Eliminating the #1 Cause of Death

Eliminating the #1 Cause of Death
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How to essentially eliminate the great scourge of the Western world.

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The #1 cause of death in the United States, however, is heart disease. Late last year, a landmark review was published on the cause of our #1 killer by a Dr. William Clifford Roberts.

First of all, who is this guy? The head of Baylor’s Cardiovascular Institute, he’s authored a mere 1,387 scientific publications, written more than a dozen textbooks on cardiology, and has been the editor-in-chief of the American Journal of Cardiology for 25 years.

Well, then, what is the cause of atherosclerosis? Well, first of all, doesn’t he mean "causes", though? I mean, there are lots of things that increase our risk of heart disease—hypertension, diabetes, obesity, inactivity, cigarette smoking. None of that matters, he says—unless we have high cholesterol. All those things can speed the buildup of plaque in our arteries, but if our cholesterol level is low enough, there’s nothing our body can build the plaque with. According to Dr. Roberts, atherosclerosis simply does not occur if elevated cholesterol is not present, regardless of how high our blood pressure is, our blood sugars, no matter how obese, how inactive, or how many cigarettes we smoke. The plaque that builds up in our arteries choking off blood flow to our heart, to our brain, to the other arteries in our body, is made out of cholesterol. If you don’t have enough bricks and mortar to build a dam choking off a river, the dam will not be built. Unless we have elevated cholesterol levels, there simply isn’t enough substrate to form these plaques throughout our arteries to trigger strokes, heart attacks, kill us, make us impotent (though, not necessarily in that order).

If cholesterol is the cause of atherosclerosis, how low does one's cholesterol have to be to become heart-attack proof? Ideally, our bad cholesterol—LDL—should be under 70. “If such a goal was created, the great scourge of the Western world would be essentially eliminated.” There are only two ways, he says, to get it down that low: put a hundred million people on a lifetime of high-dose statin drugs starting in one’s twenties, or be what he calls a “pure vegetarian fruit eater,” which is just what he calls those eating whole foods, plant-based diets.

Now, if we put everyone on drugs, then thousands of people would suffer side-effects, so: “Of course a [vegan] diet is the least expensive and safest means of achieving the plaque-preventing LDL goal, but few in the Western world are willing to live on the herbivore diet.” In his words, in a recent interview: “The best way to prevent heart disease is to be a…non-flesh-eater, a non-saturated fat-eater. (...) Because humans get atherosclerosis, and atherosclerosis is a disease only of herbivores,” he reasons, “humans also must be herbivores.”

The cause of our #1 killer is elevated cholesterol. So, according to probably the most renowned cardiovascular pathologist in the world, that means the cause of our #1 killer is: not eating vegan.

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

Please consider volunteering to help out on the site.

Image thanks to chriswong4238 via Flickr.

The #1 cause of death in the United States, however, is heart disease. Late last year, a landmark review was published on the cause of our #1 killer by a Dr. William Clifford Roberts.

First of all, who is this guy? The head of Baylor’s Cardiovascular Institute, he’s authored a mere 1,387 scientific publications, written more than a dozen textbooks on cardiology, and has been the editor-in-chief of the American Journal of Cardiology for 25 years.

Well, then, what is the cause of atherosclerosis? Well, first of all, doesn’t he mean "causes", though? I mean, there are lots of things that increase our risk of heart disease—hypertension, diabetes, obesity, inactivity, cigarette smoking. None of that matters, he says—unless we have high cholesterol. All those things can speed the buildup of plaque in our arteries, but if our cholesterol level is low enough, there’s nothing our body can build the plaque with. According to Dr. Roberts, atherosclerosis simply does not occur if elevated cholesterol is not present, regardless of how high our blood pressure is, our blood sugars, no matter how obese, how inactive, or how many cigarettes we smoke. The plaque that builds up in our arteries choking off blood flow to our heart, to our brain, to the other arteries in our body, is made out of cholesterol. If you don’t have enough bricks and mortar to build a dam choking off a river, the dam will not be built. Unless we have elevated cholesterol levels, there simply isn’t enough substrate to form these plaques throughout our arteries to trigger strokes, heart attacks, kill us, make us impotent (though, not necessarily in that order).

If cholesterol is the cause of atherosclerosis, how low does one's cholesterol have to be to become heart-attack proof? Ideally, our bad cholesterol—LDL—should be under 70. “If such a goal was created, the great scourge of the Western world would be essentially eliminated.” There are only two ways, he says, to get it down that low: put a hundred million people on a lifetime of high-dose statin drugs starting in one’s twenties, or be what he calls a “pure vegetarian fruit eater,” which is just what he calls those eating whole foods, plant-based diets.

Now, if we put everyone on drugs, then thousands of people would suffer side-effects, so: “Of course a [vegan] diet is the least expensive and safest means of achieving the plaque-preventing LDL goal, but few in the Western world are willing to live on the herbivore diet.” In his words, in a recent interview: “The best way to prevent heart disease is to be a…non-flesh-eater, a non-saturated fat-eater. (...) Because humans get atherosclerosis, and atherosclerosis is a disease only of herbivores,” he reasons, “humans also must be herbivores.”

The cause of our #1 killer is elevated cholesterol. So, according to probably the most renowned cardiovascular pathologist in the world, that means the cause of our #1 killer is: not eating vegan.

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

Please consider volunteering to help out on the site.

Image thanks to chriswong4238 via Flickr.

81 responses to “Eliminating the #1 Cause of Death

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  1. Why aren’t more doctors shouting this from the rooftops?!!
    Thank goodness for Dr. Greger and some others that will not rest until the whole world knows about this!




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  2. I’ve never been vegan or even vegetarian, but have always understood the value of eating a varied diet.

    Since the obesity epidemic exploded beginning around 1980, I must have missed this massive dietary change at that time. I was 18 in 1980 and my major exercise career was just starting. My theory is that a combination of sedentary lifestyle and worsening diet,i.e. the decline of the family farm and a huge shift to more sedentary employment combined to give this terrifying epidemic its horrible power. My tomato plants are really coming into their own! Can’t go wrong with Heirloom Tomatoes!




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    1. Don’t forget high fructose corn syrup too. I was born in 74′ and I even remember my dad hauling it as a truck driver to faygo all the time. We even used it in out koolaid. Sad, but true.




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    1. Hi Veggiecarrie, Good question. Nuts do contain saturated fats but studies have shown that eating nuts can reduce our risk of heart attacks see Dr. Gregers video http://nutritionfacts.org/videos/halving-heart-attack-risk/. Of course nuts are a concentrated source of calories(about 2800 cal/#) so if your goal is to lower your bodies fat content you might want to go easy on the nuts. I am unaware of a specific study that looks at cholesterol and nut consumption. Whole plant products like nuts also contain beneficial fats, minerals and antioxidants. So the science at this time suggests that unless you are allergic or don’t tolerate nuts then enjoy in moderation of about 1 ounce per day. Hope this helps.




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  3. Recently I heard from several vegan friends whose LDL cholesterol numbers were refusing to go down, and in one case had gone up form 102 to 108 in one year. (That particular person had been a vegan for almost 2 years by the time of the test showing LDL level of 102 mg/dL.) I remember hearing that about 10% of people do not see any significant drops in LDL levels after adopting a vegan diet. If so, what does this mean for their risk of heart disease and for Dr. Roberts’s claim (also made by other prominent researchers) that we could eliminate heart disease through vegan nutrition?




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    1. Vegan is not enough to reduce cholesterol sometimes, for optimum health, they must eliminate all processed foods, all free oils (olive oil, canola and flax oil too) and if they are having issues with cholesterol, try reducing nut consumption by at most a 1/4 cup a day of walnuts. The other side of the coin is exercise, which is almost equally as important as diet. For optimum health, 2 hours a day of rigorous exercise may be necessary.




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      1. I eat 3000 calories a day,low fat,low protein,high carb,mostly fruit,and hardly ever exercise.Maybe walk my dog.My blood work is perfect, and my cholesterol is under 100. I feel great,and maintain a 7% body fat year round.Movement is great,but you don’t have to kill your sellf in the gym.Diet. cholesterol..fat intake is the #1 problem.The fat you eat,is the fat you wear.




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    2. You would have to see what they are eating?Just because your Vegan,doesn’t mean your cholesterol will go down.Most Vegans eat 60-70-% of their calories from fat,because they think carbs are the bad guy.Check out 80/10/10,or Mcdougal diet,or Dr.Essylstein from the world famous Cleveland heart clinic.Most DR’s are recommending heart healthy oils,wich are vegan,but pure fat..Lower your fat intake,and I guarantee you your cholesterol will go down.I eat a high carb ,low fat,low protein vegan diet,blood work is perfect across the board,I eat more calories,than an 18 year old(48),and I maintain a 7% body fat year round,and hardly exercise,maybe walk my dog.Never have had a problem with diabetes,because I keep to a low fat diet.Also you will lose weight,because the fat you eat,is the fat you wear.




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      1. happy healthy & proud vegan raw foodist no health issues no medication no junk food no added sugar after all real food has dirt not labels and not a face




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  4. I eat vegan and love it.  My big downfall is exercise.  I like my projects, but nothiong really active.  I have pulled the old treadmill out from behind the junk in the garage and notice that I still resist.  I don’t want to get some bad diagnosis and hear, “If only you’d exercised more.”  Maybe saying this out loud will shame me enough.  Thanks for all your info.  So helpful.




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    1.  Lynn,

      The treadmill will burn calories, but not as efficiently as a hard workout, and that’s IF you actually get on it. Personally, I don’t know anyone that owns a treadmill and is actually thin and fit.

      You can burn calories while gaining muscle and increasing cardiovascular, rather than simply running on a treadmill. If you’re not into traditional weight lifting, then I would suggest you consider workouts like the “Spartacus” series by Funk Roberts:

      You do various weight training (dumbbells and kettlebells) and calisthenics exersizes at the same time, in timed intervals. This increases strength and cardio., while burning calories. Theoretically, you’re so oxygen “deprived” that your body continues to burn fat while you’re not working out, and does it does a lot better than simply running.

      http://www.spartacusworkout.com/program.html#week1

      Ideally, one would do this at a gym because of the equipment and the motivation (the hardest part about working out is the motivation part). Try to find a treadmill from anyone you know that’s not dusty.

      Side note: I did a self experiment to test my cardio from this type of workout. I don’t run too often, but this summer, without any warm up runs, I went straight to a 11.5K run, and found no cardio issues. I did feel really sore in my legs though.

      Well, you’re “saying this out loud” so I gave you a reply. :)




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      1. I agree. I’m eating no overt fat, nuts or seeds right now. I am a procrasonator when it comes to getting consistent with the walking, tho. I don’t run so, I think it’s the same walking on the tmill or outdoors. Probably safer on the tmill. Anything is better than nothing. lol! Yes I like doing a little weight lifting too. Thanks all for the encouragement.




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  5. Yay…my LDL (okay, last year) was 68.3; I had to go dig out my report. My doc specializes in lipids and told me to keep doing what I’m doing. And, I still eat cold water fatty fish 3 or 4 times a week…but switched to almond milk a few months ago.
    Yes, thank you for another interesting video, Doc! 




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  6. Dr. Greger, thanks so much for your informative, science based videos.  My family and I really enjoy them.  I have a question that I am having trouble answering to my friends who think I am making a mistake by eating so low fat.  What about HDL?  They are concerned that my HDL will be too low, and although it doesn’t make sense to me that it need be high if my LDL is low.  What data are out there to help clarify this when it comes up in conversation.  I try to not even discuss the way we eat at all just to avoid confrontation.  It’s too bad, because I want to share this information, but I don’t want to be backed in a corner, so to speak.  Thanks!




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  7. Dear Doctor Gregor,

    Thank you for the videos, I love all the great info.

    I have a friend that is getting into the paleo diet and he referred me to the video
    http://www.youtube.com/watch?v=vRe9z32NZHY&feature=share
    where they claim exactly the opposite…quoting a study

    KM Anderson, WP Castelli, D Levy, “Cholesterol and Mortality: 30 years of follow up from the Framingham Study.”  JAMA 1987; 257; 2176-2180

    where they claim increased death associated with lower cholesterol.  

    I am a devout vegan but all of this information is terribly confusing, I know everyone has there ulterior motives.  Any help would be much appreciated.

    Thank you!




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    1.  Dylan, low cholesterol causing increased death is an old theory.
      http://nutritionfacts.org/videos/can-cholesterol-be-too-low/

      We should also note that the population with the most centenarians per capita were the Okinawans. Here is there diet.

      Back in the 1950’s the Japanese rural Okinawan group of people
      had the most centenarians per capita. How did they live so long? Here is
      their diet

       

      Caloric Restriction, the Traditional

      Okinawan Diet, and Healthy Aging

      The Diet of the World’s Longest-Lived People and Its Potential Impact on Morbidity and Life Span

      Ann. N.Y. Acad. Sci. 1114: 434–455 (2007).

       

      TABLE 1. Traditional dietary intake of Okinawans and other Japanese circa 1950

       
      Total calories 1785

      Total weight (grams) 1262

      Caloric density (calories/gram) 1.4

      Total protein in grams (% total calories) 39 (9)

      Total carbohydrate in grams (% total calories) 382 (85)

      Total fat in grams (% total calories) 12 (6)

      Saturated fatty acid 3.7

      Monounsaturated fatty acid 3.6

      Polyunsaturated fatty acid 4.8

      Total fiber (grams) 23

       

      Food group Weight in grams (% total calories)

       
      Grains

      Rice 154 (12)

      Wheat, barley, and other grains 38 (7)

      Nuts, seeds Less than 1 (less than 1)

       
      Sugars 3 (less than 11)

      Oils 3 (2)

      Legumes (e.g., soy and other beans) 71 (6)

      Fish 15 (1)

      Meat (including poultry) 3 (less than 1)

      Eggs 1 (less than 1)

      Dairy less than 1 (less than 1)

       

      Vegetables

      Sweet potatoes 849 (69)

      Other potatoes 2 (less than1)

      Other vegetables 114 (3)

      Fruit less than 1 (less than 1)

      Seaweed 1 (less than 1)

      Pickled vegetables 0 (0)

      Foods: flavors & alcohol 7 (less than 1)

       

       

       

      Data derived from analysis of U.S. National Archives, archived food records, 1949 and based on survey of 2279 persons.

       

      Some points

       

      Their diet was 85% carb, and 6% fat. Sweet potatoes (a Japanese
      sweet potato) made up almost 70% of their calories. Nuts were less than
      1% of calories (the equivalent of 1/10 of an ounce a day) Oil was
      less than 2% of calories (which is about 1 tsp a day) and sugars were
      less than 1% of calories (less than a tsp a day)

       

      The total animal products including fish was less than 4% of
      calories which is less then 70 calories a day. That is the equivalent
      of around 2 oz of animal products or less a day.

      Looking at the prized Inuits of the paleolithic diet, their diet is comprised of almost all protein and fat. They live 10 years less then the average American. Is this something anyone would idolize? I doubt it.

      Dr. Greger covers the paleo diet here in his free ebook showing short term/long term side affects.
      http://www.atkinsexposed.org/




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  8. I believe from all that I have read, that inflammation is the cause of most chronic health problems. Perhaps a vegan diet may help to decrease inflammation but there are other ways of doing this.




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  9. Would love your advice regarding this article that someone just sent me trying to disprove that a plant based diet will reduce our risk of heart disease, cancer, diabetes, etc. My husband and I have been eating vegan for 5 months now, and he’s lost 35 pounds (I lost none, and don’t need to lose a pound). We both feel great and love the food. Been following Dr. Fuhrman’s eating plan. http://www.sciencebasedmedicine.org/index.php/the-china-study-revisited/




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  10. What is the relationship between elevated cholesterol and the cholesterol that your body makes naturally? I know vegans with elevated LDLs and assume they have a genetic cause that their body makes high cholesterol. I am a pescatarian, only eating seafood a couple of times a week, no dairy, and still have a total cholesterol of 200 and an LDL of 128. I hope my next test show an improvement on these numbers.




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  11. Can irregular menstruation with excessive bleeding and non-cessation be caused by albinism in the family history? I had to be on birth control pills most of my life from 19-50 but no one made the possible connection to albinism. I also had astigmatism and low thyroid. My sister and dad (who had albinism in the famIly) had astigmatism also. My dad’s father and mother had 7 children, 3 of them albinos. I recently read on the Internet there are some connections to diseases I never imagined. Also, is thereafter connection between albinism and pulmonary fibrosis. My daughter’s husband died of p/f and I am worried about my 16 y/o granddaughter.




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  12. I have been vegan, but recently found a source for raw milk from grass-fed, traditionally raised cows. I know that dairy is supposed to be highly carcinogenic as per “Forks Over Knives” and “The China Study” but wonder if that pertains to this high quality milk and yogurt that I make myself at home. I do not heat the milk over 112 degrees and consume the milk fresh with all its enzymes. Thank you for allowing us to ask questions!




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    1. The raw milk fad is something that should not be viewed as healthful. the issue with milk has nothing to do whether is is pasteurized or not, but what inherent nutrients exist. Here is an excerpt of a write up I have done on dairy.

      The concern with dairy and hormone dependent cancer is something to think about as well. It has been shown that consuming dairy significantly increases circulating steroid hormones in woman and that vegetarians have far less of this hormone. “In conclusion, greater consumption of red meat and dairy products might influence circulating concentrations of SHBG and estradiol, respectively. Given the well-established role of steroid hormones in breast cancer etiology for postmenopausal women, these findings may have important health implications” Tumor growth from these hormone imbalances is also evident “A dramatic increase in estrogen-dependent malignant diseases, such as ovarian, corpus uteri, breast, testicular and prostate cancers has been recognized. Ganmaa et al. investigated the incidence and mortality of testicular and prostate cancers in relation to dietary practices. Among various food items, cow’s milk and cheese had the highest correlation with incidence and mortality rate of these cancers” Children are at high risk “Among the exposure of humans, especially prepubertal children, to exogenous estrogens, we are particularly concerned with” These xenoestrogens from lactating preganant cattle (the majority of commercial cattle used for milk) significantly raised estrogen levels in male adults and reduced testosterone levels and did even more so in children. This is significant since these estrogens have mutagenic affects “Toxicological and epidemiological studies have indicated that E2 could be categorized as a carcinogen. Milk is considered to be a rich source of estrogens. Indeed, E2 concentration is higher in mammary drainage than in the peripheral circulation in high yielding cows.”

      http://www.ncbi.nlm.nih.gov/pubmed/20211044

      http://www.ncbi.nlm.nih.gov/pubmed/19904296

      http://www.ncbi.nlm.nih.gov/pubmed/19496976




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  13. Many of these postings are talking about how much exercise people are doing and working out at the gym and doing “2 hours of vigorous physical exercise every day”…??? The video and the article explain that a person’s cholesterol level is CRITICAL (and that this is determined by diet!!!!). Lifting weights or walking or doing a stairclimber or treadmill (or whatever) are all good…but the net effect on your cholesterol level is very minimal.

    Eat a whole-foods, plant-based diet and your cholesterol level will drop like a rock.




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  14. We are facing a pandemic called malnutrition. Why are we therefore espousing veganism, which would only exascerbate the problem? It would be impossible to get proper nutrients with a vegan diet, because the nutritients are just not in the soil, in most regions of the US. The climb to getting the majority of all people to just eat healthy is so great, that all of our effort needs to be getting the masses to this first base. Just eat healthy. One does not have to get fancy become vegan or eat all organic. Serenity Weight Loss and Detoxifcation Program just wants you to avoid all sugar, cereals, pork, dairy and soda, for starters. Focus on eating, chciken, fish, salad and veggies . Round out your program with the 90 essential nutrients and vitamins that all humans require, by taking well absorbed LIQUID vitamins and minerals. PERIOD. We know from 21 years of experience that even these changes are MAJOR -just getting people to take vitamins would be a major accomplishment . Why would anyone attempt to also impose veganism on people, when there are not even enough vegans to support the merits of this lifetysle? It is just not responsible, nor practical to expect the masses to adopt this lifestyle, when we are literally snatching sodas out of the hand of the masses. Stop the meaningless rhetoric. People are not going to become vegan, before they learn to stop eating their pizza, fried chicken and pork chops.One step at a time pleeeeeeeze!

    For information on the research on the benefits of mineral rich soils and the essential 90 nutrients, see Dr.Joel Wallach @www.thewallachfiles.com . and http://www.serenityweightlloss.my90forlife.com. Then join our health crusade http://www.serenityweight.bogspot.com




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  15. “non flesh eater” is a good start, but to go a bit further, shouldn’t we be telling people not to eat eggs and cheese etc. All animal foods?




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  16. after giving up red meat two years ago, I began eating a low-fat plant based diet about 20 months ago in line with the recommendations of dr. esselstyn, jr. md. after four months on esselstyns diet I saw a nice drop in cholesteral values almost in line with his study goal of total <150, and ldl<80. the problem is that on my next cholesterol check my values were going back up. I have been careful to maintain a low fat plant based diet. what am I doing wrong? is my atherosclerosis progressing?




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    1. It depends on exactly what you are eating and your lifestyle, are you consuming processed flours? Do you consume any free oils? Do you regularly exercise? Is your diet primarily whole unprocessed plant foods?




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      1. I eat whole grain breads, as low fat as I can find. no free oils. I walk every day for about 30 minutes.
        for breakfast I eat oatmeal with raisens, flaxseed meal, walnuts, apple, banana, and blueberries.
        for lunch I eat a chickpea, kidney bean, onion, tomatoe salad. nothing else added.
        for supper I frequently have a baked potatoe with onion and mushrooms and maybe green peas.
        for snack I may have a banana, or a can of peaches, or air-popped popcorn, or an apple




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        1. Not having heard any construction advice from you, I have moved forward, I hope, by eliminating popcorn and reducing the amount of russet potatoes consumed. I am concentrating on reducing the amount of higher glycemic index foods I eat. both of these have a high index. this is the advice in “dr. neal barnard’s program for reversing diabetes.”




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  17. I have been taking Crestor for the last year and the more I read about it, it’s starting to scare me. I have read a few different articles that say it is very possibly dangerous for your heart and also that it really is not having better heart attack results. I am overweight (250 pounds) 5’8″, my blood pressure is fine (125/80) and I am also taking a blood thinner and a water pill. I stopped taking my Crestor a couple of weeks ago without telling my doctor as I don’t like taking all these meds and will know try to stop eating a lot of meats and eating more vegetables. Do you think I am making a mistake by going off my statins drug? Also can you suggest a good recipe book to get me started on a plant based diet?




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    1. Statins are best avoided. My experience clinically working with Whole Food Employees at the McDougall Whole Foods program is an average drop of 40 points in total cholesterol in about a week. Although results vary from individual to individual. We have many recipe books so it is hard to recommend one. The McDougall website has recipes for free and you will probably find the newsletters on the treatment of high cholesterol( i.e. Statins May 2007, Cholesterol – When and How to Treat Sept 2002). If you are taking your diuretic for swelling that should improve as you lower your salt intake and lose weight. Diuretics work by removing sodium via the kidneys. For weight loss I refer you to my two favorite resources, Jeff Novick’s DVD Calorie Density: How to Eat More Weigh Less and Live Longer and Doug Lisle’s You Tube video, How to Lose Weight without Losing your mind. If you are taking your diuretic for blood pressure I would recommend Dr. McDougall’s Nov 2009 newsletter, How I treat patients with elevated blood pressure. Of course going plant based… no dairy,eggs, meat and fish will usually help you lose about 1/2 to 2 pounds per week depending on your diet’s calorie density(see Jeff’s dvd for details) and how much you exercise. After about 1 month I would recheck your laboratory results including a fasting glucose with your lipid panel( LDL, HDL, Total cholesterol, Triglycerides). At that point you given the information above and working with your physicians you should be able to decide on the best path for you. The link for the recipes on http://www.drmcdougall.com is under Education link. Keep tuned to NutritionFacts.org as the science keeps coming. Good luck on your journey. Bon Apetit.




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    2. Wayne: Dr. Forrester gave you an excellent and more helpful reply than I could. However, I wanted to address your last question as I have some recipe books that I particularly like. For the few recipes that call for say a tablespoon of oil to saute onions, you can just water saute or cook in the microwave:

      Vegan On The Cheap
      Everyday Happy Herbivore

      Let Them Eat Vegan

      There are many more out there, but these are my current favorites for everyday cooking.

      Good luck!




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  18. ” “Because humans get atherosclerosis, and atherosclerosis is a disease only of herbivores,” does this mean that dogs and cats do not get atherosclerosis?




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  19. Dr. Greger (or anyone else who may be reading this and know), are you aware of any vegan-friendly doctors in the Las Vegas or Henderson, NV area?




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  20. Bill Roberts was a neighbor of mine when he lived in Maryland (My father is a cardiologist and I’m a pathologist — we had much to talk about!) I share Dr. Greger’s admiration for Dr. Roberts, and of course, for his conclusions!




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  21. What are your thoughts on chiropractors? I”m trying to figure out what I want to do. I am also interested in nutrition and my health. Any ideas on careers in nutrition?

    Any careers more holistically based not popping pills? Thanks!




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  22. Hi Dr Greger – thank you so much for such wonderful and explanatory videos!

    However, I have to disagree with the issue of cholesterol as the single factor in the initiation of atherosclerosis. Many people with low cholesterol still get heart disease and many people with elevated LDL do not. What is the common factor? As far as my research says it is inflammation so irrespective of the level of cholesterol, if there is inflammation present it can initiate atherosclerosis.

    There are other factors which increase LDL and lower HDL : refined sugar, alcohol, lack of sunshine, lack of fibre, hormonal imbalance (especially women), lack of exercise, coffee, stress. According to Dr Udo Erasmus, 70% of us have a feedback mechanism whereby any cholesterol taken in via diet means that the liver produces less. So animal products don’t necessarily produce an increase in cholesterol. What animal products do is increase inflammation.

    I would really appreciate your comments!
    All the best




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    1. Hi Shot of Health. The body is complex for sure and “cause” intertwined! You may want to check out some of the other research articles about cholesterol, inflammation, etc. by using the Search functionality or the alphabetized list on the left nav bar. To get you started this is another related to your question: http://nutritionfacts.org/video/blocking-the-first-step-of-heart-disease/

      It is true that our livers have receptors that remove cholesterol from our blood. If you have an Apple product – you may want to listen to iTunes U > Academy of Achievement > Nobel Scientists > Michael Brown (MD). He talks briefly about cholesterol being removed from the body via liver and the impact of eating too much dietary cholesterol/animal fat. Thanks for your discussion.




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      1. Thank you so much Jacquie! I will definitely have a look at this subject more on your website and I will watch the video on the link you gave me. Sadly I am just coping with a terminally ill mother at the moment (cancer) and trying to work at the same time. I do appreciate your response and I appreciate it very much – very rare to get a sensible responsible on these discussions sometimes!
        Love and health to you
        S




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  23. I thought the new understanding was that it was inflammation that causes heart disease? Meaning processed white flour & sugar will also give you heart disease. I saw a quote from Dr. Esselstyn saying hes seen plenty of vegans die of heart attacks because of this.




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  24. Sorry for my ignorance, but when you say our LDL should be “under 70” I’m assuming that’s g/L? Am I correct? And on the same note, total cholesterol I understand should be 150. But again, is that g/L? Thanks so much.




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  25. I heard an analogy recently that I liked. LDL, (the bad cholesterol) is like trash, where as HDL (the good stuff) is like trash trucks.
    The more trash you have in your body the more HDL you need, the less trash the less HDL needed. The lower the total cholesterol the better, even if HDL goes down. Outside sources of cholesterol (within animal flesh) is not needed in human beings, it’s our Achilles heel.




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  26. What is your response to the best selling books:” Wheat Belly” and “Grain Brain”? The authors of both were celebrated with hoir long presentations on PBS. Why are their conclusions so contrary t6o your’s? RS




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    1. ralph: I would argue that the majority of videos on this website can be seen as a response to those books. Just looking at the videos on whole grains shows solid evidence supporting their consumption. Here’s some videos on grains:
      http://nutritionfacts.org/?s=grain

      That said, I think I remember Dr. Greger specifically addressing those books or at least flashing their covers in at least one of his videos – but I can’t find it if it does exist. :-( Maybe someone else can find it.

      Also, Dr. Greger has a free e-book called Carbophobia that delves into details on why those books you referenced are not valid. I think you can find that book if you look around. Or ask and I know someone here will get you a link.

      On PBS: PBS is out to raise money. They are happy to feature best selling authors if it will raise money for the station. The people who make the decisions to include a speaker or not do not have the expertise to evaluate the work. So, it’s perfectly understandable that they would bring on an author who is popular because he is telling people to do something that they want to do anyway–as opposed to the real, but more difficult message of what a truly healthy diet looks like.




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  27. Okay…well, im confused. i was told that GOOD sat fat would actually LOWER my cholesterol levels and my LDL while raising my HDL. So, for the past 2 weeks, ive been drinking coffee with 2 tablespoons of grass fed butter and 1 to 2 tablespoons of MCT (medium chain tryglycerides) in my coffee every morning. Ive actually lost almost 10 pounds doing this! My cholesterol is a bit high as is my LDL but my HDL is 60. So, please kind docs tell me, do I eat the “good” sat fat or not? I am a vegan btw and enjoy 2 very large green salads daily.




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    1. Tex: I’m glad you have lost weight. That’s great. But there are all sorts of ways to lose weight and some of them are very unhealthy in the long term. I’m not saying your diet is unhealthy. I don’t know enough about it. But I can say that just losing weight is not enough to say that what you are doing is good for you or not.

      It was interesting to me that you consider yourself a vegan, but still eat eat butter. The definition of a vegan is a person who does not eat animal products (ie, no meat, diary or eggs). “Animal products” would include butter. I’m not aware of anyone who would agree with you that you are vegan.

      I’m not trying to argue semantics. I think this is an important point, because you are not only taking in saturated fat with your butter, but also directly consuming cholesterol. You are also consuming 2 tablespoons worth calories that are just fat, fat and fat. No fiber, no phyonutrients, etc. I’ve never heard of something called “good saturated fat”, unless it is in the context of a whole plant food, like nuts and seeds. I know that you didn’t make that concept up. But I believe that others have made that concept up without much evidence to back it up.

      There are a whole lot of great videos on this site that give a lot of evidence showing that saturated fat in general, especially when coming from animal products, is not good for you. Neither is consuming cholesterol. You can get more great info/evidence about consuming cholesterol from Plant Positive: http://www.PlantPositive.com

      I’m not a doctor nor an expert. And I think it is great that you are eating 2 green salads a day. But you might want to think twice about consuming butter, grass fed or otherwise. Just my opinion.




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  28. What percentage of atherosclerotic plaque is calcium deposits? Would supplying adequate magnesium and Vitamin K2 in our diet eliminate calcium deposits on artery walls?




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    1. Mark: I find the information on this site to be compelling. I don’t find Drs Mercola or Senneff to be compelling. In the end, you will have to decide for yourself.




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  29. How is it possible, that people having for long time high cholesterol don’t have plaque?
    My husband (56) has since young very high Cholesterol levels and also high blood pressure, but exams showed no plaque building.(He is trying a HFPB low fat diet now, but has always been a vegetarian eating lots fruits and vegetables (but also some cheese and olive oil))

    I have also read about other such cases: “I am a 72 yr old female and have had high cholesterol for as long as I can remember (20-25 yrs.). It’s never been under 250 and sometimes 300. A few years ago I had a 64 slice CT angiogram which determined that I had no plaque buildup.”

    How is this possible?




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  30. Dr. Greger,
    If statins can cause rhabdomyolitis (a myopathy) in skeletal muscles, and the heart is similarly a muscle, would it not follow that chronic statin use may cause heart failure / cardiomyopathy?
    I would love to know if there is research on this topic.
    Thank you.
    Christine




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  31. Introduction

    Many researchers have suggested that the blood lipids play a key role in the immune defence system.1–21 There is also a growing understanding that an inflammatory response of the arterial intima to injury is a crucial step in the genesis of atherosclerosis. and that infections may be one type of such injury.22 These two concepts are difficult to harmonize with the low-density-lipoprotein (LDL) receptor hypothesis, according to which high LDL cholesterol is the most important cause of atherosclerosis. However, the many observations that conflict with the LDL receptor hypothesis, may be explained by the idea that high serum cholesterol and/or high LDL is protective against infection and atherosclerosis.

    Laboratory evidence

    Lipopolysaccharide, or endotoxin, the main pathogenic factor of Gram-negative bacteria, binds rapidly to lipoproteins,6 mainly LDL,7 and lipoprotein-bound endotoxin is unable to activate the secretion of various cytokines by monocytes in vitro.6,7,10 Also, Staphylococcus aureus α-toxin, a toxin produced by most pathogenic Staphylococcus strains and causing damage to a wide variety of cells, is bound and almost totally inactivated by human serum and purified LDL, as estimated by haemolytic titration.3

    Mice with hypercholesterolaemia due to LDL-receptor deficiency, challenged with bacterial endotoxin, had an 8-fold increased LD50, and a significantly lower and delayed mortality after injection with Gram-negative bacteria, compared with control mice.15 Also, rats made hypolipidaemic with 4-aminopyrolo-(3,4-D)pyrimide or estradiol had a greater increase in cytokine levels and markedly increased endotoxin-induced mortality compared to normal rats, and administration of exogenous lipoprotein reduced their mortality substantially.12




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  32. Hyperventilation is present in hypothyroidism, and is driven by adrenalin, lactate, and free fatty acids. Free fatty acids and lactate impair glucose use, and promote edema, especially in the lungs. Edema in the lungs limits oxygen absorption. Swelling of the brain, resulting from increased vascular permeability and the entry of free fatty acids, reduces its circulation and oxygenation; lactic acidemia causes swelling of glial cells. Swelling of the endothelium increases vascular resistance by making the channel narrower, eventually affecting all organs. Cells of the immune system release tumor necrosis factor and other inflammatory cytokines, and the bowel becomes more permeable, allowing endotoxin and even bacteria to enter the blood. Endotoxin impairs mitochondria, increases estrogen levels, causes Kupffer cells in the liver to produce more tumor necrosis factor, etc. Despite its name, tumor necrosis factor stimulates the growth and metastasis of some types of cancer. Dilution of the body fluids, which occurs in hypothyroidsim, hyperestrogenism, etc., stimulates tumor growth.”

    “The saturated fats, in themselves, seem to have no “signalling” functions, and when they are naturally modified by our desaturating enzymes, the substances produced behave very differently from the plant-derived “eicosanoids.” As far as their effects have been observed, it seems that they are adaptive, rather than dysadaptive. All of the factors that affect the brain of a fetus should be examined in relation to the aging brain. Besides estrogen and fats, I am thinking of oxygen and carbon dioxide, glucose, iron and calcium, cholesterol, progesterone, pregnenolone, DHEA, the endorphins, GABA, thyroid, and vitamin A. An additional factor, endotoxin poisoning, eventually tends to intervene during stress and aging, exacerbating the trend begun under the influence of the other factors.”

    “Endotoxin: Antimitochondrial action, causes elevation of estrogen. It synergizes with unsaturated fats, and naloxone opposes some of its toxic effects.”

    “A “deficiency” of polyunsaturated fatty acids leads to altered rates of cellular regeneration and differentiation, a larger brain at birth, improved function of the immune system, decreased inflammation, decreased mortality from endotoxin poisoining, lower susceptibility to lipid peroxidation, increased basal metabolic rate and respiration, increased thyroid function, later puberty and decreases other signs of estrogen dominance. When dietary PUFA are not available, the body produces a small amount of unsaturated fatty acid (Mead acids), but these do not activate cell systems in the same way that plant-derived PUFAs do, and they are the precursors for an entirely different group of prostaglandins.”

    “The absence of cancer on a diet lacking unsaturated fats, the increased rate of metabolism, decreased free radical production, resistance to stress and poisoning by iron, alcohol, endotoxin, alloxan and streptozotocin, etc., improvement of brain structure and function, decreased susceptibility to blood clots, and lack of obesity and age pigment on a diet using coconut oil rather than unsaturated fats, indicates that something very simple can be done to reduce the suffering from the major degenerative diseases, and that it is very likely acting by reducing the aging process itself at its physiological core.”

    “In the bowel, the capillary malfunction increases the absorption of endotoxin, which intensifies the systemic energy problem. (Polyunsaturated oils, especially fish oil, damage the bowel capillaries, allowing more endotoxin to be absorbed.)”




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  33. This is a bit late but I wanted to add that it is my understanding from research and studies read that heart disease is more of an inflammation issue. I suspect the reason for a vegan diet is because it is anti-inflammatory as long as other items aren’t added to it such as food or oils that are inflammatory. I was able to reduce my inflammation levels when I eliminated the N6 oils and and more but the results were significant. N6 (omega 6) oils are very inflammatory as opposed to Omega 3. N6 oils include all vegetable, soy, canola, and seed oils. While living in Africa, our high fat diet was the norm and heart disease was rare. Thank you for allowing this post.




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  34. Feeling disappointed with my 233 cholesterol score today after sticking to the daily dozen for 3 months. I’m slightly anemic too and borderline Vitamin D deficient. Now I’ve 2 opposite bits of advice through researching. One says It’s in my genes and I should stop all oil foods like avocados, nuts. One says, eat more whole food fats. Confused and sad.




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