Dairy & Cancer

Dairy & Cancer
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How do we explain the increased risk of prostate cancer but the decreased risk of colon cancer associated with dairy consumption?

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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.

Studies comparing country-by-country cancer rates “have shown up to a 70-fold variation in the incidence of prostate cancer worldwide with low rates in parts of Asia and Africa and high rates in North America, Australia, New Zealand, and Northern Europe.” Here’s the map of prostate cancer mortality. Could dairy consumption have something to do with it, given Northern Europeans, Americans, and Australians drink a lot of milk, whereas most non-Caucasians in the world are lactose intolerant? But just because a country drinks a lot of milk and has a lot of cancer doesn’t mean the individuals within the country that are drinking the milk are getting the cancer. That’s why we need “cohort studies,” where you find out how much milk people drink, and follow those individuals over time, and see if those who drink more milk get more cancer.

There have been dozens of such studies done. Put them all together, and “[i]ntakes of total dairy products [including low-fat milk] were [indeed] associated with increased [prostate cancer] risk.” The question is…why? Maybe it’s just all the calcium. They found that the more calcium people consumed, the higher their risk of prostate cancer. Yeah, but most people get their calcium from dairy. So, how do we know this isn’t just a dairy effect? Before we start worrying about kale and other non-dairy sources of calcium, it would be nice to see dairy calcium teased out from non-dairy calcium intakes. And that’s exactly what they did. Yes, the more calcium from dairy sources, the higher the risk of cancer, but non-dairy sources of calcium were found to be protective. So, it wasn’t a calcium effect; it was a dairy effect. This suggests that “other components of dairy” may be to blame.

They suggest it’s the animal protein, boosting the levels of a cancer-promoting growth hormone called IGF-1: insulin-like growth factor 1. If you look at 28 studies involving nearly 28,000 people—this is what’s called an albatross plot. Any study to the right of this line shows a link between IGF-1 levels and dairy products, milk specifically, or dairy protein consumption. And, any study hitting this line or over shows a significant association with higher IGF-1 levels.

This could also explain why plant-based diets can be so protective. Put watch-and-wait cancer patients on a whole-food, plant-based diet for a year—no chemo, no radiation; lifestyle changes only—and get “a significant reduction in PSA level[s],” indicative of tumor shrinkage: their bloodstream becoming nearly eight times better at suppressing the growth of cancer cells. Do biopsies, and you can show changes in gene expression, a down-regulation of critical cancer genes, effectively switching off cancer growth genes at a genetic level. Whereas, if you instead eat lots of dairy after a prostate cancer diagnosis, you may suffer “a 76% higher risk of” death overall, “and a 141% [increased] risk of” dying specifically from your cancer.

Even without IGF-1, the milk protein casein appears to be a cancer cell “proliferation promoting factor,” increasing the growth of prostate cancer cells, at least in a petri dish. And the same thing with whey, the other major animal protein in dairy. See, “nearly 100% of advanced” prostate cancers thrive by upregulating a growth enzyme called TOR. And, dairy protein boosts TOR signaling even higher, which only makes sense. Calves have to grow like 40 times faster than human babies, and so cow’s milk has to be packed with growth promoters, not to mention the hormones in milk. Especially from cows who are already pregnant again.

This “[c]ommercialized milk production by pregnant cows releases uncontrolled amounts of bovine steroid… [hormones] into the human food chain.” And so, the combination “may [well] explain the observed association between high dairy consumption and increased risk of [prostate cancer].”

“From an evolutionary perspective…the persistent ‘abuse’ of the growth-promoting signaling system of bovine milk by humans over their entire life span [not just drinking milk during infancy] maintains the most important hallmark of cancer biology:” this “sustained proliferative signaling” to grow, grow, grow. And so, there’s this interest in trying “to define [the] safe upper limits for long-term milk and dairy intake for the prevention of the most common dairy-promoted cancer in men.” But if you look at diet and cancer guideline recommendations, yeah, milk may increase risk of prostate cancer. “However, no recommendation was provided for [cutting down on dairy] because the evidence for prostate cancer conflicted with decreased risk of colorectal cancer.” High dairy intake is associated with increased prostate cancer risk, but decreased colon cancer risk.

So, it’s like alcohol may be an “intoxicating carcinogen,” but “policymakers hesitate to introduce effective alcohol policies, or even to support the addition of [cancer-warning] labels, for fear they might undermine [any] possible health benefits of alcohol use.” Now, I’ve talked about how the purported benefits of alcohol appear to be “evaporating.” Is dairy really protective against colon cancer?

If you put all the cohort studies together, where they measured dairy consumption and then followed people for years to see who got cancer, milk and total dairy consumption was indeed “associated with a reduction in colorectal cancer risk,” one of our deadliest cancers. Now, people who drink more milk just happen to tend to exercise more, smoke less, drink less, eat less meat—which could explain some of the association. “However, many of the studies adjusted for [these kinds of] confounding factors.” More likely, it was the protective effects of the calcium, “which may bind [up] pro-inflammatory…bile acids in the gut,” though high-fat dairy products, like cheese, may actually increase bile acids, explaining why the cheese appeared to cancel out the calcium benefit. So, might we be able to get the best of both worlds by consuming non-dairy calcium sources?

If you randomize people to calcium supplements, you can get a significant reduction in recurring colon polyps, which can otherwise turn into cancer, though calcium pills have been associated with adverse cardiovascular effects. And so, the best of all worlds, if you want to take a precautionary approach in terms of nutrition and cancer, is to obtain calcium through low-oxalate dark green leafy vegetables, beans, split peas, chickpeas, and lentils—or, if necessary, “calcium-fortified foods,” such as soy or almond milk.

Please consider volunteering to help out on the site.

Motion graphics by Avocado Video

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

Studies comparing country-by-country cancer rates “have shown up to a 70-fold variation in the incidence of prostate cancer worldwide with low rates in parts of Asia and Africa and high rates in North America, Australia, New Zealand, and Northern Europe.” Here’s the map of prostate cancer mortality. Could dairy consumption have something to do with it, given Northern Europeans, Americans, and Australians drink a lot of milk, whereas most non-Caucasians in the world are lactose intolerant? But just because a country drinks a lot of milk and has a lot of cancer doesn’t mean the individuals within the country that are drinking the milk are getting the cancer. That’s why we need “cohort studies,” where you find out how much milk people drink, and follow those individuals over time, and see if those who drink more milk get more cancer.

There have been dozens of such studies done. Put them all together, and “[i]ntakes of total dairy products [including low-fat milk] were [indeed] associated with increased [prostate cancer] risk.” The question is…why? Maybe it’s just all the calcium. They found that the more calcium people consumed, the higher their risk of prostate cancer. Yeah, but most people get their calcium from dairy. So, how do we know this isn’t just a dairy effect? Before we start worrying about kale and other non-dairy sources of calcium, it would be nice to see dairy calcium teased out from non-dairy calcium intakes. And that’s exactly what they did. Yes, the more calcium from dairy sources, the higher the risk of cancer, but non-dairy sources of calcium were found to be protective. So, it wasn’t a calcium effect; it was a dairy effect. This suggests that “other components of dairy” may be to blame.

They suggest it’s the animal protein, boosting the levels of a cancer-promoting growth hormone called IGF-1: insulin-like growth factor 1. If you look at 28 studies involving nearly 28,000 people—this is what’s called an albatross plot. Any study to the right of this line shows a link between IGF-1 levels and dairy products, milk specifically, or dairy protein consumption. And, any study hitting this line or over shows a significant association with higher IGF-1 levels.

This could also explain why plant-based diets can be so protective. Put watch-and-wait cancer patients on a whole-food, plant-based diet for a year—no chemo, no radiation; lifestyle changes only—and get “a significant reduction in PSA level[s],” indicative of tumor shrinkage: their bloodstream becoming nearly eight times better at suppressing the growth of cancer cells. Do biopsies, and you can show changes in gene expression, a down-regulation of critical cancer genes, effectively switching off cancer growth genes at a genetic level. Whereas, if you instead eat lots of dairy after a prostate cancer diagnosis, you may suffer “a 76% higher risk of” death overall, “and a 141% [increased] risk of” dying specifically from your cancer.

Even without IGF-1, the milk protein casein appears to be a cancer cell “proliferation promoting factor,” increasing the growth of prostate cancer cells, at least in a petri dish. And the same thing with whey, the other major animal protein in dairy. See, “nearly 100% of advanced” prostate cancers thrive by upregulating a growth enzyme called TOR. And, dairy protein boosts TOR signaling even higher, which only makes sense. Calves have to grow like 40 times faster than human babies, and so cow’s milk has to be packed with growth promoters, not to mention the hormones in milk. Especially from cows who are already pregnant again.

This “[c]ommercialized milk production by pregnant cows releases uncontrolled amounts of bovine steroid… [hormones] into the human food chain.” And so, the combination “may [well] explain the observed association between high dairy consumption and increased risk of [prostate cancer].”

“From an evolutionary perspective…the persistent ‘abuse’ of the growth-promoting signaling system of bovine milk by humans over their entire life span [not just drinking milk during infancy] maintains the most important hallmark of cancer biology:” this “sustained proliferative signaling” to grow, grow, grow. And so, there’s this interest in trying “to define [the] safe upper limits for long-term milk and dairy intake for the prevention of the most common dairy-promoted cancer in men.” But if you look at diet and cancer guideline recommendations, yeah, milk may increase risk of prostate cancer. “However, no recommendation was provided for [cutting down on dairy] because the evidence for prostate cancer conflicted with decreased risk of colorectal cancer.” High dairy intake is associated with increased prostate cancer risk, but decreased colon cancer risk.

So, it’s like alcohol may be an “intoxicating carcinogen,” but “policymakers hesitate to introduce effective alcohol policies, or even to support the addition of [cancer-warning] labels, for fear they might undermine [any] possible health benefits of alcohol use.” Now, I’ve talked about how the purported benefits of alcohol appear to be “evaporating.” Is dairy really protective against colon cancer?

If you put all the cohort studies together, where they measured dairy consumption and then followed people for years to see who got cancer, milk and total dairy consumption was indeed “associated with a reduction in colorectal cancer risk,” one of our deadliest cancers. Now, people who drink more milk just happen to tend to exercise more, smoke less, drink less, eat less meat—which could explain some of the association. “However, many of the studies adjusted for [these kinds of] confounding factors.” More likely, it was the protective effects of the calcium, “which may bind [up] pro-inflammatory…bile acids in the gut,” though high-fat dairy products, like cheese, may actually increase bile acids, explaining why the cheese appeared to cancel out the calcium benefit. So, might we be able to get the best of both worlds by consuming non-dairy calcium sources?

If you randomize people to calcium supplements, you can get a significant reduction in recurring colon polyps, which can otherwise turn into cancer, though calcium pills have been associated with adverse cardiovascular effects. And so, the best of all worlds, if you want to take a precautionary approach in terms of nutrition and cancer, is to obtain calcium through low-oxalate dark green leafy vegetables, beans, split peas, chickpeas, and lentils—or, if necessary, “calcium-fortified foods,” such as soy or almond milk.

Please consider volunteering to help out on the site.

Motion graphics by Avocado Video

Doctor's Note

Whoa, that was a long one, but I didn’t want to break it up and lose the narrative thread. I hope it was clear enough. This may be one of those that requires a second listen, because I packed a bunch in there.

Here’s the video I mentioned: Is It Better to Drink a Little Alcohol than None at All?

What about dairy for bone health? That’s controversial too. See Is Milk Good for Our Bones?

What about those that say the dairy fat isn’t so bad after all? See Is Butter Really Back? What the Science Says

What about plant milks? Check out Prostate Cancer & Organic Milk vs. Almond Milk

For more on cancer in general, see: How Not to Die from Cancer

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

94 responses to “Dairy & Cancer

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  1. I have always been confused by “fortified.” Often “fortified” foods are listed as sources of certain vitamins. For example, at the end of this video fortified non-dairy milks are recommended for calcium. However, calcium supplements are not recommended. So what is the difference between fortified foods and taking supplements? Aren’t the manufacturers just adding these vitamins back in to fortify? How is that different than my taking a calcium pill? If I dump the pill into the soy milk am I now fortifying it and everything is okay? What am I missing?

    1. SpareChaos, I agree completely with you. I don’t eat “fortified foods;” if I want a supplement, I’ll take one myself. Which, except for vitamins B12 and D3, I don’t.

      But I could guess that the calcium in fortified foods is consumed at lower levels through out the day with food, rather than in one big dose which might even be taken without food. That could make the fortified foods a safer alternative. I’d rather eat those “low-oxalate dark green leafy vegetables, beans, split peas, chickpeas, and lentils.” mmmm, good! And they provide so many more benefits than a pill or fortified food.

      1. Hi Dr J. I am with you on calcium sources! I don’t eat fortified foods either. It seems something should be addressed regarding this fortifying vs supplements. If you visit the NIH site to read about various vitamins, under “Selected Food Sources” they always list fortified foods. To me that is not a food source. I find it odd that NIH would include fortified foods in these lists. They should just make a note at the bottom of the list with some fortified options. Yes, for the most part it is smaller doses. But some products (like breakfast cereals) are like a giant multi-vitamin in a bowl. And manufacturers love putting Folate (Folic Acid) in things. It’s possible to get too much if you are eating fortified foods.

    2. I dislike the fortified non-daity milk products because they use calcium carbonate, one of the least absorbable and cheap forms out there. It also is very inconvenient for anyone who is on prescription medications that should not be taken with calcium and can cause medications to fail at the dosages in a serving (avg 450mg).

        1. I have on hand a container of Organic EdenSoy Original Soymilk: Purified Water, Organic Soybeans, Naturally Malted Organic Wheat and Barley Extract, Calcium Carbonate, Kombu Seaweed & Sea Salt. I rarely buy this brand.

          I usually buy WestSoy Organic Unsweetened Plain Soymilk (nothing added).

            1. None of the supermarkets in my area even carry the Edensoy brand. There’s a really great Spanish supermarket a few easy walking blocks from where I live, and this is the only kind of soymilk they sell. I thought I’d run out one day., so…

              Yeah, I don’t like all those strange sounding add-ons. What really IS that stuff?

      1. Excuse me Jimbo, but I don’t understand why you say calcium carbonate is one of the least absorbable forms.

        Please, check out this study:

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981009/

        “The Ca in fortified soy milk is as absorbable as the Ca in cow milk when the fortificant is Ca carbonate and somewhat less well absorbed if the fortificant is tri-Ca phosphate”

        If you could explain your point of view I’d really appreciate it. But according to the above study, I’d say that Ca carbonate is a good source of calcium.

    3. Hi, SpareChaos! I agree that “fortified foods” can be confusing. Yes, they do have nutrients added, and it is somewhat like dumping your calcium pill into your soy milk. I think that is why Dr. Greger said in the video, “if necessary,” with regard to calcium-fortified foods. It is better, I think, to get nutrients from whole plant foods, such as, in this case, low-oxalate greens and legumes. I hope that helps!

  2. I am also confused whether calcium fortified foods share the risks associated with calcium pills.
    And if so to what extent. I’d be relieved if they didn’t because fortified soy milk is by far the easiest way for me to meet the daily minimum.
    Thank you. :)

  3. I am grateful for soy milk – without it I would be forced into using milk, kefir, yogurt, cottage cheese etc. The only drawback is that it interferes with some of the antioxidants in berries and green tea.

    1. Hi Barb,
      Apparently soya milk’s blocking of anti-oxidants is not as bad as original thought. One of Dr G. recent video ( https://nutritionfacts.org/video/does-adding-milk-block-the-benefits-of-coffee/ ), state that soya milk did not interfere with the beneficial impact of coffee as per following quote from video transcript:

      “…. either way soy milk has some inherent benefits over cow’s milk, but does it have the same nutrient-blocking effects? And the answer is…no. No significant difference in the absorption of coffee phytonutrients drinking coffee black or with soy milk. What seemed to be happening is that the soy proteins do initially bind the coffee compounds up in the small intestine, but then your good bacteria can release them so they can be absorbed down in the lower intestine. So, “considering the reversible nature of binding,” as opposed to the dairy proteins, “it seems not to be as relevant” as to whether or not you add soy milk.”

      I am not a nutrition specialist but my guess is that soya milk is not likely to block the nutritional benefits of berries or green tea.

      1. Hi Steven Karekezi, you made my day! Very interesting because I also remember (and am still tring to find) a study discussed by Dr Greger on the benefits of green tea, macha in particular. The study involved a number of postmenopausal Japanese women who reaped benefits by consuming their daily beverage. When I looked the study up, they mentioned the use of soy milk with the green in the study. Thank you for your comments this morning!

        1. Tea plants are known to be very effective at taking up and concentrating heavy metals from the soil. Fluoride, lead and aluminium are the ones that always stick with me but there are others and it depneds on the soil in which they are grown and local atmospheric conditions. A certain proportion of these leach into the infusion with standrad brewed teas. However, because you are eating the actual powdered leaves when you consume matcha – in ordinary teas, the leaves are discarded after brewing – you are also getting concentrated doses of these metals (and caffeine) as well as concentrated doses of the good things from tea.
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762913/

          Green tea consumption is associated with lower mortality and short term studies show benefits from matcha consumption. However, I am not aware of any long-term studies of the effects of regulat matcha consumption on health. Does the increased absorption of the good things in green tea outweigh the negative effects of increased aborption of heavy metals and caffeine I wonder?

          1. All good questions Mr Fumblefingers! I have not yet established the macha as a daily habit, though I am pleasedwith one side effect so far. I have become accustomed to the ‘bitter’ edgey-ness to green tea though I thought it would never happen! Regular green tea with a slice of lemon and ginger is a pleasant ‘walk in the park’ .

            There are a couple companies that test for heavy metals. I may check it out just to see what’s available.

            1. I make Dr Greger’s matcha ice cream. It is divine! Frozen bananas and Matcha green tea powder and you think you’re having dessert in a Chinese restaurant.

    1. Try getting pizza with not meat/cheese. I did it about 5 years ago as an experiment and was very surprised. Unless it is some strong tasting artisan cheese, what is generally used (mozaarella) has very little flavor and mostly provides a “mouth feel”. So you get all the flavor and miss that leaden gut feeling after eating. I don’t do it often due to the incredibly high sodium content of pizza but when I do, I order it with all the veg they have and no mean/no cheese. I can eat more of it without getting over full too! ;)

      1. Geoffrey,

        Good ideas on making a “better” pizza, thank you. As a consideration, if your still yearning for some cheese like flavor you might consider the vegan cheeses now available from a number of sources. Yes its a processed food, but for your occasional “go for it” affairs it might bring on a bigger smile.

        Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

        1. Thanks. Have not tried any of the newer, more $$$ ones, but years ago I tried what was available and did not like any of them. People seem to really like Daiya but I don’t. I do have a recipe for a very easy cashew cheese that I like a lot but I also have calorie density concerns so generally just give it a pass

          If I really “must” have cheese I actually just go ahead and eat some Humboldt Fog or whatever and enjoy the heck out of it. That happens many once a year if that.

          For pizza, I mostly make my own. Found an online recipe that is supposedly the sauce used by California Pizza Kitchen so I make that or use pesto. I make the crust w/ my sourdough starter and 100% whole grain (usually kamut but have used other grains). Cover w/ lots of sautéed mushrooms, onions, broccoli, etc. When it comes out of the oven I may sprinkle w/ a little nutritional yeast. Fun to make and fun to eat!

  4. Does this mean one should never eat a slice of veggie pizza with a little real cheese or never enjoy a good piece of aged cheese on a piece of crusty Italian bread with wine? Is a once a month pleasure break being too liberal?

    1. To me that’s like asking if playing Russian Roulette once a month as a pleasure break is being too liberal. =\

      I know what you’re saying about the pizza. It’s very attractive when you’re used to eating it. But the longer you abandon foods like cheese pizza, the less you desire to have them. (I remember when I was a teenager a Hostess fruit pie was one of my top addictions. Today just looking at one makes my teeth itch. Yuk.)

      I frequently make home-made pizzas using toasted Food For Life English muffins, low-sodium pizza sauce, oregano, and a bunch veggies (red pepper, scallions, red onion, and even asparagus) as toppings. I don’t miss the cheese at all.

      cheese is a risk (today’s video and many others)
      white bread is a risk (https://nutritionfacts.org/video/is-white-bread-good-for-you/)
      alcohol is a risk (https://nutritionfacts.org/video/can-alcohol-cause-cancer/).
      and red wine is probably not much better (https://nutritionfacts.org/video/breast-cancer-risk-red-wine-vs-white-wine/)

      Strike three…

      1. Dr. Cobalt, I had to laugh as you brought back memories of my teenage years when I also loved to eat Hostess fruit pies too, especially the berry and apple ones. I thought I was doing myself a favor by snacking on them instead of candy ( I also loved eating tins of salty, greasy kippered herring as a snack). I supposed that eating the fruit was good for you, but the high sugar and shortening content along with white flour probably more than canceled out any benefit. This just shows how people, especially kids, have to be educated about what is truly healthy and what is not. Too bad my parents were not in the know. My preference for pastries and cookies instead of candy was due to their influence.

        1. I think the worst thing I ever ate routinely as a kid (and it still makes me cringe) were the Carnation Instant Breakfasts. Remember those? Yikes.

      2. I can definitely say I don’t crave sweet things any longer. But pizza…. Even after months without it, I still enjoy a slice of pizza with lots of cheese, sauce, and vegetables. Other than that, I don’t eat cheese (or much salt for that matter).

    2. A healthy way of eating if a lifestyle. There are no diet police just your own conscience when it comes down to it. Eating healthy is like exercise, the more we do it the more the benefits become noticeable. If we skip days then the benefits are less but still there. Just don’t give up.

  5. Dairy isn’t the only protein that raises mTOR levels. Getting a large amount of essential amino acids, which come from all animal proteins, will have a similar effect. This is a clue to the cancer-preventing effects of plant proteins. However, soy also raises IGF-1 levels, although it raises IGF binding proteins (IGF-BP’s) too. One wonders if the meat substitutes many of us enjoy will be found to raise IGF-1 WITHOUT raising IGF-BP’s. That would be a shame – it’s been nice to enjoy a mock Italian ‘sausage’ and the mock ‘Turkey’ roast QUORN makes. HEADS UP FOR THOSE WITH HIGH CHOLESTEROL: mTOR also drives cholesterol production – which explains why even people eating lean white meat and nonfat dairy can have high LDL levels. Gotta go PORTFOLIO!

    1. Body builders are encouraged to supplement with branched-chain amino acids (often manufactured from animal hair) which are about half Leucine. It turns out that leucine is the primary amino acid involved in raising mTOR levels.
      https://www.physiology.org/doi/full/10.1152/ajpendo.90645.2008
      Seems to me that there may by an epidemic of cancer among body builders in the future and this just goes to show how taking supplements can do more hare than good.

  6. I’m torn on this subject. There is so much positive data with regard to athletes and milk (for recovery and wanting to stimulate more IGF-1). My question is if you are one that is training pretty vigorously as an athlete, is dairy consumption ok (is the risk lower for us), vs. non active or mildly active people. I once quit cold turkey and switched to almond milk, but could not recover as well. I know he doesn’t usually respond to questions here, but it’s worth the shot. Thank you for all your work!

    1. Hello Michael,

      Thank you for your question. I am a family doctor with a private practice in lifestyle medicine and also a volunteer for this website. It makes some sense that if IGF-1 stimulates growth, in general, then maybe it would help in building more/better muscle. Here is a video by Dr. G where he specifically looks at the question of IGF-1 and muscle building: https://nutritionfacts.org/video/plant-based-bodybuilding/ — and he concludes that higher levels of IGF-1 do NOT lead to increased muscle mass. He does not address your question about whether high IGF-1 could reduce recovery time.

      There is a LOT of misinformation out there about nutrition, and that is especially so in the area of nutrition for male athletes. Myths abound, such as that men should avoid soy because it can cause breast enlargement. This is not true, as Dr. G points out in this video: https://nutritionfacts.org/video/the-most-potent-phytoestrogen-is-in-beer/

      Lots of athletes are still tempted to use anabolic steroids, because they CAN, in fact make it easier to build muscle and to recover more quickly from injury. Problem is that they cause lots of side effects including breast enlargement, small testes, low sperm count, impotence, acne, high blood pressure, changes in cholesterol, and even liver disease and coronary artery disease.

      Even if drinking milk seemed to help you recover more quickly after exercise, be aware that the milk might not have been the critical factor at all — it could have been that drinking milk made you sleepy (known effect) and you got more sleep, or that because you like milk more than almond milk you drank more of it and so were better hydrated. Since dairy consumption is associated with so many problems (Dr. G has done scores of videos on this), I just don’t think it’s a good idea.

      I hope this helps.
      Dr.Jon
      PhysicianAssistedWellness.com
      Health Support Volunteer for NutritionFacts.org.

      1. The problem with all the research cited in Dr F’s “Plant-Based Bodybuilding” video you linked is that none of it includes the key component, heavily stressing the muscles on a regular schedule with progressive overload, with higher and lower IGF-1 levels. Just flexing doesn’t get it. You have to be moving heavy weight.
        NB: I am a near vegan, zero dairy, whole foods from plants advocate

    1. The data sources are set out in the drop-down ‘Sources’ box under the video..

      Your data come from 2017. I think the prifessonal journal articles Dr Greger is quoting from use WHO data from an earlier period.

  7. Hello Prowler, and thanks for your question,

    I’m a family doctor with a private practice in lifestyle medicine and also a volunteer for this website. The quick answer to your question is that once a month is not going to hurt most of us, for almost any unhealthy food consumption, if the rest of the time you are eating a healthy, whole foods, plant-based diet. In fact, for patients who are starting from eating a “standard American diet” — with plenty of meat, dairy, and eggs, and minimal veggies, fruit, and fiber, it is very acceptable to make the transition to a WFPB diet slowly, giving up one thing at a time. Also, I have patients who just won’t give up certain foods, whether that is fish, or cheese, or yoghurt, or something else. If they are otherwise eating a healthy diet, I congratulate them on the healthy changes they DID make! When I first changed my diet about 4 years ago, I kept eating fish and eggs for about a year before I decided to switch to an entirely WFPB diet.

    However, there are some people, for example those who have had a heart attack and who still have high cholesterol, for whom eating food that is very high in saturated fat, such as cheese, is just not a good idea, especially because cheese is somewhat addictive and many people can’t stop at eating one piece per month. It’s kind of like someone who has recovered from lung cancer who wants to just smoke an occasional cigarette. So, sometimes consuming something in moderation can still kill you!

    A related issue: the bacteria in our intestines can change from healthy to unhealthy types in as little as four days. The composition of our “gut flora” has been shown to be very important in a whole variety of disease processes. So when I have a patient who wants to “take a vacation” from eating healthy, and revert back to a standard American type of diet, I refer them to these videos by Dr. Greger:
    1) https://nutritionfacts.org/video/how-to-change-your-enterotype/ — documents how change to animal based diet completely switches bacterial flora in 4 days
    2) https://nutritionfacts.org/video/microbiome-the-inside-story/ — good introduction to the role healthy gut bacteria play in nutrition and health.
    3) https://nutritionfacts.org/video/prebiotics-tending-our-inner-garden/ — about the critical role high fiber and “good bacteria” play in regulating immune function.

    I hope this helps you answer your question.
    Dr.Jon
    PhysicianAssistedWellness.com
    Health Support Volunteer for NutritionFacts.org

  8. With the evidence against dairy products piling up, I have a very hard time understanding why so many nutritionists promote its consumption. Here in Quebec, I have seen many supposedly specialists encourage dairy product consumption for their high content in calcium and protein.

    1. Nutritionist are taught to work with what their patients eat, and most American patients get most of their calcium in their diet from dairy. Nutritionist also follow USDA recommendations which is lobbied heavily by the dairy industry among the many animal as food industries.

    2. In the US, the dietitians’ professional body is called the Academy of Nutrition and Dietetics (AND). Its sole national sponsor is the National Dairy Council. I would be very surprised therefore if the professional guidance it gives to its members on dairy foods was anything but positive.
      https://www.eatrightpro.org/about-us/advertising-and-sponsorship/meet-our-sponsors

      I recall that a year after the National Dairy Council became the Academy’s national sponsor (ie major provider of funding) in about 2010, the Academy changed its position on saturated fat from one of underlining the science showing the harmful effects of high saturated fat consumption to arguing that saturated fat should no loger be considered ‘a nutrient of concern’. Perhaps coincidentally, dairy foods are the major source of saturated fat in the US diet.

  9. was consultant for years in an academic oncology department, as an immune-clinician I determined diet to prevent cancer growth after treatment and prevention. My peers were kidding me with the nutrition. My mother in law chose to follow my diet (her son is oncologist) after a cancer colon at age 63 she is now 98. Nutrition is a major part to avoid the mutation making cancer to thrive. Today the best understanding of the gut absorption explains the fluctuation of effect of intake and health.

  10. My 3 boys are D1 athletes and 1 got drafted to MLB. We are heavy into protein drinks because they all (including myself) work out daily. We were doing the almond/coconut milk to mix with whey protein. But the last 6 months I have been paying extra for raw milk coming from local organic grass fed pastures. Does raw milk follow the same protocol as pasteurized milk? Also, my one son that got drafted put on increased size last year by eating venison meat coming straight from farm. So no added bad stuff to the meat. So kind of living off the land with venison, wild hog, and raw milk. We do incorporate a lot of organic fruit and veggies in our diets. Veggies marinated in 1 gallon zip lock bag with coconut oil, garlic, black pepper and turmeric and then cooked on grill. We don’t do any soy products because I’ve done some research on those products and they screw with your hormones and increase estrogen. Any input would be appreciated. I am always open to suggestions on healthier lifestyle

    1. Hi, John C! Milk is milk, and it all includes the same naturally-occurring growth factors from the cow. The “protocol” is not the same with raw milk, because it is not pasteurized, which increases the risk of illness from pathogenic microorganisms in the milk, but that has no effect on the cancer-promoting growth factors. Milk proteins are cancer-promoting. Athletes do not need to get a larger percent of their calories from protein than other people. They do need more calories to support their levels of physical activity. Excessive protein intake is associated with a number of health problems. You can find everything on this site related to protein here: https://nutritionfacts.org/topics/protein/
      It is worth noting that a number of high-level athletes are turning to whole food, plant-based diets to improve performance and overall health. More on that here: https://nutritionfacts.org/topics/athletes/
      I hope that helps!

  11. A fantastic video, this is really the best of the best that is out there.
    Hey Dr. I’m sending you a copy of my manuscript when I have it finished in a year from now, I think you’ll find it interesting to read.

  12. I didn’t hear anything about Organic Dairy vs GMO dairy. I would love to see research on Organic vs Non-organic dairy. It is not just what we eat, but the quality of what we eat that matters!

  13. Oh wow – – this clip really cut through the mixed messages/data on these conflicting findings. And once again as a new reader of this blog i am ASTOUNDED by the growing indication that a truly whole-food diet is the best answer to our ills. 8 weeks plant-based and never going back.

  14. IDK who this other Mike is that promotes dairy lol. I’m the Mike who isn’t in favor of animal agriculture, alcohol, tobacco, harmful pharmaceuticals, etc. I don’t like it when corporations compromise the health of the world through selling this crap. When I read comments of families who kill their own animals for meat I cringe. To me, holding up big pieces of murdered flesh and sliding it down my throat every day is like a reality of continuous Hell. I do think that this killing of wild animals is a million times better for the animal than store-bought, for-profit operations (these animals are basically just tortured). But, to me, murder is murder even if the animal isn’t tortured. Just my outlook, and I hope you’ll be reasonable because most of these animals have brains much like human animals in the sense that they feel pain too, and they also feel love for their children. In Vietnam, dogs are purposely tortured and killed for food. The torture is said, in folktale, to make the meat healthier. This is totally evil, but the one day of torture that these dogs endure is nothing compared to the lifetime of crap that store-bought animals in the United States usually have to suffer on factory farms.

    “When you take into account the fact that factory farms raise 99.9 percent of chickens for meat, 97 percent of laying hens, 99 percent of turkeys, 95 percent of pigs, and 78 percent of cattle currently sold in the United States, it’s shocking how much time we waste debating each other, rather than [doing the right thing and never buying meat, eggs, or dairy ever again]”

    The worst is dairy. These cows are forcibly impregnated and caged with milk machines hooked up to their breasts every day. When they give birth, the baby calf is taken away immediately and chained up for several months until it is murdered for veal meat. The mother cow usually cries out in pain for its stolen child for about 2 days (remember silence of the lambs?) The love of this creature is abused maximally, and the forcible impregnation by human arms begins again (profit is usually the only concern, at least 78% of the time). When the mother cow becomes too sick to forcibly impregnate, it is sold to be brutally slaughtered.
    Am I the only one who thinks that this is wrong? I can’t be the only one; just think if this happened to you, or your own daughter. I wouldn’t want this for my daughter.

  15. Nutrition for the Japanese elderly – the longest – lived Japanese eat meat and dairy (insulin control)

    https://www.ncbi.nlm.nih.gov/pubmed/1407826
    Abstract

    The present paper examines the relationship of nutritional status to further life expectancy and health status in the Japanese elderly based on 3 epidemiological studies. 1. Nutrient intakes in 94 Japanese centenarians investigated between 1972 and 1973 showed a higher proportion of animal protein to total proteins than in contemporary average Japanese. 2. High intakes of milk and fats and oils had favorable effects on 10-year (1976-1986) survivorship in 422 urban residents aged 69-71. The survivors revealed a longitudinal increase in intakes of animal foods such as eggs, milk, fish and meat over the 10 years. 3. Nutrient intakes were compared, based on 24-hour dietary records, between a sample from Okinawa Prefecture where life expectancies at birth and 65 were the longest in Japan, and a sample from Akita Prefecture where the life expectancies were much shorter. Intakes of Ca, Fe, vitamins A, B1, B2, C, and the proportion of energy from proteins and fats were significantly higher in the former than in the latter. Intakes of carbohydrates and NaCl were lower.

    1. Greg,

      I have been pondering your study versus the Blue Zones where they talk about the Okinawans eating very little dairy and only 2% of their calories from animal products. The Blue Zones Gerontologist spent years with the people looking at what the Centenarians ate and the study you are referring to did a 24-hour eating journal and there were days of the year where they had festivals and did eat more meat.

      I read it from both directions and either The Blue Zones author is a boldface liar or the other people are, but I can say that the cities, which are trying to do his diet have had things like a 50% drop in diseases.

      Luckily, we don’t have to trust the stinking biased from every side Westerners.

      They have their own records.

      https://web.archive.org/web/20120113035029/http://211.76.170.15/server/APJCN/Volume10/vol10.2/Sho.pdf

      1. Greg,

        I appreciate you and what you bring to this community. I was over on YouTube today, but I came over here specifically to see what you brought to the table and I say that sincerely.

        There are politics involved in science and food and it is so frustrating when one side says one thing and the other gives the opposite facts entirely. I feel the need to examine both sides and to try to find both scientific and creative ways of figuring out who is telling the truth. Going back to the Japanese survey gave me a new starting place for this topic. Now it is The Blue Zones versus Weston Price and I know that Tom already discussed Weston Price negatively long ago, but if they have a case against him, that should be delineated.

        Thank you again. I know that it takes courage coming to a place, which doesn’t hold the same belief systems as you and you patiently come back every time the topic comes up and you don’t abuse people verbally. I respect that highly. You keep everybody on their toes and that is a good thing.

        1. And I said that one of the sides is lying, but there are other alternatives, such as the dietary changes happened and the elderly people started eating worse, but it takes a while to have those dietary changes make the real negative impact. Dr. McDougall talked about the doubling time of cancer and how it can take a decade for cancer to become visible. My relatives have been eating the SAD – mostly junk food and fast food and pizza for 55+ years without any diseases and it was as SAD as you can get. Sugar in one form or another for breakfast – donuts, Pop-Tarts, Hostess everything, Ring Dings, Ding Dongs, Lucky Charms…… Lucky us, that we only lost a few relatives at 50 and only one at 40.

          I say it because I had relatives live very elderly and if you saw them in their 80’s, you would think they grew up eating a slice of every pie and candy, but they did not have that type of eating until the culture changed and until after they had more money. So, my great-grandmother, for instance, at serious calorie restriction during the depression and during the war and during the years of her husband being a seasonal laborer and she had 6 kids to feed, and her husband had people pay him in alcohol because nobody had money. Anyway, if you saw her close to age 90, you would see a woman asking for a slice of each pie and one of each cookie and candy, but that didn’t start until she was 75 or over and she got a little pudgy, but never got Diabetes and didn’t need any medicines. She did have one medicine, but I can’t remember the name, except that she messed up the name and told the doctor that she had been taking her Hydrox religiously and her doctor said, “I think you are taking the wrong medicine.” Hydrox is a creme-filled chocolate sandwich cookie for those in Loma Linda.

          1. Deb, Whenever I encounter a “confusing” study that pops up countering the WFPBD way of eating, I resort back to basic human anatomy to realize that it is probably a biased and/or flawed study. There is so much evidence supporting the fact that human anatomy is not well suited to eating animal products: meat, eggs, fish, nor especially dairy products.

    2. The problem with observational studies is that they can be confounded by uncontrolled variables. Or they confuse cause and effect.

      Greg

      An obvious possible explanation here is that sick people often have poor appetites and avoid rich foods. Another is that consumption of animal foods in Asian countries like Japan may be a marker for higher socioeconomic status and wealth which are also associated with survival.

      Another issue is that many people adopt diets excluding meat dairy and eggs for therapeutic reasons following a serious health crisis. Consequently, heath problems may precede adoption of a more vegetarian diet rather than a vegetarian diet predisposing people to health problems

      Observational studies of people who have adopted vegetarian diets for religious reasons like North American 7th Day Adventists show that people who exclude meat from their diets have lower mortality

      1. Thank you, Tom, for your participation.

        The 24-hour food journal as a way to understand a society seems so ill-conceived to begin with.

        I also don’t understand that line about babies and 65-year-olds. I tried to read that sentence a few times, but I kept getting confused when I got to the 65-year-olds and then, they bounced back to the 100-year-olds. Babies surviving being mentioned at all caused me to wonder if they chose a wealthy versus poor place, in the first place.

        I am trying not to comment here, but dairy and cancer is a topic, which is so confusing because of the various studies.

        1. Sorry Enthusiast, I know that I am too enthusiastic for this site and I recognize that I am one of the only ones here who are beginners and I am going to try to stay on the other sites, even though this is the one set up like a chat room and those are not. I say that, but I have never seen a chat room, and it seems like a silly concept because you have to find strangers who are online at the same time you are and they have to find you and know to talk about Whole Food Plant Based from a beginner perspective. I don’t believe it can exist outside of here because Dr. Greger posts videos often enough that people come daily and that is the only way a dynamic comment section happens. This is a chat room to me. The other sites he puts up are static. This is where people can discuss things real time, but I do get that I am so enthusiastic about Whole Food Plant Based and I am trying to learn it all as a beginner and I know that would overwhelm people. I am not on social media. Just YouTube, PubMed, here and I look at the other doctors’ sites, but none of them post regularly enough to have a community.

            1. I started using Apps and having Siri add everything to my calendar and notes and young people and technology are going to change everything.

              I have 5 free cooking Apps with Vegan recipes.

              There is such momentum for this book.

              Dr Gregor,

              A Whole Food Plant Based Doctiors cooking App would be cool down the road.

              I would like all of you together because it would give enough recipes.

              I already love having the apps because I choose the recipes for the week and they automatically generate a shopping list and I also have a pantry App which I can check the ingredients against.

              Those 3 functions together would be so fabulous.

              Just dreaming, but ii have everybody’s cookbooks and would love an App combining all of you.

              1. i see the Apps and use Siri as an assistant and know that Websites are not using technology the way Apps are.

                Five years from now people should be able to jump over my comments and go straight to Toms the way I can within most of these Apps.

                An in site Siri type of thing or sites like this being so Dtrt and Alexa friendly that topics just appear intuitively.

                Efficiency.

            2. Hey Deb! Good to see you! Hope you read the notes left for you the other day :)

              You know, of all the changes I have made in diet and lifestyle, I would have to say that leaving the dairy behind was among the top 3 for making a positive impact. I never ate a lot of it (no pizza or cheese, ice cream or other products) but cutting out the yogurt, kefir and cup of milk made all the difference.

          1. Deb, I agree that this comment section is sort of like a “chat room”. I have visited this site almost every day for the last 5 years or more and have learned quite a bit from other regular posters here, including you! In fact, I don’t know of any other WFPB site that has this much interaction from the visitors.

  16. My Achilles Heel with respect to Dairy is yoghurt.
    So do I cut down/out consuming yoghurt?
    I would appreciate a knowledgable reply.
    Thank You.

    1. Dr. Bodo Melnik says that milk products fermented with probiotic bacteria (kefir, yoghurt) have a lower risk profile because fermentation, boiling and ultraheat treatments destroy milk’s software system– molecules of microRNA (Milk’s hardware, its amino acids, are still a problem. ) In contrast, a substantial amount of software survives the pasteurization and homogenization processes. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556685/

    2. Daniel O’Leary,

      I make my own soy yogurt at home. I use soy milk made from water and organic soybeans, with no additives, and starter culture. (Though I add a bit of maple syrup for flavor, but it’s optional). Incubators are not too expensive. The resulting yogurt is firm and tasty — and has none of the additives of commercially produced soy yogurt, which is why I started making my own in the first place. I couldn’t find plain soy yogurt without all kinds of “ingredients.”

      I’ve used both EdenSoy and WestSoy, though EdenSoy makes a firmer yogurt, probably because it has a higher protein content. I imagine that any soy milk made only from water and soybeans, with no other ingredients, would also work.

    1. Harriet, I’m certainly not an expert, but Dr Melnik’s conclusions about milk and cancer seem to be in line with all the other research I have read. Especially, Dr T Colin Campbell’s research connecting the milk protein (casein) and cancer.

      BTW, I visit your website quite frequently and appreciate your well-researched articles … thank you!

  17. I used to eat greek yogourt for breakfast as a source of protein. What can i take instead that would bring me protein as well ? Thank you very much :)

    1. Why do you want to eat high protein meals?

      RESULTS:
      Decreasing carbohydrate or increasing protein intake by one decile were associated with increase in total mortality by 6% (95% CI: 0-12%) and 2% (95% CI: -1 to 5%), respectively. For cardiovascular mortality, amongst women 40-49 years old at enrolment, the corresponding increases were, respectively, 13% (95% CI: -4 to 32%) and 16% (95% CI: 5-29%), with the additive score being even more predictive.’
      https://www.ncbi.nlm.nih.gov/pubmed/17391111

  18. I have a question. So I have been reading Dr. Greger book and I have been living WFPB for about 2 weeks. Before that I was on a Keto for 6 months.
    So my question is, how can someone be on Keto (or even god forbid Carnivore) and still seem healthy and well??

    1. We could also ask how can people smoke, drink and do drugs and still seem healthy and well?

      Heart disease and canncers etc usually take decades to develop. The chickens don’t come home to roost until nightfall, so to speak.

      Also, the more prominent advocates of such diets tend to consume harge amounts of healthy greens and engage in regular intense exercise. Often they engagr in calorie restriction and/or intermittent fasting as well. Such practices would benefit their appearance.

    2. Hi Jacob, Dr. Greger is actually working on a series about keto, which will come out in the next few months. To see when, be sure you are subscribed to the newsletter (just click subscribe at the top of this page).

  19. Green leafy vegetables take up a lot of space. They cost money. Using rocket leaves as an example, they are $aud 12.99/kg for me or about $usd 3.80/lb. The recommended daily intake for bioavailable calcium is about 300mg. The low oxalate green leafy vegetables are about 100mg/100g with about 50% availability. So you should be eating about 500-600g or about 1.1-1.3lb per day. Maybe a pound is enough and the rest you get from other foods. So that’s $AU40 or $US26 per person per week for your leafy greens give or take. The space they take up is solvable i guess if you buy enough fridge space or shop frequently. Supplements would make things easier. Maybe cheaper too. The large dose of a calcium supplement maybe hard on the body so a supplement with more control over the dose would be better.

  20. Arthur, I am sure someone knowledgeable can/will answer your question, but I am wondering if you have had your calcium levels tested? For most of my life I was chasing calcium in dairy products, different kinds of supplements (some broken up and taken with a meal) and for the most part i was unsuccessful. Changed my diet, wfpb, no supplements, (but I use soy milk)and just eat from Dr Greger’s Daily Dozen. I often do not get the Dozen eaten in a day, but it is what I eat… veggies, fruit, beans, grains. One year in, my doctor says to me “By the way, your calcium levels are perfect!” Easy. So I just spent my time creating wfpb meals that I enjoyed, and the calcium thing worked out well … if it hadn’t I would have discussed with my doctor how /what small supplement to add.

    1. I haven’t had my calcium level tested. That would just be blood levels. I doubt it means anything. I have been avoiding soy products ever since i had a bad experience with them. I was eating store bought natto in my morning oats about three times a week. It was from an asian grocery shop. I had no reactions for a few months then the shop stopped stocking the one i ate. I changed to another one and within a few weeks i had a sore jaw on the right hand side. I think it was swollen lymph nodes in the jaw. Although I will say that a brown spot I had on my teeth for years came off thanks to the natto. Since i stopped all soy i haven’t had that problem. It’s probably all that K2 forcing calcium to the bone. My late father had the same sore jaw problem on the right hand side while my mother didn’t because i chose not to test her. It may just be that natto is really strange. It could be a bad reaction to the hay bacillus. It could be the k2 and a low calcium intake causing a deficiency in calcium somewhere else because it was telling the body to keep putting it in bone. I don’t know. I thought the iodised salt is enough to protect the thyroid from deficiency. Maybe it isn’t. So I’ve been really shy on soy ever since.

      I’ve had a bruise or bleed under my skin underneath my adam’s apple now for at least a year. It keeps changing shape. It lessens if I go back to bread, cheese, milk and meat with not much vegetables. But i hardly ever get colds/flus or sinus congestion on this plant based way of eating. Apart from these strange anomalies.

        1. Protein, fat and fibre can reduce the glycemic load of a high glycemic index food like oats. Eating it with seeds, berries and pulses can help. If I tested it, it probably would be high though.

  21. I looked up about a way to reduce oxalate in foods and found this on PubMed.

    Biodegradation of Oxalic Acid from Spinach Using Cereal Radicles

    https://pubs.acs.org/doi/10.1021/jf051091s

    Oxalate oxidase is an enzyme that runs this reaction:

    oxalate + O2 + 2 H+ ⇌ 2 CO2 + H2O2

    So turning oxalate into peroxide but might not be so good. This could be a way to pre-soak seeds that are you are sprouting and will provide a way to disinfect them perhaps.

  22. All the studies I’ve seen relating to fish, compare fish intake to the standard (unhealthy) western diet, so fish could very well be an improvement from that, but not compared to WFPB, and it won’t help much if you reduce your heart disease 10% eating fish, but increase your risk of cancer by 20% due to the mercury in fish or the diabetes due to the fat/toxins in fish.

    Dr. Ben

      1. Hello Mark,

        First, let’s be clear that the strictly vegan men were easily the most successful group in terms of health outcomes. The vegan women struggled a bit more and brought down the average so that the pescetarians came out on top in a couple of the health outcomes. I have personally spoken with Brenda Davis, RD (Dr. Greger’s favorite dietician) who has spoken with the lead researcher behind the Adventist Health Study-2. The reasons for the pescetarian women doing better are likely because of a couple things. First, the adventist women who ate meat or fish actually ate less of those products than the men did, so their starting point was already healthier. Secondly, it is believed that many women actually became vegan because of health issues in an attempt to correct those issues. If that’s the case, then it isn’t a shock that the vegan women didn’t do as well in the end. And lastly, it’s important to note that all of them, from omnivores to vegans did far better than the national average in terms of life expectancy and disease rates, so even if the vegan women did worse than the pescetarians, they still did fantastic.

        I hope this answers your question,

        Matt, Health Support

        1. Hi

          I am sorry but that does not appear to be correct. On all cause mortality women Pescos come out on top significantly and for Men there is nothing in it. Vegans have a hazard ratio 0.72 to Pescos 0.73. Overall when putting Men and women together Pescos are well in front.

        2. Hi

          One other point I forgot to mention. The fish consumption is for all fish, yes swordfish, shark all the big fish it would be wise to avoid. What do you think would happen to those already healthy Pesco hazard ratios should people focus on small oily fish like Anchovies, Mackrel and Sardines. Yes they would almost certainly improve further.

  23. Have you seen cases where people have been cured from a pituitary or adrenal adenoma having been on a plant based diet?

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