Eliminating 90% of Heart Disease Risk

Eliminating 90% of Heart Disease Risk
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Preventing and treating chronic diseases such as heart disease, diabetes, and stroke with diet and lifestyle changes is not just safer but may be dramatically more effective

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Medical myths and dogmas die hard. Researchers creating a new body of knowledge for prevention and control of heart disease had to disprove and displace a bunch of doozies, like we used to think that heart disease was just an inevitable consequence of aging, or that cholesterol and blood pressure just naturally go up as we age. All these are now bygone notions, refuted by massive data.  But other long-standing myths and dogmas about our #1 killer epidemic persist.  For example, this notion that major risk factors, like cholesterol, account for a minority of risk and that many people have heart attacks with no risk factors; so, it’s just kind of a crap shoot – not much you can do about it.

There are rare genetic conditions that give people high cholesterol no matter what they eat, but such genetic defects occur in no more than 1 in 200 people. This means, of course, that most persons with atherosclerosis acquire it by what they put in their mouth.

The INTERHEART study showed that for men and women, old and young, and in all areas of the world, 9 potentially modifiable factors like diet, exercise, and smoking, accounted for >90% of the proportion of the risk of having a heart attack. And this has been confirmed in prospective studies.

Follow men over time and those making healthy lifestyle choices are associated with a 90% drop in risk. Same with women, 92% of the risk gone. Same with diabetes—91% of cases could be contributed to bad habits and behaviors. And the same healthy lifestyle, which includes not smoking, eating a healthy diet, exercising, and maintaining an optimal body weight, may reduce the risk of multiple chronic diseases—not just heart disease and diabetes but stroke as well. Up to 80% of strokes avoidable with simple lifestyle changes.

How does this all compare to drugs? Why change our diet, lose weight, and start exercising if we can just pop some pills? Pharmacological therapies, including cholesterol lowering statin drugs and blood pressure pills typically only reduce cardiovascular disease risk not by 90% but only by 20% to 30%. So, even on drugs, 70 to 80% of heart attacks still occur.

One of the great things about this study, the Harvard Health Professionals Follow-Up, is that they also looked at the effect of lifestyle changes on people already on medications. Even those on cholesterol and blood pressure lowering drugs may be able to get a further 78% drop in risk by eating and living healthfully. So, the choice isn’t diet or drugs. Cardiovascular medications should be used as an adjunct to, not just a replacement for, healthy lifestyle practices.

It takes time for new science to trickle down into mainstream medical practice. The practice of cardiology and medicine in general may correspond, on average, to what was being published 10 or 20 years before. So, it’s important to know if our doctors are still stuck back practicing 20th century medicine.

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 Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to KWMoore via Flickr.

Medical myths and dogmas die hard. Researchers creating a new body of knowledge for prevention and control of heart disease had to disprove and displace a bunch of doozies, like we used to think that heart disease was just an inevitable consequence of aging, or that cholesterol and blood pressure just naturally go up as we age. All these are now bygone notions, refuted by massive data.  But other long-standing myths and dogmas about our #1 killer epidemic persist.  For example, this notion that major risk factors, like cholesterol, account for a minority of risk and that many people have heart attacks with no risk factors; so, it’s just kind of a crap shoot – not much you can do about it.

There are rare genetic conditions that give people high cholesterol no matter what they eat, but such genetic defects occur in no more than 1 in 200 people. This means, of course, that most persons with atherosclerosis acquire it by what they put in their mouth.

The INTERHEART study showed that for men and women, old and young, and in all areas of the world, 9 potentially modifiable factors like diet, exercise, and smoking, accounted for >90% of the proportion of the risk of having a heart attack. And this has been confirmed in prospective studies.

Follow men over time and those making healthy lifestyle choices are associated with a 90% drop in risk. Same with women, 92% of the risk gone. Same with diabetes—91% of cases could be contributed to bad habits and behaviors. And the same healthy lifestyle, which includes not smoking, eating a healthy diet, exercising, and maintaining an optimal body weight, may reduce the risk of multiple chronic diseases—not just heart disease and diabetes but stroke as well. Up to 80% of strokes avoidable with simple lifestyle changes.

How does this all compare to drugs? Why change our diet, lose weight, and start exercising if we can just pop some pills? Pharmacological therapies, including cholesterol lowering statin drugs and blood pressure pills typically only reduce cardiovascular disease risk not by 90% but only by 20% to 30%. So, even on drugs, 70 to 80% of heart attacks still occur.

One of the great things about this study, the Harvard Health Professionals Follow-Up, is that they also looked at the effect of lifestyle changes on people already on medications. Even those on cholesterol and blood pressure lowering drugs may be able to get a further 78% drop in risk by eating and living healthfully. So, the choice isn’t diet or drugs. Cardiovascular medications should be used as an adjunct to, not just a replacement for, healthy lifestyle practices.

It takes time for new science to trickle down into mainstream medical practice. The practice of cardiology and medicine in general may correspond, on average, to what was being published 10 or 20 years before. So, it’s important to know if our doctors are still stuck back practicing 20th century medicine.

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 Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to KWMoore via Flickr.

Doctor's Note

Chronic disease, then—the leading cause of death and disability—may be a choice. See for example, Cavities and Coronaries: Our Choice. What do you choose?

Why reduce a preventable disease just 90%? How about 99.9%? See One in a Thousand: Ending the Heart Disease Epidemic

More from the field of lifestyle medicine:

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

93 responses to “Eliminating 90% of Heart Disease Risk

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  1. Hard data, hard facts, hard to swallow. As many in the John Q. Public would say, “stop telling me bad news about my bad habits.”
    This is the stuff that should be shown at EVERY medical conference regardless.
    Great editorial!




    3
    1. Where are the hard facts? Certainly not in the field of nutrition. It might well be another 50 to 100 years before we know exactly how much dairy, eggs, fish, meat and animal products in general we can consume on a daily basis. What exactly does a healthy diet mean? There are
      hundreds, if not thousands, of diets and all the proponents claim to be cutting edge science…




      3
      1. the hard facts are staring you right in the face. Health care costs from usage for chronic ( preventable) disease are skyrocketing, causing municipalities to scramble finding ways to cut costs when the WAY stares them in the face three times a day when they look at their plates!!! The obvious is overlooked for the absurd. If you step on glass, you take the glass out, you don’t go to a cardiologist for tests and procedures. Eliminate CAUSE for the cures… Beside curing preventable disease, a plant strong diet heals the environmental ecocide from animal agribusiness and eliminates the violent slaughter of sentient beings whose lives are brought into the world to fatten for slaughter. Sodom and Gamorrah.




        2
        1. You are listing the symptoms like they are detailed facts which is not the case and how animals are treated does not help me know how much milk, eggs, meat or even sugar I can consume on a daily basis.
          The fact that following a diet designed by Furhman, Ornish or Esselstyn reversed disease does not prove how every food in their diet helps nor does it prove that food left out would not also allow disease reversal. Maybe you just do not know what science is?

          I also think you are reading something into my comment that is not there. I am not suggesting people should continue following the Western Diet which has been proven in total to be unhealthy. Personally, I follow Furhman rather closely and am happy with my personal health but that does not eliminate that fact that we are a long way from knowing the full nutrition details of eggs, milk, meat and fish.




          0
        2. When you can show me the science that tells me if I should have any olive oil, eggs or milk in my diet I will believe there are at least some hard facts but they do not exist on those items today…




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          1. But you said down there that olive oil was an “obvious” thing to eliminate. So then, you must think the science is pretty hard against olive oil. I agree, and watching videos here, as well as reading books and articles seems to indicate (to me), that the hard evidence shows that we don’t need any eggs or milk in our diets. I’ve been egg and milk free for over a year and a half now, and I’m okay. I’m personally not that interested in exactly how many eggs or ounces of cheese I can “get away with.” I realize they’re just not necessary for health.

            The only people who seem to be incredibly hostile toward this whole foods, plant-based diet, are the Paleo and Atkins fad-diet promoters and internet bro-science bloggers. And, I don’t really care much what these people have to say.




            4
            1. I did not say there is science showing olive oil is bad for us except for the fact that it is 100% fat. There is no science showing it is good for us so I do not add any oils but get my fat from vegetables, seeds, nuts and avocado.
              People are confused about the Mediterranean Diet which really existed a long time ago and not today in that region where today people still consume large amounts of olive oil but are diseased and overweight because the diet is more Westernized. During the war and a few years later meat was not available and people in that area consumed more vegetables and fruits along with the olive oil. Saying it was the olive oil that made them healthy is good business but not good science…




              1
            2. Olive oil has been scientifically proven 100% to reduce your blood flow. If that sounds good to you till you have more proof of results enjoy it!




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      2. “how much dairy, eggs, fish, meat and animal products” just don’t eat them. It really itches me why some people are so dense.




        1
      3. “Facts” come from a variety of sources. If you mean nutritional research then I agree that it will be many years (100 to 500) before we have all the facts. However, what is a person to do till that time?
        I look to the five Blue Zones where a high number of people live to be a healthy 100 years old. They consume far less processed foods, eggs, dairy and meat than the Western Diet. There are also the doctors that have reversed heart disease and diabetes like Drs Ornish, Fuhrman, and Esselstyn.
        Given that most adults in the US already have heart disease it seems reasonable that a more strict diet based on whole plant-based products would be best.




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    2. I’m sorry “Doctors” are practicing twentieth century medicine?!! You have got to be kidding me for as long as I have been in medical school and practicing medicine (about 20 years now)we have known and told our patients that obesity, sedentary lifestyle, and smoking increases your chances of heart disease, diabetes, stroke, and death. Which means if you are fat, don’t exercise and smoke then your chances are very high you will have a heart attack, get diabetes, have a stroke, or die. However, most people don’t want to hear or believe this and that these factors are well within their control and THEIR responsibility. They would much rather have a magic pill that takes it all away. In this day and age with so much information readily available, I can assure you most people readily know this information and few Doctors do not freely give this advice daily to their patients.




      1
      1. Ahh…, but it is easy but imprecise to tell a patient, “don’t be fat, and exercise more.” It is much more to the point (and indeed mainstream medicine’s failures) to inform your patients that research shows “if you continue to eat meat, dairy, eggs and other animal-based products, your health problems will continue, and in spite of modern medications, your condition will continue to become worse. Instead, why not tell your patients to move their eating away from meat, dairy and eggs to a plant-based diet, so they can enjoy abundant health.” Do not put your failings and ignorance of the current research at the feet of your patients. Remember the Hippocratic oath? It’s the FOOD – let it by thy medicine!!! ‘Fix the food’ and health will follow. I reversed my Type II diabetes by changing to a plant-based diet in 90 days (without any increase in exercise), and so can (nearly) everyone else!




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        1. The point that the physician is making is that the responsibility for making major and lasting lifestyle changes does remain ultimately with the patient. Doctors can only inform. All of my primary care physicians have counseled a balanced low fat diet and regular exercise, avoiding smoking and excessive alcohol consumption. Now that I have multiple sclerosis, which is not caused by poor lifestyle choices, it is that much more important for me to be responsible for these good choices. My physicians, both primary care and neurologist with a combined 45 years of practice do recommend this, do answer questions, and practice up to date 21st century medicine. If you want or need a nutrition specialist for a particular medical condition, a referral to a registered dietician or clinical nutritionist ought to be an available option. Physicians and other healthcare providers regularly deal with patient non-compliance. Personal responsibility begins as soon as anyone leaves the exam room.




          2
          1. Agree 100% that ‘personal responsibility’ belongs to the patient. But, as has been my experience and that of most others, is the vast majority of doctors are ignorant on the use of food to treat chronic conditions, and therefore, unable to point their patients on the absolute best path. I hope you do well managing your MS. Here are some specific resources from Dr. McDougall’s site, as Dr. Roy Swank was one of his personal mentors. https://www.drmcdougall.com/health/education/health-science/hot-topics/medical-topics/multiple-sclerosis/




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          2. You, as the great patient, are the goal of all doctors. You’re right. A very intelligent woman told me that every year millions of doctors write many prescriptions that go unfilled. The standard deviation on the number of pills a patient actually takes might be 3 and the average number of pills taken might be 4. Lifestyle modification that is acceptable to the patient should be the only medicine available. I am so sorry to hear that you have MS. This site has shown that a completely vegan diet was so effective at treating MS, more so than any treatment available, that a doctor pronounced animal fat to be the cause of the disease. Perhaps it is animal cholesterol. I like nuts and dark chocolate, which are rich in saturated fat but are so healthy at preventing heart disease they should be in any diet. I will pray for you.




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        2. But maybe the effect of changing to a plant-based diet was mostly because of reduced sugars and saturated fat in your diet? There are millions of non-vegans who are quite healthy. There are a lot of long-livers among them eating meat and dairy on a daily basis.

          As you probably know even chimpanzees our closest relatives by nature are NOT 100% vegans!




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          1. The primary issue (and cause) of Type II diabetes is saturated fat in the diet that then becomes part of the lipid layer of one’s cells, clogging things up and keeping sugar in one’s bloodstream rather than allowing it to freely enter the cells as it would normally. Dietary sugars are a secondary issue. Once you remove specifically the saturated fats from one’s diet (primarily found in animal products), one’s condition can improve in fairly short order. It is amazing to me that the overwhelming majority of doctors do not know this and instead believe that Type II diabetes is not reversible. My own GP was shocked at the result, as he’d never seen it reversed before (a 20 year practicing doctor). Because they do not know this nor tell their patients, their patients just continue to get worse and take more and more medications until they do not work anymore.

            Regarding what chimps eat, yes, they have an interesting diet. In addition to a preference for fruit, they munch on green leaves, seeds, various live bugs, etc., and they do love the raw, bloody flesh of a few other smaller animals on occasion that they themselves and their pals kill. To my knowledge, they don’t cook their meat. :)

            An interesting and informative series to view over several days is ‘Plant Positive’ ‘s Youtube series on Primitive Nutrition. Pretty much skewers the Paleo diet logic.




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            1. For diabetes, this site would recommend hibiscus tea, cinnamon, flax seed meal, amla, beans, whole grains like oatmeal, a vegan diet, exercise, and losing weight such as with Fenugreek. Taken daily, these might be more effective than any prescription without the side effects. The most profitable prescription in the world, Zypreza, is a major cause of diabetes and obesity. Almost all mood disorder medicines damage blood sugars and one third of the country is on them.




              0
                1. dude: There is more that one kind of cinnamon. One kind might have some health benefits, but also comes with risks. More risks than may be worth it. Here is a high level of the topic of cinnamon. If you click through, you can find the individual videos. You won’t have to believe anyone. You can look at the scientific evidence for yourself. http://nutritionfacts.org/topics/cinnamon/




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          2. That doesn’t change the fact that millions of people with heart disease, strokes, migraines, Alzheimer’s and other dementias, cancer, Parkinson’s, diabetes, arthritis, Crohn’s, MS, lupus and/or cataracts etc. could have AVOIDED their diseases by eating a whole foods, low fat, plant-based diet. As a matter of fact, virtually no one I know over the age of about 45 does not have one of those diseases, and I bet you would call some of those people “quite healthy.”

            Chimpanzees are much closer to vegan than they are to what your diet probably is. You even admit that reducing saturated fat can help with healing. How do you avoid saturated fat while still eating animal products?




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            1. I don’t think complete avoiding saturated fats is nesessary or healty. The problem with them is like the problem of moderation with all foods. People overeat meat especially processed ones. And if we take a look at some traditional diets in cultures having less ‘deseases of civilization’ we’ll see the same principle. The diet consists mostly of plants but includes some minimum processed animal based foods.
              And that type of diet is relatively close to chimpanzeeses one. This way you don’t have to take b12 pills or be worried about adequate sun exposure etc.
              It is the right balance diet.




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              1. Is saturated fat in nuts and cocoa bad? The fact that walnuts are so healthy means that not eating them puts you at risk for heart disease. I can’t seem to understand the contradiction. Certainly get your daily minimum of saturated fats through nuts. Should you eat less than this? Should you not worry about the saturated fats from nuts?




                0
                1. Hi Matthew,

                  That’s a great question. I would not say that the saturated fat in nuts and cocoa is bad, though of course it depends on your current health just how many nuts and how much cocoa powder you should consume. For instance, I’m at my ideal weight and I enjoy a tablespoon of cocoa powder in a green smoothie a couple times a week and I use nuts in recipes several times a week, but I don’t snack on them.

                  Yes, nuts are calorically dense, but the fats found in nuts are a mixture of types of fats – monounsaturated, polyunsaturated, saturated, and omega-3 fatty acids (one type of polyunsaturated fat). This varies by the type of nut. As you probably know, nuts also contain protein, fiber and minerals. This video on how saturated fat raises blood sugar may help to clarify things: http://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/, while this video on how Nuts May Help Prevent Death may help as well: http://nutritionfacts.org/video/nuts-may-help-prevent-death/.

                  If you’re really interested, I also recommend Jeff Novick RD’s very long and detailed video on Nuts & Health available at http://www.jeffnovick.com/RD/Nuts_%26_Health.html.

                  Many studies also indicate the health benefits of cocoa powder. There are small amounts of fat in cocoa powder, but this is negligible. You can buy a brand of cocoa powder with the fat removed called Wondercocoa, but I prefer organic fair trade cocoa powder. (You can learn more about why it’s important to buy fair trade at http://www.foodispower.org/slavery-chocolate/). However, cocoa butter (the ingredient that makes chocolate solid) is very high in saturated fat and of course is usually found in chocolate with sugar as well. It would be best to keep consumption of dark chocolate to a minimum and enjoy cocoa powder without the cocoa butter, for instance, blended with silken tofu with erythrital or stevia to make a delicious chocolate mousse or blended into a green smoothie. Check out this great video for more: http://nutritionfacts.org/video/cocoa-good-chocolate-bad/

                  I believe the real heart of the contradiction is twofold: 1) The amount of saturated fat consumed in a whole food plant-based (WFPB) diet is much less than that in a standard American diet (SAD) and 2) the baggage that comes along with a WFPD diet including fiber, vitamins, minerals, antioxidants, etc. is beneficial, while the baggage that comes along with a SAD diet including cholesterol, processed sugar, chemicals, etc. is harmful. Therefore, considering a risk/benefit analysis of nuts and cocoa powder, the science seems to indicate that the benefits outweigh the risks. Bonus – both taste great! So, enjoy! :)

                  I hope this is helpful! :)

                  Emily




                  0
                  1. Thank you very much. I found this very elucidating. I hope to eat a diet that a plant based dieter would consider healthy with regards to saturated fat rather than the average American dieter’s standard intake of saturated fat.




                    0
            2. And remember that thre are no scientific evidence that it is animal based diet that solely causes all that deseases. There’s a continuing debate between low-fat and low-carb diet proponents and there are studies supporting BOTH sides! So it is all very controversial.




              0
        3. People have been able to reverse disease with diet for a long time but that does not provide the exact information required to avoid getting disease nor does it prove that all the conditions of the diet are necessary to even reverse the disease.
          You said moving away but some suggest total elimination of your list to reverse heart disease. Although research has shown that nuts and seeds may help to lower the risk of heart disease Esselstyn eliminates those to reverse heart disease but others like Furhman and Ornish do not…
          Personally, I have almost eliminated animal products from my diet but I still feel that there is fifty to one hundred years of research needed before we really know what to consume on a daily basis. That is not to say that there are not obvious things to eliminate like most processed foods, trans fats and even added oils (olive included).




          0
          1. Dr. Greger said a vegan diet was maybe too effective at treating people with heart disease. I certainly hope I am not moving away from the plant based diet!




            0
      2. Of course it has been known for a very long time that cholesterol et cetera are major heart disease risk factors, and you as doctors tell patients this, but there is a big difference knowing something is unhealthy for you and knowing just how very bad and easily modifiable a risk it is!
        “Unhealthy” has become a word that is pretty much considered the norm. I eat a piece of fruit and people tell me that I’m eating healthily! “No, not particularly, I’m just not killing myself, unlike you”. People bandy the word “healthy” about like it is a extreme! What is continuing to come to light in the 21st century is just how effective removing many animal products, and certain others are from your diet is for your health and well-being.
        It is crucial that people know the extent of the unhealthiness of each lifestyle factor in their life so that if they continue one, they actually know just how much harm they are doing themselves, rather than just “being unhealthy”, which I say again, people see in their minds as “normal”. One only has to look at the term “health freak” to see this. Someone doesn’t have to freakish at all in health devotion to come under this category. Simply to follow the recommended government guidelines.

        In short, the work Dr Greger is doing is ace, and just what is needed. What we need to do is support him and spread the good news, namely just how much hope there is in combating these self harm epidemics.




        0
        1. Dan, I’ve started writing Doc’s website on the back of my business cards…when I’m at Whole Foods or Farmer’s market and someone asks me about the fresh turmeric I’m buying (“what do you use that for?”) I’ll discuss it briefly but with great enthusiasm and then give them the business card and ask them to check out this website. We DO need to spread the word!




          0
      3. Doctor, that is a minuscule portion of the nutritional information people need to be healthy. It does not answer the mother’s question of how much, if any, milk to give to her fourteen year old children. I do agree that most people prefer a magic pill and not many follow diets suggested by Fuhrman, Ornish, Esselstyn and others. There has been way too much bad information put out by USDA and even the medical field. The role of cholesterol and LDL levels have changed over time and even now may not be relevant. Presently the thought is that LDL should be below 100 but it is not backed by science.




        0
        1. How do you get your HDL above 60? That has been medical advice for decades, but to date, there are few recommendations. Like Chocolate covered nuts, cranberry juice, red wine, maybe peanuts, and some fish, I guess here we’d recommend Nori. Does it work? The single best guess at longevity is HDL, and we have been silent on how to improve it! Or lower triglycerides.




          0
          1. Reduce significantly or eliminate simple sugar like
            Corn syrup, honey, sweetened soft drinks, candy, baked goods, jam/ jelly. Same with refined carbs like grains. Focus on whole plant-based foods.
            Exercise at moderate pace at least 150 minutes a week. Up your Omega-3 fats with wild salmon, chia seeds, flax seeds. Have a few nuts daily, especially walnuts and almonds.




            0
      4. Palmer was scheduled for another operation when he died. You think any doctor told him exactly how to eat a year ago before putting in a pacer? I do not know but I would believe that a doctor told him more vegetables and fruits while less meat. Of course, that has never reversed heart disease to my knowledge but I think it is common advice!




        0
  2. I loved the observation about doctors practicing what they learned in medical school versus what the most cutting-edge science is saying. It reminded me of all of those TED talks and whatnot given by Ray Kurzweil, and I for one can’t wait for the day that IBM’s Watson is who we go to when we need the advice of a general practitioner. Watson won’t be prone to the old bias of “What I learned in my twenties is gospel truth”; Watson will be connected to the cloud and will be able to tell me, when I ask for the latest research on chronic fatigue syndrome, “Glad you asked. A research article was published 17 seconds ago. I’ve just read it, and it’s really going to help you out. Here’s what you do….”




    0
    1. I’m guessing NF readers could all tell stories into the night about having to bring the latest articles into our doctors’ offices. I was diagnosed with osteopenia and had to be the one to press to get my vitamin D levels tested. Guess what? Super low. Then I had to research appropriate supplementation dosages and when my levels still didn’t rise, had to research why not. Many folks are happy to merely have a doctor who will order the tests they want, but rarely do we have practitioners that take the lead with education. I’m weary of being my own doctor and there is NO one on my medical insurance plan that has an integrative perspective. So, I can choose to pay out-of-pocket for an actually knowledgeable practitioner or stick with the doctor who will comply with my request for blood panels, etc.




      0
        1. I learned I needed to take D with the largest meal of the day (one with fat). I needed to take 5000, not 2000 IU daily. I may not having been getting enough vitamin K. I also took a sublingual liquid rather than pill . . . I finally responded and got out of the low 20’s into the high 40’s.




          0
          1. My last D test came in at 39 (5,000 iu /day)…going for 70-80 or so….8,000 iu per day. Also take a K supplement. Magnesium…strontium.

            The saying among doctors is…don’t be your own doctor. I say that when you get older…it’s probably a good idea to emphasize your health first…and who is going to be most interested in your health? You are…




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  3. If one is under extraordinarily high stress, through illness or unfortunate life events, how would that put an extra tax on a body?
    What can be done to provide the maximum possible support apart from more antioxidants?




    0
      1. Meditation can add more than ten years to your life, the same benefit as being married and more than the benefit of being in Church. Maybe I should meditate about being married at a Church!




        0
    1. Someone to share with (friends or professional therapist). Aerobic exercise like running or cycling. A very personally engaging activity. Yoga, guided meditation, qigung, martial arts. Pema Chodron’s books and videos.




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  4. Wondering if you have any insight or opinions on the safety and value of COQ10 SUPPLEMENTS for both heart
    health and energy support/generation. I hear good stuff of this supplement, but do have concerns regarding its
    safety and overall “synthetic” nature.




    0
    1. Co Q10 appears helpful for some heart patients, particularly with respect to endothelial function and hypertension. That said, Co Q10 has also proven dissappointing as a longevity agent, indeed it may slightly shorten mice lifespans (1, 2, 3).




      0
    1. That is a salient point. If you know a grapefruit would lower your bad Cholesterol as much as a pill why do they put you on the pill? Is it because they think you’re more likely to take the pill? The doctors actually know you are less likely to take the pill than the grapefruit. The pills are poison and come with recipes for meat for the guilt of not taking the medicine. Then they start a panic circle that might mean the literal pill is what killed the patient.




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  5. Superior doctors discuss health attitudes that work. Your website suggests veganism or at least vegetarianism as an intervention at any stage in life. So is eating Soy nuts or soy products, drinking green tea, eating tomatoes, eating a salad every day with olive oil and vinegar or pickle juice, eating probiotics, eating cocoa, eating a half cup or more of nuts (or two half cups of different nuts), could really improve your heart health. Beans are extraordinarily good for heart health and there’s no upper limit on how much of those we should eat. Whole grains can be conveniently found in breakfast cereal, oatmeal, and maybe kind bars. They are important for heart health. These are immediate strategies to battle heart disease and eliminate it at any age. Cholesterol by definition comes from animals. Some is recommended in the daily diet, some is in milk and cheese and chicken and turkey, but the body can make its own cholesterol. Saturated fat is in plants too, like Chocolate and nuts. Are too much of these fats bad for you even though they come from plants? I think they should be consumed in moderation, despite the fact that they seem ironically slimming.




    0
    1. If you’re truly concerned about ‘what to do’ about it all, why not consult a good plant-based nutritionist? Jeff Novick is one of the best, and is available for consultations. http://www.jeffnovick.com/RD/Home.html

      You seem to be confused about the health benefits of consuming olive oil, whether or not a salad/greens should be consumed daily, and/or have a distorted view of the ‘correct’ amount of nuts to consume daily. Jeff can help.




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  6. If i understood correctly the research points towards life style changing which every doctor today say to their patient that they should eat healthy foods and do exercise. The problem is that healthy foods changes depending who you are asking.




    0
      1. What i mean is, the research doesn’t talk about plant base diet. Like everyone els they are saying we should eat better foods and do exercise. If you went to your family doctor he would say that you still should eat meat, chicken eggs fish and milk, but beware from junk food and do exercise because in their point of view this is what it means healthy lifestyle. However we do know that it simply isn’t enough.




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  7. No doubt doctors have been telling patients to eat healthier ever since the beginning of the obesity epidemic back in the mid 1970s. Clearly, it doesn’t work for the majority. That medicine does not acknowledge this, but continues to do the same ineffectual thing year after year, points out that doctors don’t know and don’t care, enough. If not, why the hell are they practising medicine?

    And I wonder when NutritionFacts will address that what we put in our mouth is determined in great part by our psychoemotional state, which is determined by our values. Will doctors eventually be telling people to change their values?




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  8. My oldest sister (78) was diabetic, etc for years. She was more obsessed with indulging herself than caring about her health. She would change doctors rather than listen to healthy advice. Finally she came to the hard fact of change or die. She started changing and then went to an 18 day lifestyle center (4yrs ago) similar to McDougall’s program. The renal stenosis did not resolve because the veins were too damaged even for a stent so that portion was replaced this year because her blood pressure wasn’t controllable.

    Her daughter is about 300 lbs and no one dare mention anything to her about her weight or health. Thanksgiving at her house was – turkey, ham, lefse, mashed potatoes, gravy, candied yams, green bean casserole, pumpkin and apple pies with whipped cream. Her husband does the cooking and is slim (eats 1 meal per day) but has no say in how she eats either.

    My neighbor thinks she is eating healthy by cutting down on fat and eating mostly chicken/fish instead of beef, using 1% milk. I have shared info with her but to no avail.

    I could go on and on about the people around me. Even the ones who hear/know the truth but WILL NOT change to better their lives/health. My doctor practices and teaches a wfpb diet. His wife teaches cooking classes. BUT you can not make people change. A few change before it’s too late but most do not. Very Sad Fact.




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    1. You are soooo right. I recently had a conversation with John Mackey, co-CEO of Whole Foods, where he revealed that in spite of going vegan a number of years ago, his brother-in-law resists all logic and persuasion attempts. It is indeed (as stated here by Dr. Greger) a cultural, social and traditional problem in families/society. My sister-in-law and her sister have type II diabetes, but would evidently rather have a foot amputated (seriously under consideration right now) than give up cheese. Casomorphins rule!




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    2. Can relate. I have two sisters…one with 2 knee replacements…obese. The other with one knee replaced…overweight and diabetic. An obese brother who doesn’t want to give up on “the foods he loves”. Another brother… a doctor who is obese and who lives by his “drug bible”. Can’t make much of a dent in these people. Like most they are egos with a lot of inertia…don’t want to change. Most are retiring early mostly due to health issues?

      Probably important to protect ones self from the retrograde ideas they espouse? It’s not easy to make real changes in ones own life…let alone change those who don’t have a clue?




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  9. The problem perhaps is the influence of food manufacturers’ marketing , claiming that this or that food is so “healthy” for you, and well meaning health professionals do say “eat more healthy foods” but not How-to, because they’re either too busy or not familiar with nutrition/science. This website is so helpful for those who are interested in making a positive change to their diet and health.




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    1. People genuinely don’t know what healthy really is, and I think that, for example, kids should be taught the government guidelines, and told

      “This is a standard american diet, this is not ok to eat at all. This will probably kill you!”

      “This is a standard human diet. This is ok to eat, and you must eat at least like this (food pyramid)”

      “This is how to eat if you want to be healthy and live a long life, the more you eat like this the better!”




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      1. Government guidelines are not that great, either. Too much bread, grains…. which the body turns into sugar, and without exercise, turn into fat and diabetes. In addition to the genetically modified grains (they may not have permission to modify grains, but that doesn’t prevent us from finding 10 acre field after 10 acre field of GMO wheat which crosses pollen in the wind with other fields of wheat nearby) and the fact that wheat is sprayed with roundup the day before being harvested, to make the plants softer so they aren’t so hard on the harvesting equipment…. No I would put grain at the top and green vegetables on the bottom, most abundant level of the government’s food pyramid.




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        1. We see now how ineffective the ” food pyramid ” approach to education has been. The research on animal Vs plant based diet was not as well known as it is now. People who are not overweight or have diabetes carry on following the national guidelines and the consequences seem to show up at around age 60 – 70 unfortunately.




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        2. I’m arguing that kids should be taught that the food pyramid system should be taught as a minimum diet for healthfulness, rather than the optimum, and shown that the more plant based they eat etc the healthier they will be.




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    2. Guerrilla advertising has memes all over facebook and pinterest claiming saturated fat coconut oil is good for you and cures everything if you just eat enough of it, using it in your wheat and sugar laden baking…. and the latest is now butter.. curing everything.. healthy and good for you. We need to bring back truth-in-advertising that was taken away in the Bush administration.




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  10. Statins are often recommended as the global answer for CVD. For those with secondary prevention issues…they are considered a necessity. Should those with secondary prevention issues necessarily become reliant on statins?




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  11. Whenever there is a conflict of interest between “Science” and “Capitalism”, “Science” is pushed under the rug. A good example is tobacco industry fighting against scientists with proof that smoking is very addictive and unhealthy. The same may be said of genetically modified foods, global warming, and vegan diet and lifestyle.




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  12. I have just finished an experiment in which I tried veganism diet for 3 months. Since I have in the past changed my dietary habits to achieve a massive reduction in my cholesterol, I was curious how becoming vegan would affect my physiological parameters. Prior to starting this experiment, I was consuming a healthy omnivorous diet. Therefore I didn’t expect veganism to improve my health as profoundly as it would improve the health of someone formerly consuming a typical American diet.

    Basically the changes I made to my previous diet were:
    1. Eliminated about 3 daily servings of nonfat Greek yogurt, whey protein, and/or egg whites.
    2. Eliminated about 2-3 weekly servings of sardines and/or canned salmon.
    3. Eliminated all meat, which I previously ate about once or twice a month.
    4. Replaced daily triple-strength fish oil capsules with daily Ovega-3 algae capsules.
    5. Increased consumption of beans, peas, lentils, and potatoes.

    Although it was very easy for me to avoid junk food at the grocery and relatively easy for me to avoid eating junk food at home, I usually failed to resist treats at parties. During this experiment, I did violate veganism on a few occasions at parties by consuming baked goods containing dairy products and eggs. But at least I was completely vegetarian – having consumed absolutely no meat or fish – for 3 months. I’m quite certain that at least 99% of my calories during this experiment were from vegan sources.

    Thus I have been consuming less protein, less saturated fat, and more carbohydrates over the past 3 months. I predicted this would slightly lower my total cholesterol, LDL cholesterol, and (unfortunately) HDL cholesterol, and slightly raise my HbA1c and fasting glucose.

    My starting status as compared to optimal values were:

    Weight 167 148-160
    Height 5′ 9”
    Waist 32”
    Hips 37”

    Triglycerides 72 60
    LDL cholesterol 118 <80
    VLDL cholesterol 14
    Ratio chol/HDL: 2.97015 <2.5

    Blood pressure 108/70 <120/80
    Fasting glucose 90 <90
    Fasting insulin 4 <3
    HbA1c 5.1 <5.8
    hs-CRP 0.2 <1.3
    Homocysteine 8.8 <7.5

    My ending status as compared to optimal values were:

    Blood pressure 112/78 (+2/+8) <120/80
    Fasting glucose 87 (-3) <90
    Fasting insulin unavailable <3
    HbA1c 5.0 (-0.1) <5.8
    hs-CRP unavailable <1.3
    Homocysteine unavailable <7.5

    Weight 161.8 (-5.2) 148-160
    Height 5' 9” (no change)
    Waist 31.5” (-0.5”)
    Hips 37” (no change)

    Triglycerides 69 (-3) 60
    LDL cholesterol 118 (no change) <80
    VLDL cholesterol 14 (no change)
    Ratio chol/HDL: 3.4 (+0.43) <2.5

    My hypothesis that my cholesterol would drop a little and fasting glucose and HbA1c would increase was refuted by this experiment. I predicted that my total, LDL, and HDL cholesterol would all decrease from veganism. Although my total cholesterol did indeed decrease, this wasn't a welcome change because the decrease was the result of a reduction in exclusively HDL. The highest my HDL has ever been was about 1.5 years ago when I was consuming lots of saturated fat from coconuts, eggs, and dark chocolate. My prediction that my fasting glucose and HbA1c would increase due to higher carbohydrate consumption was also wrong because these values dropped. So in conclusion, it seems that for me a healthy vegan diet is no better than a healthy omnivorous diet low in saturated animal fat.

    I found a vegan diet pleasurable, although it was an inconvenience when going out to eat with friends and family because vegan options in most restaurants are very scant. At no time during this experiment did I have a craving for meat, eggs, or dairy.

    I'm looking for suggestions to increase my HDL and drop my LDL. This might be hard because I spent quite a lot of time perusing Nutritionfacts.org and implemented most of the suggestions found there.

    My staple foods during this experiment:

    “Vegetables”: 5+ servings daily
    Leafy greens, onions, scallions, broccoli, cauliflower, bok choy, cabbage, kale, brussel sprouts, green beans, beets, carrots, celery, eggplant, zucchini, tomato, avocado.

    Fruits: 2-4 serving daily
    Berries, lemons, grapefruit, oranges, apples, bananas, grapes, watermelon, pineapple, mango.

    Legumes: about 2 cups daily
    Lentils, peas, black beans, kidney beans, pinto beans, garbanzo beans, tempeh.

    Starches: about 4 servings daily
    Potatoes, sweet potatoes, squash, quinoa, corn.

    Nuts and seeds: 1-2 oz daily
    Chia seeds, flax seeds, pistachios, pecans, walnuts, almonds, filberts, Brazil nuts.

    Drinks:
    Water, black coffee, tea, herbal tea, cocoa, beer/wine (max 4 per week).

    Spices/vinegar: lots!
    Turmeric, curry powder, garlic, ginger, fenugreek, cayenne, black pepper, chili powder, cumin, sage, basil, oregano, cinnamon, clove, apple cider vinegar, balsamic vinegar, red wine vinegar.

    Supplements:
    B complex, D3 4,000 I.U. (wintertime), Ovega-3 500mg.




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  13. Here in lies the problem with why people turn away from health and diet. One day something is good for you or causes cancer and the next its totally new information. I have joined a really good gym and am doing High Intensity Interval Training. The membership came with an hour with a “Nutritional Expert”. Our meeting ended 2 hours and 15 minutes later…:) They pounded in to me that I was to eat Eggs, Butter and red meat and vegetables every day and that all the research has shown that in fact sources were wrong with cutting these staples out. They have up on the wall the cover I think to Time Magazine with show a scoop of butter and says “Butter is Back”. I was making a shack every day with 50 grams of Acai berry pulp, One stick of cinnamon, half a cup of blueberries, half a cup of cranberries and one cup of Kefer. Do I cut the cinnamon out now? I eat a cup of steel cut oats every morning with 50 grams of walnuts and a banana. The “nutritional Expert” says if I do not stop eating oatmeal I will make no gains no matter how hard I work out. Do you see where I am going with this? Google is butter good for you. Google are eggs good for you.




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    1. I think you have the healthiest diet! The walnuts and oats may eliminate heat disease and you are getting more antioxidants each day than millions of Americans, maybe combined. Great work.




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  14. To Beth wasn’t it discovered that PETA has killed 100 of thousands of animals that were brought to them by people thinking they would be saved? I think the issue is you do not value peoples freedom.




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  15. Thanks Matt. It’s during the day when things break down. Do you see my point about hearing different things from different sources?




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    1. Stick to your “oats” and prove them wrong. It is up to you to decide what is the more reliable scientific source of information that you want to go by. I have listened/read for several years. I no longer listen to anyone who says that animal products are healthy. Besides all the unhealthy aspects of animal products think of the prions and other things that used to be animal diseases that are now found in humans. Also water is becoming a precious resource and too much is wasted on raising and slaughtering animals.




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      1. This video is part of a series, the story is not over. Please see “watch next video” on the right hand panel. Dr. Greger has gathered much of the research on gmo.




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    1. Riz Juan Choonara: Great question! It’s one of my favorites. I’m a bit of a cookbook junkie. I have tons and tons of them. I can’t just pick a single one. But here are a few of my favorites. Just leave out the oil if the recipe calls for it (I can tell you two methods on how), and then most of these are filled with pretty healthy options:

      Vegan Casseroles (my current favorite)
      Everyday Happy Herbivoir
      Vegan On The Cheap
      Let Them Eat Vegan

      Also, you might consider going on the free 21 Day Kickstart program. They will hold your hand for 21 days, including meal plans, recipes, videos, inspirational messages, and a forum where you can ask questions.
      http://www.pcrm.org/kickstartHome/
      (Click the green “Register Now” button.)

      Hope that helps. Good luck!




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    1. Sarah is selectively reporting. While writing in 2015 she cites the 2011 Cochrane review and not the 2013 update, probably because she did not like the update’s statement that risk of bias was low and/or the abstract’s statement of the Authors’ Conclusions which simply said:

      “Reductions in all-cause mortality, major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins.”




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    1. Hi alot,

      Statins can certainly be helpful in reducing cholesterol, and therefore heart disease and stroke, but they do come with side effects (as noted in the study) and they don’t work for everyone. In fact, this study found the “number needed to treat” was 91. That means that 91 people would have to take statins in order to prevent one person from having a heart attack or stroke. And the other 90 are, basically, taking a statin for no reason. Wouldn’t you rather just eat some plants? :)

      Here’s the full article:

      statin article

      Dr. G talks about plants and heart health here:

      how to prevent a stroke

      heart disease




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  16. Any advice? In last 4 months I lost nearly 20 lb. following Dr. John McDougall starch-based diet, dropping from 209 to 190 lb. (I’m 6 feet tall). However, my LDL actually got worse, from 155 in January to 168 now. The good news is the weight loss, plus my blood sugar dropped from pre-diabetic to normal. But my doctor now says the cholesterol problem is genetic, and that I should be on statins. Thoughts?




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