Club Soda for Stomach Pain & Constipation

Club Soda for Stomach Pain & Constipation
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Is carbonated water good or bad for heartburn, dyspepsia, and bowel regularity?

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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.

“Natural bubbling or sparkling mineral waters have been popular for thousands of years.” Manufactured sparkling water has been around ever since a clergyman “suspended water over a vat of fermenting beer.” “For centuries, carbonated water has been considered capable of relieving gastrointestinal symptoms,” including tummy aches, but we didn’t have good data until this study was published.

“Twenty-one folks with dyspepsia [an upset stomach] and constipation were randomized into two groups in a double-blind fashion” to drink one-and-a-half quarts of carbonated water versus tap water, every day for two weeks. Dyspepsia was defined as “pain or discomfort located in the upper abdomen,” including “bloating and nausea.”

And, carbonated water improved dyspepsia, compared to still water (tap water), and improved constipation. “Drink more water” is a common recommendation for constipation, but they didn’t observe a clear benefit of the added tap water. Seems you need to increase fiber and water, rather than just water alone. But, sparkling water seemed to help. Now, they were using sparkling mineral water. And so, whether these effects are due to the bubbles or minerals, we can’t tell from this study.

There’s been a concern that carbonated beverages may increase heartburn, GERD (acid reflux disease). But that was based on studies like this, that compared water to Pepsi. Soda can put the Pepsi in dyspepsia, and contribute to heartburn. But, so may tea and coffee, in people that suffer from heartburn. That may be partly from the cream and sugar, though, since milk is a common contributor to heartburn, as well. Carbonated water alone, though, shouldn’t be a problem.

Similarly, while flavored sparkling drinks can erode our enamel, it’s not the carbonation, but the added juices and acids. Sparkling water alone appears a hundred times less erosive than citrus or soda. So, a sparkling mineral water may successfully treat stomachache and constipation without adverse effects—unless you’re a teenage boy opening a bottle of sparkling wine with your teeth, especially on a hot day after you shake it up, placing one at risk for a “pneumatic rupture of the esophagus.”

Please consider volunteering to help out on the site.

Image thanks to stevepb via Pixabay. Image has been modified.

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.

“Natural bubbling or sparkling mineral waters have been popular for thousands of years.” Manufactured sparkling water has been around ever since a clergyman “suspended water over a vat of fermenting beer.” “For centuries, carbonated water has been considered capable of relieving gastrointestinal symptoms,” including tummy aches, but we didn’t have good data until this study was published.

“Twenty-one folks with dyspepsia [an upset stomach] and constipation were randomized into two groups in a double-blind fashion” to drink one-and-a-half quarts of carbonated water versus tap water, every day for two weeks. Dyspepsia was defined as “pain or discomfort located in the upper abdomen,” including “bloating and nausea.”

And, carbonated water improved dyspepsia, compared to still water (tap water), and improved constipation. “Drink more water” is a common recommendation for constipation, but they didn’t observe a clear benefit of the added tap water. Seems you need to increase fiber and water, rather than just water alone. But, sparkling water seemed to help. Now, they were using sparkling mineral water. And so, whether these effects are due to the bubbles or minerals, we can’t tell from this study.

There’s been a concern that carbonated beverages may increase heartburn, GERD (acid reflux disease). But that was based on studies like this, that compared water to Pepsi. Soda can put the Pepsi in dyspepsia, and contribute to heartburn. But, so may tea and coffee, in people that suffer from heartburn. That may be partly from the cream and sugar, though, since milk is a common contributor to heartburn, as well. Carbonated water alone, though, shouldn’t be a problem.

Similarly, while flavored sparkling drinks can erode our enamel, it’s not the carbonation, but the added juices and acids. Sparkling water alone appears a hundred times less erosive than citrus or soda. So, a sparkling mineral water may successfully treat stomachache and constipation without adverse effects—unless you’re a teenage boy opening a bottle of sparkling wine with your teeth, especially on a hot day after you shake it up, placing one at risk for a “pneumatic rupture of the esophagus.”

Please consider volunteering to help out on the site.

Image thanks to stevepb via Pixabay. Image has been modified.

Doctor's Note

Whoa, what was that?! My little cameo was me playing around with a green screen. I’m trying to find ways for the videos to be more engaging than just showing study after study, but there may be a fine line between engaging and dorky :-). The goal is to widen the appeal to reach more people, without distracting from the scientific rigor. What do you think? Should I do more little bits like this with me on screen, or do you think that detracts from the professionalism? Please let me know in the comments section below.

For more on combating acid reflux, see Diet and GERD Acid Reflux Heartburn and Diet and Hiatal Hernia.

Other videos on healthy beverages include:

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

223 responses to “Club Soda for Stomach Pain & Constipation

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  1. Are the “rock” minerals in these mineral waters absorbable by humans? It is my understanding that the minerals
    in water are, basically, little pieces of rock, and our body can not utilize them. Maybe they even cause harm? A lot
    of debate on this one, but proponents of water low in TDS (total dissolved solids) often claim that the minerals in
    food are of absorbable nature, yet with the mineral it water it is just picking up pieces of rock and residue from the
    streams, lakes, etc. Makes me wonder about possible bogus benefits of consuming minerals through pure sea salts.




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    1. Apparently they are absorbed.
      “On its website, the National Osteoporosis Foundation (NOF) states that there is no connection between the carbonation in soft drinks and bone loss and that certain carbonated mineral waters (the ones rich in calcium and those that are more alkaline) have actually been shown to improve bone health.”Feb 18, 2013




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  2. I like to see your face, and I think it personalises the whole thing. I like any info – articles are good, too, and they give you time to digest the content. (No pun intended.) Yes, changing things up from time to time is good, as long as the content is easy to understand and the links are visible – or placed under the video. And thank you a thousand times for your service to people.




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      1. I have to disagree here. I really, really like the original videos that just show the studies and charts. They are visually interesting enough with the shots of the actual studies, without being, as you said, “dorky”.

        If you decide to play around with the videos, be careful not to use repetitive background music. I’ve send one of your videos where by the second half, I was really tired of the repetitive music.




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  3. I have been consuming at least a tablespoon of flax a day and following Dr. Gregor’s daily dozen recommendations, yet am still constipated and am having difficulty losing weight, which is a secondary goal of mine. Can anyone offer additional suggestions?




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      1. I have been vegan for 4 years, have been eating whole food plant based for about 3 months, previously consuming larger amounts of processed vegan foods. I only “go” at most every couple days.




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        1. Can you increase your water consumption? Exercise is also an important factor for regularity. Are you following the exercise recommendations in the daily dozen? If you are getting plenty of fluids and exercise, you might try adding a little more fat(nuts, avocado) and try a bran cereal for breakfast or snack.
          It is startling that you have such a problem on a vegan, whole food diet. I generally have two BMs a day.




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          1. I try to drink about 64 ounces of water or tea a day, but, I also work in aviation. I walk about 10000 steps a day, and try to get additional cardiovascular as my job allows. But, yes, I agree it is startling, unfortunately, my current situation is a vast improvement from when I was not eating vegan.




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            1. hi Ellie, I can’t add much to the excellent suggestions of EquaYona, other than to mention two things that helped me. I use 1 tbsp ground flax in my oatmeal in the mornings, but, if having issues, 1 tbsp in 1/4 cup water last thing at night before bed works wonders. The other thing is to avoid gluten free bread products if you use them at all.. I find one slice of this ‘bread’ at lunch with salad very effective. Best of luck

              http://www.mannaorganicbakery.com/item/organic-sprouted-bread-banana-walnut-hemp.html




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              1. Hi Ellie, I can suggest brown rice, beans and steamed broccoli or kale. These are hi fiber foods, sweet potatoes especially the Japanese purple potato are great has well. Bean soups are great as well. I suspect you are not getting hi fiber foods during the day. I’m pretty regular with 2 BM a day




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              1. I would disagree with you . I do not think it is a lack of fiber since the person is already on a whole foods diet . It is a lack of peristalsis of the digestive tract , the contraction and relaxation of the digestive tract which moves the food or more correctly the waste products along . 2 or 3 glasses of water at body temperature first thing in the morning has helped a lot of people according to our naturepathic doctor we go too. For still sluggish movement sauerkraut juice or sauerkraut has helped the most stubborn cases .




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                1. yes esben I agree with the peristalsis idea.. I was given buscopan for gall bladder pain, nausea etc, but then later with continuing issues I was given Domperidone to speed up the digestive process. I then felt a lot better. The coffee is definitly necessary though. I will give the sauerkraut a try too. thank you!




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                2. I have a sluggish digestive tract caused in part by injuries to nerves and muscles; also migraine can slow down and sometimes even stop gut activity. When it doesn’t want to work properly nothing makes a difference. WFPB has made it less of a problem but there still are spells.




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            2. Your problem is much more extreme than mine, but this works for me: I put 1 tablespoon of chia seeds in about a cup of water every morning, stir and then leave it sitting on the counter for about 10 minutes. Then, not before, add a rounded teaspoon of magnesium citrate powder. I use one called Natural Calm, which is available in health food stores. Stir it up well, add a bit of stevia if you wish, and drink it down. I used to do the same thing an hour or so after dinner at night, but it was definitely overkill, so I dropped the evening dose.




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            3. Hi, Ellie Lee-Wesson, I noticed there are lots of helpful advice regarding your issue with constipation even though you are on PBWF. You mentioned you are in aviation, does your job entails traveling on plane and being on high altitude? Because that could be the issue since going on high altitute causes dehydration a lot. Hydrating 20 minutes before meal and one hour after meal.The suggestions of chia seeds, flax seed, psyllum and magnisum and dissolving in warm water are very good. Also pineapple juice, prune juice also 1 table spoon good extra virgin olive oil and coffee tend to help with the bowel movement. Also having fruit one hour before meal or two hours after meal can be helpful.




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              1. Yes, I am on planes 12-14 hours a day most days. I do drink a lot of water, both still and sparkling (as mentioned in the video). I do also drink a lot of black coffee. Do you have any suggestions for fruit that packs well for travel that I could bring with me on the plane? Or other good fibre rich foods that I could pack and can be eaten raw or in a microwave?




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                1. I would suggest dried organic figs and prunes and raisins in a little bag. Also what I usually do when I travel make my own bag of raw whole nut mixtures. I would also try organic herbal tea cleanse before flights and after your flights to cleanse your colon. I hope these suggestion are useful and wish you safe flights.




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                2. Is it true that the airplane cabins are pressurized to an equivalent of 10,000 ft? I have been a whole food plant based vegan for 4 years now and have at least 2 bowel movements a day. Whenever I fly or visit the mountains over 6,000 ft I become constipated. My food and water consumption is the same but still a no-go. In these circumstances I take “Triphala” a herbal supplement. Does the trick. I suspect your constipation has to do with atmospheric pressure. Anyone else have a similar experience?

                  /




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                3. HI! I just wanted to add that caffeine will contribute to dehydration. I try and drink 1 gallon of water a day (I just carry a big ol jug with me everywhere) Also, if the water is purified, add some mineral drops or consider taking a magnesium supplement with added minerals.




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                  1. Val,

                    To clarify, purified water can contain the typical constituents, including the minerals. When we are concerned is when one uses distilled water or R/O (reverse osmosis) which indeed is deficient in minerals. When commercial water purification takes place it can mean just about anything. Some firms only use a particulate and/or carbon filtration, whereas other choose multistep processes including R/O and ion exchanges, etc.

                    The use of the mineral drops has been shown to not be an effective means of fully remineralizing the water. There are differences in the ionic aspect of the naturally occurring minerals in water and other chemical considerations including ph/conductivity etc.

                    By using veggie juices and preferably clean water, without the need for an R/O system or distillation, you will derive a higher mineral intake. It should be noted that there have been multiple studies looking at the reduced rates of heart disease with hard water (water high in calcium or magnesium . http://jama.jamanetwork.com/article.aspx?articleid=328424 and http://www.sciencedirect.com/science/article/pii/S0140673673901955

                    If you’re using a water softener use the potassium, not the sodium salts. I’m curious, whats the construction of your gallon jug ? Refer to the videos here for some suggestions :http://nutritionfacts.org/?fwp_search=plastic&fwp_content_type=video and avoid the inappropriate plastics.

                    Dr. Alan Kadish Moderator for Dr. Greger




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                    1. Thank you! Sorry the only water available in this area is reverse osmosis and tap so I clumsily typed purified to mean R/O water. That’s good to know about the remineralizing drops. I use glass jugs (super heavy). How does one get purified water (with minerals intact) . Our tap has way too much chlorine in it and we do not have access to well or rain water (live in desert). Thank you again!




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                    2. Val,

                      Have you considered using a carbon block filter to address the chlorine ? There are a number of manufacturers and no two carbon block filters are necessarily the same, in terms of how they are packed or amount of active substance present.

                      You can check your results with an easy test kit, for pools, as well as the obvious sniff test. Good luck and shop smart (i.e.. ask lots of questions) Dr. Alan Kadish Moderator for Dr. Greger




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              2. Psyllum and magnisum are not normally recommended on this website , at least not what i can find , the recommendation was mineral water not oil ! I believe DR. McDougall drinks this soda water as well, I would surely give it a try . all i can say is in my best impersonation of Arte Johnson from the old laugh in show……..very interesting




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          2. Why would you think its startling. Everybody I know who has tried whole foods diet has had problems with constipation . I now have known 4 people who went whole foods. 2 tablespoons whole flax in a cup of water in the morning, plus 2 cups warm water , will normally get some movement .Also half a cup sauerkraut twice a day has solved the problem for people even ones that have had a life long problem with constipation.




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            1. It is startling because whole PLANT foods(I assume that is what you meant) usually means a great increase in both fiber and fluids. Although I have rarely ever had constipation in my life, my vegan diet has increased my bowel movements to 2-3 times a day. I have never heard of anyone on a plant based diet having persistent problems with constipation. Until now. ;)




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              1. Insufficient fat on my very low-fat whole foods plant based diet nearly killed my guts. Also, I did not adjust my fluid intake to accomodate for all of the additional fibre I began consuming, which added to the problem. I was hurting so bad that I couldn’t sit without severe pain and I looked as if I had swallowed a beach-ball for days at a time regardless of how many veggies or fibrous foods I ate.

                Anyway, I hope it was the fat. My only overt fat was coming from oats and two tablespoons of flax a day. I was coming in at under 30grams fat per day. Now I have added about 1 ounce of nuts which seems to have helped.




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                1. Glad to hear you are feeling better. I have always consumed a lot of fluids and peanut butter and whole peanuts have been important in my diet since I was in my teens. Lucky preferences, I reckon.




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              2. I agree. It would leave me to believe they’re not following the daily dozen or haven’t read the earlier books by Dr. Fuhrman, McDougall, Campbell, and Barnard or even Dr. Greger’s book.




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            2. I was on vegan diet for 15 years before going on strict PBD for fourteen years now and have never been constipated and usually have 2 BM per day and sometimes three. Just good old brown rice and beans will do the trick. Also, I’ve never heard of people going on PBD having problems. Most of them have more per day than they’ve ever had. Going on a PBD doesn’t automatically mean you’ll have problems with constipation though I can see how it could happen when I’ve seen some of the recipes and photos they’re showing of what they’re eating. I know the early PBD doctors all talked about no more constipation and to expect 2-3 BM per day. You need grains, brown rice and not white and beans. I’m on IG and see the PBD and vegan newbies and their plates and I see very little fiber, lots of white rice and deserts galore.




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              1. I think because you have been WFPB for so long that it works for you . Someone who has not eaten a veg in 50 years may have a different experience , DR. McDougall talked about it at some length in one of his videos. I know flax works ,but if soda works too sounds pretty good to me,
                Cheers.
                Nothing tastes better than feeling good!




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        2. Ellie, there a lot of good comments on the subject. Certainly we would need more information. Eating a mostly WPFD shouldn’t CAUSE constipation…and it should RELIEVE most constipation episodes simply because of the fiber (yes you need to have water to help fiber regulate the bowels). And if it doesn’t, we have to ask why. Sure magnesium should help but you should be getting ample Mg in your diet. Sure flax and chia should help but if it is isn’t we have to ask why. Someone mentioned Thyroid and that is a very plausible cause and it should be investigated. Exercise certainly is important but even a relatively sedentary lifestyle on a plant diet should get the bowels churning. Other ideas certainly would be neurological. Scar tissue. Hormonal. Concurrent meds and more…all relating to peristalsis which someone else mentioned. You may also be having some food sensitivities (yes even good foods can cause a sensitivity in your body). Now…even though I have set you up with that I still have patients who need Mg to get it going despite being on a mostly Plant based diet and we have ruled out Thyroid, etc, …so my simple answer is Magnesium Oxide start low and go slow but other reasons SHOULD be investigated to rule out other primary causes.




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          1. I forgot to add that adding some HCl to your beverages may help to stimulate the bowels and possibly digetive enzymes (depending on other concurrent symptoms)




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    1. Are you being consistent in your efforts to follow Dr. Gregor’s Daily Dozen? I ask because he recommends 1.5 cups of beans per day, plus a serving of cruciferous vegetables (kale or broccoli or cabbage), plus a cup of cooked greens (more kale, or collards, romaine, etc.). Add to that some fruit and a serving of berries, plus more vegetables. When I manage to eat that way (I try to do it every day, but fall short of complying 100% most days) it makes a big difference. It’s a ton of fresh food, water, and fiber.




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      1. I try, but, as I previously mentioned, I work in aviation so hitting all of the checkmarks in the app is difficult, but I consistently hit 20 of the 24




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        1. I find whole wheat pasta + cannellini beans + greens (broccoli raab or swiss chard or kale) in a garlicky vegetable broth to work very well in this department.

          I think it’s because it has the fiber + liquid all together. Maybe give it a try? It’s delicious. Hope this helps!




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        2. I work in aviation as well, I travel with a thermal bag and several days of vegan food, rice/quinoa based grain salads travel well, you can call hotels ahead and check for a fridge, use happy cow to find vegan food on layovers. I use freezer packs, but this bag lets you throw in loose ice and doesn’t leak




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          1. Do you work for a mainline or a regional? I also bring my food, but, don’t often have time to eat until the evening. During the day, I try to eat fruit, beans and greens etc. At night.




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            1. mainline, typical flight is 2 hours or more so there is time to eat enroute. If you’re at a regional I could see that eating during your workday could be a problem.




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            2. There is one other explanation for your constipation, I haven’t seen anyone bring it up. It’s possible that you are really tiny and eat tiny amounts of food. If that was the case, it might be normal for you to not have a BM everyday. Hopefully you are not starving yourself. I have never heard of anyone being constipated that is truly on a whole foods, plant based diet and following Dr. Greger’s daily dozen. You mention that you don’t eat until evening.




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    2. This comment has little scientific evidence behind it. It is just a suggestion.

      With your current diet you probably eat at least the minimum recommended amount of fiber, but even that is about a third of our ancestral fiber consumption. Thus additional fiber in your diet isn’t going to hurt you. Further, if you drink some fiber before eating food you should feel full earlier during your meal.

      Accordingly, I suggest that before lunch and dinner you disperse a tablespoon (15 ml) of psyllium husks into 10 oz (300 ml) of water and drink it. The fiber should help with the constipation by providing bulk, and may slightly reduce the amount of food you eat which will, over time, help with weight loss.

      For weight loss without counting calories or feeling hungry, try the Dr McDougall maximum weight loss advice.
      https://www.drmcdougall.com/misc/2005nl/050100pupushing.htm




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    3. Not everybody has the same body. There could be non dietary factors to constipation like genetic (asymmetry and development) or nervous (enteric nervous system)




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    4. Hi Ellie, have you looked at your stress levels? A few years back I was only ‘going’ once a week, despite plenty of veggies, water and exercise. My doctor recommended looking at the stress in my life, and making sure I took time out to relax made a huge difference.




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      1. Also, if you’re struggling to lose weight that can be due to stress – high cortisol levels make your body hold onto fat. I believe the idea is that historically if we were in a high stress situation this would make sense because this would often be accompanied by famine.




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        1. I had tried everything when I was constipated, which is most of my life, and nothing helped at all till a few years ago when I found Magnesium Oxide. Too much fiber is not at all good. It’s irritating to the lining of your stomach and it will leave you bloated and even more constipated. Psyllium Husks can be especially binding and cause more harm than good. The ONLY thing that’s helped me is H2Go by Lane Labs (I’m not affiliated in any way with the company). It’s basically Magnesium Oxide in tablet form and you take 6 tabs at night with a full glass of water. That’s it. It’s a bit like taking Milk of Magnesia without the awful taste of the liquid. You can reduce the amount of tabs as your condition improves. It’s not habit forming, and it acts by binding water to your colon. Therefore, be sure to stay hydrated. It also does not replace regular magnesium in your body because mag. oxide is not the kind of magnesium that gets well-absorbed by the body. I have shared this product with many people who all got immediate relief. Good luck.




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    5. Hi, I’d recommend preparing, in a high powered blender, 1 liter (4 cups) of water, 4 tablespoons chia seeds, a nub of fresh ginger and an apple. Blend on high for 30 to 45 seconds. Let this sit at least 10 minutes before drinking. Consume this throughout the day in addition to your current regiment (I’m assuming you are consuming ground flax, be sure that this is adequately hydrated too). Eat a few prunes as Cheryl suggested, as prunes are high in fiber and contain dihydrophenylisatin, a natural laxative. Be sure to increase your water consumption somewhat as the chia seeds, flax and prunes absorb a lot of liquid while in your body. If your bowel movements do not improve significantly within 3 or 4 days, try adding a bit of magnesium citrate to this regiment, perhaps as a separate drink.




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    6. One other suggestion….I go on seven day meditation retreats, where we sit for 14 hours a days and have relatively little time for bathroom breaks. I know from talking with others that constipation is an issue for a lot of the participants. Which brings me to something you said…the flax seed…I have found that if I consume (as a breakfast cereal), at the meditation retreats, about 4 to 6 tablespoons of flax seed (well hydrated with water) and 10 to 14 hydrated prunes for breakfast that constipation is not the slightest of an issue. I’m not sure if constipation is a physical possibility with this cereal. If you try it, increase your flax seed and prune consumption gradually.




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    7. A sudden leap in fiber content would cause constipation; i.e.: going from a mostly processed vegan diet to WFPB. I have a note I think is from one of Dr. G’s videos, sorry I wasn’t able to find the link for you, suggesting when adding fiber to the diet, to increase by only 5g at a time to allow the gut microbiota time to adjust. The average American eats 15g of fiber/day. Eating WFPB, I get about 60g/day. The video suggests a 5g/day increase for one week, then 5/g more the next week, etc. for a smooth transition to a higher fiber baseline. 5g can be found in a half a cup of refried beans, 1/3 cup of hummus, a generous handful of nuts, a very large apple, 1 cup of broccoli, 1 cup of quinoa.




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    8. Hi Ellie,
      My name is Laura and I am a health coach. I have found that my clients have lost the most weight when focusing on increased vegetable consumption over anything else. But we are talking veggies at breakfast lunch and dinner. It actually is easier than you think, especially if you have smoothies for breakfast. Hope this helps!




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    9. Hi Ellie, perhaps try carefully avoiding gluten for 30 to 45 days to see if it makes a difference? I was constipated since childhood, and avoiding gluten made a significant difference for me (and then later quitting dairy also helped). At times I also put two to three table spoons of flaxseed in a big mug with boiling water, let it cool down enough to drink/spoon it up. It’s an odd texture to get used to, but I find it much better than any ‘over the counter’ constipation medications that doctors prescribed for me in the past. When I travel I always carry a container of flax seed with me for this – don’t know if I get exposed to gluten when traveling or if it’s time on planes, etc, but mugs of flax seeds always come to the rescue.




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      1. Oh, and the mug of flaxseed would be on top of adding 2 heaping teaspoons of whole flaxseed and 1 tablespoon of ground flax to my cereal every morning.




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    10. Magnesium and Constipation?

      Gerolsteiner Mineral Water ~ Magnesium ~ Best Price ~ Trader Joe’s/Whole Foods
      See: “Is Your Bottle Water Killing You?” by Dale Kiefer ~ February 2007




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    11. Ellie Lee-wasson: You got lots of good replies for one issue, but I don’t remember any replies addressing weight loss. Here are some resources for you. Dr. Greger covers the concept of calorie density for weight loss here: http://nutritionfacts.org/video/nutrient-dense-approach-to-weight-management/

      But to really get the concept, check out these free and entertaining talks: https://www.youtube.com/watch?v=xAdqLB6bTuQ and http://www.jeffnovick.com/RD/Calorie_Density.html along with this article: http://www.jeffnovick.com/RD/Articles/Entries/2012/5/20_A_Common_Sense_Approach_To_Sound_Nutrition.html

      For ideas on applying the concept: Try the free PCRM 21 Day Kickstart program: http://www.pcrm.org/kickstartHome/ Or get Jeff Novick’s Fast Food videos for tasty, affordable, fast and healthy calorie density recipes. Also, on-line and free is a YouTube series of recipes/cooking shows called something like Chef AJ and The Dietician. I know that Chef AJ will not steer you wrong in terms of weight loss and providing accurate nutrition information.




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    12. I have trouble with constipation also. I have found that if I drink a cup of strongly steeped Rooibos and Honey Bush Tea it does the “job” the next morning. I think it’s mainly the Rooibos that has the main effect.




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    13. Dr G recommends both prunes and seltzer. Two prunes a day, and a glass or two of seltzer per day are good. Magnesium citrate which helps prevent leg and foot cramps and migraines is also effective.




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      1. I’m afraid I’ll have to agree. If I were a new visitor on this website, I’d probably think the information presented can’t be very serious.

        Luckily I know otherwise!




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  4. These videos have changed my life! You do a great job keeping the data moving around so that it is easy to engage and stay focused. And your voice is unique with nice modulation and expression.




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  5. I enjoyed seeing your smiling face, the only thing I didn’t like was it looked like you were walking. You looked to be bouncing around a lot vs standing still and speaking. Not bad for a first attempt.




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  6. I love your videos. I think that adding engaging elements and animation is helpful, but not if it’s just a joke or random tidbit. I think if you have animated graphics explaining the research not just graphics showing the paragraphs of the research you are citing, that that would be engaging for more viewers.

    I like the way that it was just the animation small at the bottom, I think if you could have figured or objects at the bottom like that that help describe the phenomenons you are talking about that that would be helpful and cool.




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  7. I think the cameo would be more effective if it was at the beginning or the end of the video (or both). It could also be used in the middle, as you did here, if there is something in particular you want the viewer to take notice of. Using it that way would be very effective; whereas popping in at the middle for no direct (narrative) reason will, more likely, be a distraction.




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    1. Also, I wouldn’t record it while you’re on your treadmill desk, and I’d get your tech people to adjust the audio so it’s on the same level as the video (again, to avoid distraction and to make it feel more of the piece as a whole)




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  8. Dr. Greger, I don’t think the cameo detracts from the professionalism of the video. Hey, you are already a little goofy… in a good way. Creative and fun is great, as long as the truth is intact and shared in a clear and straightforward manner, which has always been the case. I depend on and appreciate your level of integrity. It sets you apart in a big way.




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    1. Well, for my 1.5 cents, you know, inflation these days, I though it was fun. I think it depends on the seriousness of the subject. It wouldn’t be appropriate for a subject like say cancer, but here, its fine.




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  9. Because you asked, yes, this green screen effect is too dorky. If you’re going to do it, you need to at least stand still rather than walk on your treadmill. Bobbing around is disrespectful of your audience.




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  10. The videos have already been engaging enough, in fact great. You’re skilled at framing several studies as a story. Short (under 5 minutes when possible) is of course important to get people to watch. You define medical terms, which works for keeping people connected, but you use them, which usefully reminds people what you are. The puns are great and add when woven into the presentation. But I think appearing out of the blue (or green) is too much: it distracts; it’s sort of a non sequitur; it overexplains (this is a funny part!). I don’t think you have to improve these videos. The perfect is the enemy of the good, and in this case the excellent.




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    1. I like the variety in terms of the tone and length of the videos. The puns are sweetly dorky and are apt for videos on subjects such as the value of legumes in the diet. I like Dr Greger’s ability to also deliver scathing wit when critiquing bad practices in the food industry or misleading use of scientific studies.

      I would also appreciate more in-depth, longer videos on technical subjects; these would appeal to both interested lay people as well as health professionals (who should be targeted directly, I think). Such in-depth treatments could get picked up by instructors of nutrition and health classes. I know from my brief stint at teaching that it is very helpful to find audio-visual materials without performance restrictions (a general statement on the site could be made regarding rights and permissions for both non-profit and for-profit schools and colleges).




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      1. Longer videos for health professionals and interested laypeople: great suggestion. Maybe a different section of the website, referenced at times by the shorter videos . . . .




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  11. I tried to find seltzer in the store a while ago but couldn’t, and passed on the club soda because I thought I remembered it had salt in it? Would it be an issue if you drank a lot of it?




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    1. I am interested in the answer to your question too Vege-tater. I was worried about club soda and/or some mineral waters raising blood pressure. If I recall correctly, Dr Greget said sipping on a glass of water with 1/2 tsp baking soda in it does not raise blood pressure, but not sure about the bottled water.




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  12. I found the walking motion to be quite distracting and I imagine it would be detrimental to a first-time viewer becoming a daily viewer. I think appearing in the videos for brief moments is a good idea however. I would suggest these appearances be still, and feature you dressed in what I’ll call a “doctor costume”. Surely people’s subconscious assignment of credibility is likely to be highest when the doctor speaking to them fits their idea of what a doctor should look like. A stethoscope around the neck, together with “Dr. Greger” labelled scrubs, may actually save lives.




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    1. Your comment made me realize something. Dr. Gregers videos do not just appear on NutritionFacts where we all know and love him. Dr. Mercola and Green Med Info often showcase his videos and blogs. Others may be more critical and unfamiliar with Dr. G, so I believe that a professional appearance and delivery really is important.




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  13. Since the voice does not always match the mouth movement it is distracting. Showing more pictures having to do with the subject discussed would help. Even embedding the picture on the start would be good.




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    1. The main issue that arises with carbonated beverages is the other additives, such as phosphorus and caffeine, which when combined with too little calcium may contribute to bone loss, via acid neutralisation and urinary calcium losses. The studies I have seen correlating intake of fizzy drinks and bone density are based on sugared, caffeinated and diet sodas (such as cola), not pure mineral water.

      I did manage to find these, which are interesting-
      https://www.ncbi.nlm.nih.gov/pubmed/18926940
      http://jn.nutrition.org/content/138/2/435S.full




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  14. I definitely got a kick out of the cameo, but did find it a bit distracting when it showed up during the stream of info. I think seeing you in the beginning as an intro, or at the end with a parting shot would be a great injection of a personal touch though, if possible. Although I am personally content with the standard format, since your mission is to reach out to as many people as possible, I would love to see more graphically engaging efforts to educate and (I hate to say it) entertain, because unfortunately, the people we need to reach the most are the least likely to appreciate the dry scientific facts, no matter how pertinent or convincing. Not that I hold a lot of hope for the majority, but every effort counts! I am not a Facebook fan, though I do use it to share important info, like from here, (without actually having to see the latest spate selfies or other self absorbed and mindless trivia), and can count the number of times I got any feedback over the years. So sad.




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    1. My reaction to the cameo is similar to Vege-taters. It was a surprise, and made me laugh, but if mini Dr. Greger appears again in the middle of a video, it wouldn’t be funny. I also found the cameo to be distracting. In fact after it appeared I had to go back 30 seconds to get my bearings and remember what was being discussed. I think an appearance of Dr. G at the very end of the video might be the way to do it.




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  15. On the dorkiness question:
    It made me laugh, ’cause indeed, it can get tedious to see flying text boxes around the screen.
    I religiously watch all videos, so a bit of humor is fine by me. And M.G. can do no wrong in my opinion anyway…..

    BUT

    I often show clips to friends, and that clip might be ther first time they have a glimpse of the good doctor.
    So as long as serious topics (say: alzheimers) are presented in a way so that a family members of an AD patient cannot feel it to be flippant, I am OK with as much humor as can be squeezed in.

    B.T.W. the very !!!! GOOD !!!!! thing about “combating the leading causes of death” is the very fact that there is lots of laughter in it from the audience. It is a long preso and for people who are not yet quite “into” plant based food think, the humor makes the 60 minutes of data palatable and fun to watch. Kinda like popcorn at the movies.

    Good luck




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  16. I apologize if this is too far off topic but has the doctor ever approached the topic of diverticulitis? I would like to find a way to treat it without resorting to antibiotics




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    1. LK: I found two videos which mention diverticulitis in the title: http://nutritionfacts.org/video/does-fiber-really-prevent-diverticulosis/ and http://nutritionfacts.org/video/diverticulosis-when-our-most-common-gut-disorder-hardly-existed/

      And here is a search page for all mentions of diverticulitis anywhere. Other videos and blog articles may have additional information of use. Hope this helps. http://nutritionfacts.org/?fwp_search=diverticulitis&fwp_content_type=post%2Cvideo




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  17. I would say, only do the videos if it’s fun for you to do them, because it’s absolutely not necessary for keeping things interesting. The subject matter, your voice and your rye sense of humor take care of that.




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  18. The green screen cameo was certainly unexpected but what a great way to add some pizzazz to the video… keep up the great work!




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  19. The little Dr. Greger is not advisable AT ALL: Kind of ‘robotic’ for my taste. But, if instead of the little ‘mopped’ it may show up another thing or a little ‘something’ or ‘somebody’ to mimic one dry gesture joke related with what is being explained.




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  20. Loved your spritely appearance in yet another great video. Well done! It’s especially enjoyable to see the expression on your face as you deliver your one-liners!




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  21. Loved it! Purple too! Anybody that uses reason to run their life will sign on anyway, like it or not. For all the rest; a little entertainment can’t hurt.




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  22. I love the appearance of the mini Dr. Greger in the video! Please continue. Breaking up the study results like that helps me remember better.




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    1. Hello – I don’t know about the constipation aspect of ginger ale. But if you have a truly upset stomach. . .feeling nauseous like you might ‘lose your cookies’, ginger ale does work. Works great when one is pregnant and has that awful vomiting feeling. I’ve used it for car and air sickness as well (motion sickness). Helps. But the catch is you need to use true ginger ale with true ginger in it. Ginger-flavored soda won’t work. You can also make your own ginger tea brew using fresh ginger root – smash some in a cup, add some hot water and something to sweeten it if you need that; let it brew a bit. It’s excellent. Vernor’s ginger ale – if you can find it – is a true ginger ale drink and you can also find true ginger drinks in a health food store some times. I keep ginger root frozen in 1″ chunks in my freezer so that I have it when I need it. When needed, toss a piece in the microwave on defrost and you’re ready to go. An additional benefit of freezing your ginger root is that the freezing process breaks down the fibers in the ginger. So if you’re using it to make tea/drink or in cooking the root is softer and easier to grate, chop, smash, etc. Ginger also has great antioxidant properties. It’s just great overall. I’m not an ice cream eater but my Mother was and she just loved ginger ice cream.
      All the best . . .




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  23. I would like to comment on the 2016 speech delivery. Please remove the languor and return to the faster, I-can’t-wait-to-share-this-with-you style. Truthfully, I didn’t sit through it. I understand you give a lot of speeches, but you can’t let it show. It felt like you weren’t enthused to be there – I wasn’t either.




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  24. I prefer the more professional approach, and I would think it would instill more confidence.

    What I would like to see, in order to draw more viewers, is some TV coverage. (If you have some, I apologize; it hasn’t been when I was watching). Maybe start with free sources. Why not approach Ellen DeGeneris about some guest appearances. There must be a lot of possibiliites like that (but stay away from that snake oil salesman Dr. Oz!)

    Then consider somre very short prime time national ads with a one-sentence teaser (Did you know that the number one killer in this country is food?) plus your URL. Maybe set up a new URL just for this, so there won’t be confusion between nutritionfacts.org, nutritionfacts.com, nutritiondata.com, nutritionaaction.com, etc. – and also to guage the success of the ads. Maybe something like eatforlife.com (people are more used to .com than .org, and I don’t think they think “commercial” when they see it. Actuallly lock up both versions and have them both go to your site. Hopefully you could get enough donations to pay for the ads. Have you asked for foundation support?




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  25. I personally like the simple format of the scientific studies being shown while they’re being cited, but I am aware of the fact that I could just be fighting against change for the sake of fighting against change.

    The cameo reminded me of the “Whoopsie!” guy from Mortal Kombat. LOL




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  26. Hello Dr. G – i’ve been enjoying reading everyone’s reaction to your appearance in this video. So I thought, . . What the heck! I’ll throw in my very small two cents :-) When I saw Ghost of Dr. Greger slyly ooze into the video with your Hitchcock-like smile and then slyly ooze into oblivion again I couldn’t take my eyes off of you. It was a page right out of “Psycho”! Remember that shower scene? I must confess I was so busy watching you I didn’t concentrate on anything that you were saying. Given that we are still hovering around Halloween, I thought well Dr. G. must still be in “scare the pants off of us” mode with your eerie cameo. That’s how it felt to me. . . a little bizarre, . . caught my attention, . . felt sort of creepy, . . .fit with Halloween/Day of the Dead, . . . etc. So I won’t say whether I liked it or didn’t like it . . . just how it struck me.
    But, as you know by now, . . . we all love what you do overall and are grateful for this site and for you. Thank you, as always.




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  27. I like the addition of your face. I can see the concern about dorkyness. Perhaps having your face in a fixed location from beginning to end would add interest with less dorky effect.

    A curious side note. As I was writing this comment I was waiting for an eye exam. When I told the young intern ophthalmologist that I had lost 40 lbs on a WFPB diet in response to my recent diagnosis of arteriosclerosis, he lit up. Not only had he heard of Ornish, he said he’d read some of How Not To Die and now visits nutritionfacts.org regularly. It’s so encouraging to discover a new generation of incoming doctors who are aware of nutrition as the most powerful path to healing.




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  28. The cameo? Once is enough. I felt like a 2 year old seeing a jack-in-the-box for the first time. It disrupts the video and detracts from the content. My vote–stick with the original format.




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    1. I have spoken to a dentist about this prior and she suggested using a straw, drinking it relatively quickly (minimising exposure) and rinsing the mouth with water or bicarb soda after.




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  29. I love seeing the studies, in the “old” format, but am always delighted to see you speaking, as well. I agree with others that it’d be best if you appeared at the beginning and/or end. While on the topic of format, I didn’t really care for the animated videos. Many thanks for the fantastic service you’re doing!! Aloha, Mary




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  30. Ellie, every body is different. I, too, have suffered from long-term constipation on a largely “healthy” diet. For me, dairy is critical to avoid. It seems the most important aspects to keep things moving for me are whole grains, huge salads, and beans. A key for me has been a daily savory breakfast of brown rice or quinoa, lentils, and salad (greens, red cabbage, red onion are standard), all mixed in together. I sprinkle walnuts and flax seeds on it, too. Sometimes sauerkraut. I love it so much I often repeat this same meal for lunch and/or dinner, too. Good luck!




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    1. Thanks for listing specific things to try. My wife is a very long sufferer too. We are trying more fermented and she is now pretty much FODMAP free and seeing some results but still having off days. She likes baked potato…I wonder if we should replace that with quinoa or rice?




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  31. Once again a helpful video and to give my input about the new feature: While I was delighted to see Dr. Greger appear unexpectedly I think perhaps the appearance would be best at the very end and indeed the “professional attire” perhaps with some identification might be helpful, so folks new to NutritionFacts.org would know indeed that the creator is making an appearance. It’s great that an already wonderful presentation can be tweaked to become even better.




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  32. Would love the information in text form too as often I like to just read and absorb rather than listen. I tend to flag the videos and don’t get around to watching whereas text I can glance at and if it interests me I read further.




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    1. hi Michelle, the info is available in text for right below the video where it says “view transcript” and “sources cited” . Often I will watch the video, then click on the transcript button to read or check the studies mentioned.




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  33. A little of you Dr. G – with a lot of other facts/pix to look at. Watching you is, uh, entertaining at times, but I like to see graphs and visuals to get a better grasp of the facts and info you share.




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  34. Definitely keep playing with the Green screen- only us doctors are capable of being offended by such a fun-loving thing, but don’t worry about us!! I was totally fine with it because I know who you are, I know you like to walk on the treadmill, and I know your work (in other words, I trust you), but I can see someone naive to your Internet persona having a different opinion. Consider adding the sub-video of yourself to the majority of the video, but that will add considerably more work…

    No matter what you decide- keep it coming!!! You are changing the world my friend…




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  35. If your popping up is much extra work, I don’t find it particulary special, but certainly not tacky or taking away from! What I have found VERY annoying for awhile now, is when I try to turn off the CC or expand to full screen (using my phone) I’m automatically taken to YouTube! It didn’t used to do that.




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    1. I second your complaint re turning off cc and being taken to youtube. It’s persistant and obnoxious, and yes, it didnt used to do that. May just give up on the videos and read the text




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    2. Hi B, thank you for bringing this to our attention! Have you submitted a Help desk question for our support staff? This is something they can look into, as we definitely want the experience to be as seamless as possible across all devices! If you submit a Help question, please include the type of device you’re using. Hopefully we can figure this out or get an answer for you!




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  36. Is the sodium in club soda a real concern for folks on a salt restricted pattern? I always look for selzer water but often the only option is the salted kind.

    I dig the cameo more than somewhat. He was walking on his standing desk treadmill thing




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  37. “…there may be a fine line between engaging and dorky.”
    Indeed. But I liked seeing Dr. Greger pop up on the screen.
    A bit dorky, but very engaging.




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  38. Thea – this is off-topic but I can’t remember where the original discussion is located.

    You recently exchanged posts with someone who expressed concern about arsenic in brown rice. One other point worth bearing in mind on this issue is bioavailability.

    The arsenic found in (most) rice is inorganic and only about one third is bioavailable. This is true of 100% of supermarket rice in Australia for example. However if the rice is grown in arsenic contaminated irrigation water (or cooked in contaminated water) then bioavailability increases. This would be true of much Bangladeshi rice, rice from West Bengal in India and French rice. I do not know about the US but Louisiana rice had a reputatation for arsenic in the water.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764129/




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    1. Tom Goff: Thanks for this post. I *really* appreciate your contributions on this site. This is just one more example of your quality posts.
      .
      I remember that conversation you are referring to, because I was trying to come up with the “ultimate answer” – ie, something comprehensive that I can trot out when a common question comes up. In that post, I had referred to a previous post of yours where you wrote, “We know that fibre consumption inhibits absorption of minerals, heavy metals etc and it is reasonable to assume that the bioavailability of arsenic in brown rice is therefore less than that of white rice.” (http://nutritionfacts.org/video/worth-switching-white-rice-brown/#comment-2729297566 )
      .
      Here you are expanding on this idea of bioavailability, and I think it is an important point. I’m going to save this latest post in the hopes that I will remember to incorporate it into my answer the next time this comes up. ;-)
      .
      Here’ s a question this idea raises for me: If memory serves, when articles about arsenic and rice are written, it goes something like this: “Some brands of brown rice have been found to have significant amounts of arsenic in it. We know that arsenic is very dangerous. Therefore we should stay away from brown rice.” My question is: Do we actually have any evidence that people who eat a lot of brown rice have negative consequences? Or is it just speculation and caution at play? The idea of bioavailability comes into play here. Just because some brown rice has some arsenic in it, that doesn’t necessarily mean that it is harmful. Is anyone actually getting sick from eating brown rice? I don’t know if we know the answer to that question or not, but I figured you would know if anyone. :-)




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      1. Thanks Thea but unfortunately I was in a rush to go out and got things 180 degrees wrong! A salutary lesson …

        When I came back home, I re-read the journal article and deleted the post. The study was of biovailability in pigs but suggested that inorganic arsenic bioavailability is higher not lower than that of organic arsenic. Also, it did not look at brown rice specifically merely basmati white and Australian long grain white.

        I still think that it is reasonable to assume that arsenic bioavailability is less from brown rice for the reasons discussed previously but there’s no conclusive evidence as yet. This study from 12 months ago is suggestive because, despite a higher arsenic content of brown rice, it found urinary arsenic excretion rates are similar for white and brown rice. That is, it suggests (but does not “prove”) that pound for pound you are going to absorb the same amount of arsenic from white rice as you are from brown rice because bioavailability from brown rice is lower. However, I am drawing a very long bow when I say that. The study’s authors on the other hand suggest that
        “One explanation for this finding is that the two-day recalls may not be able to capture the long-term rice consumption. In addition, the outer layer part of rice grain, i.e., the pericarp and aleurone layer, which are removed during polishing process, makes up only a minor part of the grain (around 14%). Thus, at the same intake amount, the relative differences in arsenic concentrations between brown and white rice are less than those between bran per se and white rice (8).”
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081491/

        Similarly, I don’t think there is any hard evidence of people actually getting sick from eating brown rice as such. Most of the assumed hazard comes from modelling rather than real world data. However, there is evidence of higher disease rates in rice eating populations where ground water has high levels of arsenic but that’s a different matter.

        As to the high arsenic content of (brown) rice and resulting ill effects, the evidence relating to CVD (at least in the US) shows no effects from rice consumption, either white or brown.
        http://ajcn.nutrition.org/content/101/1/164.full
        Of course, broader studies of whole grains in general find a protective effectfrom their consumption. While they include brown rice, they do not separately identify its effects eg
        http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2087877




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        1. This is one of my all time favorite NF videos. http://nutritionfacts.org/video/great-grain-robbery/
          (Oh, and check out the first four seconds if you want a good chuckle.)
          It’s really hard for me to believe that eating brown rice could be anything but great for you. But what do I know? I do know that arsenic is a naturally occurring element in some ground water. I wonder how the amount of arsenic in brown rice compares to that in other foods calorie wise?




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          1. Thanks Blair. Yes, Dr G definitely had a different style in 2007!

            You can work out the arsenic content of food for a given amount of calories by finding the amount of arsenic in say 100g of any food then finding the calorific value of 100g of that food. This is easier said than done because arsenic content will vary from place to place, brand to brand etc and be affected by eg feeding/fertilising practices. Unfortunately, there aren’t many lists around. This HK paper is quite useful but may not be fully relevant to foods available in your area.
            http://www.cfs.gov.hk/english/programme/programme_firm/files/Report_on_the_first_HKTDS_Inorganic_Arsenic_e.pdf

            You can get the calorie content of 100g of most foods from eg the US National Nutrients Database
            https://ndb.nal.usda.gov/ndb/foods/show/2871?fgcd=&manu=&lfacet=&format=&count=&max=50&offset=&sort=default&order=asc&qlookup=raw+broccoli&ds=

            The problem is that this will simply tell you the amount of (inorganic) arsenic available not the amount absorbed. Brown rice has higher levels of fibre and phytic acid than white rice which may affect heavy metal and mineral absorption (Inorganic arsenic is a heavy metal I believe).
            http://nutritionfacts.org/2015/10/15/how-to-reduce-your-dietary-cadmium-absorption/

            Also, because it contains more fibre, brown rice will likely have a faster progression through your system and elimination than white rice, leaving less time for absorption. Further, the more processed the food, the greater the digestibility (usually) and this appears true of white vs brown rice..
            https://www.ncbi.nlm.nih.gov/pubmed/2822877

            All of these things, may affect uptake of arsenic.

            So, brown rice may have more arsenic than white rice but it’s not certain that people actually absorb more arsenic from brown rice than white rice, or if they do by how much. As I mentioned in my post to Thea above, there is some evidence from a November 2015 study which hints that total arsenic absorption from brown and white rice may be approximately equal, for a given weight of rice

            It is even possible that, if you cook rice with a high volume of water, you may end up absorbing less arsenic if you eat brown rice than you would if you eat white rice. But this is more speculation on my part.
            http://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm319948.htm




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            1. Unfortunately this article is behind a pay wall:

              “Main sources of dietary iAs [inorganic arsenic] intake in the U.S. include rice and other grains, vegetables, and fruits. Due to low concentrations of iAs, seafood is not a primary contributor to dietary iAs intake.”

              “A variety of experimental in vitro gastro-intestinal protocols have been used, however, few studies have included As speciation before and after the in vitro extraction. Current data suggest that the bioaccessibility of iAs in rice is quite high, typically 70% or more indicating that iAs in rice is highly bioavailable. ”
              http://www.sciencedirect.com/science/article/pii/S0048969715301418




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              1. Thanks Lemonhead. That’s a good find.

                It confirms that not all the arsenic in rice is bioavailable. It has in fact long been assumed that almost all dietary arsenic is completely absorbed but this shows that ,while absorption is high, it is not as high as previously assumed – see p314 in
                https://www.crcpress.com/Arsenic-Research-and-Global-Sustainability-Proceedings-of-the-Sixth-International/Bhattacharya-Vahter-Jarsjo-Kumpiene-Ahmad-Sparrenbom-Jacks-Donselaar-Bundschuh-Naidu/p/book/9781138029415

                By the way, I understand that seafood is high in organic (as opposed to inorganic) arsenic………………..
                “There are numerous other arsenic species, many of which we know little about. For example, fish and algae contain arsenobetaine (C5H11AsO2) as well as arsenoproteins, arsenolipids, and arsenosugars (Feldmann and Krupp 2011; Schmeisser et al. 2006), many of which have not been characterized. Arsenobetaine is generally considered to be of low toxicity compared with some forms of inorganic arsenic (Leffers et al. 2013; Taylor et al. 2013). Some arsenosugars have been shown to be bioaccessible and metabolized in humans, and limited studies demonstrate toxicity in vitro (Feldmann and Krupp 2011; Leffers et al. 2013). Because seafood can contain up to 100 times more total arsenic than rice does, and contains a variety of poorly understood organoarsenical compounds, researchers are calling for more detailed studies of these forms of arsenic (Feldmann and Krupp 2011; Molin et al. 2015).”
                https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937867/

                It is a shame that this article you cite is behind a paywall because it is not clear that this level of bioavailability applies to brown rice. It talks about “typically 70%” and of course people typically eat white rice. Also I am not sure what in vitro tests were used but “The physiologically based extraction test (PBET) is an in vitro test system for predicting the bioavailability of metals from a solid matrix and incorporates gastrointestinal tract parameters representative of a human (including stomach and small intestinal pH and chemistry, soil-to-solution ratio, stomach mixing, and stomach emptying rates)………. For arsenic (As), the results of the PBET are overpredicting bioavailability study results in rabbit and primate
                models (2-11% difference between in vitro and in vivoresults, depending on the animal model).”
                http://soils.ifas.ufl.edu/lqma/SEED/SWS6262/pdf/Ruby-96.pdf

                This may or may not not be directly relevant because it is about absorbing arsenic from soil rather than food but does demonstrate that in vitro tests alone may not always be reliable guides. The situation is very complex eg “factors that modify arsenic metabolism in vivo (e.g., folate content in diet and the gut microbiome) may result in differences in metabolism and absorption”
                https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937867/
                This could favour white rice (in the US at least) because I understand that by law it has to be fortified with folate.




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                1. Perhaps parboiled rice is fortified, but none of the white rice I’ve bought is fortified (typically I get Trader Joe’s basmati from India or jasmine rice from Thailand). Tonight I’m going to serve the TJ’s white basmati along with the black Japonica from Lunenberg (I could OD on that stuff, it’s so good). Last week we had a lot of whole farro (that’s another starch I could OD on, but I’d only have to worry about the caloric content).

                  Most people can detoxify organic As pretty well, that’s why it’s not as much concern, though I remember an article on a sub-population that had trouble with it (it was in Hong Kong or Taiwan, I think). Then there are sub-populations that can detoxify inorganic As quite well, to the point of being resistant to iAs poisoning.
                  http://www.nytimes.com/2015/03/13/science/an-unlikely-driver-of-evolution-arsenic.html?_r=0

                  My ancestry is northern European and, according to 23andme, nothing else. I doubt I can manage inorganic As very well. I’m also a rather small person with a history of urinary neoplasia, so I think I will mind my intake of iAs. I probably wouldn’t eat 4-6 servings of brown rice per day, as I’ve seen some (larger, very physically active) vegetarian/vegan people report.

                  In general, I think it is a good idea to vary one’s diet. There’s a lot of other whole grains and pseudograins to choose from, as well as sweet potatoes and squash that can serve as starch sources. I’ve got what my husband calls an ‘armada’ of delicata squash on my counter right now; I wish they were available all year long. They have an excellent nutrient profile, take just a few minutes to cook in the microwave, and their skin and seeds are edible.




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                  1. Thanks, yes. I believe that all US-grown white rice is fortified
                    http://www.thinkrice.com/at-home/nutrition/

                    However, I understand that white rice is general is only required to be fortified with folic acid if it is labelled “enriched”
                    https://www.ncbi.nlm.nih.gov/books/NBK208880/

                    Yes, the general view is that organic arsenic is not a problem. However, there are some doubts about the validity of this view – see my previous post about the different types of organic arsenic in seafood.

                    I agree that eating a varied diet is the best way to go.




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            2. I read that at least some of the arsenic comes from poultry manure fertilizer. The poultry are treated with arsenic to kill parasites as I remember. I guess some of it runs off, and some of it gets eaten by the birds. Either way it ends up in the manure and and in the soil of the crops fertilized by it.

              I went to a talk given by our local sanitary and wetlands department. They said that arsenic was a naturally occurring element in, at least some, ground water. That was all they said. So I get the sense that at some level, arsenic isn’t a problem. But I really don’t know and from what you say, I’m not at all sure that anybody does.

              I heard a meat eating friend complaining that he din’t want to eat beans because they contain a (relative to other plants) high amount of methionine. He seems to have missed that all animal products contain multiple times as much methionine as beans. (Listens only to the popular press for his nutritional information.) My guess is that animal products have a lot more arsenic than brown rice. We probably just don’t know what’s in them. No nutrition facts label on the stuff and the list of “allowable chemicals” in meat is not exactly light reading for someone who isn’t a chemist. Just don’t know….




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        2. Tom Goff: Thanks for taking the time for the follow up! And for answering my question. :-) I thought the following was very interesting: ” there is evidence of higher disease rates in rice eating populations where ground water has high levels of arsenic but that’s a different matter.” Also note that the IHD translation was appreciated. (I’m sure not just by me.)
          .
          I’m glad I clicked through as you added and extra interesting bit after I got the e-mail. Thanks!




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      2. Hi Thea. Following up Lemonhead’s post below, I came across this abstract which lends weight to the idea that, while there is more arsenic in brown rice, it may well be less bioavailable and that arsenic is actually least accessible in brown rices. I say “may” because the study is based on in vitro research so some caution is appropriate:
        “The bioaccessibility of arsenic in rice decreases in the general order of extra long grain, long grain, long grain parboiled, to brown rices.”
        http://www.tandfonline.com/doi/full/10.1080/03601234.2012.611431?scroll=top&needAccess=true

        Unfortunately, I don’t have access to the full article because it is behind a paywall. Perhaps the NF researchers might check it out some time?

        This idea of a lower bioavailability of arsenic in brown rice (compared to white rice) is also supported by the November 2015 study I mentioned previously where “We observed that intakes of white and brown rice were both associated with higher total urinary arsenic concentrations, and the inorganic arsenic concentrations were not different between participants who primarily ate white rice versus those who ate brown rice:”
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081491/

        In other words, switching from brown rice to white rice to lower arsenic uptake from food would not achieve the type of reduction suggested by a simple comparison of the arsenic contents of white and brown rice, and may even be altogether unnecessary.




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  39. As much as I appreciate the continuing effort at outreach by Dr. Greger, the popup video cut-out is so unexpected as to be disconcerting. The unexpected format aside, the video figure is still Dr. Greger, delivering the same information.

    Dr. Greger’s approach is already sufficient to reach new audiences. Reaching people with nutritional facts need not depend upon video gimmicks, however humorous– the information is delivered clearly, and in exactly the most compelling fashion.

    Even so, Dr. Greger’s experiment shows him faithful to his own argument physicians should stop at nothing to engage their audiences




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  40. Dr. Greger – We love you, but I think the pop-up vids of you commenting are very . . . dorky.
    I think it’s better to show more images related to the topic (e.g. flax farms or raspberry close-ups).
    THANKS,
    Ron




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  41. Hi Dr G love your videos! I like your sense of humor and enjoy your puns. Think it is a great idea to experiment with different formats to reach various audiences, For introductory videos aimed at reaching new people, such as short summaries from How Not to Die series, think might be wise to be fairly formal. It is about establishing trust through the presentation style as well as the content. I’ve seen a few TED talks about public speaking/leadership with suggestions based on research. A million thanks for all your efforts toward improving health through educating us! I look forward to your videos and am always looking for opportunities to introduce others to your site.




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  42. This kind of videos are indeed more distracting: I then have to select more because the relevant is arbitrarily mixed with the Irelevant. That would bothering me after a time and perhaps I would quit completely. Instead : to make things more appealing: i would be more interested in studies showing perhaps opposite results as these you are citing and then weighing out arguments and wrestle for truth would be very interesting….much more than fun videos…




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    1. Renate Jackson: re: “i would be more interested in studies showing perhaps opposite results as these you are citing and then weighing out arguments and wrestle for truth would be very interesting.” I’m guessing that you are talking about including those results in standard daily videos of the day. Just in case you aren’t aware, however, I thought I would point out some existing articles and videos which focus on analyzing studies which contradict the main message of this site:
      http://nutritionfacts.org/2016/10/04/how-to-design-saturated-fat-studies-to-hide-the-truth/
      http://nutritionfacts.org/2015/10/29/why-some-dietary-cholesterol-studies-fail-to-show-harm/
      http://nutritionfacts.org/2014/08/14/how-the-meat-industry-designed-a-highly-misleading-study/
      http://nutritionfacts.org/video/the-saturated-fat-studies-set-up-to-fail/
      http://nutritionfacts.org/video/bold-indeed-beef-lowers-cholesterol/
      http://nutritionfacts.org/video/eggs-and-cholesterol-patently-false-and-misleading-claims/
      http://nutritionfacts.org/video/how-the-egg-board-designs-misleading-studies/
      http://nutritionfacts.org/video/who-says-eggs-arent-healthy-or-safe/




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  43. Haha. Although I thought it was very funny when you popped up, I must admit that it does feel like it detracts from the professionalism a bit too much.
    I feel less inclined to send this video to someone directly if they aren’t familiar with Nutrition Facts.




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  44. There are considerable variations in the quality of drinking water in Norway. The researchers studied variations in magnesium and calcium levels in drinking water between different areas, as these are assumed to have a role in the development of bone strength. They wanted to examine whether there was a correlation between magnesium and calcium concentrations in drinking water and the incidence of hip fracture.

    The study results show that magnesium protects against hip fracture for both men and women. The researchers found no independent protective effect of calcium.

    It’s well known that cardiovascular deaths, including sudden cardiac deaths, occur far less frequently in areas that have hard water, which contains lots of minerals, compared to areas with soft water, which is relatively mineral free. British researchers took a close look at this data and narrowed the protective effects to one specific mineral: magnesium.

    Magnesium is a viable option for preventing sudden cardiac death because it plays key roles in several aspects of cardiovascular health, and deficiencies are linked to an increased risk of hypertension, heart attack, heart failure, and death. Subpar levels also promote electrical instability in the heart and are associated with a variety of rhythm disturbances, including ventricular arrhythmia and sudden cardiac arrest. * no sources

    ……………

    Researchers recently took 124 healthy women between the ages of 66 and 76. All of them were attending a fitness program. Perhaps that’s one of the reasons they were healthy? They gave half of the women 300 mg of magnesium a day for three months. The other half did not get the supplement.

    Before and after the experiment, all of the women were scored according to their performance on the Short Physical Performance Battery (SPPB). The SPPB is a group of easy tests that combines the results of how fast a person can walk, how good their balance is, and how long it takes them to sit up and down in a chair five times. The test is used to predict disability and monitor physical function in older people. The scores have been able to predict the risk of disability, the risk of dying, and the risk of being admitted to a nursing home. With that in mind, I don’t think there is anyone out there who would not want to have a better SPPB score if they could. So how did these women do?

    The results were extremely encouraging. All of the women had the same scores before the study. And all of the women had an improvement in their scores at the end of the three months. But the women taking 300 mg of magnesium performed up to an amazing 60% better than those deprived of it. The authors of the study put the results this way, “These findings suggest a role for magnesium supplementation in preventing or delaying the age-related decline in physical performance.” Frank Shallenberger, MD

    ……………..

    So the local yokels decided to soften the water supply…replacing calcium and magnesium and iron with salt….or some salt of chlorine? Supposed to save the appliances….seems the toilet collects deposits about as fast though.




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    1. Yes, I notice that Dr Shallenberger added that “the magnesium supplement they used was magnesium oxide. This is by far the worst form of magnesium you can get because it’s so poorly absorbed. A much more absorbable form is magnesium citrate. That’s the form I use in my Super Immune QuickStart powder. Just one scoop a day gives you more than the 300 mg used in this study”
      http://www.secondopinionnewsletter.com/Health-Alert-Archive/View-Archive/12423/The-single-supplement-that-can-improve-your-physical-performance-by-60.htm

      Unfortunately, in this particular study, no placebo or other intervention was used for the control group. Therefore it is possible that the improvement seen in the treatment group could simply be due to the placebo effect.
      http://ajcn.nutrition.org/content/early/2014/07/09/ajcn.113.080168.abstract




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  45. imo – drop the green screen thing – it added nothing but cringe and if at best just made you look silly. I would be less likely to take you seriously with the green screen pop up.




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    1. The cameo was great. Make it like an easter egg, on occasional videos, with a different look each time (color of shirt, hat etc. You were on your famous treadmill, which was funny. Next time maybe you could be on the squash court, or walking your dog or, well, don’t spend too much time on that. Anyway, you, and all who are involved, do an extraordinary job. Thank you Dr Gregor and friends.




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  46. NO! Dear Dr Greger I have been in the media/film industry my whole life and so would like to advise you not to do bits like tis of you on screen for many reasons. When I share your exceptional, valuable and life saving information with people some do say you look like you need a bit of sun. So thereby questioning your own health. So it’s so important how you present yourself especially to newcomers filled with that initial skepticism and looking for things they can criticize. On another note I cannot thank you enough for How Not To Die I have now bought and given away 12 copies! It’s a bible…




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  47. I liked you popping in on the video! I vote for cameos :) I drink a large bottle of Pellegrino every day. I was a tad bit concerned about erosion. Thanks!




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    1. K,

      Good point as enamel erosion is not to be taken lightly. One of the keys to reducing your concern, rinse your mouth with non-carbonated water or a non-acidic veggie juice after your Pellegrino. Dr. Alan Kadish moderator for Dr. Greger




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  48. Love the videos, Dr. Gregor! But I don’t like the green screen. I do think it detracts from the professionalism and the message. if you want to include clips of you speaking directly to the camera in the videos to make a point, that may be better. Just my opinion!




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  49. An occasional cameo lends a little levity to the serious subject matter of most videos. Thanks for the videos. You do a great job of distilling a lot of important data to a logical conclusion that leads to better health for mankind.




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  50. Not keen on the pop-up Dr G, sorry. It might just be it that as it’s new it needs a bit of work, but personally, I found it distraction.




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    1. Glad you asked doc, but I do agree with Chris here. I think it’s too much. Could quickly become “overproduced” and gimmicky. I hope you’ll stick to the professionalism side of the scale here and much prefer less motion and unnecessary visual complexities. I’m also highly distractible-the pop-over screen that I couldn’t control here for so long ALMOST completely drove me from the site. That’s how much I dislike “pop-in” EXTRA complexities.




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  51. My GERD was so bad that I couldn’t drink carbonated water at all. Then I got hooked on PPI’s to control the symptoms. Then I took control of my health via FOOD.

    It took a few weeks but eventually weaned myself from tummy pills of any sort. I was just having a sip of fizzy water when I started this video. Happy to be able to drink it again without setting my esophagus on fire and without pills.




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    1. Same thing here. The PPI’s were barely working and I kept having to get stronger and more expensive Rx’s ($300 / month). I just quit them and switched to doing alka seltzer when it was really bad and tried every natural / alternative treatment I could find. I’m not sure what exactly got rid of the GERD; seems to have been a combination: probiotics, more fiber and resistant starch, less saturated fat. Now I can eat raw garlic and onion.




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      1. In case it’s not clear, I was eating WAY too much meats, oils, sugar, and other processed junk or SAD-with a few “feel good-seems okay” foods thrown into the mix. Another disease of lifestyle NIPPED with diet.




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  52. re: Dr. Greger’s appearance.
    I come down on the side of the cameo appearance being jarring and distracting. Rather than engaging, I found it gimmick-y. It took me away from being able to follow the gist of the video, and I had to go back and listen to part of the video again even though I was expecting you appearance. I would be in favor of doing something like this once every year or two if there is a particularly good place to do so and if the frequency is kept way down. That would be a way to appease people who liked it without affecting the integrity of most videos/the site in general.
    .
    I have no problem with the current video format of study after study, with direct quotes and animated graphs. The lack of visual business is a welcome feature to me and gives us time to think about what you are really saying. I do have one suggestion, though. NutritionFacts used to also include quizzes/guessing in your videos, which I had liked. It helped me to listen with more of an active mind if I was trying to guess the outcome of a study before you gave the answer. Maybe you could include a few of that type of format again.
    .
    I think it is great to always be thinking about improving and taking risks to try something out. I appreciate that you asked us what we think! Boy did you get an ear full. I just don’t think you need to greatly worry about making the videos more engaging. I find that the videos are pretty engaging the way they are. Fascinating content doesn’t need special effects for the sake of special effects.




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    1. Watching it twice might not be all that bad , some of us don’t learn that fast anyways . I imagine that the pop up is effective as some advertisers are using it . Almost like 3D.
      My first impression was I liked it.




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      1. esben andersen: I agree that watching a video twice can be a great idea. The information presented is some videos is dense, and it can be easy to miss something. But having to watch twice when I missed something because of a distraction that Dr. Greger caused, that’s not good at all. That’s a waste of my (precious) time.
        .
        Advertisers have different goals than NutritionFacts. Advertisers are trying to get you to remember and desire to purchase a brand or product, not to impart trustworthy technical information surrounded in a sea of misinformation imparted by others. I’d say that ‘advertisers are doing it’ is not in and of itself a good argument for doing something here on NutritionFacts.
        .
        Everyone is entitled to their opinion on this. You have yours, and I have mine. :-)




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        1. I used to google a lot about health issues simply because I had more time when I retired and because I had health issues , my family and friends had health issues as well. Now I recall once in a while I would come to this site by the way of youtube mostly and I would always dismiss it or take lightly as youtube seemed not as creditable as something written down .So now I’ve listened to the video with just listening not watching , then I watched and then I read the transcript . I think if the transcript had included the studies that would have been my choice.
          Now having it mulled over in my mind I now agree with you Thea , theres already so much info crammed into the video , it is better without the pop ups.
          I concede I have been Trumped.




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          1. esben andersen: Smart experiment on your part. (and your ending made me laugh) Even without the graphs and references, I find myself using the transcript as often as watching videos. I’m glad we have both. And I agree that the transcript could have more features. I just don’t think we have enough volunteers for that.

            FYI: Late yesterday I turned over a tally of people’s responses to NF staff. At least a tally so far. No worries though: the ‘nos’ so far out numbered the ‘yeses’ that your one vote switch won’t make a difference.

            I hope your health issues are working themselves out.




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  53. I say thumbs down on the pop-up videos. For me, it DID detract from the seriousness (and value) of the conventional videos. In fact, I actually missed the content while I was distracted by the insert. I occasionally post comments in comment sections such as the NYT or the Guardian, sending readers to NutritionFacts and assuring them that Dr. Greger is not another Dr. Oz. The pop-ups might have people disagreeing with me.
    If you want a broader audience, maybe create a new stream that DOES appeal to those less committed to staid lit reviews, but make it a genre unto itself as apposed to this hybrid?
    Whatever you do, I will keep viewing! I have sent How Not to Die to a half dozen friends as presents now.




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  54. I believe the short video of Dr. Greger was creative, but distracting. I find the current pace and structure of the videos helps me to focus on what is being said. I appreciate being able to pause, to look at the text of the study. Would like to hear more about the statistics used and the power of the studies. Not everyone is into statistics, maybe include a rating of the quality of evidence in the citations? Imagine if the general public knew more about assessing published data, that would be cool.




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  55. Dr G: Thanks for soliciting feedback on your new style. Pop-ups may seem harmless and fun but they have complex consequences – they lead to a form of forgetting and a form of inattention. The former, as any good Psych 101 student will tell you, is called “retroactive inhibition” where what you learn/see “now” during an interruption can “wipe out” what was learned/seen prior to the interruption. The inattention and forgetting resulting from a distraction is complex but involves at least two related phenomena – “change blindness” and “inattentional blindness”. The former is such as in the examples below – the grey screen between images effectively wipes out (deletes) your iconic visual (very short term) memory of the preceding image – so that you end up not noticing what changes between the two images (you can’t spot the difference as you the info has been wiped out). It’s also a form of inattentional blindness – the scurge of our roads – texting and driving, phoning and driving…they move your mind so much you don’t see what’s in front of you – you become effectively blind. Pop-ups are a menace to one’s attention. Avoid.
    Ex 1: https://www.youtube.com/watch?v=qtiOm9GVrws
    Ex 2: https://www.youtube.com/watch?v=bh_9XFzbWV8
    more: http://www2.psych.ubc.ca/~rensink/flicker/download/index.html




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  56. I too agree that instead of just popping in and out, either start or finish with a cameo. Love this site!! I miss it on the weekends!! :-)




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  57. I find the videos already interesting as they are, but I do like to see your face as well. It also helps understanding the bits with humor when seeing your facial expression at the same time. I think this especially applies to non-native English speakers.
    It could be an idea to have your face in the video the whole time, as with skype, when you see yourself in a little window. The popping up was a little distracting in my opinion.




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  58. It definitely detracts from the message and the professionalism. Keep up the good work.
    Steven Gottlieb, MD, pediatrician, Yakima, WA




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    1. Steven E. Gottlieb, M.D.: If you are talking about the popups/green screen, please note that we have several videos pre-recorded. But the vote was clear and no new videos will be made with the popups.




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  59. I write a Sunday Newsletter for Women in the Latter Lanes and often use the content from your web site then embed a link to nutritionfacts.org. This allows the more serious readers to delve into it on your site. Sometimes, I am able to add humor or share my own experience to lighten the load of medical jargons. Enough about me and let me answer your question if using a “lighter tone and voice” would detract from the professionalism of your website. Five years ago, I would have said, “Yes, it would make it somehow less credible.” Today, I sing a different tune. The goal is to inform that Hippocrates’ message, “Let food be thy medicine,” turns out to be true. For the millions of people who may not know who he was or have not entertained this idea (people distrusting of those proclaiming to be in the know), the message needs to appeal and be understood. As I write this scroll of communication, I’m reminded of a blog on NPR called Goats and Soda. Because I selfishly don’t want you to change anything on how you communicate about the studies, could the “lighter” articles be identified in a way to let people know that this article is a more readable version (for the busy reader). Just a thought. Thank you for your work. It has made me a healthier person and my husband (by default) a 85% believer. The 15% counts for his egg and chicken intake. Happy New Year.




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    1. What stage CKD are you? There a good overview of Nutrition and CKD from a plant based perspective at PCRM Usual diet treatment for constipation is more fiber (fruits and vegetables, whole grains and beans) and more fluids (and some plain club soda). CKD can exaggerate constipation d/t fluid limits, multiple meds, and diet restriction. Earlier stages (1-3), one can be more liberal with fluid/diet than later stages (4-5).. However, more recently there is more attention being put on plant based diets in the later stages too.
      There was a great book:
      Hogan, Brookhyser, Joan, THE VEGETARIAN DIET FOR KIDNEY DISEASE TREATMENT, 2ND ED
      Also, Dr. Greger has some videos on kidney disease which may offer some suggestions…
      http://nutritionfacts.org/video/how-not-to-die-from-kidney-disease/
      http://nutritionfacts.org/video/treating-chronic-kidney-disease-with-food/
      other resource:
      http://www.pcrm.org/health/health-topics/nutrition-and-renal-disease.




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  60. I thought your pop up self was dorky, but in a very hysterical way!! Made me laugh, which is always a good thing. I was able to continue focusing, maybe more so on the subject at hand :)




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  61. HI John Smith. I’m a dietitian and volunteer moderator who helps Dr. G answer questions. Thank you for yours! I’m wondering if the connection might be more that at certain doses, magnesium supplements, Vit C supplements and flax oil can cause diarrhea? For example, 30 g (2 Tbsp) flax oil can cause diarrhea in some people (http://www.webmd.com/vitamins-supplements/ingredientmono-990-flaxseed%20oil.aspx?activeingredientid=990).
    Hope this helps a bit!




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