Convergence of Evidence

Convergence of Evidence
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Profile of an editorial published by Dr. Dean Ornish in the American Journal of Cardiology describing the optimal diet, and how simple choices can be as powerful as drugs and surgery.

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Dr. Ornish published an editorial in the American Journal of Cardiology last year that I think really sums up where we are, describing a growing convergence of scientific evidence that an optimal diet is mostly plant-based. Make sure it has nuts, soy, and fiber, and you can drop your bad cholesterol as much as taking drugs every day for the rest of your life—but without the cost, and without the side effects. Save the country $20 billion.

Of course, most patients aren’t even given the plant-based option, because of the patronizing belief among doctors that no one will actually do it. But in reality, most people don’t want to take the drugs. People hate the side effects. They don’t make you feel any better, and it’s scary popping pills every day so you don’t keel over and die. People don’t even want to think about it.

However, when people actually improve their diets, you actually feel so much better, so quickly, that it reframes the reason for making these changes from fear of dying—which usually is not sustainable—to joy of living, which often is.

And the diet doesn’t just help your cholesterol. Unlike the drugs, a plant-based diet can also prevent and treat diabetes, hypertension, obesity, prostate cancer, breast cancer, etc. Pills can’t do all that. And instead of being on a list of medications—one drug for this; one or two drugs for that; there’s not one diet for heart disease, another one for diabetes, a plant-based diet covers all the bases. Why? Because plant-based foods contain more than 100,000 different disease-preventing nutrients. Let me say that again: 100,000 phytonutrients. Only found in plants.

You know, blueberries have the anthocyanins for memory. Tomatoes are rich in the red pigment lycopene, which targets heart disease and cancer. Ginger’s got gingerols for hypertension; pomegranates have some totally different phytonutrients. And let’s never forget kale! The list goes on and on.

And you can’t just take these phytonutrients in a pill. Beta carotene pills may actually increase cancer risk, as opposed to the whole carrot, which may lower our risk. And we probably couldn’t swallow a hundred thousand pills a day anyway.

Then he talks about his work stopping and reversing the progression of even severe coronary artery disease. Slowing, stopping, or reversing cancer. Living and eating healthy actually changes you on a genetic level, upregulating disease-preventing genes, and downregulating genes that promote breast cancer, prostate cancer, inflammation, and oxidative stress. Drugs can’t do that.

The bottom line: people tend to think of breakthroughs in medicine as new drugs, lasers, high-tech surgery—but they have a hard time believing that simple choices can be as powerful as drugs and surgery. But they often are. Sometimes, even better.

And I will leave you, on that note.

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

Please consider volunteering to help out on the site.

Credit goes to Dr. John Smith. Image thanks to U.S. Department of Agriculture via Flickr.

Dr. Ornish published an editorial in the American Journal of Cardiology last year that I think really sums up where we are, describing a growing convergence of scientific evidence that an optimal diet is mostly plant-based. Make sure it has nuts, soy, and fiber, and you can drop your bad cholesterol as much as taking drugs every day for the rest of your life—but without the cost, and without the side effects. Save the country $20 billion.

Of course, most patients aren’t even given the plant-based option, because of the patronizing belief among doctors that no one will actually do it. But in reality, most people don’t want to take the drugs. People hate the side effects. They don’t make you feel any better, and it’s scary popping pills every day so you don’t keel over and die. People don’t even want to think about it.

However, when people actually improve their diets, you actually feel so much better, so quickly, that it reframes the reason for making these changes from fear of dying—which usually is not sustainable—to joy of living, which often is.

And the diet doesn’t just help your cholesterol. Unlike the drugs, a plant-based diet can also prevent and treat diabetes, hypertension, obesity, prostate cancer, breast cancer, etc. Pills can’t do all that. And instead of being on a list of medications—one drug for this; one or two drugs for that; there’s not one diet for heart disease, another one for diabetes, a plant-based diet covers all the bases. Why? Because plant-based foods contain more than 100,000 different disease-preventing nutrients. Let me say that again: 100,000 phytonutrients. Only found in plants.

You know, blueberries have the anthocyanins for memory. Tomatoes are rich in the red pigment lycopene, which targets heart disease and cancer. Ginger’s got gingerols for hypertension; pomegranates have some totally different phytonutrients. And let’s never forget kale! The list goes on and on.

And you can’t just take these phytonutrients in a pill. Beta carotene pills may actually increase cancer risk, as opposed to the whole carrot, which may lower our risk. And we probably couldn’t swallow a hundred thousand pills a day anyway.

Then he talks about his work stopping and reversing the progression of even severe coronary artery disease. Slowing, stopping, or reversing cancer. Living and eating healthy actually changes you on a genetic level, upregulating disease-preventing genes, and downregulating genes that promote breast cancer, prostate cancer, inflammation, and oxidative stress. Drugs can’t do that.

The bottom line: people tend to think of breakthroughs in medicine as new drugs, lasers, high-tech surgery—but they have a hard time believing that simple choices can be as powerful as drugs and surgery. But they often are. Sometimes, even better.

And I will leave you, on that note.

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

Please consider volunteering to help out on the site.

Credit goes to Dr. John Smith. Image thanks to U.S. Department of Agriculture via Flickr.

56 responses to “Convergence of Evidence

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      1. Dr.Greger can you please explain ketogenic diets and ketosis..? Do you have videos on this anywhere? People talk about it especially on youtube haha and I’m wondering what the research on this says? Is this like an Atkins diet?

        Some videos if you’re curious as to what is out there on youtube on this stuff and who’s advocating for it.
        https://youtu.be/_434ERRbkj8 -> Eric Berg
        https://youtu.be/dSLf4bzAyOM -> Dr Eric Westman
        https://www.youtube.com/watch?v=Q9socQcwPIs
        https://youtu.be/H7mjm9LyW-c
        https://www.youtube.com/watch?v=Qn68fSYqYQs
        https://youtu.be/1H2zCdtz-2s




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        1. I’m curious as to how this agrees or clashes with plant based diets and whether these guys are the new atkins? Is this the new dairy/meat industry funded diet haha? Curious as to the effects on arteries and life span and so on for people on such diets since people on youtube seem really into this stuff..

          Thanks!




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          1. People want to eat healthier but there are all these voices saying something different and that seem legitimate or as if backed by science to normal people who aren’t researchers or doctors/nutritionists so I can understand how confused people are or believe whatever they first see from atkins to paleo to keto and so on.

            Sigh even if there is a consensus in the research you go to normal people or youtube and wow the amount of people who each hold beliefs that don’t reflect the consensus (or partly reflecting this) shows how much work needs to be done to combat the media manipulation or how much bigger our marketing budgets need to be. This is why we all need to learn to use business as a force for good and replace the businesses making money currently keeping people sick and unhealthy! And a need for community based approach too?

            Thanks for your work in clearing up this mess with your research backed videos. Could you show out of e.g. all the studies published or out of e.g. a few thousand studies which ones agree about plant based and which ones are bogus or say something else and so on? It’d be cool to e.g. look at 1000 or 10,000 studies and see how many were backing the plant based diet, how many were inconclusive or bullshit studies or later refuted and so on.. Which ones contribute to what myths or which studies are used to prop up other diets and so on?

            I think seeing the ‘97% of scientists agree with global warming’ figure and seeing it illustrated as a pie chart and with literal people making up the 2 groups for the sake of visualisation makes it clear and shows how good the 3% are at creating doubt. I’d like to see something here relating to food so we can share this with others? I think it could convince even more people?




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        2. Tharun: I don’t speak for Dr. Greger, but I may have some information that is helpful to you. When I researched ketogenic diets in the past, I found definitions that said that such diets are very high fat, very low carbohydrate diets. I would call it, “Atkins Extreme.” While I agree that it would be nice for Dr. Greger to specifically use the ‘ketogenic’ word in a few posts, this website does currently cover the concept of high fat diets in general. You might look under ‘paleo’ as a subject to get some ideas. Also, note that Dr. Greger wrote a free book called “Carbophopia” (which later got a new title “Atkins Exposed” I think). You can learn about the flaws of low carb diets in that book.
          .
          Some years ago, one of our moderators, Rami, wrote a very nice post about the known harms of ketogenic diets. I copied the text for you below. Below that is another post from Tom Goff, a wonderfully knowledgable poster here, who also addressed ketogenic diets and the science we have around such diets killing people sooner.
          .
          Does this help?

          **************************************

          FROM MODERATOR RAMI:

          Ketogenic diets (very low carb, high fat) have been shown to be helpful with children with epilepsy for the short term. All other aspects of the diet for the short term show ill health effects. Its not something you want to put your body through. I will share the SHORT TERM evidence below. The long term evidence is also damning, but here is short term data.

          “Cognitive Effects of Ketogenic Weight-Reducing Diets,” researchers randomized people to either a ketogenic or a nonketogenic weight loss diet. Although both groups lost the same amount of weight, those on the ketogenic diet suffered a significant drop in cognitive performance.After one week in ketosis, higher order mental processing and mental flexibility significantly worsened into what the researcher called a “modest neuropsychological impairment.”
          http://www.ncbi.nlm.nih.gov/pubmed/8589783

          A review over low carb diets revealed that “Complications such as heart arrhythmias, cardiac contractile function impairment, sudden death, osteoporosis, kidney damage, increased cancer risk, impairment of physical activity and lipid abnormalities can all be linked to long-term restriction of carbohydrates in the diet.”
          http://www.ncbi.nlm.nih.gov/pubmed/14672862

          Low-Fat Versus Low-Carbohydrate Weight Reduction Diets
          Effects on Weight Loss, Insulin Resistance, and Cardiovascular Risk: A Randomized Control Trial

          This study looked at 24 people who were overweight/obese and divided them into 2 groups. One group was low carb, high fat and the other high carb, low fat.
          High carb group: 20% calories from fat/60% calories from carbs
          Low carb group: 60% calories from fat/20% calories from carbs
          In addition, the study was designed so that participants would lose 1 pound per week, so calories were reduced by 500 per day.

          Volunteers were given pre weighed foods given as daily portions and were assessed by a dietician to make sure that they were adhering to the diet. After 8 weeks, this is what was found to be significant between the two groups. The low carb, high fat group experienced arterial stiffness which basically means impaired arterial function. What this means is that the people on this diet experienced low grade inflammation which can lead to the growth of atherosclerotic lesions and can become heart disease. “It is possible that the high fat content of a low-carbohydrate diet exerts detrimental effects on endothelial function, which raises concern s regarding the long-term safety and efficacy of low-carbohydrate diets…Currently, supported by evidence from long-term trials, we believe that a low-fat diet should remain the preferred diet for diabetes prevention.”
          http://diabetes.diabetesjournals.org/content/58/12/2741.long

          Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity
          20 subjects participated in this study. “The [low carb] diet provided 20 g of carbohydrates daily, supplemented with protein and fat content according to the Atkins’ diet recommendation.19 The [low fat] diet provided 30% of the calories as fat, modeled after an American Heart Association diet.” I wouldn’t exactly call the low fat diet “low fat”, but regardless, its far less fat then the low carb diet. Both groups were given 750 calories less with pre made meals so they would stick with the protocol.
          After 6 weeks, there were significant differences between the low carb and the low fat group. The researchers performed a brachial artery test which basically tests to see if arterial function is impaired or not. Typically, the arm is cut off from circulation for about 5 min., then they release the arm, and measure how dilated the blood vessels are. If the blood vessels are constricted, it represents arterial impairment whereas dilation indicates good arterial health.
          On week 2 of the diet, both low carb and low fat groups had poor arterial health and were not significantly different, but by week 6, those on the low carb diet had far worse arterial health then before, and those eating low fat had far better.
          (See figure 1: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702133/figure/F1/ )
          This again shows that this type of diet is promoting heart disease risk.
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702133/

          Low carbohydrate, high fat diet increases C-reactive protein during weight loss.
          Unfortunately, I was unable to find the full text of this study so it is difficult for me to view the details and all I can do is base my conclusions of the study based on the abstract which is not something I like to do. Regardless, the study revealed a very interesting finding. It showed that when subjects of the study went on a low carb, high protein diet for 4 weeks, they had a 25% increase in C-reactive protein. C-reactive protein is a marker of inflammation which basically means that this group of people were promoting the development of a chronic disease. In contrast, the high carbohydrate subjects decreased their levels of C-reactive protein by 48%.
          http://www.ncbi.nlm.nih.gov/pubmed/17536128

          Comparative Effects of Three Popular Diets on Lipids, Endothelial Function, and C-Reactive Protein during Weight Maintenance
          This study is quite interesting. It examined 18 adults aged 20 or over for 6 months. The aim of the study was to examine their health when on 3 diets, the Atkins diet (high fat, low carb), the South beach diet (Mediterranean) and the Ornish diet (low fat, high carb). They found no significant differences between the 3 diets in terms of calories consumed. The results are interesting as seen in table 1 of the study.
          They found higher LDL in the Atkins diet and lower LDL in the low fat Ornish diet. They also found significantly higher levels of C-reactive protein in the atkins diet as opposed to the Ornish diet. What was also found was that the atkins diet had poor results for the Brachial Artery test which again shows impaired arterial function. “High saturated fat intake may adversely impact lipids and endothelial function during weight maintenance. As such, popular diets such as Atkins may be less advantageous for CHD risk reduction when compared to the Ornish and South Beach diets”
          http://engine2diet.com/usrfiles/files/publishedstudies/obesity/comparative-effects-of-3-diets.pdf

          ****************************

          FROM TOM GOFF (in response to Rami):

          Great post. As you note, the long term effects of ketogneic and other low carb diets are really scary. We know for example that low carb diets do not just increase risk, they increase actual mortality. This effect, however, seems mainly confined to low carb diets based on animal fats and proteins. Low carb diets based on vegetable fats and proteins are apparently much less dangerous. Early death sounds like a pretty undesirable side effect of ketogenic diets to me..
          http://www.bmj.com/content/344/bmj.e4026
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989112/
          http://jaha.ahajournals.org/content/3/5/e001169.full
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/

          This is only observational evidence. Nevertheless, experimental studies with animals underline the dangers of ketogenic and other low carb diets:
          “C57BL/6J mice were fed with a HF diet (60% kcal/fat) or control diets (15% kcal/fat) for 27 months. One-half of the mice on the HF diet developed obesity (diet-induced obese (DIO) mice), whereas the remaining mice were diet resistant (DR). At 8 months of age, both DIO and DR groups had increased hyperglycemic response during a glucose tolerance test, which was normalized in 16-month-old mice. At this latter time point, all groups presented similar performance in cognitive tests (Morris water maze and inhibitory avoidance). The survival curves of the HF and control diet groups started to diverge at 15 months of age and, after 27 months, the survival rate of mice in the DIO and DR groups was 40%, whereas in the control diet group it was 75%.”

          Source: “High saturated fat and low carbohydrate diet decreases lifespan independent of body weight in mice
          “http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922950/

          There was another interesting mouse study published in 2014:
          ‘The team put mice on 25 different diets, altering the proportions of protein, carbohydrates and fat. The mice were allowed to eat as much food as they wanted to more closely replicate the food choices humans make.

          “The healthiest diets were the ones that had the lowest protein, 5 to 10 to 15 per cent protein, the highest amount of carbohydrate, so 60, 70, 75 per cent carbohydrate, and a reasonably low fat content, so less than 20 per cent,” Professor Le Couteur said.

          “They were also the diets that had the highest energy content.”
          “We found that diluting the diets to reduce the energy intake actually made the animals die more quickly.”
          The mice that ate a high-carbohydrate, low-protein diet lived about 50 per cent longer than those on the low-carb diet.”
          http://www.abc.net.au/news/2014-03-05/low-carb-diet-may-shorten-your-life-study-finds/5299284
          http://www.cell.com/cell-reports/fulltext/S2211-1247(15)00505-7
          http://www.cell.com/cms/attachment/2032903762/2049230860/mmc2.pdf




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      1. Thanks for your work in clearing up this mess with your research backed videos Dr.Greger and team. Could you show out of e.g. all the studies published or out of e.g. a few thousand studies which ones agree about plant based and which ones are bogus or say something else and so on? It’d be cool to e.g. look at 1000 or 10,000 studies and see how many were backing the plant based diet, how many were inconclusive or bullshit studies or later refuted and so on.. Which ones contribute to what myths or which studies are used to prop up other diets and so on? We can then show people you’re not cherry picking which is their attack or excuse for not watching your videos or not following a plant based diet especially if it’s currently at odds with their current eating habits and if they’re looking for a reason to attack you and vegan/plant based diets?

        People want to eat healthier but there are all these voices saying something different and that seem legitimate or as if backed by science to normal people who aren’t researchers or doctors/nutritionists so I can understand how confused people are or believe whatever they first see from atkins to paleo to keto and so on.

        Sigh even if there is a consensus in the research you go to normal people or youtube and wow the amount of people who each hold beliefs that don’t reflect the consensus (or partly reflecting this) shows how much work needs to be done to combat the media manipulation or how much bigger our marketing budgets need to be. This is why we all need to learn to use business as a force for good and replace the businesses making money currently keeping people sick and unhealthy! And a need for community based approach too?

        I think seeing the ‘97% of scientists agree with global warming’ figure and seeing it illustrated as a pie chart and with literal people making up the 2 groups for the sake of visualisation makes it clear and shows how good the 3% are at creating doubt. I’d like to see something here relating to food so we can share this with others? I think it could convince even more people?




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      2. How many more people have to die before most people realise what the consensus is! :'( Before businesses and the food industry changes? We all need to start food businesses or something and change the industry. Use business as a force of good and to create progress. Do good + make money and hopefully more people will jump on the bandwagon/change?

        Been thinking about food business ideas recently actually. From community kitchens/nutrition centres/research places to food clinics/centres and so on.. How do we maximise impact healthwise meaning for each person + in terms of reaching as many people as possible, how do we save people money on food, connect them to a community of healthy and kind people and so on.. Would you allow people to show your videos if a business did food/nutrition education? Would they just have to buy your dvds or pay for a license or to show them or something?

        Though on the other hand with populations rising this is somewhat keeping our species in check with all these preventable diseases? It’s interesting to think what’ll happen as we cure/reverse/prevent more and more diseases and live longer and longer.. And our impact on the planet..

        But I guess we’d cut back on our environmental destruction if we ate healthier and more plant based even if more people were to live longer..? And if we believe that it’s possible for people to be alive and to do more good (than harm/bad) for themselves, their families, communities, society and the environment/world then we should (continue to) work hard to help people lead healthier, happier, better lives!

        Do you have any videos looking at environmental impacts of different foods/diet? Or is that an area you wouldn’t comment on since it’s outside of your expertise? Could you get a friend or colleague who has spent a long time in this field and understands the research + what they’ve seen in reality/practice in the world to make a nutritionfacts style video backed by research studies about environmental impacts of different diets?




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        1. Tharun: I agree that the environmental impact of a diet is something we all need to consider. If you can get a chance to watch the documentary Cowspiracy, I think you will be very pleased as the information is very helpful and presented in a fun way. There is also a free talk you can watch that includes much of the same information, though not quite as entertaining. Here is that talk: https://www.youtube.com/watch?v=Fws0f9s4Bas&feature=youtu.be




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  1. The food and beverage industry spends billions of dollars every year marketing junk to us, to our children, contributing to the public’s confusion about basic, accepted nutrition principles. I’m glad to be one little voice trying to push out some science!




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  2. Is Co-Q-10 necessary for heart health…if so, is ubiquinol so much better than ubiquinone? Or, is this just a lot of hype and another waste of money?




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  3. Dr Greger: I had artery bypass surgery in 1997 and have a prescription for 40 mg. of lipitor to lower my cholesterol. Three months ago I went to a vegan no oil diet, and even though I cut the lipitor dose in half, I was pleased to learn that my cholesterol measured a mere 97. My LDL reading was also only 50 but my concern is that my HDL level was only a very low 27. Should I be concerned?




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    1. Congratulations on improving your diet and reducing your medication. You have made great strides in minimizing the chance of recurrent problems. I would not worry about the low HDL. HDL goes down with the other cholesterols when you adopt an improved diet… partly due to the reduction in a transport molecule in your blood so free HDL is not as low as you might assume. The levels of LDL and total cholesterol you report should allow you to further reduce or eliminate your statin. You need to continue to work with your physician(s). I would suggest reading Dr. Caldwell Esselstyn’s book on Preventing and Reversing Heart Disease… he also has a new DVD out but I haven’t had a chance to view it yet. I would also suggest you read Dr. McDougalls newletter article on Statins, http://www.drmcdougall.com/misc/2007nl/may/statins.htm and keep tuned to nutrtionfacts as the science and recommendations keep changing. Good luck.




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  4. Incredible info. It’s such a shame that this info is NOT given attention from the media. One would think newspapers and media would be ALL OVER it. Ground-breaking news that is too practical to make the cut???

    The thing is, vegetarian diets for lipid lowering advice… It’s not first line advice, as of yet anyway, and to suggest it as a healthcare professional, one can be seen as promoting their own lifestyle without sufficient guidelines to back you up. So, when will this get enough regognition to be used as a first-line Rx????




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    1. Never, I’m afraid. There’s no $ in it. Can you imagine what a big decrease in bypasses, other heart surgery would do to the profession? There´s no lobby for kale or broccoli, sadly




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    2. As this very article states, as much as $20 billion dollars could be saved with proper diet and nutrition. Prior to 2015 I had only been to see a doctor twice in 15 years; once for shingles and the other for a very stubborn boil. That equates to a great deal of money lost for the medical industry. In 2015 I did a complete series of doctors visits simply to have everything tested and see if I had any issues I should address. My results were just slightly elevated cholesterol and deficient in vitamin D. All my other tests came back clear as a bell including my mammogram and pap smear. I am 60 years old.

      During all those diagnosis visits, I would sit in the examining rooms adding up the thousands and thousands of dollars invested in the medical equipment alone. Those exuberant expenses aren’t paid for by healthy people. I call it the Big 3; big business, big pharma and big government thereby making it a ‘huge’ uphill battle. You could actually call it the Big 4 because the first three are pulling the strings of the 4th; the media.




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  5. Hi,
    We too long for the day that healthcare providers will have the majority voice on the optimal diet, but until then, we can have that one voice crying in the wilderness! Even one soul won will put out the word exponentially through their circle of influence, and so on and so on! One patient at a time. People still put a lot of stock on the word of a trusted physician, especially one who practices what he or she preaches. Physicians ought to promote what they have actually experienced. Their message will be that much more impactful.
    Walk your talk, talk your walk,
    Arlene




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  6. Dr. Gregor, could you please let us know where to find the interesting figure with phytonutrient compounds from different vegetables? I would love to use that when I talk to my patients about the benefits of a vegan diet. 




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    1.  I’ve added the source above and placed the graphic in supplementary materials. Too bad we can’t squeeze all 10,000-or-so in :)




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  7. Excellent lecture you gave at the Nat’l Animal Rights Conference!!  Thank you for all you do.  It is very frustrating when I suggest the benefits of a plant-based diet to people, only to hear them reply that their physician tells them to keep eating lean meats and dairy…end of story.  They are done listening to anything I have to say.




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  8. I am a new vegan with diabetes Type 2. I am told I need to take B12 supplements but the pills seem to have hugely more than required. However my diabetes website pointed me to research that taking the drug metformin which I am on means you need much more B12 supplement. My pharmacist recommended 1mg a day which seems ridiculously more than than the 5mcg my Dr recommended or the 2.4mcg per day that other sites recommend. The pharmacist said that 1mg a day is fine as it is water soluble and one excretes what is not required. Very confused. Help




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  9. B12 is not well absorbed, thus the larger pills. Since it is stored in the liver and there is no known detrimental effect for overdosing, you should be fine with the 1200mcg a few times a week .




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  10. Dr. Greger, I had the pleasure of meeting you at Health Fest in Marshall, Tx and loved your presentation Uprooting the Leading Causes of Death and bought several CDs. I eat a low fat, whole food, plant-based diet but recently my total cholesterol and LDL shot up. A year ago I was at 183 and LDL of 101, not as good as I’d like, but as low as I think I can get. This week I retested and it was 225 and LDL 137, HDL 70. I exercise strenuously 30 minutes/day and my BMI is 21. I am 52 years old. So . . . I’m wondering what other factors are at play and whether stress is a factor. Have you reviewed literature on the relationship between cholesterol and stress?




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    1. I have the pleasure of taking care of patients at the McDougall Whole Foods program. One area you might look at is fruit and fructose consumption. Whereas “glucose” is our bodies fuel and burned by every cell in the body… “fructose” is only metabolized by the liver to uric acid, inflammatory aldehydes, triglycerides, cholesterol and glycogen. I have had several patients adjust their fruit consumption down or reduce consumption of recovery drinks or bars which might contain fructose. Even though your LDL is high your LDL/HDL ratio is good. As far as stress goes… it has been linked to a wide range of disorders… in my almost 40 years of practicing medicine I’ve been more impressed by the fact that when patients are under stress they eat and exercise differently. Keep up the good habits and stay tuned to NutritionFacts.org. As an athlete you might enjoy Scott Jurek’s book, Eat Run. He has recipes he uses for recovery.




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      1. Hi Don can you please explain ketogenic diets and ketosis..? Do you guys have videos on this anywhere on nutritionfacts? People talk about it especially on youtube haha and I’m wondering what the research on this says? Is this like an Atkins diet? Some videos if you’re curious as to what is out there on youtube on this stuff and who’s advocating for it. Curious as to how it agrees or clashes with plant based diets!
        https://youtu.be/_434ERRbkj8 -> Dr. Eric Berg
        https://youtu.be/dSLf4bzAyOM -> Dr Eric Westman
        https://www.youtube.com/watch?v=Q9socQcwPIs -> Dr. John Bergman




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  11. As a newly diagnosed breast cancer patient, I was hoping to find specific information regarding treatment in this video. I did not.
    I have followed a vegetarian diet for over 15 years, and a mostly plant based diet for the last three. Additionally I take multiple vitamins everyday, go to exercise classes at the gym 4 days a week and do not smoke, drink alcohol, coffee, tea or soft drinks. I still developed breast cancer. Stop telling people that this will not happen if they will only make better choices.




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    1. I’m a vegan going on 6 months now. What I’ve garnered from all I’ve read is that it improves your odds against diseases. There are no gaurantees in life. No one here or anywhere has stated illness will not happen. I can tell you since I’ve changed my diet to entirely WFPB I feel so much better on so many levels. For one, I was borderline diabetic with very high cholesterol. Not anymore. That alone makes it worth it to me.
      I wish you well!




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  12. I have been listening to many of your videos and I´m always impressed and schoked as to why we don´t know so much more. Thank you, thank you, thank you…. What about juicing, which seems to be a new fad?




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  13. I switched to a plant based diet nearly 3 years ago, lost 70 lbs and feel a lot better. One thing is still bothering me: I easily get cold. Right now I’m sitting in 80 degree F in shirt&shorts and feel comfortable. But at work, I’m wearing winter clothes and am still freezing. 2 weeks ago it hit me and I actually got a cold and sick. Any thing I could do?




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    1. Additional info: I came to healthy eating listening to Dr. McDougall and then many more through his Advanced Study Weekends. I’m eating mostly whole plant and lately really ramped up my green leaves consumption. I’m easily constipated even on a whole plant diet. I’m now thankful for this near instant feedback.




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  14. Dear Doc, I suffer from fluctuating blood pressure. It’s high in the mornings and drops to low BP around noon and rises again bY night. What would be Your advice for this issue? – Paul




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    1. Hi Paul, as you can see I am not the “Doc”!

      Is this an ongoing issue of fluctuations? For how long? How high? How low? Do you have any other health problems? Caffeine use? Tobacco Use? Stressed? Do you work at night or sleep at night-so morning for you is? In other words need some more information.

      The BP does normally have fluctuations throughout the day usually in pattern of: normally lower at night while sleeping. BP starts to rise a few hrs. before you wake up. BP continues to rise during the day, usually peaking in the middle of the afternoon. Then in the late afternoon and evening, BP begins dropping again.




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  15. Hi Guys,
    My Dr recently commented on my Orange Palms and said I most probably have carotenemia- I eat a lot of coloured vegetables because I eat salads and cooked veg every day and I like my food to be colorful.
    I was trying to find out which fruits and veg I should cut out to reduce the orangeness… I eat carrots, including the purple variety, pumpkin, beetroot, red and yellow capsicums, tomatoes and sun dried tomatoes, and I have strawberries/ other berries/ mandarines at least once a wk- do I need to cut out all of these or just carrots?
    One source I found even said that spinach and broccoli where high in Carotene! Can you shed some light?

    Alice




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  16. How perfect are berries (as well as most fruit) for the human design. Nutrient for nutrient, they match almost exactly the same as the nutrients in human breast milk. They draw you in with bright colors, wonderful smells, and beg to be eaten. And the tree or bush they come from keeps on living and giving to the next creature who passes by. Sounds like the perfect food for the human design.




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  17. Hi Doctor,
    Does irradiation of spices and vegetables (like garlic, onions, potatos, etc.) before marketing to the public lowers the amount of antioxident in them?
    Thank you!




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    1. Hi Moran. That’s a good question I think the antioxidant content remains. I am not sure if they are testing irradiated black pepper, but in this video it appears healthful. I couldn’t find any research perhaps others know? Feel free to post some research if you come across anything. Sorry I cannot provide more.




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  18. dr. gregor is the best. ornish too. I’m paleo for three years now, but my ldl’s sky-rocketed. i’m going to change the proportion of my diet to even more plants, and less animal. thanks, Craig.




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  19. Hello Doctor and thank you so much for your time and effort on this. Here’s my question.

    Say that i am with a doctor or another health professional and they try to warn me about the dangers of a vegan diet. You see, these people won’t fall for a “studies have shown…” argument, because they are supposed to know studies better than me. So i need something that is convincing, legitimate and serious for them. Something short enough to be used in a spoken conversation. I tried to used the American College of Cardiology once, but i got the response “neah… those are just two or three ignorants who are dangerous” :/




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    1. My 2 cents is: Someone who is committed to not learning about the nutritional science will not be swayed by anything you say. However, if I had to pick something to say, I would repeat one of Dr. Greger’s points:
      .
      “There’s only one diet that’s ever been proven to reverse heart disease in the majority of patients—a diet centered around whole plant foods. So, anytime anyone tries to sell you on some new diet, do me a favor. Ask them one simple question: “Has it been proven to reverse heart disease—you know, the number one reason you, and all your loved ones, will die?” If the answer is “No,” why would you even consider it, right? Only one diet has ever been proven to do that. That’s not cherry-picking—there’s only one cherry.
      .
      In fact, if that’s all a plant-based diet could do—reverse the number one killer of men and women, shouldn’t that be the default diet, until proven otherwise? And, the fact that it can also be effective in preventing, arresting, or reversing other leading killers—like type 2 diabetes, and hypertension—would seem to make the case for plant-based eating simply overwhelming.” from: http://nutritionfacts.org/video/taking-personal-responsibility-for-your-health/




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      1. Well, that’s true. I did use this argument a few days ago, when i got my son his Poliomyelitis shot. He said that, of course a plant based diet would save lives and that is nutritionally “useful”, but this doesn’t mean we should abolish all other kinds of food (meaning, animal food). For once again he pointed to the “balance” thing: You should eat a moderate amount of all kinds of food because feeding exclusively on plants will sooner or later cause a deficiency of iron, vitamins and calcium and “your son will be in serious danger, weak and jealous of what other kids eat”. You see, this is frustrating…




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        1. That type of reply demonstrates that a) this person did not actually absorb what you said and b) is extremely ignorant about nutrition. Such a shame as medical professionals should be the ones leading the way here…
          .
          You may know this already, but just in case it will make you feel any better, here is a NuturitonFacts video showing that omnivores end up with more nutritional deficiencies than vegans: http://nutritionfacts.org/video/omnivore-vs-vegan-nutrient-deficiencies-2/
          .
          Also, I don’t know if this will be of interest to you, but there are two recommendations I often make when people ask nutrition questions about kids. You didn’t ask. Just ignore if this is presumptuous. One recommendation is to check out the site Vegetarian Resource Group, VRG, which Dr. Greger has spoken favorably of at one point. They have a whole section on kids, including a particular overview article I like. Here are the links: Overview: http://www.vrg.org/family/kidsindex.htm and Summary Nutrition Article: http://www.vrg.org/nutshell/kids.php The other resource is a book that Dr. Greger recommends in his book. The book is called Becoming Vegan. The Express Edition has a chapter on kid nutrition needs. You might find that helpful too. Now that I think about it, PCRM, has some great kid nutrition info, but I don’t have any links handy at the moment.
          .
          Good luck dealing with those doctors. I tend to prep myself ahead of time before I go in, reminding myself that doctors are great for some things and not for others and I need to draw the line on what the doctor is allowed to influence to only those areas doctors are trained in.




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        2. http://nutritionfacts.org/video/everything-in-moderation-even-heart-disease/

          Moderation in cholesterol for example kills. This is from the transcript: “…But, as Dr. Esselstyn wrote in Cleveland Clinic Journal of Medicine, in cholesterol lowering, moderation kills. Even if all Americans kept their total cholesterol below 200 mg/dL, millions would develop coronary artery disease. Strong evidence showed we need to keep our total cholesterol under 150 to stem America’s epidemic of coronary artery disease. What kind of evidence? Well, in many cultures, coronary artery disease is practically unheard of when total serum cholesterol levels are under 150 mg/dL. And here in the U.S., in the famous Framingham Heart Study, few of those with levels below 150 developed heart disease, and none died of it….”

          People don’t want to change their habits. It can mean giving up/changing their culture or spending extra energy/money/time or questioning their current values and so on.. So they try and say oh everything in moderation or ‘you don’t have to remove it completely’ and so on. This is why we need to get to kids/people early so it’s not difficult.. But show them health side + environmental side + ethical side and I think all this together convinces people more than just health alone for some people.. Especially those who’re healthy or seem healthy currently and don’t feel like there’s a reason to change health wise? Some of these fitness people and gym people and so on?

          If more athletes start competing and winning as vegans/plant based that’ll convert some of these gym/exercise folk. If we’re happier, healthier, less stressed and living better lives and it doesn’t look difficult then more people should jump on the bandwagon. We’ve got to show that this isn’t hard and that the outcomes are well worth the change/lifestyle!

          We need to stack the reasons for this as opposed to against this so people have no reason but to change. They need to see people in the media and in their communities who’re doing better off as a result of changing!




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  20. Dr. Greger … Really enjoyed watching Food Choices and your dry humor made the documentary.

    Could you send the convergence of evidence to Dr. Kaayla Daniel. While she makes some good points about eating too much unfermented soy, she feels a need to promote that myths that individuals on a plant based diet do not get enough vitamins, minerals and protein and of course claims there are not scientific studies that indicate saturated fat and cholesterol contribute to heart disease.

    Great site, great stuff




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  21. Dear Dr. Greger,
    I have watched many of your videos and read many of your posts of the last years. I appreciate very much how you present actual studies and summarize the findings, setting you apart from any other nutritional site I’ve yet come across.
    I am writing you to ask for some help.
    I am 31 yrs old, American, living in Germany since Fall 2008. Since about that time I developed an intolerance to milk products, and now I can no longer touch anything originating from an udder. But my intolerance didn’t stop there. Over the course of the last several years I have developed sensitivities to the following food groups (I used to be able to eat everything just fine):
    – Gluten
    – Legumes (any bean, any lentil, and soy)
    – Broccoli & Cauliflower
    – Orange vegetables
    – Chicken
    – All raw fruit except citrus & berries
    – All raw vegetables
    My symptoms incl. anything from diarrhea, terrible stomach and intestinal cramps, constipation (only with gluten), and extensive and painful gas.
    I have been to multiple gastroenterologists. I’ve had multiple upper and lower GIs, and I even had the procedure where I swallowed a camera, wore a belt with which it communicated, and had pictures taken of my intestines. The only results that came of any of this was a diagnosis of IBS as well as a slow intestine. I have been given Mesalazine, which helps greatly, but I still have so many problems, even when I avoid anything on the list above (which I almost always do.)
    Now, not being able to eat some of those foods is mostly a convenience issue – esp. when I eat out, not being able to eat gluten or dairy makes things SUPER difficult.
    However, the ones that I find the most nutritionally bothersome are the legumes and the various vegetables. You preach a whole food plant based diet, or at least a diet very rich in vegetables and vegetable protein. But for some reason over the last few years I’ve developed intolerances to these things. I don’t know if these are reversable at all, and I’m concerned about my health because of their absence in my diet. I do try to eat as many vegetables as I can, but there are only a few I can eat, so I know I eat too many carbs and too much meat.
    If you have any idea how I might be able to be helped, I would appreciate any pointers.
    Thank you.

    PS: I have many other diagnoses and take many other medications, most of whom I started taking either just before or just after moving to Germany. No doctor I know sees any connections, but I’ve learned the hard way how limited a single doctor’s scope of knowledge can be, so I’m looking for answers outside of the box.




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    1. Tulpen2323: I am Christine, a NF volunteer moderator. I am wondering whether or not any of the medications you were taking at the time your symptoms began, or are taking now include antibiotics that may have negatively affected your gut flora. Do beans and other legumes cause problems for you even if they are pureed? You might want to see these for ideas that might help with your IBS:
      http://nutritionfacts.org/?fwp_search=ibs&fwp_content_type=video
      Stick with the foods you are able to tolerate, and try slowly reintroducing small amounts of pureed legumes, as they are one of the preferred foods of the beneficial gut bacteria. I hope that helps!




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