What did a pilot study on How Not to Die’s Daily Dozen and How Not to Diet’s 21 Tweaks find?
Daily Dozen Diet Put to the Test for Weight Loss
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.
In How Not to Die, I compiled the healthiest of the so-called Green Light foods into my Daily Dozen checklist, and encouraged people to try to fit them into their daily routine. I made it into a free app, Dr. Greger’s Daily Dozen, available for iPhone and Android, so anyone and everyone can try to check off all the boxes every day, and track their progress over time.
As the feedback poured in from millions of people giving the app a try, two themes of complaints arose. The first was that it was just too much food. There was no way they could eat all that food in one day. In response, I explained that the Daily Dozen was aspirational, something to shoot for, just a tool to inspire people to include some of the healthiest of healthy foods into their daily diets. The vast volume of food I prescribed was on purpose. I was hoping that by encouraging people to eat so much healthy stuff, it would naturally crowd out some of the less-healthy stuff. After checking off twenty-four servings in the Daily Dozen, there’s only so much room left for a pepperoni pizza.
Ironically, the second major complaint we got is that it doesn’t have enough calories. I had to explain that the Daily Dozen just represented the minimum I encourage people to eat, not the maximum, and that, certainly, training athletes requiring thousands more calories would have to eat much more. This all got me thinking, though. Too much food but too few calories? Sounds like the perfect weight-loss diet!
The Daily Dozen is by definition all Green Light foods, all whole plant foods, so that right there bakes in all 17 ingredients of the ideal weight-loss diet I introduced in my book How Not to Diet. What about the calorie count? A systematic review of successful weight-loss strategies concluded that given the metabolic slowing and increased appetite that accompanies weight loss, to achieve significant weight loss, calorie counts may need to drop as low as 1,200 calories a day for women, and 1,500 calories a day for men. And what do you know? Plug in common foods into each of the categories, and the Daily Dozen averages about 1,200 calories, with the higher-calorie food choices nailing 1,500 calories.
In the second half of How Not to Diet, I focus on things that can further accelerate the loss of body fat, regardless of what you eat, which I encapsulated in my 21 tweaks. My free Dr. Greger’s Daily Dozen app had become so popular at that point that I decided to revamp it with these new features. Now, if you switch over to the weight-loss setting, you can make a game out of how many fat-busting boosters you can squeeze in every day, along with your Daily Dozen checkboxes. Does this actually help people lose weight, though? You don’t know until you put it to the test.
As part of a master’s thesis in lifestyle medicine at the Lithuanian University of Health Sciences, a graduate student conducted: “Weight control and lifestyle change using Dr. Michael Greger’s Daily Dozen and 21 Tweaks: does it really work? A pilot study.” How cool is that? It’s a before-and-after study with no controls, so it’s really more like a case series of four men and four women, on average obese, who were encouraged to use the app and follow the Daily Dozen and 21 Tweaks for four weeks, preceded by a prep phase, which included education sessions and even a cooking class, then followed up for a month after the diet.
At the end of the four-week intervention, an average weight loss of about 15 pounds (6.80 kg) was achieved, along with a few inches dropped from the waist. The two folks with diabetes lowered their sugars by about 50 points. LDL cholesterol dropped by 35 points. That’s the kind of drop we’d see with a first-generation statin. Three reached their ideal range, under an LDL of 70. That’s really the most important thing, as heart disease is the leading killer in Lithuania, as it is in the United States. And in addition to physical health, mental health appears to improve as well.
A month after the study was over, the participants appeared to be able to retain enough healthy eating habits to maintain the weight loss and improved well-being. But as they strayed, their cholesterol and blood sugars crept back up. It was so cool to read all the participants’ comments. They never felt hungry, their taste buds started changing, and they even learned to cook a little oatmeal. Of course, what they were really happy about was losing all that weight while experiencing some positive side effects. Now obviously a small, uncontrolled study is some super-weak sauce evidence, but what it did show is that it’s possible to make a lot of diet and lifestyle changes at once, and if they’re healthy changes, they may bring about some healthy effects.
Please consider volunteering to help out on the site.
- Ramage S, Farmer A, Eccles KA, McCargar L. Healthy strategies for successful weight loss and weight maintenance: a systematic review. Appl Physiol Nutr Metab. 2014;39(1):1-20.
- Žižka R. Weight control and lifestyle change using Dr. Michael Greger's Daily Dozen and 21 Tweaks: Does it really work? A pilot study. Master's thesis. Lithuanian University of Health Sciences. 2021.
- Lithuania. IHME.
- United States. IHME.
Motion graphics by Avo Media
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.
In How Not to Die, I compiled the healthiest of the so-called Green Light foods into my Daily Dozen checklist, and encouraged people to try to fit them into their daily routine. I made it into a free app, Dr. Greger’s Daily Dozen, available for iPhone and Android, so anyone and everyone can try to check off all the boxes every day, and track their progress over time.
As the feedback poured in from millions of people giving the app a try, two themes of complaints arose. The first was that it was just too much food. There was no way they could eat all that food in one day. In response, I explained that the Daily Dozen was aspirational, something to shoot for, just a tool to inspire people to include some of the healthiest of healthy foods into their daily diets. The vast volume of food I prescribed was on purpose. I was hoping that by encouraging people to eat so much healthy stuff, it would naturally crowd out some of the less-healthy stuff. After checking off twenty-four servings in the Daily Dozen, there’s only so much room left for a pepperoni pizza.
Ironically, the second major complaint we got is that it doesn’t have enough calories. I had to explain that the Daily Dozen just represented the minimum I encourage people to eat, not the maximum, and that, certainly, training athletes requiring thousands more calories would have to eat much more. This all got me thinking, though. Too much food but too few calories? Sounds like the perfect weight-loss diet!
The Daily Dozen is by definition all Green Light foods, all whole plant foods, so that right there bakes in all 17 ingredients of the ideal weight-loss diet I introduced in my book How Not to Diet. What about the calorie count? A systematic review of successful weight-loss strategies concluded that given the metabolic slowing and increased appetite that accompanies weight loss, to achieve significant weight loss, calorie counts may need to drop as low as 1,200 calories a day for women, and 1,500 calories a day for men. And what do you know? Plug in common foods into each of the categories, and the Daily Dozen averages about 1,200 calories, with the higher-calorie food choices nailing 1,500 calories.
In the second half of How Not to Diet, I focus on things that can further accelerate the loss of body fat, regardless of what you eat, which I encapsulated in my 21 tweaks. My free Dr. Greger’s Daily Dozen app had become so popular at that point that I decided to revamp it with these new features. Now, if you switch over to the weight-loss setting, you can make a game out of how many fat-busting boosters you can squeeze in every day, along with your Daily Dozen checkboxes. Does this actually help people lose weight, though? You don’t know until you put it to the test.
As part of a master’s thesis in lifestyle medicine at the Lithuanian University of Health Sciences, a graduate student conducted: “Weight control and lifestyle change using Dr. Michael Greger’s Daily Dozen and 21 Tweaks: does it really work? A pilot study.” How cool is that? It’s a before-and-after study with no controls, so it’s really more like a case series of four men and four women, on average obese, who were encouraged to use the app and follow the Daily Dozen and 21 Tweaks for four weeks, preceded by a prep phase, which included education sessions and even a cooking class, then followed up for a month after the diet.
At the end of the four-week intervention, an average weight loss of about 15 pounds (6.80 kg) was achieved, along with a few inches dropped from the waist. The two folks with diabetes lowered their sugars by about 50 points. LDL cholesterol dropped by 35 points. That’s the kind of drop we’d see with a first-generation statin. Three reached their ideal range, under an LDL of 70. That’s really the most important thing, as heart disease is the leading killer in Lithuania, as it is in the United States. And in addition to physical health, mental health appears to improve as well.
A month after the study was over, the participants appeared to be able to retain enough healthy eating habits to maintain the weight loss and improved well-being. But as they strayed, their cholesterol and blood sugars crept back up. It was so cool to read all the participants’ comments. They never felt hungry, their taste buds started changing, and they even learned to cook a little oatmeal. Of course, what they were really happy about was losing all that weight while experiencing some positive side effects. Now obviously a small, uncontrolled study is some super-weak sauce evidence, but what it did show is that it’s possible to make a lot of diet and lifestyle changes at once, and if they’re healthy changes, they may bring about some healthy effects.
Please consider volunteering to help out on the site.
- Ramage S, Farmer A, Eccles KA, McCargar L. Healthy strategies for successful weight loss and weight maintenance: a systematic review. Appl Physiol Nutr Metab. 2014;39(1):1-20.
- Žižka R. Weight control and lifestyle change using Dr. Michael Greger's Daily Dozen and 21 Tweaks: Does it really work? A pilot study. Master's thesis. Lithuanian University of Health Sciences. 2021.
- Lithuania. IHME.
- United States. IHME.
Motion graphics by Avo Media
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Daily Dozen Diet Put to the Test for Weight Loss
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Content URLDoctor's Note
I explain my traffic light system for ranking the relative healthfulness of Green Light vs. Yellow Light vs. Red Light foods in Dining by Traffic Light: Green Is for Go, Red Is for Stop.
The Daily Dozen was first introduced in How Not to Die. Rather than being a meal plan or diet in itself, the Daily Dozen is to be used as a checklist to inspire you to eat more healthfully and design more balanced meals.
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