A Workplace Wellness Program that Works

A Workplace Wellness Program that Works
4.98 (99.57%) 46 votes

The return on investment for educating employees about healthy eating and living.

Discuss
Republish

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“How do you wipe out the nation’s heart disease epidemic?” According to the Center for Science in the Public Interest, one of the best approaches for preventing the disease in the first place is the “CHIP program,” which tells people to eat more whole plant foods, and less meat, dairy, eggs, and processed junk. It is considered to be “a premier lifestyle intervention targeting chronic disease that has been offered for more than 25 years,” through which more than 50,000 individuals have gone. And, most CHIP classes are run by volunteers, “sourced primarily through the Seventh-Day Adventist Church, which has an interest in positively influencing the health of their local community.” Why the Adventists? Well, they have “a health philosophy built around [a] biblical notion that the human body” should be treated as a temple, and many of the participants of the program are Adventists, too. Is that why the program works so well—because they just have faith? You don’t know, until you put it to the test.

“The Influence of Religious Affiliation on…Responsiveness to the Complete Health Improvement Program.” They looked at 7,000 participants. Even though Adventists make up less than 1% of the U.S. population, about one in five CHIP-goers were in the Church. How did they do compared to the non-believers? “Substantial reductions in selected risk factors were achieved” for both Adventists and non-Adventists, but some of the reductions were actually greater among the non-Adventists (non-SDA). “This indicates that [Seventh-Day Adventists] do not have a monopoly on good health.”

Middle-class, educated individuals also disproportionally make up CHIP classes. Would it work as well in poverty-stricken populations? We didn’t know… until now. How about trying to reduce “chronic disease risk factors among individuals living in rural Appalachia,” one of the poorest parts of the country? Conventional wisdom has been that you need to have some “financial ‘skin in the game’” to really commit to lifestyle change programs. So, if offered for free to impoverished communities, maybe the results wouldn’t be as good. But, “[t]he overall clinical changes [were] similar to those found in other 4-week CHIP classes throughout [the U.S.],” suggesting CHIP may benefit across socioeconomic lines and “independent of payment source.” So, why don’t employers offer it free to employees to save on healthcare costs? CHIP is described as “achieving some of the most impressive outcomes published in the [medical] literature,” clinical benefits and “cost-effectiveness” as well.

Lee Memorial, a healthcare network in Florida, offered it to some of their employees as a pilot program. Sadly, healthcare workers can be as unhealthy as everyone else. They reported an average 17-pound weight loss, 20-point drop in LDL cholesterol, and blood pressure normalization in most participants. They invested about $38,000 to make the program happen, but then saved, just in that next year, $70,000 in reduced healthcare costs, because they became so much healthier, for a financial return on investment of like 1.8 times what they put in. But, there hadn’t been an ROI study published in a peer-reviewed medical literature… until, Dexter Shurney stepped up to the plate, and published this workplace study out of Vanderbilt.

Now, “[t]here was a high degree of skepticism at the planning stage of the study that active engagement could be realized…around a lifestyle program that had as its main tenets exercise and a plant-based diet.” Vanderbilt is, after all, in Tennessee—smack dab in the middle of the stroke belt, known for their Memphis ribs. Yet, they got on board enough to improve their blood sugar control and cholesterol, as well as “positive changes in self-reported…health and well-being.” “Health-care costs were substantially reduced.” For example, nearly a quarter were “able to eliminate one or more of their medications,” and so, got about a two-to-one return on investment within just six months—providing evidence that just “educating a member population about the benefits of a plant-based, whole foods diet is feasible and can reduce…health care costs.”

The largest workplace CHIP study done to date involved six employee populations, including, ironically, a drug company. A mix of white collar and blue collar, and check out what happened to the worst off. Those starting with blood pressures up around 170 over 100 fell down to around 140 over 85. Those with the highest LDL cholesterol dropped 60 points, a 300-point drop in triglycerides, a 46-point drop in fasting blood sugars. Theoretically, someone coming in with both high blood pressure and high cholesterol might experience “a 64 to 96% reduction in overall risk of” a heart attack, our #1 killer.

“For the cost of a Humvee,” Michael Jacobson from CSPI figured, “any town could have a CHIP [program] of its own.” And: “For the cost of a submarine or a farm subsidy, the entire country could get a CHIP on its shoulder.”

Please consider volunteering to help out on the site.

Image credit: chiphealth.com. Image has been modified.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“How do you wipe out the nation’s heart disease epidemic?” According to the Center for Science in the Public Interest, one of the best approaches for preventing the disease in the first place is the “CHIP program,” which tells people to eat more whole plant foods, and less meat, dairy, eggs, and processed junk. It is considered to be “a premier lifestyle intervention targeting chronic disease that has been offered for more than 25 years,” through which more than 50,000 individuals have gone. And, most CHIP classes are run by volunteers, “sourced primarily through the Seventh-Day Adventist Church, which has an interest in positively influencing the health of their local community.” Why the Adventists? Well, they have “a health philosophy built around [a] biblical notion that the human body” should be treated as a temple, and many of the participants of the program are Adventists, too. Is that why the program works so well—because they just have faith? You don’t know, until you put it to the test.

“The Influence of Religious Affiliation on…Responsiveness to the Complete Health Improvement Program.” They looked at 7,000 participants. Even though Adventists make up less than 1% of the U.S. population, about one in five CHIP-goers were in the Church. How did they do compared to the non-believers? “Substantial reductions in selected risk factors were achieved” for both Adventists and non-Adventists, but some of the reductions were actually greater among the non-Adventists (non-SDA). “This indicates that [Seventh-Day Adventists] do not have a monopoly on good health.”

Middle-class, educated individuals also disproportionally make up CHIP classes. Would it work as well in poverty-stricken populations? We didn’t know… until now. How about trying to reduce “chronic disease risk factors among individuals living in rural Appalachia,” one of the poorest parts of the country? Conventional wisdom has been that you need to have some “financial ‘skin in the game’” to really commit to lifestyle change programs. So, if offered for free to impoverished communities, maybe the results wouldn’t be as good. But, “[t]he overall clinical changes [were] similar to those found in other 4-week CHIP classes throughout [the U.S.],” suggesting CHIP may benefit across socioeconomic lines and “independent of payment source.” So, why don’t employers offer it free to employees to save on healthcare costs? CHIP is described as “achieving some of the most impressive outcomes published in the [medical] literature,” clinical benefits and “cost-effectiveness” as well.

Lee Memorial, a healthcare network in Florida, offered it to some of their employees as a pilot program. Sadly, healthcare workers can be as unhealthy as everyone else. They reported an average 17-pound weight loss, 20-point drop in LDL cholesterol, and blood pressure normalization in most participants. They invested about $38,000 to make the program happen, but then saved, just in that next year, $70,000 in reduced healthcare costs, because they became so much healthier, for a financial return on investment of like 1.8 times what they put in. But, there hadn’t been an ROI study published in a peer-reviewed medical literature… until, Dexter Shurney stepped up to the plate, and published this workplace study out of Vanderbilt.

Now, “[t]here was a high degree of skepticism at the planning stage of the study that active engagement could be realized…around a lifestyle program that had as its main tenets exercise and a plant-based diet.” Vanderbilt is, after all, in Tennessee—smack dab in the middle of the stroke belt, known for their Memphis ribs. Yet, they got on board enough to improve their blood sugar control and cholesterol, as well as “positive changes in self-reported…health and well-being.” “Health-care costs were substantially reduced.” For example, nearly a quarter were “able to eliminate one or more of their medications,” and so, got about a two-to-one return on investment within just six months—providing evidence that just “educating a member population about the benefits of a plant-based, whole foods diet is feasible and can reduce…health care costs.”

The largest workplace CHIP study done to date involved six employee populations, including, ironically, a drug company. A mix of white collar and blue collar, and check out what happened to the worst off. Those starting with blood pressures up around 170 over 100 fell down to around 140 over 85. Those with the highest LDL cholesterol dropped 60 points, a 300-point drop in triglycerides, a 46-point drop in fasting blood sugars. Theoretically, someone coming in with both high blood pressure and high cholesterol might experience “a 64 to 96% reduction in overall risk of” a heart attack, our #1 killer.

“For the cost of a Humvee,” Michael Jacobson from CSPI figured, “any town could have a CHIP [program] of its own.” And: “For the cost of a submarine or a farm subsidy, the entire country could get a CHIP on its shoulder.”

Please consider volunteering to help out on the site.

Image credit: chiphealth.com. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

This is the final video in a four-part series on CHIP. If you missed the first three, check them out:

I was so excited to finally get to this topic. It was something I prioritized before diving into this next book project. Just think how much money self-insured companies could save if they helped empower their staff about the power of evidence-based nutrition.

I think up to this point the only other workplace videos I have are Plant-Based Workplace Intervention and Plant-Based Diets for Improved Mood & Productivity.

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

66 responses to “A Workplace Wellness Program that Works

Comment Etiquette

On NutritionFacts.org, you'll find a vibrant community of nutrition enthusiasts, health professionals, and many knowledgeable users seeking to discover the healthiest diet to eat for themselves and their families. As always, our goal is to foster conversations that are insightful, engaging, and most of all, helpful – from the nutrition beginners to the experts in our community.

To do this we need your help, so here are some basic guidelines to get you started.

The Short List

To help maintain and foster a welcoming atmosphere in our comments, please refrain from rude comments, name-calling, and responding to posts that break the rules (see our full Community Guidelines for more details). We will remove any posts in violation of our rules when we see it, which will, unfortunately, include any nicer comments that may have been made in response.

Be respectful and help out our staff and volunteer health supporters by actively not replying to comments that are breaking the rules. Instead, please flag or report them by submitting a ticket to our help desk. NutritionFacts.org is made up of an incredible staff and many dedicated volunteers that work hard to ensure that the comments section runs smoothly and we spend a great deal of time reading comments from our community members.

Have a correction or suggestion for video or blog? Please contact us to let us know. Submitting a correction this way will result in a quicker fix than commenting on a thread with a suggestion or correction.

View the Full Community Guidelines

  1. This is a very timely video. Now that the economy is booming and businesses are hiring like crazy, this would be the perfect time to introduce the CHIP program in the workplace all over the country. The CHIP program sounds like the perfect opportunity to spread the word about the WFPD diet to a large number of people. Thanks to Dr Greger for helping to advertise it.

    1. Thought I may add, the economy booming may to a extend depend upon ones standing or role in the economy.
      From the Hill but based on bureau of labor statistics…seems actual real wages have decreased.. thehill.com/policy/finance/401341-wages-drop-despite-economic-boom

  2. Can we get an urgent update on that 2017 study (1) showing increased lung cancer risk from supplementing B12? This study showed increased cancer risk in people supplementing B12 at dosages far below that recommended by Dr. Greger. The increase in cancer risk was not limited to smokers, people who had quit smoking more than 10 years ago had almost double the cancer risk compared to people not supplementing with B12. I saw this already addressed by Dr. Kim Williams and by Dr. Thomas Campbell, the latter changed his B12 recommendations in may 2018.

    A paper (2) published in 2015 in the European journal of clinical nutrition already mentioned the following about this;

    “Concerns have been raised regarding the stability of cyanocobalamin (Cbl). It has also been said that Cbl should not be used in smokers as it has a cyanide moiety and smokers have an excess of thiocyanate in their blood, which can disturb the metabolism of Cbl and increase its excretion. Hydroxocobalamin (HCbl) is the form of vitamin B12 that lacks the cyanide moiety and has a hydroxyl group instead. Thus, HCbl may be a better agent to use in cases of B12 deficiency, especially in smokers”.

    The same sentiment can be seen expressed by Dr. McDougall in one of his newsletters, that was partially dated to 2007 (3);

    “Cyanocobalamin. This is a synthetic B12 compound sold commonly as supplements and used for food fortification. All four forms (natural and synthetic) are converted in the body into the metabolically active molecule cobalamin. However, some people do not efficiently make this conversion with the “cyano” products. Plus the cyanide portion of the cyanocobalamin molecule accumulates in the body. Cyanide is a well-known poison that was once used as a chemical warfare agent that can cause death. In small doses, as taken in vitamin B12 supplements (cyanocobalamin), cyanide may have long-term toxicity. Early symptoms of mild cyanide toxicity include a headache, dizziness, fast heart rate, shortness of breath, and vomiting.”

    In 2012 Dr. Greger was asked a question (4) about the safety of cyanocobalamin by one of the readers on Nutritionfacts;

    “I have followed you for years and purchase your tapes. Met you in Ann Arbor at the food co- op. Is it true Cyanocobalamin b12 ( which you recommend for us as vegans) turns into cyanide and the best b12 to take is hydroxycobalamin?Per Raymond Francis MIT scientist. That’s what his website shows anyway. His comments were it is man-made , not natural, and not well utilized. What is absorbed is turn into cyanide. Could you please clarify, help.”

    Dr. Greger responded to this;

    “Let me guess: Mr. Francis sells hydroxycobalamin supplements? It’s like the whole coral calcium scam. Calcium is cheap as chalk–in fact, it is chalk! So how are you going to bilk people out of lots of money? You sell some sort of special calcium. Same with B12 supplements. B12 is so cheap to produce that supplement manufacturers try to come up with all sorts of fancy ways to “add value” to products so they can charge $30 a bottle. Unless you’re a smoker, have kidney failure, or base your diet around cassava root, cyanocobalamin should be fine. That’s what I take!”

    The B12 (dosage/type/safety) subject, seems to be the Achilles heel of the wfpb community, no one agrees on the type or dosages to take.

    Dr. Greger recommends 2.5000 mcg cyanocobalamin every week. Only after extensive searching did I learn that he advises against methylcobalamin not because it is more expensive but because there is insufficient proof of it’s efficiency. This fact is never mentioned in Dr. Greger’s video’s and not on the recommendation page, it is only found on the B12 page here (5).

    After some more searching, I see that Dr. Greger made a reference on twitter to a website called the veganrd for a particular B12 post. (6). This post was presumably written by Ginny Kisch Messina, MPH, RD and has the following to say about methylcobalamin;

    “It’s not because cyanocobalamin is “better.” It’s simply because it’s been well-studied and we have more reliable information about appropriate dosages.For those who prefer to take methylcobalamin, it’s likely that 1,500 mcg per day would meet needs. (17) But again, it’s difficult to make specific recommendations about this.”

    If you don’t have enough time to research these things (like me) and you’re taking methylcobalamin 2.500 mcg, chances are that you are going to become deficient in time. (that’s what happened to me anyway, most B12 sold in Germany is methylcobalamin).

    And the list of confusion goes on;

    * Dr. Fuhrman says 200mcg/day B12 as methylcobalamin or taken one time as 1.400 mcg per week
    * Dr. Thomas Campbell lowered his dosages after that study (1) to 10-20 mcg per day or around 500 per week (and yet he has no preference for cyano or methyl as they “both raise B12 levels”.)
    * Dr. Mcdougall says 5 mcg per day or 500 mcg per week but not as cyanocobalamin as it causes cancer.
    * Dr. Esselstyne wants us to take 1.000 mcg per day but doesn’t mention in what form
    * The worst B12 recommendation of them all was coming from the PCRM who talked about eating fortified foods like “meat substitutes and Kellogs cereals”.

    (1) Brasky, Theodore M., Emily White, and Chi-Ling Chen. “Long-term, supplemental, one-carbon metabolism-related vitamin B use in relation to lung cancer risk in the Vitamins and Lifestyle (VITAL) cohort.” J Clin Oncol 35.3440-3448 (2017): 2017.
    http://www.capsumed.com/images/pdf/studie-vitaminb-lungenkrebsrisiko.pdf
    (2) Thakkar, K., and G. Billa. “Treatment of vitamin B12 deficiency–Methylcobalamine? Cyancobalamine? Hydroxocobalamin?—clearing the confusion.” European journal of clinical nutrition 69.1 (2015): 1.
    (3) https://www.drmcdougall.com/misc/2017nl/apr/b12.htm
    (4) https://nutritionfacts.org/questions/which-type-of-b12-is-best/
    (5) https://nutritionfacts.org/topics/vitamin-b12/
    (6) http://www.theveganrd.com/vegan-nutrition-101/vegan-nutrition-primers/vitamin-b12-a-vegan-nutrition-primer/

    1. Thank you for such question! I also have the same question point. Recently I faced up the recomendation for cianocobalamin from Dr. Greger and I was surprised. I have been taken methyl for about 4 years after extensivly research (but maybe not so good).

      Please Dr Greger, give us new videos about that point.

    2. Hello Netgogate,
      I previously wrote a response, on 8/30/17, to someone who was concerned about the 2017 study you mention which supposedly demonstrates an increased risk of lung cancer in people who take cyanocobalamin. Here it is, again:

      AUGUST 30TH, 2017 AT 11:04 AM
      Hello Bjorn,
      Thank you for your question. I am a family physician with a private practice in lifestyle medicine, and am a volunteer moderator for this website. I also have a master’s degree in epidemiology. This is an interesting study. I just looked at it in detail, and scrutinized the tables of data. I do not think their conclusion is warranted.
      Here is their conclusion: “When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (> 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (> 55µg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers.”
      I see several problems with this conclusion:
      1) If B12 consumption is associated with lung cancer, then the more B12 you consume, the higher your risk of lung cancer should be. This is called a “dose-response” relationship. But here are the data for men (Note: there was no significant association for women), using their figures for 10-year average daily consumption of B12. First, their categories of consumption, with the number of cancer cases in each category in parentheses:
      Non-user (n=179), 0.1-5 mcg/day (n=78), 5-25 mcg/d (n=138), 25-55 mcg/d (n=23), >55 mcg/d (n=28).
      The relative risk of cancer in these groups, when adjusted for a bunch of different variables, including smoking:
      Non-users RR=1.00 (by definition); 0.1-5 mcg/d: 0.93, 5-25: 0.94; 25-55: 1.04; >55: 1.98 (confidence interval 1.32-2.97).
      There is not much of a dose-response relationship here.
      2) The number of cancer cases in each group is very small (23, and 28 for two of the B-12 consumption groups). This means that any association they find is somewhat suspect — even if it is “statistically signifiant” — i.e. the confidence interval doesn’t include 1.00.
      3) There is clearly confounding, by smoking status. By their own admission, “the risk was even higher among men who were smoking at baseline.” But what they don’t say, until you delve into the tables, is that, due to the small number of never-smoker lung cancer cases (n=20), this group was excluded from the analysis! Note, that they DID analyze (see immediately above) two groups of size 23, and 28. Is that because there is actually NO relationship between B12 intake and risk of lung cancer among non-smokers?**
      4) If there really is a relationship between B-12 intake and lung cancer, why does this only occur in men, but not women? It doesn’t make sense biologically. They try to give a rationale for this sex difference in their discussion, but I don’t buy it.
      So, my conclusion is that if you are a male smoker, there may be some reason to worry about taking B-12 supplements, but given the very small numbers in this study, and the lack of a consistent dose-response relationship, this is a long ways from being proven.
      Dr.Jon
      PhysicianAssistedWellness.com
      Volunteer moderator for NutritionFacts.org
      ** NOTE: Researchers love to have significant results, and manipulating the data to make results look more significant has been documented to occur.

      1. Dr. Jon, thank you for your response. Even Netgogate’s comment included this statement in his quote from Dr. Greger:

        “Unless you’re a smoker, have kidney failure, or base your diet around cassava root, cyanocobalamin should be fine.”

        I did wonder at the evidence for these exceptions to the recommendation to take cyanocobalamin..

        1. I don’t think people who quit smoking more then 10 years ago consider themselves “smokers”.

          I think this is all handled a bit lightly.

      2. Moderator.

        Please make sure that the info about the bio-availability and/or lack of evidence of methylcobalamin being the main reason for why cyanocobalamin is being prefered in the recommendations is available for everybody. It is not only related to cyanocobalamin being cheaper or being “equally effective” as mentioned in one of Dr. Greger’s video’s. You would presumably need lots more of the methyl form to reach the same effect.

        1. Here is the serving of B-12 video.

          https://nutritionfacts.org/video/cheapest-source-of-vitamin-b12/

          https://nutritionfacts.org/video/daily-source-of-vitamin-b12/

          I had to go back to my comments on Plant-Based London to figure out the logic.

          1) People don’t go to the ER for cyano B-12. They DO get serious health problems for being deficient.

          2) PubMed gives the advice if people take the Methyl version, they also have to take other versions with it. “Vitamin B12 (cyancobalamin, Cbl) has two active co-enzyme forms, methylcobalamin (MeCbl) and adenosylcobalamin (AdCbl). There has been a paradigm shift in the treatment of vitamin B12 deficiency such that MeCbl is being extensively used and promoted. This is despite the fact that both MeCbl and AdCbl are essential and have distinct metabolic fates and functions. MeCbl is primarily involved along with folate in hematopiesis and development of the brain during childhood. Whereas deficiency of AdCbl disturbs the carbohydrate, fat and amino-acid metabolism, and hence interferes with the formation of myelin. Thereby, it is important to treat vitamin B12 deficiency with a combination of MeCbl and AdCbl or hydroxocobalamin or Cbl. Regarding the route, it has been proved that the oral route is comparable to the intramuscular route for rectifying vitamin B12 deficiency. Hard to know which one will bring Methyl up to Cyanobalamin’s success rate. They compare the others to that. 8-week supplementation with 3-µg cyano-B12 elevated serum cobalamin more than 3 µg hydroxo-B12

          3) Some people will choose Methyl. I can’t because I forget pills for weeks at a time. If you do the “23 and me” test, you can tell if you have MTHFR gene mutation. Then, you need some Methyl donors, but more Methyl donors aren’t always better: https://www.ncbi.nlm.nih.gov/pubmed/25841986

          4) The amount of cyanide in 2 tablespoons of flaxseed is over 5600x the amount in 25µg of cyanocobalamin and there already is an antidote. You can take the cheap stuff once per week and maybe take the antidote B-12 version during the week if you feel like it. I know that sounds like strange logic, but it is what it is.

          5) I am going to defend Neal Barnard’s advice, too, because when they tested B-12 levels in people, one out of six meat eaters were deficient and the people who had the best levels were either supplementing or eating cereal. (Nutritional yeast will do it, but you have to use it every single day and that doesn’t happen in my world either.)

          1. September 5th, 2017 by Jack Norris RD

            A recently-released study from the University of Washington found an increase in lung cancer among male smokers with a vitamin B12 intake of 55 µg per day or more (3). There was no increase in lung cancer among women, women smokers, or non-smoking men.

            Because this study raises concern about vitamin B12 supplements for smokers, I’ve updated the VeganHealth.org article, Smokers and Cyanocobalamin. The article is short, so I’ve reproduced it here:

            Because smokers receive cyanide from smoking, and vitamin B12 can actually be used to detoxify cyanide due to its strong affinity for the cyanide molecule, there’s a concern that perhaps cyanocobalamin will not be effective for smokers.

            For example, hydroxocobalamin injections decreased blood cyanide levels by 59% in smokers (1.5-3 packs/day) and cyanide was eliminated in the urine as cyanocobalamin (1). In another study, smokers were found to excrete 35% more B12 than nonsmokers (2). But in another, serum B12 of smokers didn’t differ from nonsmokers, and the Institute of Medicine concluded that “The effect of smoking on the B12 requirement thus appears to be negligible (2).”

            But most smokers have an intake of hydroxocobalamin, and other non-cyanocobalamin forms of B12, through animal foods, while vegan smokers do not have a non-cyanocobalamin source of B12 unless they seek out a supplement. There’s no research on B12 and vegan smokers, but I’m not aware of any who have had trouble warding off B12 deficiency.

            Additionally, one prospective study found an increase in lung cancer with B12 supplements among male smokers for the highest intake group of 55–275 µg/day (3). Other research has not found an association with vitamin B12 in cancer, but it hasn’t been studied thoroughly among male smokers. However, an arguably better piece of evidence comes from a randomized, clinical trial that did not find an increase in cancer with increasing serum B12 levels (from 400 µg/day) in a population with a high rate of smoking (4).

            At this time, there doesn’t seem to be enough evidence to warrant separate vitamin B12 recommendations for smokers.

            References

            1. Forsyth JC, Mueller PD, Becker CE, Osterloh J, Benowitz NL, Rumack BH, Hall AH. Hydroxocobalamin as a cyanide antidote: safety, efficacy and pharmacokinetics in heavily smoking normal volunteers. J Toxicol Clin Toxicol. 1993;31(2):277-94.

            2. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press; 2000.

            3. Brasky TM, White E, Chen CL. Long-Term, Supplemental, One-Carbon Metabolism-Related Vitamin B Use in Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort. J Clin Oncol. 2017 Aug 22:JCO2017727735.

            4. Ebbing M, Bønaa KH, Nygård O, Arnesen E, Ueland PM, Nordrehaug JE, Rasmussen K, Njølstad I, Refsum H, Nilsen DW, Tverdal A, Meyer K, Vollset SE. Cancer incidence and mortality after treatment with folic acid and vitamin B12. JAMA. 2009 Nov 18;302(19):2119-26.

            http://jacknorrisrd.com/

          2. Deb

            My understanding is that there is no B12 whatsoever in nutritional yeast despite claims found on alternative health websites. That is, UNLESS the nutritional yeast brand is specifically fortified with B12.

            Some foods contain B12-analogues which mimic B12 in certain tests but they do not have the same health effects as real B12.
            https://veganhealth.org/vitamin-b12-analogues/

            I think that is why some seaweeds and yeasts were previously thought to provide B12. However hese old ideas seem to linger on in alternative health land, much like the bizarre beliefs about saturated fat, cholesterol and grains that proliferate there.

    3. Netgogate:
      Many a food people eat regularly contains cyanogen glycosides, which dissociate in the stomach due to acidic conditions releasing hydrogen cyanide. Given the minute quantities of cyanocobalamine a daily dose provides, it’s hard to believe that the cyanide from cyanocobalamine is harmful.

      1. We are using high dose isolated supplements not protective dietary whole food sources. The molecule could possibly function differently in this manner.

        1. Let’s just say that taking supplemental B12 is a necessary evil with similar negative effects as seen with other isolated supplements in certain groups.

          These harmful results are not coming from subjects eating a WFPB diet anyway.

          I’m sure future research will offer some more on which types and dosages to use so that there can be a consensus among the medical community.

          1. Thanks but it’s futile, you can’t compare this to foods that is the general idea. The molecule in foods (possibly) acts differently.

            1. I looked up cyanide poisoning and cyanide-related deaths and in one country 96.6% of the deaths were suicide by something with a whole lot more cyanide than B-12.

              The medical numbers aren’t there.

              There aren’t young children showing up with cyanide poisoning.

              Like I said, it does happen with Apricot Kernels, but it doesn’t happen with B-12.

              I just looked at the list of 12 cyanide-related deaths in Tehran over the course of 4 years and it was from pesticides and things like opiates, but even with all of the opiate abuse, it is not “cyanide poisoning” killing most opiate users.

              I understand that you are afraid and it is okay for you to take the Methyl version, but the bigger risk is not getting enough B-12 and Dr. Greger has 3 graphic videos of people with their spinal cords rotting away from not getting enough B-12. THAT is something to have a healthy fear of.

              1. Mostly, I just want to say that Dr. Greger reads his comments and from what I have seen, he is quite a good host to us and does respond to things we request.

                Dr. Greger, could you please include the dosage of the other versions of B-12 for the people who need Methyl Donors or who are smokers or have liver problems on your recommendation page?

                Or a statement or advice for people who can’t take cyano for whatever reason.

    4. Here is the thing, from what I have read, Methyl – form isn’t enough. If you take it, you need to take the Adeno-form.

      There is way more cyanide in flaxseeds than in cyano-form, and people eat those every single day, but I know that people take Apricot Kernels, which have way more cyanide than either of those and, yes, if you are a child or a very thin person, taking Apricot Kernels will have you end up in the ER for cyanide poisoning and yet, somehow, nobody is ending up in the ER with cyanide poisoning from either flax seed or cyano-B-12. That is the point.

      Plus, there is an antidote to cyanide poisoning, even if you get it from the Apricot Kernels. https://www.ncbi.nlm.nih.gov/pubmed/22694886

      The antidote happens to be another form of B-12, so if you are worried, take hydroxocobalamin with the cyanocobalamin. Or take the Methyl Version with Adeno- version. You need either cyano or methyl with cyano or methyl with adeno to avoid damage to the myelin sheath, is what it said in a pub med article, which I read. They said that cyano is more complete and methyl is not complete. I have to try to find the article again but don’t have time right now.

      Those of us who forget to take our B-12 every day need to use cyano, but I do use some methyl donors, just in case I have a methyl donation problem. I probably don’t, but some people do, so maybe it is a good idea if we get tested for methylation problems if we are worried about it.

      The problem is that too many methyl donors can cause problems, too and that is another study, and people ARE using the methyl version of everything because they are afraid that they have dirty genes.

      Sorry that I am not including all of the links. I will be back.

      The thing is, I think I was worried about the whole cyano thing, but I don’t worry about it when I eat flax seed and that tells me that people are stirring things up. I wasn’t even worried when I ate an Apricot seed, but Tom showed me that I probably should be worried enough to not give them to my dog because 5 Apricot seeds were enough to put a child in the ER. Yes, the B-17 people are lying when they say that the cyanide won’t affect the normal cells, but Dr. Greger is not lying when he says that there are conditions, which you should be careful and he has said that and maybe he needs to say that part every time, because people don’t tend to know how to take responsibility for their own medical conditions and their own doctors aren’t telling them anything at all.

      1. What makes me laugh is that there are people who use B-17 and who eat flax seeds and they are afraid of cyanocobalamin.

        Cut back on the Apricot seeds.

        1. Th sweet apricot kernels are fine – they have only very tiny amounts of amygdalin and cyanide. That is why they are are useless as sources of laetrile/amygdalin/B17′

          Bitter apricot kernels on the other hand contain significant amounts. That’s why eating enough of them can be fatal.

          ‘Hydrogen cyanide (HCN) poisoning due to amygdalin (AMY) in apricot seeds is one of the public health issues in Turkey. The aim of this study was to investigate the AMY content of 13 different apricot seeds including bitter and sweet ones, and which are either sulfurized or roasted. The AMY content was determined by high performance liquid chromatography (HPLC). Release of HCN was predicted and total amount of seeds which can cause poisoning was calculated. The mean AMY content of bitter seeds was 26 ± 14 mg g−1 and that of sweet seeds was 0.16 ± 0.09 mg g−1. The consumption of small amounts of bitter seeds may cause cyanide poisoning.’
          https://www.researchgate.net/publication/274868430_Amygdalin_in_Bitter_and_Sweet_Seeds_of_Apricots [accessed Aug 09 2018].

  3. What with people who are already B12 deficient?

    Dr. Greger says in a 2012 video;

    “A 2,000 microgram (cyanocobalamin) supplement every day for two weeks should do it, before having patients starting or resuming their regular, reliable regimen of B12.”

    But an article from 2015 (1) is advising to use both 500-750 μg cyanocobalamin and 500-750 μg methylcobalamin as both “are essential and have distinct metabolic fates”.

    The preferred formulation for vitamin B12 deficiency should be a combination of the active forms of vitamin B12, MeCbl and AdCbl, or HCbl/Cbl. In case of the oral route, about 500–750 μg of each, MeCbl and AdCbl, would be required.

    (1) Thakkar, K., and G. Billa. “Treatment of vitamin B12 deficiency–Methylcobalamine? Cyancobalamine? Hydroxocobalamin?—clearing the confusion.” European journal of clinical nutrition 69.1 (2015): 1.

  4. I am all for these types of nutrition and exercise interventions. However, worker wellness programs are concerning–they seem to be aimed at increasing the surveillance of workers. This recent article in the NYTimes (summarizing a peer-reviewed journal’s recent findings) also suggests that wellness programs don’t show proof of working (because they’re observational not RCT). https://www.nytimes.com/2018/08/06/upshot/employer-wellness-programs-randomized-trials.html

  5. As a Nutritionfacts user it would be nice to be able to refer to something that is a little bit more up to date than a 5 or 10-year old video on an important subject.
    I know Dr. Greger is busy with stuff and his agenda is filled until 2029 but it seems like the basic research is not always being cared for. If some of that effort that is going into translating the entire Nutritionfacts website and the books into multiple languages would be going to additional reviewing of the literature, there wouldn’t be so much lag and we wouldn’t need to wait on something because it’s on the wrong side of the alphabet.

    While I highly doubt Dr. Greger or anyone of us believes white potatoes cause cancer, there still is a page (1) on Nutritionfacts with a 2009 video claiming white potatoes cause cancer…

    I tried to read Dr. Greger’s books and websites in my mother’s tongue (Dutch) but it’s like a google translator text, it just doesn’t make sense because either translation is really difficult when the translator is not a biochemist himself/herself or there isn’t a ready to use substitute word for certain essential terms. These translations are redundant, borderline incomprehensible texts and I’m certain that they won’t sell very good in the other countries. It seems like much effort for nothing.

    Perhaps we should all donate some money so that an additional reviewer(s) can be hired, like a whole building full of Michael Greger’s? :-)

    (1) https://nutritionfacts.org/topics/potatoes/

  6. I searched the reference made in that question by David Tunison and posted in 2012 on Nutritionfacts. https://nutritionfacts.org/questions/which-type-of-b12-is-best/

    The name that comes up is “Raymond Francis”, while I do not know the guy he doesn’t look like the supplement seller that Dr. Greger calls him out to be.
    Here is a link to the B12 article on his website. http://raymondfrancisauthor.com/the-b12-deficiency-epidemic-silent-and-serious/ It just seems like a well-written article and I couldn’t find any products being sold. Quote.

    “Most of the B12 on the market is in the form of cyanocobalamin. Cyanocobalamin is a man made molecule that the body has problems metabolizing. It is a poor source of B12, and it leaves behind a toxic cyanide molecule that the body is forced to detoxify. Low-end manufacturers use this form because it is cheap (About 100 times cheaper than the good stuff!). A high-quality formula will contain a combination of methylcobalamin and hydroxycobalamin.”

    I’m not sure why price always pops up in these arguments but it seems like it shouldn’t, methylcobalamin is just as expensive in Europe as cyanocobalamin.

    But the quote seems to hint at doing a combination of B12 forms, we see this reflected in other sources I quoted above.

    1. Netgogate, I remember that 2017 study from the numerous discussions about it on this forum since the time it was published. Health professionals and seasoned NF fans alike have mentioned the curious fact that no association was found in female smokers. Only men.

      I myself use fortified soy milk, but no separate supplements.

      1. 1) The results of this cyanocobalamin discussion you speak of, is not reflected by anything written on the Nutritionfacts blogs or videos since 2012. That is a problem.

        2) The lack of info on methylcobalamin on the recommendation page is also a problem. Some of us are getting B12 deficient because of such neglect.

        3) The fact that there is no consensus among wfpb doctors in 2018 seems to hint at a real controversy and a lack of available evidence which only makes confident comments more suspect.

        1. I guess one reason for the differences in dosage suggestions is that poeple tend to eat different rates of fortified foods.

          My 2.500 methylcobalamin weekly was sufficient during two years because I was drinking soymilk fortified with cyanoC.

          When I switched to a non fortified version (I didn’t like the calcium that was also added) the methyl dosage wasn’t sufficient anymore causing sub optimal levels after some months. My MMA test this week friday should reflect whether there is a real deficiency or not.

          I’m going to order the B12 cyanoC toothpaste from Sante and will supp both methylC and cyanoC in pill form for 2 weeks if I’m deficient.

          1. When you come to think about it, isn’t it kinda funny or at least ironic that if we (Nutritionfacts) are right about the uptake and dosages for supplemental B12, that a Fuhrman, a Thomas Campbell or a McDougall are possibly suboptimal or even deficient in vitamin B12?

            If they really are taking those low dosages, I hope they also eat some additional fortified foods and check their stuff regularly. Except for Esselstyne, he’s taking like almost three times the dosage recommended by Dr. Greger. :-D

            1. Laughing, yes, I know it is so confusing.

              I watched one roundtable on YouTube and laughed because none of the doctors knew what to say.

              It wasn’t a Dr. Greger video. It was a John McDougall and other WFPB doctors.

              What I remember is that John reserved the right to change his mind as many times as he wants, based on whatever the research ends up being.

              Unrelated to those doctors, there are other doctors who say things like the Methyl form is the most bioavailable form, but then, if you keep researching, the next doctor will say, “No, the Methyl has no advantage because the prefix has to be removed as part of metabolism, then a Methyl needs to be put back on at the end.”

              I know that one study said that the cyano form is the one, which tested better at increasing the B-12 levels compared to hydroxy and compared to methyl. One researcher on PubMed reviewed it as a topic and I think they used the word, “hype”.

              Hype, it is. No matter what.

              However, if you have dirty genes, then taking the Methyl donor version can be a good thing unless you take too many of your vitamins in the Methyl version.

              If it weren’t for fortified foods, I probably would already be in trouble.

              1. I could have sworn that the Methyl version was one you had to take every day.

                I couldn’t figure out which Dr. Greger video said it.

                People are saying it as a once per week, but I thought that was the Cyano version.

                It might have been the B-12 used with homocysteine video.

  7. “For the cost of a submarine or a farm subsidy, the entire country could get a CHIP on its shoulder.”
    – A Los Angeles-class fast-attack submarines and has an estimated cost of $2.4 billion.
    – A Nimitz-class nuclear-powered aircraft carrier which have an estimated cost of $4.5-5 billion for each unit.
    – U.S. taxpayers fork out about $20 billion annually, according to the U.S. Government Accountability Office.Jul 12, 2015
    – The FDA budget was $4.7 billion for FY 2016.

    Ya know. We are already spending a lot of money and food and health advertising, but we’re not really getting our money’s worth. If the FDA spent its health outreach budget on research based health messaging instead of trying to convince the US public drink more milk, eat more beef, cheese, eggs, lamb, pork and poultry and that GMO’s and Roundup treated crops were perfectly healthy, I bet we could see similar if not better results.

    Of course as long as the FDA and our nation’s healthcare policy is being run and dictated by big Ag and Pharma, there is little chance of that happening any time soon because public policy is for sale to the highest bidder…

  8. I’m interested in hearing Dr. Greger’s comments on a new diet/nutrition book that has received “rave” reviews. It’s called “The Big Fat Surprise” written by Nina Teicholz. I haven’t read the book, but it supposedly is based on scientific evidence. It basically says that all of our concerns about saturated fat and cholesterol are wrong and that we should go ahead and eat meat, butter, eggs, etc.

    Is this just another industry sponsored book based on bad nutrition studies?

    1. No. It is a book by a journalist hoping to emulate the financial and mediaa success of Gary Taubes (another journalist) who published similar books about 10 years ago. It contains a lot of the same/similar material and pretty much makes the same claims.

      It makes for sensational reading and attracts people who want to be told that eating lots of butter, meat, cheese and animal fat is healthy. Add in a juicy doese of conspiracy theories and it should sell like hot cakes.

      I doubt if it was industry-sponsored but it is based on ignoring the bulk of the scientific evidence, misrepresenting a number of key facts and misinterpreting various studies. There are some detailed critiques here:

      https://thescienceofnutrition.wordpress.com/2014/08/10/the-big-fat-surprise-a-critical-review-part-1/
      https://thescienceofnutrition.wordpress.com/2014/04/21/fat-in-the-diet-and-mortality-from-heart-disease-a-plagiaristic-note/
      http://carbsanity.blogspot.com/2014/06/plagerizing-plagiarism-and-plagiarists.html

      If you want sound science-based works on nutrition and health, you don’t have to buy highly sensational mass market books on ‘health’ claiming to overturn decades of established science. In fact all of those can pretty much be guaranteed to mislead and to usher an uncomfortably large number of people into an unnecessarily early grave. Instead, just download the free reports by panels of world-class experts published by the like of the World health Orgnaization, the World Cancer Research Fund and the US Dietary Guidelines Advisory Committee

      http://www.who.int/dietphysicalactivity/publications/trs916/en/
      https://www.wcrf.org/dietandcancer/summary-third-expert-report
      https://health.gov/dietaryguidelines/2015-scientific-report/pdfs/scientific-report-of-the-2015-dietary-guidelines-advisory-committee.pdf

      Of course, these aren’t sensational or easy reads – in fact they can be dull and heavy going.

      But they accurately reflect the science. Unlike many books by journalists. Don’t they say that journalists never let the facts get in the way of a good story? This seems to apply with knobs on to Teicholz’s book (and Taubes’ before hers).

    2. Bob

      I should also mention the American Heart Assocation’s Presidential Advisory on dietary fats and cardiovascular disease. It was authored by a panel of the US’s leading experts and analyses all the evidence. Again it is not an easy read but it is well worth it because it exposes the dangerous claims made by Teicholz as misleading nonsense. Reading it could save your life if you are in any way tempted by the claims and facile reasoning of Teicholz, which are enthusiastically promoted by her fans.

      https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000510

    3. As for cholesterol, the European Atherosclerosis Society issued a consensus paper last year to adddress all the absurd claims made by people like Teicholz: They noted that ‘Atherosclerotic cardiovascular disease (ASCVD) and its clinical manifestations, such as myocardial infarction (MI) and ischaemic stroke, are the leading cause of morbidity and mortality throughout the world.’ and stated:

      ‘We assessed whether the association between LDL and ASCVD fulfils the criteria for causality by evaluating the totality of evidence from genetic studies, prospective epidemiologic cohort studies, Mendelian randomization studies, and randomized trials of LDL-lowering therapies. In clinical studies, plasma LDL burden is usually estimated by determination of plasma LDL cholesterol level (LDL-C). Rare genetic mutations that cause reduced LDL receptor function lead to markedly higher LDL-C and a dose-dependent increase in the risk of ASCVD, whereas rare variants leading to lower LDL-C are associated with a correspondingly lower risk of ASCVD. Separate meta-analyses of over 200 prospective cohort studies, Mendelian randomization studies, and randomized trials including more than 2 million participants with over 20 million person-years of follow-up and over 150 000 cardiovascular events demonstrate a remarkably consistent dose-dependent log-linear association between the absolute magnitude of exposure of the vasculature to LDL-C and the risk of ASCVD; and this effect appears to increase with increasing duration of exposure to LDL-C. Both the naturally randomized genetic studies and the randomized intervention trials consistently demonstrate that any mechanism of lowering plasma LDL particle concentration should reduce the risk of ASCVD events proportional to the absolute reduction in LDL-C and the cumulative duration of exposure to lower LDL-C, provided that the achieved reduction in LDL-C is concordant with the reduction in LDL particle number and that there are no competing deleterious off-target effects.

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

      https://academic.oup.com/eurheartj/article/38/32/2459/3745109

  9. I publicized yesterday’s CHIP video to my over 200 longtime healthy lifestyle contacts, and to many leaders in this field. Here is one leader that I was thrilled to hear back from:

    T. Colin Campbell (- – – – – -@cornell.edu)
    To:you Details
    HI Bill,

    Please feel free to share my comments on the CHIP program.

    Hans Diehl contacted me many years ago to have me speak at quite a few CHIP events—Rockford IL, Kalmazoo MI, and many Adventist events arranged by his associates. I first came to know Hans in the early 1990s when we, with our colleagues, worked on the writing of a book on Western Diseases, arranged by our colleagues Dennis Burkitt and Norman Temple.

    As I came to know the CHIP program and on one occasion was invited by Hans to join a feedback session with the ‘patients’, I was always impressed that this program was the most effective community out-reach program going.

    I am delighted that you are giving it the attention that it deserves, as well as highlighting Hans’ efforts to make it work.

    Regards,

    Colin

    T Colin Campbell
    Jacob Gould SchulmanProfessor
    Emeritus of Nutritional Biochemistry
    Cornell University

    On Aug 8, 2018, at 3:12 AM, maule5662h wrote:

    DO WATCH THE VIDEO!

      1. My dog would thank Colin, too.

        He was diagnosed with Hemangiosarcoma about 9 weeks ago and I watched Colin in a few videos and I watched the doctor in Ireland who was inspired by Colin. I switched my dog to Vegan and my vet is still scratching his head.

        My dog is still alive and he is one of the people I would have to thank.

  10. Looks like wishful thinking. The book “upends the conventional wisdom about all fats with the groundbreaking claim that more, not less, dietary fat—including saturated fat—is what leads to better health and wellness,” but there seems to be no awareness that the source of the fat is what matters. Saturated fat from whole coconut butter is fine, but saturated fat from ghee is a disaster.

    1. Hi Joshua,

      I am curious where you got the information on the source of saturated fats?

      I was watching John McDougall’s video on autoimmune conditions and he was talking about MS improving 95% with a low-fat diet and I ponder Dr. Barnard being able to reverse Diabetes with a low-fat diet. I have pondered the whole coconut oil thing, but does that not paralyze the endothelial?

      I was surprised that olive oil did paralyze the endothelial, but now I will be even more surprised if coconut oil doesn’t.

    2. Joshua

      Coconut butter is a distinct improvement on coconut oil but I am not aware of any evidence that the saturated fat in coconut butter is harmless or ‘fine’.

      Cooconut butter is 82% fat and 89% of that is saturated fat. That is a very high saturated fat content.compared to other nut butters
      http://nutritiondata.self.com/facts/custom/627740/2

      The AHA Presidential Advisory on fats and heart disease strongly recommended replacing saturated fts of all kinds with polyunstaurated or monounsaturated fats. However, it should be remembered that the expert panel which wtote The Presidential advisory stated ‘we note that a trial has never been conducted to test the effect on CHD outcomes of a low-fat diet that increases intake of healthful nutrient-dense carbohydrates and fiber-rich foods such as whole grains, vegetables, fruits,and legumes that are now recommended in dietary guidelines.’ (page e8)

      https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000510

  11. I am wondering if the effects of the CHIP program hold over time, or if more support over time is needed to keep people on track. Also, are people in the program taught how to prepare meals they haven’t been accustomed to preparing?

    1. connie 421, my brother and his spouse took a CHIP program in Rochester, MY, about 2 years ago; it sounded very complete, with nutrition, meal planning and cooking, and exercise classes. I think it even came with a free or greatly reduced price 6 month gym membership (maybe with the JCC? That’s where he exercises). In the CHIP program, for example, he learned to cook oil-free. They both adhere to the program, though he is more motivated: several years ago, he was overweight, and on several meds, including for high BP, high cholesterol, and diabetes. He’s since lost 70 pounds, and come off all his meds. Though he did start eating vegan before he took the CHIP program, I think. His success has made him even more motivated.

  12. Well, after reading all of this I guess I better go to just one Cyanocobalamin b12 2500 mcg tablet a week. I have been taking one every day. Yikes! I have been a vegan two and a half years with no cheating ever.

    1. I know that Dr G recommends it but I wonder if a large weekly dose is the most effective opion. According to the US National Institute of Health

      ‘Approximately 56% of a 1 mcg oral dose of vitamin B12 is absorbed, but absorption decreases drastically when the capacity of intrinsic factor is exceeded (at 1–2 mcg of vitamin B12) [8].’
      https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

      ‘Existing evidence does not suggest any differences among forms with respect to absorption or bioavailability. However the body’s ability to absorb vitamin B12 from dietary supplements is largely limited by the capacity of intrinsic factor. For example, only about 10 mcg of a 500 mcg oral supplement is actually absorbed in healthy people [8].’
      https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/#h2

      I don’t know how old you are but Dr Greger recommends that ‘Those over 65 years of age should take at least 1,000 mcg (µg) cyanocobalamin every day.’
      https://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

      This recommendation is presumably based on the fact that many older people have difficulty absorbing b12 (although the US RDA for people 51 and over is still only2.4 mcg) and that 1,000 mcg daily may reduce homocystine levels in older folks (with no long term adverse effects).
      https://www.ncbi.nlm.nih.gov/books/NBK114302/#ch9.s35

      Jack Norris however also agrees that 1,000 mcg daily may be more appropriate for people aged 65+
      https://veganhealth.org/daily-needs/

      1. Thanks for the comment TG. I am 61 years old. I just bought another bottle of the 2500 mcg B-12 but this time I chose the Methyl form as I have been reading back and forth on the benefits of the 2 choices. I wonder if I should just take one of each and alternate between them like every 3 days so it would be like taking 2 tablets a week. Any benefit to using both varieties? Or is one actually better/safer than the other?
        Thanks

        1. Good question, Dave. I think nobody knows for sure if one form is better than another. The US National Institutes of Health state ‘Existing evidence does not suggest any differences among forms with respect to absorption or bioavailability’. That’s good enough for me so probably the conclusion should be stick with cyanocobalmin since it is the cheapest and best studied. This is what both Greger and Norris advise.

          However, alternating between the two types seems like a very sensible way to cover all the possibilities. Jack Norris, a high respected Registered Dietitian,suggests that 1,000 mcg of B12 twice per week should be taken rising to 500 mcg-1,000 mcg daily for people 65 and over. He also offers a very useful analysis of the scientific evidence regarding the bioavailability of the B12 forms.
          https://veganhealth.org/methylcobalamin-and-adenosylcobalamin/

          For what it is worth, I am currently taking 1,000 mcg daily of the methyl form (I am 68). Plus a couple of hundred mcg of the cyano form in a vegetarian multivitamin.

          1. TG, Thanks for the followup. I think I will rotate every three days and take a Methyl, then a Cyano as they are 2500mcg each. The last bottle of Methyl was cheaper than the Cyano type I usually buy. I got 300 tablets for $22-24 and the Cyano is about the same price for 250 tablets (Natures Bounty Quick Dissolve from Amazon). I used to figure that Dr. Gregor said if you took too much the body would get rid of the excess. Now that I read about the cyano form and the cyanide I think I will cut back a little. :)

  13. I get all my B-12 from actual meat. Rib-eye, that’s my favorite. Rib-eye fat is so tasty.
    Plants, I don’t do well with those. So I mostly skip them.
    Must be OK. Late 50’s. No meds at all. Same energy I had when I ws in my 20’s. Visible abs.

    1. Eeeuuuuu. :-( I never ate steak since the day, many moons ago, I almost choked to death. I was out with some friends and the damn chunk of gristly beef carcass just wouldn’t go down. Kept swallowing, and swallowing, and swallowing. My friends just looked at me in horror. They probably knew nothing about the hemlock maneuver, anyway, so probably prayed like crazy. Somehow I finally got it the hell down. But….never again! Never touched steak since that time, and over the years have weaned myself off all animal carcasses. To me they tasted nasty — nothing delicious about them at all.

    2. Are you confident that your good fortune will continue into your 60s and beyond? A diet that is almost universally considered unhealthful probably isn’t in your favor.

    3. Actual real honest to goodness meat….
      Cattle all of them spend their last serveral months in feedlots being fattened for slaughter.
      I could produce this and that from biased veggie and vegan sites, instead I will produce substance from the beast themselves the cattle industry and their specific on feelot feedings which include not only these substances which are completely artificial but vit B-12….

      ” Growth promotants are among the many sophisticated tools used by feedlots and other producers to raise more beef, more rapidly, using less feed, while maintaining high standards of animal health, carcass quality and food safety. Growth promotants include ionophores, growth implants, and beta-agonists. A number of products within each category are approved for use by Health Canada’s Veterinary Drug Directorate.
      One study2 found that overall average daily gain was 21% higher and feed efficiency was 23% better for grain-finished cattle given both implants and ionophores compared to control cattle. Economists John Lawrence and Maro Ibarburu at Iowa State University reported that feedlot average daily gain increased when ionophores, implants, and beta-agonists were used by 3%, 16% and 16% respectively. Feed efficiency improved 4% with ionophores, 10% with implants, and 14% with use of beta-agonists.”

      1. Source Beef cattle research institute a authority in the field of cattle management..read all about it yourself don’t take my word on it..

        Good old ribeye….don’t mind the antibiotics implants and all the rest….www.beefresearch.ca/research-topic.cfm/optimizing-feedlot-feed-efficiency-8

        1. A bit more from the piece, sounds pretty good to me….
          “Ionophores are often erroneously included in discussions about the concern of antimicrobial use in livestock and the potential link to antimicrobial resistance in humans. These antimicrobials are not used in human medicine, and therefore reducing or eliminating their use would have detrimental impacts on cattle production with no benefit for human health. When advocate groups spread statistics like “over 80 percent of all antibiotics used in the United States are used in food animals, and the vast majority of this use is for animals that are not sick”, they not only ignore the much higher populations and body weights of livestock compared to Americans, they include ionophores in the calculation.”

          How about a good old round of ionophores to go with that ribeye.
          Do you know the B-12 you get in the beef since all cattle see feedlots before slaughter is by feed supplemented with B-12 to increase weight?

          Of course not……this is natural stuff this rib eye. Care to see some supplemental feed lots feed supply content..I can provide them if necessary.

          1. To specify cattle generate B-12 from colbalt found in grains in different types and amounts when cattle mature and are able to ruminate.
            But to protect the oft event of lack of colbalt in the soil and then the grains and particularly of concern with corn fed cattle they are routinely given B-12 as a entrance measure to feedlot..

    4. The average age at which males in the US experience their first heart attack is about 65, and for colon cancer the averge age at diagnosis is 68. So you may be a little premature in concluding that your diet is in fct delivering good health. Come back when you are 70 an let us know how your diet has worked out, eh?

      https://healthmetrics.heart.org/wp-content/uploads/2017/06/Heart-Disease-and-Stroke-Statistics-2017-ucm_491265.pdf
      https://www.cancer.net/cancer-types/colorectal-cancer/risk-factors-and-prevention

  14. I am going to forward this information on to my colleagues in Occupational Health Nursing. They would love the evidence base of this lifestyle intervention.

    The workplace is an optimal place for health promotion and we occupational health nurses are often at a loss for what really works.

    Thanks Dr. Greger and Team!

    A proud and healthy monthly supporter of Nutritionfacts.org. ;)

Leave a Reply

Your email address will not be published. Required fields are marked *

Pin It on Pinterest

Share This