid. When you see the facts as they are outlined above by Dr. Greger it is very hard to not want to throw the pills in the garbage can. It has been said that young doctors entering medical school want to take care of the “whole” patient but by the time they graduate medical school they want to only focus on the “hole” that’s in the patient, meaning that the practice of medicine is so narrowly focused and “super subspecialized” that we’ve lost the forrest for the trees. And as we can see – we’re not doing a very good job at focusing on the “hole”. It’s going to take a movement (that we are in the midst of) and patients like yourselves asking questions over and over again combined with doctors who really want to treat the patient and not the symptom. I certainly have hope. What about vitamins to replace plants? ……you might ask. Take a look at these studies reviewed by Dr. Greger a few years ago Produce Not Pills to Increase Physical Attractiveness There are certainly exceptions to every rule……..Vitamin Supplements Worth Taking

    7. I see this reaction often! I think much of it stems from fear: fear of change, regret that we may have been doing it wrong all this time, fear of the unknown diet we are afraid we could not comply with. Having our lifetime personal beliefs challenged can be difficult to handle for some individuals. The truth sometimes hurts but we need to push thru all that.

    8. almost everybody I know thinks like that. However I see many young people have switched to a plant based no oil diet. I think the old generation must die off before something new will start. Question is: will the biosphere survive long enough?

      1. I spent the night in the Biosphere in Arizona. The man that showed us around the place asked a qwuestion…What did they learn fromliving in the Biosphere? ” Nothing”, he said

    9. Actually he might be right in this way: Humpty can’t just start eating salads and have his million pieces go back together again.

      In 2012 the US spent $250B on diabetes care. 100% of it was palliative as there is no cure. Go lookup a list of colleges in the US who have an endowment of $1B. Not even 250 long.

    10. People would rather take a pill than change their lifestyle. When confronted with the hard reality, denial through minimalizing is the first response.

  2. Why is it that that Dr Greger neglects to mention that in the trial he refers to 5 patients on the vegan diet died of non cardiac events while none of the standard diet patients died of non cardiac events – an important caveat even if many more patients were in the vegan group. Why is death ignored????

    1. Hi Herb,

      I believe you are misreading the publication. There were two groups, 177 that followed the vegan diet and 21 who did not. Of the ones following the vegan diet, 81% improved, 8% remained the same and 10% got worse. 5 of them (3%) died indeed, but not due to cardiac events (3 cancer-related deaths, 1 fatal pulmonary embolism, and 1 case of pneumonia). Of those who didn’t follow the diet and only took medication, 0% improved, 38% remained stable and 62% got worse. 2 of them (9.5%) died due to cardiac events.

      It’s all detailed in Table 2 of the manuscript:

      You can play with the numbers all you want, but the picture is very clear. Much more so than with any other study involving medications. The only thing missing here is a study with much larger numbers to make the statistics more convincing (with the authors themselves suggest).



        1. It may or may be statistically significant, as you yourself point out by your use of the word ‘probably’.

          My point which seems to be studiously avoided by all commenters it that the 5 deaths vs zero should have been disclosed in the video. Particularly since there are a number of trials that show a high all cause mortality associated with a significant reduction in cholesterol, which a vegan diet certainly results in.

          1. You’re not being honest about the stats here. All cause mortality was 5 to 2, not 5 to zero. It’ll take a larger randomized controlled study to determine if your cholesterol “deficiency” hypothesis is has any validity.

            1. You’re correct -non cardiac mortality is 5 to 0. All cause is 5 to 2. I meant to say non cardiac instead of all cause as I correctly stated in other comments.

          2. Which trials?

            What I tend to note is that the major meta-analyses to date indicate no serious risk of excess non-CVD mortality from statins:


            Given that Greger was principally comparing different treatments in terms of benefits to CVD and did not take care to specifically mention any non-CVD mortality in any of the drug studies he cites, I don’t really see what has you in knots about this one omission versus all the others.

          3. “It may or may be statistically significant, as you yourself point out by your use of the word ‘probably’.”

            ‘Approximately’ is perhaps a better adverb for what Arjan is doing, because that comparison is grounded in a relatively standard statistical test. 5/8.4 is the expected number of non-CVD deaths for the non-adherent group if as a null hypothesis, you assume they have the same non-CVD mortality estimated for the adherent group. However, 5/8.4 is substantially less than 1, meaning that there must be a substantial probability of getting 0, meaning we fail to reject the null.

            More formally, if the expected number of deaths under the null hypothesis is 1-x and the probability of zero deaths is p, then 1-x >= 1-p. So in this case x is 0.40476 and p > 40%, and is thus clearly not significant at the 95% confidence level.

      1. I’m not playing with numbers. 5 people on the vegan diet died of non cardiac causes and none of the others. That’s a fact which you acknowledge. I am not questioning that the vegan diet was much better at preventing cardiac events. What most people also want to know is whether their overall chance of death is better or worse on a particular diet. By omitting the fact that 5 vs 0 people died of non cardiac causes on the vegan diet, he is omitting a very material fact. One can have a reasonable debate about whether a vegan diet leads to more cancer, embolisms, pneumonia etc, but one can’t have have that discussion if the facts are not revealed can we?

        1. “What most people also want to know is whether their overall chance of death is better or worse on a particular diet.” With all due respect Herb, every last one one of us, regardless of diet, has an infallible 100% chance of death.

          1. Your comment takes the grand prize for a non sequitur. I appears that you can provide no substantive rebuttal to my comment. The logical result of your comment would be – Why bother doing any trial if we all have a 100% chance of death? Thus this – and every health – site might as well shut down. Is that what you’re suggesting?

            1. It seems what you meant to say is “What most people also want to know is whether their overall chance of death in a specific manner is increased or decreased on a particular diet”. My reply was fair based on what you wrote.

              Today’s video addresses the conflict doctors face prescribing medications with efficacy rates that could be significantly bested if our treatment paradigm was to encourage and support lifestyle change when a patient is a candidate for Rx treatment. The study of 198 people that you’re referencing focuses on already very sick people with CVD who’ve agreed to change their diets from omnivorous to plant-based with the support of intensive nutritional counseling – and for which there were significant positive results for those adhering to the new diet.

              Yes, there were people in both groups who died (5 in the adhering group from three different manners of death and 2 in non-adhering from similar manner of death). And yes, of course, the question can be asked, did adherence to the new diet contribute to the three other manners of death in that group? Or did non-adherence contribute to that cause of death? We can also ask, would these patients have died from those same non-CVD events, or even CVD events regardless? Would it have been sooner? But, that’s all we can do is ask questions so it’s not that as you said, “death is ignored”….but in the context of this video, highlighting the outliers of the study doesn’t add one way or the other to the point of the video.

        2. It was a royal use of the pronoun “you”, I was not accusing you personally of playing with the numbers. My apologies for the lack of clarity.

          I will insist that the really important numbers are how many people improve/don’t get worse with the vegan diet+drugs vs the drugs-only group. Those numbers are incredibly clear. But if you want to focus on deaths this is what I see:

          – 5 people died out of 177 with a vegan diet+drugs –> 2.8%. NONE of them for cardiac events.

          – 2 people died out of 21 with only drugs –> 9.5%. All of them for cardiac events.

          As a percentage, more people die when they take only the drugs. To be honest, with a population of only 21 individuals the 9.5% percentage is pretty meaningless to me. But it is significant to me that out of 177 patients with a vegan diet, in several years, NONE died of a cardiac event.

          As I see it, people dying for causes other than cardiac events is not relevant to this study. If there had been 20 people dying of say, liver cancer, I would be worried about the effects of the vegan diet. But they didn’t, so I won’t

          We can discuss to the end of days about what is relevant/material and what is not, but I guess it is a subjective matter. For me it is pretty clear that those deaths were unrelated to the study and therefore I would also leave it out of a 4 minutes video that discusses many other things. If someone is really interested in the details, he/she can look at the paper, which is cited in the video.

          If you wanted to have a discussion about the effects of diet on some other disease, then you should look at a study looking at that particular disease.



          1. Floren,

            You’re concluding that the other deaths were not related to a vegan diet. I’m saying you can’t a priori assume that and thus the numbers should have been disclosed, particularly given the many studies that show cholesterol lowering drugs (which I know is not the same as a vegan diet) often lead to higher non cardiac deaths. I would feel much better if the Dr had disclosed the excess deaths and attempted to explain why they should be disregarded. I guess at this point we’ll have to agree to disagree but I certainly respect your viewpoint.

            1. Herb,

              You are right, no one can positively conclude those deaths are unrelated to the diet. But you do not have not enough data pointing in that direction in this study either. If you take 177 people with cardio vascular disease (CVD) with a mean age of 63+/-10 years, after 3.7+/-2 years (these are the numbers from the study)it is perfectly within expectations that 5 of them will die of a number causes.

              So, I cannot say with absolute certainty that those deaths are unrelated to diet, but I can say with great confidence that statistically speaking there is nothing suspicious in those 5 deaths and that the only observation with any statistical significance (and a great one for that matter) is the fact that nobody died of a cardiac event in a group of 177 people that were already sick at the beginning of the study.

              I still think that since the video was about the low efficiency of drugs, looking at the nitty-gritty details of 5 deaths with no statistical significance in a study that is mentioned as an counter-example, is really going to far.

              As you say, I will agree to disagree :)

              Have a great afternoon Herb.


            2. Herb,
              Do you honestly expect no deaths from people who are this seriously ill? I don’t think anyone who reads studies (testing vegan diet or not) with this population would even assume there were no deaths. I don’t imagine a layperson would either.

              1. The issue isn’t that people died. The issue is deaths in each group. I don’t think most people would expect 5 vegan deaths vs 0 non vegan deaths (non cardiac). As I’ve written above I believe it should have been disclosed and discussed. That’s the only point I’ve been making.

                1. Surely, you’ve met people in your life who have had 5 more people die in their lives than yours. Is this statistically significant to draw some conclusion that that person may be the cause of death? Or how about that thing called chance? Now, if it was 50 in 2000, 500 in 20000, etc then it would warrant consideration. Much ado about nothing. Run a larger study (or fund it) and then we can move the conversation in a serious direction.

                2. Hey Herb,

                  I think it is good that you pointed out a possible neglection of information here. Always need to question what people tell you.
                  Anyway – on the matter I do agree with Floren and others. You can’t really compare the total numbers of 5 vs 0 for two reasons.
                  First -> there were a lot more vegans in this study – so if the mortality rate would be the same it would need ~0.5 deaths in the non-vegan group (which is not far off from 0 actually.
                  Second -> You can’t really discard the two cardiac deaths either, since they couldn’t die of any other cause since heart attack had them first, eventhough they might have been stage 4 cancer patients or something else.

                  In my opinion stating the fact of 5 deaths vs 0 deaths in non cardiac deaths for vegan vs non-vegan seems to be more misleading than saying nothing at all, considering the above. No offense.

        3. Herb… 177 were those that followed the vegan diet and 21 who did not. More people equals more possibility of deaths…what’s not to understand? If those following the non vegan died would have been 177, the deaths (in proportion) would have been 16!!!

  3. You know, I had no idea that drugs were that ineffective! My husband and I haven’t taken any medications for 30 years, and we know that healthy lifestyle come first. It’s obvious that medications have some nasty side effects, however I never imagined the effectiveness rate could be as low as 3%! And you know those effectiveness rates are usually from the drug company’s own research, which means that’s a generous 3% (aka possibly 0%).

    1. That 3% can be misleading. Let’s say 6% of people in the trial who take the placebo get the disease without treatment. If 3% of the trial participants get the disease there is an absolute risk reduction of 3% (6-3%). Yet the relative risk reduction is 50% (half of the 6% who were expected to get the disease did not get it). Drug companies almost always publicize the 50% number rather than the 3% number for obvious reasons. Both numbers are important however to inform one as to what to expect from taking a drug.

      1. Good point. Worth keeping in mind, though, that in this video Dr Greger is comparing high risk patients (who have a 5 % reduction in absolute risk taking pills) but a 60% chance of major cardiac event (using Esselstyn’s group of high risk patients). So the relative risk reduction of the pills would still only be about 10%. Correct me if I’m wrong.

          1. Yes, but so did the control group. Diet made all the difference:

            “Major cardiac events judged to be recurrent disease totaled one stroke in the adherent cardiovascular participants—a recurrent event rate of .6%, significantly less than reported by other studies of plant-based nutrition therapy. Thirteen of 21 (62%) nonadherent participants experienced adverse events.”

    2. “There are lies, damned lies, and statistics”, but any doctor should be capable of clearly explaining to you what your expectations should be when taking a drug prescribed by her/him. It’s their job to give us the pertinent information and ours to make a decision.

      1. Then Tom ran into Huck. Huck was carrying a dead cat. (Not at good sign) What are you gonna do with the cat? Gonna cure ma warts.
        – Yr a hoot :)

  4. Dr. G., I was hoping you’d stress (more) the dangerous side effects from those horrible drugs you mentioned in the article (Fosamax, etc.). When I was a kid, I used to hallucinate from swallowing even a spoonful of cough medicine, Some people are highly sensitive to medications, and I think I’m one of them. Therefore, I try to live in such a way that I’ll never have to be prescribed any. Avoiding doctors is one of the ways. :-)

    “With record numbers of patients suffering or dying as a result of
    prescription drug side effects, many wonder why medications that are
    considered dangerous are allowed on the market. The truth is that nearly
    all medications, both over-the-counter and prescription, have some kind
    of undesirable and sometimes dangerous aftereffects, from muscle aches
    to death.”

  5. I’m a 72 year old female with a blood pressure that runs in the 130-145 systolic with a diastolic usually in the 80s and have been on 2 blood pressure medications for probably 15 years. My cholesterol is around 200 but I do not take statins. I’ve been a vegetarian for 47 years, a vegan for about 8 years and the last 3 1/2 years have not been using added fats or oils . I do eat nuts, avocados and olives in moderation. I limit my salt intake as well. Do you have any suggestions to bring both my cholesterol and B/P down?

    1. May I suggest at least walking around the block once a day but as much exercise as you can reasonable tolerate. Another physician wrote a book called How to grow younger as you grow older as I remember. Also do not smoke.

    2. You need to work with your physician(s) to decide what is best for you. You need to balance the risks of the drugs with the benefits. If you have been on two BP medications and have changed your diet it is reasonable to revisit the need for your medication. First step is to understand what your goal for BP should be. At your age your BP results would be considered acceptable by all current guidelines. You might be a good candidate for a trial off going off done of your medications. A home BP monitoring kit will help you and your physician test this out. I would suggest that you read Dr. John McDougall’s article, “How I treat patients with elevated blood pressure” in his November 2009 newsletter… go to his website. He has the most experience and understanding of the clinical literature that I am aware of. He is very good at avoiding over diagnosing and treating patients as well as the most appropriate medications. Good luck.

    3. For blood pressure, this site recommends beets, hibiscus tea, seaweed, grapefruit, beans, brazil nuts, whole grains, vegan diet, and flax seed meal. For high LDL, this site would recommend: nuts (particularly almonds), whole grains (like Cheerioes or oatmeal), flax seed meal, kiwi, grapefruit, red yeast rice, dried apples, amla, and beans like chickpeas.

    4. Take a closer look at your vegan diet – if you are eating any foods made from flour (bread, pasta, crackers, etc.), then eliminate them completely and only eat whole grains (brown rice, quinoa, buckwheat, millet). Also, you may not be getting enough greens. Blend yourself a greens smoothie daily. My recipe: 2 handfuls of fresh greens (kale, arugula, or spinach), 1-2 fresh fruits (usually 1 banana or 1 apple with core removed or 1 cup berries), 1-2 medjool dates with pits removed, juice of 1/2 lemon, about 1.5 – 2 cups water. Blend well and enjoy – it’s really very tasty and easy to digest. Exercise, usually a 15-30 minute daily walk will work in addition to your regular activities.
      I also suggest that you look at taking a probiotic supplement at least 3x/week. There has been research showing that gut flora may be an important factor in hypertension:

  6. As I sit here in my office enjoying my lunch of carrots, celery, apples, hummus and nuts I am reading the chart of a patient admitted yesterday for depression. 52 y/o woman, BMI 34. Here is her list of home medications: colace, Reglan, Ditropan, Inderal, Protonix, Neurontin, Compazine, Zoloft, Seroquel XR, lorazepam, Lipitor, Dilaudid, Antivert, aspirin, Evista, and, finally, Zofran. Oh, and she said she was having a migraine during our interview and requested a shot of Imitrex. Lest one might think she is an outlier, I can assure you that this is not an atypical patient. I’ve discussed lifestyle changes with her in the past. She prefers pills, especially when someone else, ie. the taxpayer, is footing the bill.

    1. She most certainly could benefit from a lifestyle change, but I don’t know that it’s realistic for a person in the grips of depression to take on the taxing task of changing their diet. I have suffered from chronic depression since I was a child, and before the last time it got bad, I was doing really well losing weight and eating healthy. But it’s a lot of effort to avoid the things I want to eat, and when I really don’t care whether or not I wake up in the morning, I’m certainly not going to choose the long-term benefit of a salad over the immediate benefit of a box of cookies.

      But you do have her admitted…. so… she eats what you give her or she doesn’t eat? :)

      1. I learned long ago that there is little to be gained by forcing a diet for a few days in the hospital on someone with a lifelong history of unhealthy eating. I do draw the line when 300 pounders demand double portions. Our hospital actually does offer healthy alternatives, at least for snacks. That is where I get my supply of veggies and hummus.

        1. 2 years the clip is on youtube and within 18 hours after my attack its gone for copy right reasons. Hit a nerve hard huh?
          You must have a very low opinion of everybody here indeed if you think them incapable of seeing right through that move.
          I’m done here, what a joke.

        2. Some people are unwilling to give up the unhealthy lifestyle because this is who they are. This is the life that they are uncomfortably comfortable in. “Who would I be if I weren’t this sick person seeking medical attention?” “This is the way I was brought up.” And they won’t break out.

          Adrian, In my opinion you are way out of line.

          1. I am out of line, and I’m sorry if I caused you upset.
            But this person Psych MD is a charlatan, who asserts himself as a person of importance and station, while he is not.
            Talks the talk of caregiver but has repeatedly shown disdain to lesser beings, this is not a good person.

    2. She prefers pills, especially when someone else, ie. the taxpayer, is footing the bill.

      NOT the first time I noticed something weird about you, maybe you should put some effort into finding a different occupation.
      This one is clearly not one that comes natural to you, the role of care giver I mean.

        1. Yes it is, but I suspect this person doesn’t just study nutrition facts here, I think decent people mannerisms have his interest too, to better mimic.

            1. That was not exposing for what he really is, I pointed out inconsistencies that could cause harm to either people or his reputation.
              And as person of good character he pointed out that any help toward maintaining quality control was most welcome, and offered his email to all to do just that. You are quite delusional if you think yourself of anywhere near similar caliber.

      1. Dear Arjan, in the recent study about antidepressants, they found people who take them are more likely to attempt to kill themselves with an antidepressant overdose than people who are not on antidepressants. They dressed this up to say people who do not take antidepressants are not likely to kill themselves and that antidepressants save lives. We are pretty sure antidepressants cause anxiety and depression and cause suicide attempts. These are very powerful and very dangerous pills. Almost all of them cause a loss of libido, weight gain, and impair some type of brain function. Many people who come to this site believe that the vegan diet can, at least biochemically cause happiness in the mentally ill. These are people who are told they will not be in control of their minds for the rest of their lives and will have to always be on these medicines for ever. The people who take them know there are terrible debilitating humiliating side effects and that the pills don’t work very well. I was happy to run into this report, vitamin B3 and Vitamin C for the treatment of mental illness, as a counter point. by Dr. Hoffra.

  7. There are two schools of thought. the old school who are products of their parents and social environment and the New school, willing to break free learn why we are sick and do something to change their life. The best advise is don’t waste your time and choose to not own the outcome from people who are not interested in getting well. Let them experience their life the way they chose to learn from it to grow their spirit and soul whether its healthy or not. To own their misery is just an negative energy drain on you. Concentrate your efforts on your own health, wealth and wisdom and share only when others ask for it. Tell them….”don’t ever eat anything green, you might get well.”

  8. I was tod by drs maybe 6 yrs ago i had to start taking pharmaceuticals for extremely high bood pressure n cholesterol, or i would die.changed my diet instead to whole foods,now they say i have blood pressure of a teenager. I feel 20 yrs younger,actually went 100%vegan about a yr ago.i am 58.friends n family tell me how awesome it is n I’m the healthiest person they know but they continue their lifestyle of destruction. Never will understand the logic.

    1. Congratulations Jimmie on how you’ve taken control and turned your health around over the past six years. It is a huge accomplishment, and a path that few are willing to take even if gravely ill. I think that the lifestyle of destruction you’ve mentioned is because most people are addicted to their high fat, high sugar, and high processed foods diet. There is research showing how processed junk foods light up the same areas of the brain as heroin:

      The age of convenience we live in, at least in the West, is a blessing and a curse.

  9. When I was diagnosed with heart disease ,I was already organic vegan that did not stop my heart attack and being stented in one artery and found out the other three artery’s were at 90 , that was two years ago ,unfortunate for me my dad died from high cholestrol at 49 yrs when I was 13 ,I had my heart attack at 51 yrs I did not want to take statins I had no choice because my body produces high cholestrol ,and since that drama I now have other health issues ,so I never eat meat I am vegan and still in for more stenting .

  10. Comparing trials is possible (=meaningful) only if they are comparable. A single trial w/ no control group nor other interventions, based on an already very selected & motivated individuals vs a large amount of large, comparative trials (comparing the efficacy of statins against best known treatment) … There is no meaningful comparison here.

    Esselstyn’s diet may be more effective than current treatment options. Or it may not be. This cannot, however, be shown without a PROPER trial. Greger’s video is – simply put – useless.

    1. Dr. Greger implies clearly that a larger trial would clarify if the Esselstyn treatment works as well in a larger population. The video is not useless. The Esselstyn treatments show a proof of concept, which is a reasonable basis for funding a larger trial. Granted, no drug company is going to fund the study, in the meantime we have to do our best with the information available. Furthermore, the video points out the large gap between expectations and efficacy, and how both influence patient decisions.

  11. Can anyone please tell me exactly just how is plant-based diet is better? Every time I want to be a vegan, people around me always say that ‘plants’ (vegetables and fruits) are GM foods, are using lots of pesticides, chemical fertilizers, etc. Now I don’t really know what to eat. Thanks in advance!

    1. Commoner: Your confusion is understandable. First, please note that there are only 9 legally authorized/commercially available GMO plant foods in America. So, your friends’ idea that vegetables and fruits are GMO foods in general is simply not true. Some people even question whether GMO foods are a health threat at all, but if GMO foods bother you, those foods are quite easy to avoid.

      One way you can avoid GMO foods AND limit exposure to harmful chemicals is to eat organic when you can. But even if you can’t eat organic all that often, check out this information, which puts the question of “pesticides, chemical fertilizers, etc” into perspective:

      “A new study calculated that if half the U.S. population ate just one more serving of conventional fruits and vegetables, 20,000 cases of cancer could be prevented. At the same time the added pesticide consumption could cause up to 10 extra cancer cases. So by eating conventional produce we may get a tiny bump in cancer risk, but that’s more than compensated by the dramatic drop in risk that accompanies whole food plant consumption. Even if all we had to eat was the most contaminated produce the benefits would far outweigh any risks.”

      So, this idea that eating plants = eating chemicals = extremely harmful is a false equation. It is even more false when you understand the concept of bio-accumulation. If your friends think that those chemicals are bad for health, then they definitely shouldn’t be eating animal products since those chemicals get concentrated the higher you move up the food chain.

      The above quote from Dr. Greger is also helpful because it starts to get at your first question: ” just how is plant-based diet is better?” A whole food plant based, such as the one that Dr Greger recommends (see link below), minimizes your risk of getting the major diseases of our time. Including: cancer, heart disease, diabetes, etc, etc, etc. You can see proof of this claim by watching the many videos on this site. I would summarize by saying that in general, whole, intact, minimally processed plant foods promote health and protect against diseases. Animal foods are strongly linked to increasing our risk of getting debilitating diseases and early death. The good thing is that you can get all this benefit while still eating great food!

      I hope this helps. Let me know if you would like some advice on how to get started.

  12. Today I spoke with an oncologist with 30 years of experience. It was a casual conversation, I was not his patient. He said some positive things about the progress made on cancers and how rewarding his career has been, etc. I have SUCH skepticism now but I was polite and did not tell him I thought he full of bologna.
    My work in healthcare is becoming more and more uncomfortable for me. I am not sure what to do or what my next step could be. Doctor’s and hospitals scare me!

    1. totally. I’m a Feldenkrais Practitioner, which means I’m very far down the tree of treatment plans. I get back-pain patients who had surgery and 60-100 sessions of PT already, still all covered in sweat and taking strong pain medication because of high pain. It’s shocking how they have been treated. Doctors are very quick to take out the knife and to cut through flesh and bones. It’s their fav. They are butchers. Not all of them, of course, but too many of them.

  13. Dr. Greger, I want to educate people about nutrition, specifically about vegan nutrition. I know nutrition is nutrition, whether or not it’s vegan, but I personally want to teach people how to eat vegan in a healthy long term way. My conflict with this is what is best? Doctor, dietitian, nutritionist? I know you’re an amazing doctor when it comes to nutrition, but most doctors don’t learn about treating people through nutrition. What do you think is the best path? I’m sort of at a cross roads, because currently I’m majoring in mechanical engineering, and my engineering interests seem to have been high jacked by vegan education interests. It seems I can help more people, the planet, and animals, through health education…especially my close family. Thank you for taking the time to read and reply to this.

    1. Hi Erika. I think it really depends on where you see yourself working in the future. I think any position in healthcare would be important if you were to focus on nutrition. We sure are in need of health educators so I would recommend seeking out where you see yourself in a job setting (hospital, school, non-profit) and what that position may look like. Of course, medical school is 7+ yrs, and dietetic school perhaps on 4 depending on programs. Whatever you choose best of luck and keep us posted! If it’s helpful my journey started off cooking food for breast cancer survivors and lead to becoming a dietitian. Family will be difficult to help regardless of your profession ;-) They’re family.

      Thanks for your nice post and good luck with schooling moving forward!

  14. I’m confused. Before statins my cholesterol was 219, then after I started, it dropped to 109 – prompting a switch to a milder statin, but that drop is not a 5% drop.

    1. I think everyone will have a different reaction to statins and the video is just talking about the benefits on average. I hope that helps clear the confusion. The good news is that your levels plummeted and now you are prompted to go on a lower dose! That is the direction you want to see…

      Best to you,

  15. Hello everyone! Can anyone help me with the math here:
    “The best cholesterol-lowering statin drugs can do here is an absolute risk reduction of 3.1% over 6 years. A whole foods plant-based diet has been shown to work twenty times better, an absolute risk reduction of 60% after less than 4 years.”.

    How did Dr. Michael Greger arrived to this number when speaking about the results of Dr. Esselstyn study?

  16. I have an electrical problem with my heart. I also have hypothyroid and high cholesterol. I have been meat-free for three years but only gave up dairy about a year ago. I just gave up all oils as well. Are there any studies that you know of that would indicate whether diet can reverse an electrical problem. My doctor thinks I will need to see a cardiologist and have a pacemaker. She does not believe in nutritional intervention. She has prescribed a statin.

    1. Imu2day: I’m not a doctor, but it seems like you are describing two problems, one “electrical” and the other high cholesterol. I know that diet can address the cholesterol problem. I don’t know about the other problem. I may be that you need a pacemaker for your electrical problem, but a diet tweak for your cholesterol problem?

      It sounds like you are on the right track when it comes to addressing the cholesterol problem. But the devil is often in the details. I would recommend reading Prevent and Reverse Heart Disease by Caldwell Esselstyn. That book not only includes excellent information about addressing high cholesterol, it also includes some recipes in the back of the book that will give you practical guidance on how to put the diet into practice.

      Sometimes people have to tweak their diet even more. Here is a copy of a post from Joseph who is sharing some information from Dr. Greger:

      “My go-to Dr. Greger answer (paraphrased) for those who have tried everything and still have high LDL, try focusing on the saturated fat sources (coconut oil; cocoa butter, and yes even nuts and seeds). I would also make sure you’re doing the Jenkins portfolio diet, including foods like (beans, okra, flax, etc.) and get thyroid function tested. Dr. Jenkins developed a portfolio diet for lowering cholesterol, and it actually includes some nuts. Weight loss is important if there is too much abdominal fat (abdominal circumference exceeds half height). So check with your doctor about these measurements. And if your diet is top-notch and LDL is still too high then try Dr. Esselstyn’s 6 servings of greens a day to keep nitric oxide flowing. More on Dr. Esselstyn can be found here and here. If you still find it’s not coming down consider a statin.


      I don’t know your situation, but I would be highly concerned about seeing a doctor who doesn’t understand that the best way to address high cholesterol is through diet. It speaks to a lack of very basic education, and a lack of concern for your health given that statins can have a terrible impact on some people’s health. You may not have a choice. I’m just suggesting that if you do have a choice, another doctor might be something to look into?

  17. Hello everyone!

    Joseph Gonzales R.D
    Can you help me with the math here:

    Dr. Michael Greger says that “the best cholesterol-lowering statin drugs can do here is an absolute risk reduction of 3.1% over 6 years. A whole foods plant-based diet has been shown to work twenty times better, an absolute risk reduction of 60% after less than 4 years.”.

    How did Dr. Michael Greger arrived to this number when speaking about the results of Dr. Esselstyn study?

    Thank you for all your help here in the forum

  18. Another way to look at statins:

    Kristensen ML et al. 2015. The effect of statins on average survival in randomised trials, an analysis of end point postponement. BMJ open, 5(9), p.e007118.

    Death was postponed between −5 and 19 days in primary prevention trials and between −10 and 27 days in secondary prevention trials. The median postponement of death for primary and secondary prevention trials were 3.2 and 4.1 days, respectively. Statin treatment results in a surprisingly small average gain in overall survival within the trials’ running time.

  19. Wow. So many of your study reviews are incredibly upbeat and hopeful. I am a 74 year old woman who has been struggling with “prediabetes” for a long while. I have eaten “low glycemic” blah blah for several years and finally found your book in January. I immediately jumped on your plant based diet and as a foodie have been enjoying it the whole way. As a “normal weight” obese person due to my hip to waist ratio, I have lost 14 pounds (a lot since I began trying last September but easier since I began plant based) and 1 1/2 inches around my waist. BUT sadly my blood sugar is still as high as it was running between 100 and 115. Might it come down over time or should I ever give in to the MDs suggestions of (gasp) insulin? Should I avoid higher carbohydrates like grains? I admit I do enjoy wine several times a week. Suggestions or patience welcome.

    1. Hi Kate, I am excited to hear that you have been implementing the WFPB diet and seen positive changes in your weight. I wonder if you have been doing any physical activity as well? Walking, among other things, does wonders for your insulin levels. It may help to further decrease your insulin. I would definitely encourage you to stick with the dietary changes you have made as it does take some time for the body to adapt to changes. I wish you all the best!

      1. Thank you for responding. For exercise the past year I do wonderful Suffi yoga 3 to 4 times a week, I am walking a mile a day 1/2 mile up a San Gabriel mountain and a half mile down — slow about 25 minutes. In addition I work out with weights 2,times a week. I’d say it is moderate in intensity. I haven’t yet lost 10% of my body weight and I am not naturally losing as I did. I am still obese in terms of hip to waist ratio anything over .85 and I am .86. Should I cut oils or carbs? Or just relax and give it time.? Course,I would love to do the latter. I am enrolled in Kaiser which has a plant based belief but have not come across one Kaiser MD who practices that way. Again thanks.

  20. Hi Everybody,
    I am 52 years old, have an ideal weight (164 cm/50kg) and have been a vegetarian for 32 years and a vegan for almost ten years now … but still have an incredibly high cholesterol level (over 350). So there must be a genetical and/or childhood factor to it! I really do what I can to eat a healthy diet … but my cholesterol won’t go down any further. (Mind you, when I was a young woman, I had levels of over 400 … so there has actually been some improvement, although not really dramatic!) I don’t take any drugs to bring my cholesterol down … instead, I just hope that my healthy lifestyle will be enough to give me some more healthy years. Life’s not fair … my husband is no vegan and no vegetarian – and he has ideal cholesterol levels ;-) … so although nutrition and lifestyle are important (of course they are), there are other factors in life that have a considerable influence on us … and we can not change all of them. That’s life!!
    Nevertheless … let’s continue to eat as much yummy plants as we can :-) !!
    Best regards from Germany – and good health to all of you!

  21. There are reports on the web that Niacin is the best and cheapest cholesterol reducer. doesn’t address the niacin flush theory, or niacin use, period.
    I’d like to ask that this be addressed in “Ask the Doctor” or in a video?
    Until Dr Gregor refutes it, I’ll continue to believe there might be some truth in it – that niacin/nicotinic acid is the “supplement” answer to statin drugs?

  22. I’m reposting someone else’s question from before because I am also interested in the answer

    Can you help me with the math here:

    Dr. Michael Greger says that “the best cholesterol-lowering statin drugs can do here is an absolute risk reduction of 3.1% over 6 years. A whole foods plant-based diet has been shown to work twenty times better, an absolute risk reduction of 60% after less than 4 years.”.

    How did Dr. Michael Greger arrived to this number when speaking about the results of Dr. Esselstyn study?

    1. Hi Ders,I’m just throwing my 2 cent math Calc in here since it appears simple enough.A 60 % reduction is 20 times better than a 3 % reduction in round numbers and the big picture.  However, it would actually be better than 20x because that’s achieved in less than 4 years (vice 6 years).  So 20x is basically an under-rated generalization.Dave

      Sent from Yahoo Mail on Android

  23. I’m 56 and a few years back I got a health check that revealed my blood pressure was 140/90. My doctor advised me to take medication for it (Ramipril) which I did and my blood pressure fell to 135/89. I thought that was quite good as I was no longer in the pre-hypertension danger zone. Fast forward to August last year, and I began an almost vegan diet (I still have milk in my coffee). Today, 13 months later, my blood pressure is now 113/72 and I stopped the medication about 11 months ago. So Ramipril led to a 5 and 1 reduction and diet led to a 22 and 17 point reduction, over and above the drug. I never would have thought that diet could have such a profound effect on my health and it is mainly because of this site that I decided to change – that, and I was sick of TV dinners.

    So, thanks Dr Greger!



  24. Thank you for featuring this information, Dr. Greger. And all the knowledge you share! I love your book, videos and articles and am looking forward to your cookbook. The info in this video has made up my mind as far as whether or not to go on a statin. I’m sensing my new doctor will want to put me on one after looking at my past lipid panels and the one I’m scheduled for in a week. My cholesterol has always been high (200 range), especially later in life it’s shot up, sometimes to 300. I’m 60 and have always been physically active. My doctors haven’t put me on cholesterol lowering drugs, I’m assuming, because my ratios. Triglycerides are around 42-100 and HDL 50-60. LDL though is always high: 133-204. I’ve been “vegan,” for 5 years, eating lots of beans and greens, veggies, grains etc. but have had a hard time giving up oils, saturated fats and some processed foods like convenient frozen soy burgers once a week. I’m scheduled for a blood test and fear my doc is going to push statins. The thought of it has given me the motivation to finally remove the oils, saturated fats and processed convenience foods. My grandfather died at 49 of a massive coronary and my mother had open heart surgery 5 years ago. Yikes! Thanks again, Dr. Greger, for the education in proper nutrition!

  25. In my 57 years, it’s been my experience that Americans are creatures of convenience. Pills are convenient. Lifestyle changes are not.

    The AMA, in my opinion, has tried to, over the decades, indoctrinate the masses into believing that MD’s are some sort of demi-gods. I think a lot of MD’s do nothing to discourage this idea. I have seen my share of “I am the all-knowing physician, and you are just an ignorant patient” types. They don’t listen.Then they moan and complain when they get sued for malpractice, then it’s, “We’re only human! We make mistakes too!”

    I’ve had the same GP for the past 13 years. He knows better than to offer me a medication without also offering me a non-pharmaceutical alternative. Wonderful MD. He listens. When I tell him my body is telling me something, he pays attention to what I’m saying. I’m very lucky to have found him.

  26. I am a 63 year old male. I have been largely vegetarian for the past 10 years. One year ago, after receiving discouraging results from a blood test I have followed a strict whole food plant-based diet with an emphasis on starch a la Dr. John McDougall. No vegetable oil if I can avoid it. The results from my lab work from one month ago are discouraging. I would value your reactions.

    In October 2016 my total cholesterol was 286. In October 2017 it was 265; not much improvement in spite of my consistency with the diet. Triglycerides went from 356 in 2016 to 256 in 2017.

    My blood pressure tested normal. EKG indicated no blockage. Chest x-ray showed no problems.

    I do not want to take a statin drug. Would I be foolish not to?

  27. Barry- I appreciate you’re trying hard to bring that cholesterol down with a WFPB diet and it’s frustrating the LDL hasn’t come down more (although it HAS come down and the drop in triglycerides is remarkable.) Still you may need to do some more tweaking and it will take some careful consideration and consultation with your doctor to determine if statins are appropriate for you.
    One of wise moderators gave an excellent response to the issue of LDLs not budging despite a wfpb diet. Please review Joseph Gonzolez RD’s words and then discuss a follow up plan with your doctor:
    For those who have tried eating a whole food plant-based diet and still have high LDL, you should make sure you’re not eating plant sources of saturated fat, such as palm kernal oil, palm oil, coconut oil, and cocoa butter (found in chocolate). Of course if you were you wouldn’t be eating a whole food plant-based diet, but you’d be surprised how many people tell me they are and they’re like “Yeah, and I eat a spoonful of coconut oil a day.” I’d also cut out unfiltered coffee. Then once you have gotten rid of the things that increase your cholesterol you need to pack your diet with foods that actively lower your choleserol. So, for example, the components of the portfolio diet for lowering cholesterol. I’ll highlight some of the diet tips found in Dr. Jenkins protocol using Dr. Greger’s videos as reference.

    1) Load up on foods high in soluble fiber. This means tons of beans (see what kind are best: canned or cooked), vegetables like okra, plenty of whole fruit, oatmeal, and flax/chia seed. Find ways to use beans. Lentil stew, dal, curries, bean burritos, bean soup. If you don’t like beans whole, like in a salad, maybe try them as a spread or as hummus?

    2) Take about 2 Tablespoons of ground flaxseed daily and 4 Brazil nuts monthly. Sprinkling ground flax on oatmeal in the morning is an easy way to get enough. Or add it to a smoothie. If you buy the flax whole just add it in the blender first, grind it, and then add the rest of your ingredients.

    3) Focus on several cups of greens daily to help keep nitric oxide flowing. Vegetables loaded with nitrates have been shown to improve heart health. Beets and arugula have tons! (See video on where other vegetables rank on nitrate levels). Yes, green smoothies count if you’re adding the right foods like berries and dark green leafy vegetables (kale, spinach, even parsley). What’s better? Raw or cooked vegetables? Well, it may depend on what veggies are cooked. Lastly, a word of caution for those going wild on greens is that overdosing on raw greens can happen.

    Dr. Greger says to get thyroid function tested, too. A low-functioning thyroid can contribute to high cholesterol so it’s good to rule that out. Weight loss is also important if there is too much abdominal fat. Is your height more than twice your waist circumference? So there are a lot of factors to consider, but if folks are practicing heathy eating and managing body weight and still find their LDL is not coming down they should definitely consider a statin. As I always say make sure to check with your doctor about all of this. It’s important to be transparent and communicate with everyone.

    Lastly, here are some of the best videos to help understand more about diet and cholesterol. Sometimes folks will ask questions like does cholesterol have a lower limit, or, what about the size of LDL particles does that matter? ​Thankfully Dr. Greger addresses this in his video: Does LDL size matter? and Cholesterol does not appear to have a lower limit. A few concerns with dietary cholesterol is that there’s a plateau effect issue and the postprandial (after eating) issue. These videos explain the issues further: When Low Risk Means High Risk and Eggs and Arterial Function. Find out what’s an Optimal Cholesterol Level to shoot for. ”
    Best of health as you continue to improve your cholesterol score while recognizing how much you’re already doing to minimize your cardiac risk.

    1. Confused by “you should make sure you’re not eating plant sources of saturated fat, such as palm kernal oil, palm oil, coconut oil, and cocoa butter (found in chocolate).”Previously understood that saturated fats from plants (nuts, seeds, avocado) was ok.  Clearly too much is too much but slightly puzzled regarding minimizing all plant-based saturated fat and yes I am guilty of adding some cocoa butter to my morning coffee smoothie vice butter (pushed by Bulletproof).Also, so many “Doctors” on PBS pushing the value of eating “good fats”.I do put Dr.Greger and FIRST on my list of what is TRUTH … just wondering specifically about small amounts of cocoa butter, pressed avocado oil, and whether these are definite no-nos in the nutritionfacts spirit of healthy fats.  i.e. Are nuts and seeds and avocados the ONLY permitted/recommended sources of good fat?

  28. I’ve been on a plant-based diet for four years and my LDL has slowly crept up from the 140s to now 202. My physician, as well as a cardiologist he consulted with, have asked me to take a Statin. I am very hesitant to do so. Can anyone on the research team tell me if they have found research articles related to compensatory elevated LDL in those on a plant-based diet?

  29. Good question, but lets back up a bit. A “plant based diet” covers a wide spectrum of food intake, some of which can cause dyslipidemia that would warrant a statin. As an example, a diet of potato chips, french fries, white bread and coke is plant based but would likely make one’s LDL go way up. The plant based diet that decreases dyslipidemias is “whole food plant based.” In addition, you would benefit from a lack of processing, so no bread, no oils….think “farm to mouth”. If you list a typical day’s food and what/frequency of your “cheats” then we can better help you.

    Dr. Ben

    1. Dr. Ben, Thank you for your reply. Just to give you some background, I’ve been a registered nurse for the last 30 years and for the last eight years I’ve done diabetes, cholesterol, and blood pressure care management.

      I teach a whole foods plant-based diet to all of the patients I work with, in the hopes that they will agree and improve their health outcomes. In regards to my food choices and indiscretions, I would say I’m plant-based/ Whole Foods 95% of the time. I do not use oils and the legumes and grains that I cook are cooked in a digital slow cooker with vegetable broth.

      My usual breakfast is one cup of soy milk, 2 tablespoons of flaxseed, 1 to 2 branches of kale or a handful of organic baby spinach blended into a smoothie.

      My lunch is usually four handfuls of baby spinach with chunks of avocado, cut strawberries, handful of walnuts, and a tablespoon of salad dressing.

      My dinner is usually cut up steamed or raw vegetables such as Kohlrabi with 1/4 cup of unsalted nuts. I may also have some fruit in the evening, but that is more rare recently.

      My indiscretions are is below: 1 tablespoon of salad dressing daily on my salad (braswells Vidalia onion and peppercorn) 1 tablespoon of coffee mate powder creamer daily Periodic small amount of chocolate (Hersheys chocolate kisses) We eat out about three times a month and we get either something from Veggie Grill or a Mexican restaurant. We may order spinach enchiladas or a bean and rice burrito at the Mexican restaurant. I would likely also eat about 10 of the tortilla chips at that time.

      Again, the thing that’s the most alarming and odd to me is that I had a way better LDL when I was eating meat for at least one meal a day and lord knows what else I ate at that time that was not on the whole foods/plant-based recommendations.

      I have heard from a few physicians that I work with that they have heard about compensatory elevated LDL for some on a very low fat diet. In fact, Dr. Jason Fung in his book The Obesity Code mentions the same.

      That is why I wrote the posting, with hopes that you would know of any research articles related to compensatory elevations in LDL for those following this type of eating recommendations. Thank you.

      1. I haven’t heard of this phenomenon; however, I have heard that people who have difficulty lowering their cholesterol often have an issue with Lipoprotein(a). I would recommend getting it checked. It’s a simple blood test. This is something that Dr. Joel Kahn talks about a lot on his youtube channel.

      2. The short answer is that I have not seen any published clinical studies demonstrating a compensatory increase in LDL. The long answer is that from what you listed, I notice the following: 1) it appears that you’re starving yourself as there does not appear to be enough calories in what you eat to sustain a normal human; 2) if you are in a significant calorie deficit, I have seen studies that show an increase in serum triglycerides, probably as fat stores are mobilized to sustain you; 3) the salad dressing and creamer and other “cheats” may be enough to raise LDL, we’ll never know, until you “put it to the test” by eliminating them and retesting your LDL. 4) the studies I’ve seen, for the most part, show that a “hand full” of nuts is the optimal amount as the morbidity and mortality curves start to “wander”
        back to baseline with increase nut consumption (this is not a published conclusion, just my personal observation of the data); 5) if you’re going to test/experiment on yourself, I would say also cut out the nuts, avocados, flax and soy milk…ie eliminate all significant fat sources as it appears that, other than what sounds like a small amount of fruit, you’re getting most of your calories from fat which could increase your LDL; 6) finally, maybe there is no significant meaning to your elevated LDL since you’re likely testing fasting lipids when, as Dr. G says, “we live in a postprandial world”

        Dr. Ben

        1. Dr. Ben, Thank you for your reply and your insight. Obviously you don’t know my entire medical history, but what’s relevant to know is that I was eating my “cheat” foods even four years ago, along with eating meat and other animal products. So again, why would my LDL be higher now than four years ago?

          Also, based on the knowledge I have of the whole foods plant-based diet, why would I stop flaxseed, nuts, avocados since they are known sources of good fat and two of them were included in Dr. Greger‘s Daily Dozen.

          Is there a way perhaps of running this issue by Dr. Greger? I’ve tried to times to set up a consultation with Dr. Klaper as suggested on your website, but no one has ever reply to my request.

          If you’re unable to ask Dr. Greger specifically, I’ll just make an appointment with the lifestyle medicine physician local to me. I appreciate all your feedback.

          1. Your chief complaint is your concern about your LDL. Since everyone’s physiology is somewhat different, and LDL is known to increase with fat intake, then to try to determine the mechanism, you’d eliminate all significant sources of fat. You can always add them back later when you figure out what is going on. Also, while these foods are considered healthful in MOST people, they are not a requirement. The other thing to consider is your body fat%, as metabolic syndrome, as you know, can cause LDL increase. The one thing you may not realize is that BMI often underestimates visceral fat, so while you might fall into a “normal” BMI, you may have abnormal and unhealthy amounts of visceral fat. You might consider also having that determined with something like DEXA.

            I’ll forward your post to someone that may be able to assist further in finding someone to see face to face.

            Dr. Ben

            1. Dr. Ben, Thank you again for your reply. I understand what you mean in regards to the BMI. While my current BMI is approximately 24, I may have a higher amount of visceral fat.

              I look forward to anyone you might be able to get to reach out to me to discuss this issue. I will start deleting various foods to see if that will help with the LDL reduction as well. Thank you so much.

            2. Dr. Ben, I wanted to let you know that I found several links on YouTube for the exact thing that’s occurring with my LDL level being so high happening to others. There are many details to this occurrence that I can’t get into in this message, but Let me know if you’d like me to tell you the names of the links. Thank you.

              1. Aloha Noshin: while this info may be comforting it is important enough that the results need to be objectively investigated and published in a peer-reviewed journal article. Without the cold bright light of scientific scrutiny, too many confounding issues are possible such as placebo effect, inadequate sample size etc. If the solutions they discuss in the video are zero risk, by all means give them a try, but if not, I would suggest you look for more objective evidence. Medical research history is full of millions of examples of hopeful yet unsubstantiated claims of benefit that were found to be false when investigated under the proper protocols.
                Laetrile, fish oil and frequent mammograms are just a few examples.

                Dr. Ben

  30. Unless someone is quite old when starting drugs, I’m not sure the lowered risk over 4–6 years is terribly relevant. Are there any figures on reduced risk over 10 or 20 years?

  31. Hi
    I embarked on a strict plant based diet 6 months ago, following a heart attack and quadruple bypass. My aim was, not only a healthier diet but to reduce my cholesterol to such a level that I didn’t need to take statins.

    After watching videos by Dr’s Michael Greger and Neal Barnard stating how cholesterol levels drop substantially among people who follow plant based diets I approached my latest blood tests with great anticipation.
    How low would my levels have dropped?

    Imagine my disappointment to discover my cholesterol remained exactly the same as it was pre plant based diets, at a resolute 5.6 (UK measurement). Much to my disappointment I am now back on statins.

    How can this be?
    Is 6 months not long enough for a plant based diet to be effective?
    Is it possible that some people just produce cholesterol naturally irrespective of diet, as my doctor suggests.
    Can anyone please shed some light on why this might be the case?

    The only good news is that all my other test results were described as ‘perfect’ and gave testimony to how good my diet was.

  32. Hi Chris,

    I’m sorry that you’re feeling disappointed. After all the hard work I’m sure you’ve put into eating healthy I can imagine it was disheartening to not see changes in your cholesterol levels.

    Your doc is correct; cholesterol levels are influenced by MANY factors, such as genetics, diet, smoking, and exercise. If you are predisposed to higher cholesterol levels than it will take longer for you to see a change in your numbers. That being said; have you noticed a change in the way you feel or look? Do you feel healthier? These benchmarks are just as important as your lab work.

    Also, keep in mind that heart disease is influenced by many factors as well. High cholesterol levels are just one contributor to heart disease. A healthy diet and regular exercise are very important in managing heart disease (arguably more important than your cholesterol levels are). Even if you are not seeing a change in these numbers yet, it does not mean that your heart is not already noticing a difference. Hopefully you will be able to get off of your statin with time; if not, that is okay too.

    Best of luck,


    1. Hello Julia

      Thank you for your encouraging reply.
      I have just returned from my Dr’s and the news was slightly worse, it seems the nurse who gave me my results gave me the ratio figure of 5.6, my cholesterol had actually increased on the plant based diet from 5.6 to 7.0!

      Despite this extremely disappointing news I am resolved to continue eating solely plant based food, and hopefully in time I will see my figures reduce as you suggest. I think what is most disappointing is that the videos by Dr Greger and Dr Barnard seem to focus on the huge drops in cholesterol levels that can be achieved, and give no mention to the fact that some people won’t see any changes or that their levels can actually go up. So I embarked on my plant based journey full of optimism, now I’m feeling very deflated but I won’t give up.

      I am 55 years old, have never smoked, have always eaten relatively healthily and drink about 1glass of wine/wk.

      Yes I do feel much healthier on my plant based diet and everyone says how well I look, so yes this is an important factor to keep in mind.
      I know the cholesterol figure is just one factor in heart disease, the size of the cholesterol is also important as is inflammation within the body, especially the arteries. However if the Dr’s mentioned earlier ignore the inconvenient truths of the experiences of people like me, then it can cause me (and others) to treat, with suspicion the rest of the information they provide us with. This is a shame as because I am sure they are well intentioned.

      I will keep going and look for further information on what plant based foods can help reduce levels of cholesterol, that I can incorporate into my diet.

      Many thanks once again for your reply.

      Kind Regards


  33. I’m going to chime in here: I skimmed over the conversation, but I didn’t see where you listed what you’re eating and drinking other than the wine? Please keep in mind that “plant based” is not enough. It must be “whole food plant based” and even then sometimes we need to modify it further. As an example: my father who had bypass surgery at the age of 55 developed new clogging of his grafts, and angina, even though he was “plant based” because he ate a lot of whole wheat bread that was technically “whole food plant based” but not very healthy. When he ate a lot of beans and spinach he noticed over time his angina subsided. If you list what you eat, we might be able to help.

    Dr. Ben

    1. Hi Ben

      Thank you for your reply.

      First thing, yesterday I came across some information that suggested the rise in my blood cholesterol might be caused by the ‘cleaning’ effect on my arteries of a plant based diet. The cholesterol in my arteries is being dissolved, by the plant based diet, into my blood stream where it will be removed from my body. This is the cause of the elevated cholesterol and the levels will remain elevated until this process has been completed, this could take 6 – 12 months.
      I suppose it is a ‘theory’ and I will need monitor my future cholesterol tests to see if they support this.

      Ok on to your question about diet.

      I eat about 1 loaf of whole meal bread each week, usually with vegan spread. My bread intake has reduced considerably since I began a plant based diet due to the lack of ‘easy food’, to use in a sandwich. Now summer is approaching I envisage salad sandwiches will be a weekend, lunchtime treat.

      Breakfast is usually a home made musli with gluten free oats, goji berries, cranberries, raisins, sunflower seeds, pumpkin seeds and pine nuts. This is topped with a chopped banana and some blueberries. Almond milk is also used. All the ingredients are organic.

      Lunch will be something like a roast vegetable sandwich on brown bread, with hummus used to coat the bread rather than any kind of spread. This is purchased from a vegan cafe close to work.
      For variation I might have falafel and salad on a wrap, or a sweet potato and quinoa burger (grilled) on a vegan bun, again with hummus. Most Wednesday’s there is a market in town and I have a bbq jackfruit wrap with salad from a vegan stall.

      Dinner can be varied – black bean chilli, aloo motor, roast veg with couscous, sweet potato and broccoli curry with coconut milk, Thai green curry, vegetable stir fry, pineapple and kidney bean stew. All these are homemade using mostly organic products and eaten with brown rice.
      If I use any oil it is either the 1 cal spray, or organic, cold pressed rape seed oil or a good quality olive oil, the quantities of oil I am using is far less than I used prior to my plant based diet.
      Often if pressed for time I will have hummus with bread sticks or baked beans on toast, sometimes I make my own baked beans, other times they are shop bought, organic baked beans.

      1. Unfortunately you consuming significant processed carbs (bread), refined/isolated oils and high fat foods (falafel/hummus/vegan-spread) that can put you at risk for heart attack and stroke. You’re eating plant based, but not unprocessed whole food plant based. If you’d like to lower lipids without statins, you’ll need to eliminate those foods. The best way to do this is to go to the produce section and eat only those things with minimal to no processing: fruits and veggies from the farm to your mouth with no other added items.

        All available evidence is that elevated blood cholesterol puts you at risk for heart attack and stroke. The idea that the elevated cholesterol is from arterial cleaning is risky and just wishful thinking until someone actually publishes a peer-reviewed study.

        Sorry to be the bearer of bad news. If it’s any consolation, I love olive oil, hummus, bread and falafel as well, but my cholesterol goes way up when I eat these things.

        Dr. Ben

        1. Hi Ben Thank you for taking the time to reply and for the information you provide.
          I did suspect this would be your answer and I agree, most people’s diets, including those follow plant based, contain scope to be improved.  However the point is, when I ate a traditional diet – butter, bread, meat, eggs, dairy and a great deal more processed food than I do now my cholesterol was 5.6. Now I have cut all those products out of my diet and gone ‘plant based’, my cholesterol has increased to 7.0.Why should this be and how is it possible?
          Can we conclude that a ‘normal’ diet of meat, dairy, eggs etc is more heart friendly than a plant based diet, albeit one that has a small amount of processed food contained within it?I’m not an expert, or indeed medically trained but that just doesn’t seem possible to me.
          As you say, we need to await studies to see if a temporary rise in blood cholesterol levels is a result of arteries being cleaned by a plant based diet or maybe it might be a result of my bodies natural response to a diet low in cholesterol containing food. If it is the latter, then I can’t see any diet, no matter how restrictive ever producing these remarkably low levels of cholesterol often reported by the notable proponents of plant based diets.
          I will follow your advice and remove hummus from my diet, I will also cut down on bread with the goal of removing that too.I can also omit the falafels too.This will leave me with almost zero processed food in my diet.
          I await my next cholesterol test with interest.

          1. I completely understand what you’re saying. Please keep in mind that total cholesterol is just one risk factor that is linked to CVD. There are many others and we don’t know if those have improved in you. Please keep in mind that Metabolic Syndrome is a significant issue in many people. The processed carbs and fat could be worsening this as compared to meat that might have been worsening your homocysteine, TMAO and HS-CRP. We would not know without testing while you were eating meat. At the end of the day, all of this is academic since none of these tests matter as compared to “All Cause Mortality” which is lower in whole food plant based eaters. Staying alive is job #1.

            Dr. Ben

  34. I need some input, Stat!…grin
    I have been purely vegan for two years.
    watching or reading Dr.Gs emails/videos every day
    instead of my cholesterol going down…485
    it has gone up to 999
    bad being 109 to 173
    how can I get the numbers lower without drugs

    1. Hello Holly! Thanks for your comments.

      It’s great that you have adopted a vegan diet!

      I’m sure this video will be from your help and give you ideas about other foods you can introduce to your diet “The best food for high cholesterol”

      Beans, Beans, They’re Good For Your Heart
      Food Antioxidants, Stroke, & Heart Disease

      However, there’s just too much to talk about cholesterol! so if you have a little extra time, you can check the whole section of videos Dr. Greger has made about the subject:

      Hope this is from help!

  35. Vegans simply cut out animal products. Some vegans I know eat Oreo cookies, potato chips and Pepsi all day. That would likely shorten ones lifespan. Dr. G recommends an unprocessed whole food plant based diet since this is what the scientific studies support. If you list the foods you’ve been eating, we might be able to help.

    Dr. Ben

    1. I’m surprised, Oreo cookies really!
      Here is what I eat Organic oatmeal cooked in RO water with blueberries. Sometimes I add organic black beans to change up the flavor. When finished I sprinkle organic cinnamon on top. This is breakfast accompanied by a 12 ounce glass of water 1/4 teaspoon of organic tumeric in vegan gel caps, 2500 ml of D3.

      Lunch Salad consisting of, all organic,dark green leafy kale, red and green cabbage, black or pinto beans, shredded carrots, green peas on a 8 inch plate with Brianna’s poppy seed dressing diluted volume by half with RO water because it has 1gram saturated fat per tablespoon. I have stopped eating the dressing.

      Some days I’ll eat the salad as a taco in an organic whole wheat tortilla.
      There is no saturated fat in the organic tortilla, 6 inch diameter. I spread hummus on the tortilla for flavoring.

      Dinner Saute of, all organics, white button mushrooms, broccoli, carrots, black or pinto beans, green peas, fresh garlic, in a cast iron skillet. The cast iron skillet has a little spray if sunflower oil on it because it’s cast iron but the can say O saturated fat on the label. I use the water from the black beans can to heat the food and use the lid to steam the food about 7 or 8 minutes instead of really cooking it.
      After it is off the stove I spoon some about 2 cups of the mix over fresh kale, ref and green cabbage, and then place a half avacado that the skin has been peeled off for added absorption. I sometimes sprinkle fresh ground ginger in for added Tang.
      Beverage is RO water.

      I make my own Green tea blend with other organic flavors, delicious! And drink throughout the day.

      I am legit guys. I haven’t seen an Oreo in probably 45 years I never liked sweets as a child. My fav food was broccoli. I know it sounds weird but that was me. I have never drank a Pepsi. REALLY.
      I was always what they called “a weird child” I liked the real flavor of food. Processed food like Pringles, ding dongs, and the like all had a plastic taste in my mouth so I never ate them. I guess it was nature’s way if saying to me this stuff is toxic. The dessert item I ate as s child was ice cream. But I stopped eating dairy products nearly 30 years ago because all the talk about health risks.

      I was Paleo until 2 years ago when I came across an interview of Dr. G.
      Walking on a treadmill talking about his grandmother and how he has a no nonsense way of presenting facts about food. Ever since I have been eating the daily dozen way.
      The main reason I think my health ent wacky is because there was a gas leak in my apartment and we we’re all evacuated to hotels. I was on high levels of Pregnazone for about eight months to help me breath. That put fifty pounds on me with no exercise for nearly a year.
      Which might be the cause of sky rocketing trygliserides if 700.

      Now you know the more of the story. Now will you talk more sense instead of assuming I eat junk.

      I have increased my water intake and exercise and do not eat in-between meal snacks. I am looking for real answers.

    2. I just read my post I forgot to add I also take b 12, and eat apples which I dip in hummus, as an after dinner snack. I also put organic mixed nuts in home made colslaw.
      But have omitted the nuts and salad dressing do to saturated fats until I figure out the cholesterol problem

      1. No one is assuming you eat junk. When we answer questions in these forums, and someone says “vegan” we need to let them know that this term can mean many things. As you pointed out, gaining weight and lack of exercise can be the cause of serum lipid increases. Keep in mind that visceral fat is deposited first, which is not good lipids. Shedding the excess weight and getting frequent exercise will likely improve your lipid profile. Also, it’s best to eat food that is unprocessed whole food.. Commercial hummus typically has added oil which does not qualify as whole food. Best to make your own without adding any oil. Eating organic food will likely have zero effect on your lipids.

        Dr. Ben

        1. I saw the post about your father cutting out wheat. I will replace the wheat tortilla with romaine lettuce. I love a good burrito. What grains do you suggest I am going to make a pot of quinoa.
          Is the saturated fats in raw organic nuts ok to eat? Do they raise the cholesterol.

          Thank you for your response

        2. I apologise I thought you were responding directly to my post when you mentioned Oreos. Glad I sent you a sample meal plan. What do you think about Sweet potatoes?
          Thanks for the imput

          1. Sweet potatoes and whole grains may be ok. Its not so much about the fat in these foods as about eating too much and the processing. I love sweet potatoes so much and can eat so many that I get fat and my lipids go up.
            Any unprocessed whole grain should be ok as long as you don’t eat too much of them. When in doubt, eat the sweet potato raw.

            Dr. Ben

            1. Thanks for the imput! We love making baked sweet potatoes that look like french fries. And yes, I have started drinking water every hour or so so I am not as hungry at meal time. The addd benefits if lots if water intake is I get to salt my fries, lol.
              Im getting really good exercise now. In two weeks I get my blood retested.
              I’ll send the results! It is bound to be better.

              Portion control, no olive oil, and homemade hummus, grin. Beans are soaking. I am going to make a batch of quinoa to replace the bread

              Thanks for the input! Say hi to Dr. G. for me.

          2. Holly, check nutrition you can search for anything on that site.  Nuts no cholesterol; it’s only found in animal products and your body makes what it needs.  Sweet potatoes are good for you. They form the bulk of many Asian diets are are one of your healthiest choices for satiating carbs.  

            1. So it doesn’t matter that saturated fats ar in raw organic nuts. That’s exciting it is a great grab and go snack when I am hiking. Great news! I like a variety of nuts walnuts, hazelnuts, almonds, and Brazils. I would like to add a few raisins to the mix but they all come processed so I never have.

              I am focusing more on portion sizes now that I can get exercise. With drinking many glasses if water I am not as hungry as usual. This will help get the weight off.

              Thanks for your input

              1. You still have to watch the amount of nuts… a handful a day is as much/the most you should eat.  You can easily over do them cause they are calorie dense.

                  1. Who said vegans/plant based diets get 90% of protein from beans?  There is protein in virtually every natural food, and from a caloric equivalency perspective, many vegetables have more protein per 100 calories than meat.

                1. I listen to his utube q and a each month but not questions never seem to reach the top. Maybe one if you can ask him to explain the protein factor, or give a teaser from his new book how not to diet.
                  Thanks for all you do

        3. Dr. Ben I got the lab results back and the TG went from 699 to 479 by cutting out olive oil and nuts Total cholesterol went from 339 to 325 HDL 52 to 54 LDL 139 to 170 why did this go up?
          Sodium 133 to 138 after adding salt to food as requested by physician here but my blood pressure went from 100/62 to 120/80 not happy about that

          I am so confused as to what to eat now since LDL went up and TG only lowered 220 points.
          The doc asked me to increase water intake and to salt my food because of low sodium. Now I not only have high cholesterol but headaches and muscle aches too since adding salt add and 1/2 gallon of water to my day causing frequent washroom visits.

          I need answers since eating vegan isn’t lowering my cholesterol naturally

          1. Electrolyte imbalances can be a serious problem and not something to experiment with over the internet. I suggest you appoint with a licensed doctor that specializes in functional medicine or preventive medicine and that is familiar with the extensive research showing the benefits of an unprocessed vegan diet.

            Dr. Ben

          2. Hi Holly

            I feel your pain, I am in a similar situation to you.
            When I ate a ‘normal’, modern diet my cholesterol was around 5.6, six months after eating a plant based diet it rose to 7.0. (UK) I asked the same questions as you and got a similar response, my diet is unhealthy, I’m eating too much of this, or too much of that.

            To be honest the truth of the matter is that ‘they’ (the vegan diet exponents) don’t know the answer. We are a minority, the exception to the rule that they are trying to establish, that a vegan, whole food plant based diet is the cure for everything. The reason they don’t know the answers is that the studies into this condition have not yet been undertaken. I doubt very much that people like Neal Barnard or Michael Granger will even acknowledge our plight let alone give us any answers because: a) they don’t have any answers.
            b) we aren’t good for their cause.

            My latest blood tests show my blood chemistry to be perfect after 8 months on a plant based diet, my cholesterol has started to come down with the help of 20 mg of statin. My results are in the lower range for PSA, lipids, liver function, kidney function and thyroid, it is only my cholesterol that refuses to reduce without medical intervention.

            There are 2 medical conditions that are hereditary, one causes high cholesterol the causes elevated levels of both cholesterol and triglycerides, I suspect we might have one of those. I’m sure Dr Ben can elaborate for us but they seem to be caused by an inherited faulty gene.

            I embarked on my vegan diet hoping it would eliminate the need for statins but I am arriving at the conclusion that this will never happen. The information put forward by Michael Gregor, Neal Barnard and others is misleading in that a whole food, plant based diet IS NOT the panacea for all medical conditions. It will not lower everyone’s cholesterol, no matter how strict they are. It will work for a great proportion of people but not everyone.

            However I do believe it is the healthiest diet a person can eat and everyone will see benefits from following it.

            I does not alter the fact that I do believe Mr Gregor, Mr Barnard et al are deliberately misleading people by giving them false hope. I did expect more from them, I expected them to be keen to look into cases like you and me to see if they could discover what the problem was. Yes I feel let down by them, and I will now treat everything they say with suspicion but I will continue eating a whole food, plant based diet.

  36. Curious how nutrition may effect abnormal heart rhythms. I have atrial tachachardia but meds aren’t a good option because my heart rate and blood pressure are already pretty low and I had trouble on them, ablation may be an option down the road. Caffeine and alcohol may have an effect, wondering if the right nutrition could improve it.

  37. My wife and I have been ovo-lacto vegetarians for over 20 years, and after recently attending a lecture by Dr. Greger, we both decided to go vegan and adopt a diet of plant-based, mostly non-processed foods to see whether the vegan diet would help. My wife and I ate virtually identical diets. We both have exercised regularly (I run approx. 4-5 miles 3 times per week) since well before adopting the vegan diet. In terms of lifestyle, the only change in our lives was that we became vegan after having been ovo-lacto vegetarians. After 3 months as a vegan, my wife’s results (in terms of cholesterol) were encouraging. Her total cholesterol lowered from around 230 to around 190. My cholesterol levels (both HDL and LDL) remained exactly the same (total cholesterol of 229). I’m 68 years old, and an artery probe has revealed that I do have some plaque build-up in my arteries. My doctor says that genetics also plays a substantial role in cholesterol production, and that I’ve done everything I can in terms of lifestyle/diet. He’s suggesting a statin. Dr. Greger places so much emphasis on diet that I would like to hear him say something about the role of genetics in cholesterol production. I don’t doubt that Dr. Greger’s dietary recommendations do reduce cholesterol levels for substantial portions of the population, and I’m sure that my cholesterol would be higher if I were not a vegan who exercises regularly. But what would Dr. Greger recommend for someone like me?

  38. Hi George- I’m a cardiologist and a Health Support Volunteer with Dr Greger. The most impactful lifestyle action on total and LDL cholesterol is a whole food, plant based, low fat diet. This, on average, can get the total cholesterol to drop about 35%. You’ve already made a great change. If you still cook with oils/fats and/or eat out much, you may consider replacing processed oils. For example, saute in low salt vegetable broth rather than oil. This can also lower the LDL cholesterol. If triglycerides are the issue, both fat and sugar contribute to raising them. Exercise helps triglycerides (and can raise a low HDL (good cholesterol)), but doesn’t impact LDL all that much.

    Those who eat a whole food, plant based diet without added fats who still have a total cholesterol over 220 often have Familial Hyperlipidemia (FH). This is genetic. It is generally substantially improved by eating whole food plant based without oils, and this is strongly advised for FH patients. But it may also be necessary to use a statin medication as well. Some FH patients have even needed their blood filtered of cholesterol periodically! But with the new (but also very expensive) PCSK9 inhibitors, those with FH can now get their LDL cholesterols much lower, thus reducing risk of blocked heart arteries/heart attack.

    In summary, see if there are added fats you can eliminate. Once you’ve done that, if your cholesterol is still that high, a statin may be needed. The best LDL is as low as possible, 70 or less.

    Dr Anderson, Health Support Volunteer

  39. I have osteoporosis and my doctor wanted me to take flosamax.I did my research on Flosamax and I will not take the poison. My doctor got upset at me. I am 68 and do not take any medications. I have a better chance of not getting fractures as with taking the medication. I do take d-3 and MK-7 along with multiple vitamins. I went Vegan 3 months ago. I find it strange that my doctor must follow Dr. Greger or he wouldn’t have given me a copy of Dr. Greger’s list of recommendations of foods to eat. When he gave me the list, I had to smile and say ohh Dr. Greger I get his emails sent to me from his site. I have known about the doctor for 3 years or more. I have read his book and have his cookbook. I also had the chance to meet Dr. Greger in Novi, Michigan last Sunday. It was great.

    1. It’s Great that your Dr. knows of and uses info from Dr. Greger.So he should also know that almonds and prunes and phytates (all beans, grains, nuts, and seeds) have studies showing positive effects on osteoarthritis.But, Doctors write drug prescriptions to manage diseases.  That’s how they’re trained and expected to comply in medical practice; but you know that.
      “those who ate the most phytates were estimated to have significantly lower risk of major fracture, and lower risk of hip fracture, specifically.  This is thought to be, in part, because phytates help block the formation of bone-eating cells, and their bone-eating activity. You can see how much more bone is eaten away in the non-phytate group on the left.  Now, the drug Fosamax can have a similar beneficial effect. But phytates don’t have the side effects associated with this class of bisphosphonate drugs”.

      1. Thanks David for responding. My doctor didn’t recommend anything else. All they can do is push drugs on you, to keep you coming back. I had been taking a calcium supplement too., but it didn’t do any good by the time I had the second bone density. After I did my research on calcium supplements too. I found out with them I was harming myself more than doing any good.
        So, the next time I went to my doctor after I had already quit taking it. I ask the doctor if calcium supplements were any good. He said no. He had known I was taking them previously. Long time ago, when the doctors were pushing hormone pills to women going through the change. I told them at the time I wouldn’t take them either. Glad I didn’t. It took them 50 years to find that it causes cancer.

        1. I’d say moderation for a few reasons:1 dates are sweet, a handful is a lot of sugar.2 dates like prunes will move your system…3 include dates in your diet meaning stock pure organic dates and include a little here and there in your dishes.  I haven’t reviewed the study to see how many dates they used but it’s more about variety and inclusion in your diet than a specific amount per day… just get them in you. But phytates, always and plenty.

  40. I have spent the majority of my life (granted, it’s in a brief infancy of 27 years) focussed on health and fitness. I have no relatable qualification or noticeable achievements (beyond personal mountain marathon achievements).

    Roughly 2 years ago I began following a Vegan lifestyle, due to an interest in understanding how it generally affected my health and lifestyle. As a consequence, I considered myself to feel less fatigued, but more importantly, I caught the common cold considerably less often…to the extent I was no longer ‘the guy that is always ill, even though he’s always looking after his health and fitness’.

    Roughly 1 year ago, I randomly purchased a subscription to a private company (Thriva), who perform blood tests to determine whether you have any deficiencies. Although I was expecting B12 or Vitamin D deficiencies, to my surprise, I found that my cholesterol was absolutely sky high (8.12 mmol/L total, with 5.5.7 mmol/L LDL; see below for timeline of results.).

    As expected, I began investigating this further. I spoke to a cardiologist, who performed an ECG, Stress Test and 24hr blood pressure test, to which they were all healthy results.

    My next course of action (As aforementioned, i’ve focussed so much of my life on health and fitness, the thought of succumbing to Statins for the rest of my life, at the age of 27, was ridiculous) was to utilise the suggestions within the How Not To Die book, based on significant research, in the hope it would lower my cholesterol. I’ve looked into Wahls, and his conclusions that 70% of cholesterol is completely under our control, alongside the Brazil nuts and fruit based studies, which concluded with significant reductions in Cholesterol levels.

    Given I already followed a 2019 Vegan diet (I.e. a 2019 Vegan diet is no longer whole food plant based), I decided to spend four weeks with an extremely strict whole food, plant based diet, on top of the extremes of consuming 2 brazil nuts every week and achieving a MINIMUM of 7 pieces of fruit a day (as per referenced studies in the book). I understand four weeks isn’t representative, but I would’ve excepted, at the very minimum, for results to remain unchanged. Unfortunately, after four weeks (tested 05/07/19) my cholesterol results increased;

    Type 05/07/19 09/04/19
    Cholesterol 6.83 6.75
    Triglyceride 0.61 0.79
    HDL 1.76 1.84
    LDL 4.79 4.55

    Given in general, I live a healthier lifestyle than the majority of individuals, to find out that my cholesterol results have increased following the books specific suggestions (As a bare minimum, I hit 21/24 everyday on the Daily Dozen), I’ve never been so gutted in all my life.

    I couldn’t imagine having to resort to Statins….However, do I have to accept that my genetics have failed me?? I will receive the results of a genetic test in the coming weeks, but I’ve no idea whether to trust medical practices on this subject anymore.

    I’ve no idea where else to post this, so as per the Contact Page on this site, i’m pasting it here…



    1. Hi spring03,

      Thank you for that, but i believe my post may have mislead you into thinking i was Vit D deficient, which isn’t the case.

      It was more around whether I need to succumb to the idea that my heightened cholesterol really is genetics, due to The Daily Dozen diet (alongside a very active lifestyle) somehow resulting in an increase in LDL and decrease in HDL.



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