Evidence-Based Weight Loss – Live Presentation

Evidence-Based Weight Loss – Live Presentation
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In his newest live presentation, Dr. Greger offers a sneak peek into his new book How Not to Diet.

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Why don’t we give a big, warm welcome to Dr. Michael Greger?!!

[Applause]

Surely, if there was some safe, simple, side-effect-free solution to the obesity epidemic, we would know about it by now, right? I’m not so sure.

It may take up to 17 years before research findings make it into day-to-day clinical practice. To take one example that was particularly poignant for my family: heart disease.  You know, decades ago, Dr. Dean Ornish and colleagues published evidence in one of the most prestigious medical journals in the world that our leading cause of death could be reversed with diet and lifestyle changes alone—yet, hardly anything changed. Even now, hundreds of thousands of Americans continue to needlessly die from what we learned decades ago was a reversible disease. In fact, I had seen it with my own eyes. My grandmother was cured of her end-stage heart disease by one of Dean’s predecessors, Nathan Pritikin, using similar methods.

So, if effectively the cure to our number-one killer of men and women could get lost down some rabbit hole and ignored, what else might there be in the medical literature that could help my patients, but that just didn’t have a corporate budget driving its promotion? Well, I made it my life’s mission to find out. That’s why I became a doctor in the first place and why I started my nonprofit site, NutritionFacts.org.

Everything on the website is free. There are no ads, no corporate sponsorship. It’s strictly noncommercial, not selling anything. I just put it up as a public service, as a labor of love, as a tribute to my grandmother. [Applause] New videos and articles nearly every day on the latest in evidence-based nutrition—what a concept.

Ok, so, what does the science show is the best way to lose weight? If you want testimonials and before-and-after pictures, you have come to the wrong place. I’m not interested in anecdotes; I’m interested in the evidence. When it comes to making decisions as life-and-death-important as the health and well-being of yourself and your family, there’s really only one question: What does the best available balance of evidence show right now?

The problem is that even just sticking to the peer-reviewed medical literature is not enough as, “False and scientifically [misleading] unsupported beliefs about obesity are pervasive” even in scientific journals. The only way to get at the truth, then, is to dive deep into the primary literature and read all the original studies themselves. But, who’s got time for that? There are more than half a million scientific papers on obesity with a hundred new ones published every day. Even researchers in the field might not be able to keep track beyond their narrow domain. But that’s what we do at NutritionFacts.org. We comb through tens of thousands of studies a year so you…don’t have to. Very nice!

And indeed, we uncovered a treasure trove of buried data, like today I’ll cover simple spices, for example, proven in randomized, double-blind, placebo-controlled trials to accelerate weight loss for pennies a day, but with so little profit potential, it’s no wonder those studies never saw the light of day. The only profiting I care about, though, is your health. That’s why 100 percent of the proceeds I receive from all of my books, and DVDs, and speaking engagements are all donated to charity. I just want to do for your family what Pritikin did for my family.

              But wait, isn’t weight loss just about eating less and moving more? I mean, isn’t a calorie a calorie? That’s what the food industry wants you to think. The notion that a calorie from one source is just as fattening any other is a trope broadcast by the food industry as a way to absolve itself of culpability. Coca-Cola itself even put an ad out there emphasizing this “one simple common-sense fact.” As the current and past chairs of Harvard’s nutrition department put it, this “central argument” from industry is that the “overconsumption of calories from carrots would be no different from overconsumption of calories from soda….” If a calorie is just a calorie, why does it matter what we put in our mouths?

Let’s explore that example of carrots versus Coca-Cola. It’s true that in a tightly controlled laboratory setting, 240 calories of carrots (10 carrots) would have the same effect on calorie balance as the 240 calories in a bottle of Coke, but this comparison falls flat on its face out in the real world. You could chug those liquid candy calories in less than a minute, but eating 240 calories of carrots would take you more than two-and-a-half hours of sustained constant chewing. [Laughing] Not only would your jaw get sore, but 240 calories of carrots is like five cups—you might not even be able to fit them all in.

Our stomach is only so big. Once we fill it up, stretch receptors in our stomach wall tell us when we’ve had enough, but different foods have different amounts of calories per stomachful. Some foods have more calories per cup, per pound, per mouthful than others. This is the concept of calorie density, the number of calories in a given amount of food. Three pounds is about what the average American eats in a day. As you can see, for example, oil, has a high calorie density, meaning a high calorie concentration, lots of calories packed into a small space. Drizzling just a tablespoon of oil on a dish adds over a hundred calories. For those same calories, you could have instead eaten about two cups of blackberries, for example, a food with a low calorie density. So, these two meals have the same number of calories. You could swig down that spoonful of oil and not even feel anything in your stomach, but eating a couple of cups of berries could start to fill you up. That’s why yes, biochemically a calorie is a calorie, but eating the same amount of calories in different foods, can have different effects.

The average human stomach can expand to fit about four cups of food; so, a single stomachful of strawberry ice cream, for example, could max out our caloric intake for the entire day. For the same two-thousand calories, to get those same two thousand calories from strawberries themselves…you’d have to eat forty-four cups of berries. That’s eleven stomachfuls. As delicious as berries are, I don’t know if I could fill my stomach to bursting eleven times a day. Some foods are just impossible to overeat. They are so low in calorie density, you just physically couldn’t eat a enough to even maintain your weight. In a lab, a calorie is a calorie, but in life, far from it.

Traditional weight-loss diets focus on decreasing portion size, but we know these “eat less” approaches can leave people feeling hungry and unsatisfied. A more effective approach may be to shift the emphasis from restriction to positive “eat more” messaging of increasing intake of healthy, low-calorie-density foods, but you don’t know, until you… put it to the test.

Researchers in Hawaii tried putting people on more of a traditional, Hawaiian diet with all the plant foods they could eat, unlimited quantities of fruits, vegetables, whole grains, and beans. And, the study subjects lost an average of seventeen pounds in just twenty-one days. Calorie intake dropped by 40 percent, but not because they were eating less food. They lost seventeen pounds in three weeks eating more food, in excess of four pounds a day. How could that be? Because whole plant foods tend to be so calorically dilute, you can stuff yourself without getting the same kind of weight gain. They lost seventeen pounds in three weeks eating more food. That’s why in my upcoming book, How Not to Diet, which I am very excited about, [clears throat], that’s why “Low in Calorie Density” is on my list of the 17 ingredients for an ideal weight loss diet.

As noted before, Americans appear to average about three pounds of food a day. So, if you stuck with mostly these foods, you can see how you can eat more food and still shed pounds.

A landmark study set to be published next month found that, even when presented with the same number of calories, and the same salt, sugar, fat, fiber and protein, processed foods led to weight gain, two pounds gained over two weeks; and unprocessed foods led to weight loss, two pounds down in the same two weeks. Here’s one of their processed food meals…which is probably healthier, actually, than what most people eat. Non-fat Greek yogurt, baked potato chips, sugar-free diet lemonade with a turkey sandwich, has the same number of calories as this…what the unprocessed-meal-food folks were eating, kind of a southwest entrée salad with black beans, avocados, nuts…that’s the calorie density effect. Same calories but there’s just more food, no wonder it satisfied their hunger.  And they ended up four pounds lighter in two weeks eating more food.  So, how can you decrease the calorie density of your diet? Well, just a quick peek at the two extremes should suggest two methods: abandon added fats and add abandoned vegetables.

Method number one: Covertly put people on a relatively low-fat diet, and they tend to lose body fat every day even though they can eat as much as they want. If you instead give those same people the same meals, but this time sneak in enough extra fats and oils to change it to a high-fat diet, they gain body fat every day.

            In fact, in a famous prison experiment in Vermont, lean inmates were overfed up to ten thousand calories a day to try to experimentally make them fat. This turned out to be surprisingly difficult. Most starting dreading breakfast and involuntarily threw it up. The researchers learned how difficult it was to have people to gain weight on purpose— unless, you feed them lots of fat. To get prisoners to gain thirty pounds on a regular diet, it took about 140,000 excess calories per certain amount of body surface area. To get the same thirty-pound weight gain just by adding fat to their diets, all they had to do was feed them about an extra 40,000 calories. When the extra calories were in the form of straight fat, it took as many as a hundred thousand fewer calories to gain the same amount of weight. A calorie is not a calorie—it depends what you eat. In this case, lowering fat content effectively made up to 100,000 calories, disappear. That’s why “Low in Added Fat” is on my list of ideal weight loss ingredients as well.

There are, however, two important exceptions. Processed foods with “reduced-fat claims” are often so packed with sugar that they can have the same number of calories as a higher fat product. SnackWell’s fat-free cookies, for example, at seventeen hundred calories per pound are as calorie-dense as a cheese danish.

The other exception is to the low-fat rule is that vegetables are so calorically dilute that even a high-fat veggie dish, like some oily broccoli with garlic sauce, tends to be less calorie dense overall, which brings us to the second strategy for lowering calorie density: instead of sneaking out fat, sneak in vegetables.

The biggest influence on calorie density is not fat, but water content. Since water adds weight and bulk without adding calories, the most calorie-dense foods and the most calorie-dense diets tend to be those that are dry. Some vegetables, on the other hand, are more than 95 percent water, and not just iceberg lettuce. Cucumbers, celery, turnips, cooked napa cabbage, bok choy, summer squash, zucchini, bean sprouts, and bamboo shoots can top out at 95 percent water. They’re basically just water in vegetable form. A big bowl of water-rich vegetables is practically just a big bowl of trapped water. The effect on calorie density is so dramatic the food industry wants in on the action. They figure they could use nanotechnology to “structure a solid processed food similar to a celery stalk with self-assembled, water-filled, …nanocells or nanotubes.” No need, as Mother Nature beat you to it.

When dozens of common foods, pitted head-to-head for for their ability to satiate appetites for hours, the characteristic most predictive was not how little fat or how much protein it had, but how much water it had. That was the number one predictor of how filling a food is. That’s why “High in Water-Rich Foods” is on my list, too.

Water-rich foods like vegetables, topping the charts with most more than 90% water by weight, followed by most fresh fruit, coming in around the 80s. Starchier vegetables, whole grains, and canned beans are mostly 70s, meaning three-quarters of their weight: pure water. In general, when it comes to water-rich foods, most whole plant foods float towards the top, most animal foods fall somewhere in the middle, and most processed foods sink to the bottom.

In a famous series of experiments, researchers at Penn State decided to put water-rich vegetables to the test. Study subjects were served pasta and told to eat as much or as little as they’d like. On average, they consumed about 900 calories of pasta. What do you think would happen if, as a first course, you gave them a hundred calories of salad composed largely of lettuce, carrots, cucumber, celery, and cherry tomatoes? Would they go on to eat the same amount of pasta and end up with a thousand calorie lunch, 900 plus 100? Or would they eat a hundred fewer calories of pasta, effectively canceling out the added salad calories? It was even better than that. They ate more than 200 fewer calories of pasta. Thanks to the salad, a hundred calories in, 200 calories out. So, in essence, the salad had negative 100 calories. Preloading with vegetables can effectively subtract a hundred calories out of a meal. That’s how you can lose weight by eating more food.

Of course, the type of salad matters. The researchers repeated the experiment, this time adding a fatty dressing and extra shredded cheese, which quadrupled the salad’s calorie density. Now, eating this salad as a first course didn’t turn the 900-calorie meal into one with less than 800 calories. Instead, it turned it into a meal with calories in the quadruple digits. It’s like preloading pizza with garlic bread—you could end up with more calories overall.

So, what’s the cut-off? Studies on preloading show that eating about a cup of food before a meal decreases subsequent intake by about 100 calories; so, to get a “negative calorie” effect, the first course would have to contain fewer than a hundred calories per cup. As you can see in this chart, this would include most fresh fruits and vegetables, but having something like a dinner roll wouldn’t work.

But, hey, give people a large apple to eat before that same pasta meal, and rather than consuming two hundred calories less, it was more like three hundred calories less. So, how many calories does an apple have? It depends on when you eat it. Before a meal, an apple could effectively have about negative 200 calories.

You can see the same thing giving people vegetable soup as a first course. Hundreds of calories disappear. One study that tracked people’s intake throughout the day even found that overweight subjects randomized to pre-lunch vegetable soup not only ate less lunch, but deducted an extra bonus hundred calories at dinner, too, a whole seven hours later. So, the next time you sit down to a healthy soup, you can imagine calories being veritably sucked out of your body with every spoonful.

Even just drinking two cups of water immediately before a meal caused people to cut about 20 percent of calories out of the meal, taking in more than 100 fewer calories. No wonder overweight men and women randomized to two cups of water before each meal lost weight 44 percent faster. Two cups of water before each meal, 44 percent faster weight loss. That’s why so-called “Negative Calorie Preloading” is on my list of weight loss boosters: all the things I could find that can accelerate weight loss regardless of what you eat the rest of the time. Negative calorie preloading just means starting a meal with foods containing fewer than a hundred calories per cup. That would include many fruits, vegetables, soups, salads, or simply, a tall glass of water.

Anything we can put on that first-course salad to boost weight loss even further? In my “Amping AMPK” section I talk about ways to activate an enzyme known as the “fat controller.” Its discovery is considered one of the most important medical breakthroughs in the last few decades. You can activate this enzyme through exercise, fasting, and nicotine, but is there any way to boost it for weight loss without sweat, hunger, or the whole dying-a-horrible-death-from-lung-cancer thing?

Big Pharma is all over it. After all, obese individuals may be “unwilling to perform even a minimum of physical activity,” wrote a group of pharmacologists, “thus, indicating that drugs mimicking endurance exercise are highly desirable.” So, “it’s crucial that oral compounds with high bioavailability are developed to safely induce chronic AMPK activation” for “long-term weight loss and maintenance….” But, there’s no need to develop such a compound since you can already buy it any grocery store. It’s called vinegar.

When vinegar—acetic acid—is absorbed and metabolized, you get a natural AMPK boost. Enough of a boost to lose weight at the typical dose you might use dressing a salad? Vinegar has evidently been used to treat obesity for centuries, but only recently has it been…put to the test.

A randomized, double-blind, placebo-controlled trial on the effects of vinegar intake on the reduction of body fat in overweight men and women. The subjects were randomized to drink a daily beverage containing one or two tablespoons of apple cider vinegar or a controlled drink developed to taste the same as the vinegar drink, but prepared with a different kind of acid so it didn’t have actual vinegar in it. Three months in, the fake vinegar group actually gained weight (as overweight people tend to do), whereas the genuine vinegar groups significantly lost body fat, as determined by CT scan. A little vinegar every day led to pounds of weight loss achieved for just pennies a day without removing anything from their diet. That’s why one of my 21 tweaks to accelerate weight loss, is two teaspoons of vinegar with each meal, either sprinkled on your salad or even just added to tea with some lemon juice.

The beauty of the vinegar studies is that they were not just randomized, controlled trials, but placebo-controlled trials. Some studies aren’t controlled at all. Women asked to eat a ripe tomato before lunch every day for a month lost about two pounds, but without a control group you don’t know if the tomato had anything to do with it. Just being enrolled in a weight-loss study where you know they’re going to come back and weigh you again in a month can have people to change their diets in other ways. I mean it’s certainly possible. A tomato is 95 percent water; so, you’d be filling up a fist-sized portion of your stomach with only about fifteen calories before a meal, it’s certainly possible, but we’d need a better study to prove it for weight loss.

Stronger studies have control groups. At least, for example, randomize people to a weight-loss diet with or without one to two cups of low-sodium vegetable juice and those drinking the vegetable juice lose significantly more weight. Or split people into two groups and give half about two tablespoons of goji berries a day, and forty-five days later, the goji group appeared to cut two-and-a-half inches off their waistline compared to no change in the control group. But any time you have one group do something special, you don’t know how much of the benefit is due to the placebo effect. In drug trials it’s easy: you give half the people the actual medication and the other half an identical-looking sugar pill placebo. Both groups are then doing the same thing—taking identical-looking pills—and so, if you see any difference in outcomes, we can suspect it’s the due to the actual drug. But what would placebo broccoli look like? That’s the problem.

You can’t stuff cabbage into a capsule, but there are some foods so potent that you could actually fit them into a pill to pit them against placebos: spices. Want to know if garlic can cause weight loss? Give people some garlic powder compressed into tablets versus placebo pills. And? Garlic worked, resulting in both a drop in weight and in waistlines within six weeks. They used about a half teaspoon of garlic powder a day, which would cost less than four cents.

Four cents too steep? How about two cents a day? A quarter teaspoon of garlic powder a day, about a hundred overweight men and women were randomized to a quarter teaspoon worth of garlic powder a day or placebo, and those unknowingly taking the two cents worth of garlic powder a day lost about six pounds of straight body fat over the next fifteen weeks.

Now if you can splurge up to three cents a day, there’s black cumin. A meta-analysis of randomized, controlled trials shows weight-loss efficacy again just a quarter teaspoon a day. Not regular cumin, this is a completely different spice known as black cumin. What is black cumin? You obviously haven’t been reading your bibles. Described as a “miracle herb,” besides the weight loss, there are randomized controlled trials showing daily black cumin consumption significantly improves cholesterol and triglycerides…significantly improves blood pressure… and blood sugar control. But I use it, just cause it tastes good—I just put black cumin seeds in a pepper grinder and grind it like pepper.

With more than a thousand papers published in the medical literature on black cumin, some reporting extraordinary results like dropping cholesterol levels as much as a statin drug, why don’t we hear more about it? Why weren’t we taught about it in medical school? Presumably because there’s no profit motive. Black cumin is just a common, natural spice. You’re not going to thrill your stockholders selling something that you can’t patent, that costs, three cents a day.

Or you can use regular cumin, the second most popular spice on Earth. Those randomized to a half of a teaspoon at both lunch and dinner over three-months lost about four more pounds and an extra inch off their waist, found comparable to the obesity drug known as orlistat. That’s the “anal leakage” drug you may have heard about, though the drug company evidently prefers the term “fecal spotting” to describe the rectal discharge it causes. The drug company’s website offers some helpful tips, though, “it’s probably a smart idea to wear dark pants and bring a change of clothes with you to work.” You know, just in case their drug causes you to crap your pants at work. I think I’ll stick with the cumin.

Cayenne pepper can counteract the metabolic slowing that accompanies weight loss and accelerate fat burning as a bonus. Ginger powder! Over a dozen randomized controlled trials starting at just a quarter teaspoon of ground ginger a day showing significantly decreased body weight for just pennies a day. Proven in placebo-controlled trials to work, but you probably never heard about any of this because they can’t make enough profit. Don’t get me started.

But let me go back to the Coke versus carrots example. A calorie is not a calorie because drinking this, is not the same as eating this. But even if you consumed the same number of calories, chewed for hours to pack in all those carrots, a calorie may still not be a calorie, because it’s not what you eat, it’s what you absorb. As anyone who’s ever eaten corn can tell you, some bits of vegetable matter can pass right through you. A calorie may still be a calorie circling your toilet bowl, but flushed calories aren’t going to make it onto your hips.

That’s where fiber comes in. If you bump people’s fiber intake up, even to just the recommended minimum daily fiber intake they start losing weight, because they experience about a 10% drop in daily caloric intake. Why should more fiber mean fewer calories? Well first, it adds bulk without adding calories. Cold-pressed apple juice, for example, is basically just apples minus fiber. And you could chug a bottle of juice in a couple of seconds, but to get the same number of calories, you would have to eat about five cups of apple slices. That’s the difference fiber can make, but it’s not just a calorie density thing.

Imagine what happens next: The apple juice would get rapidly absorbed as soon as it spilled out of your stomach into the gut, spike your blood sugars, whereas the sugar trapped in the mass of chewed apple slices would be absorbed more slowly along the length of your intestines. Nutrients can only be absorbed when they physically come in contact with the side of your intestine, with your gut wall. Fiber never gets absorbed; so, it can act as a carrier to dilute or even eliminate calories out the other end. And fiber doesn’t just trap sugars. It acts as a fat- and starch-blocker, too.

Those on a Standard American Diet lose about 5 percent of their calories through their waste every day, but on a higher-fiber diet we can double that. It’s not what you eat, but what you absorb; so, you can lose weight on a high-fiber diet eating the exact same number of calories simply because some of those calories get trapped, get flushed down the toilet, and never make it into your system.

And it’s not just the calories in the high-fiber foods themselves that are less available. High-fiber foods trap calories across the board. So, eat a Twinkie on a high-fiber diet and you absorb fewer Twinkie calories. It’s like every calorie label you look at gets instantly discounted when you are eating lots of fiber-rich foods, which is why it makes it onto my list.

My section on other fat-blocking foods starts out with a command to “Eat Your Thylakoids”, doctor’s orders. What on earth is a thylakoid? Just the source of nearly all known life—and, the oxygen we breathe, no biggie. Thylakoids are where photosynthesis takes place, the process by which plants turn light into food. Thylakoids are the great green engine of life, microscopic sac-like structures composed of chlorophyll-rich membranes concentrated in the leaves of plants.

When we eat thylakoids, when we bite into a leaf of spinach, for instance, those green leaf membranes don’t immediately get digested. They last for hours in our intestines and that’s when they work their magic. Thylakoid membranes bind to lipase.  Lipase is the enzyme that our body uses to digest fat; so, you bind the enzyme – you slow fat absorption.

If all the fat is eventually absorbed, what’s the benefit? Location, location, location. There’s a phenomenon known as the ileal brake. The ileum is the last part of the small intestine before it dumps into your colon. When undigested calories are detected that far down in your intestines, your body thinks “I must be full from stem to stern,” and puts the brakes on eating more by dialing down your appetite. This can be shown experimentally. If you insert a nine-foot tube down people’s throats and drip in any calories: fat, sugar, or protein, and you can activate the ileal brake. Sit them down to an all-you-can-eat meal and, compared to the placebo group who had only gotten a squirt of water through the tube, people eat over a hundred calories less. You just don’t feel as hungry. They feel just as full, eating significantly less. That’s the ileal brake in action.

This can then translate into weight loss. Randomize overweight women on a diet to “green-plant membranes” (in other words, just covertly slip them some powdered spinach) and they get a boost in appetite suppressing hormones, a decreased urge for sweets. Yes indeed, spinach can cut your urge for chocolate. And boom, accelerated weight loss. All thanks to eating green, the actual green itself, the chlorophyll-packed membranes in the leaves.

Now, the researchers used spinach powder just so they could create convincing placebos, but you can get just as many thylakoids eating about a half cup of cooked greens, which is what I recommend people eat two times a day in my Daily Dozen checklist of all the healthiest of healthy things I encourage people to fit into their daily routine.

In the journal of the Society of Chemical Industry, a group of food technologists argued that given their fat-blocking benefits, “thylakoid membranes could be incorporated in functional foods as a new promising appetite-reducing ingredient”—or you can just get them in the way Mother Nature intended.

Which greens have the most? You can tell just by looking at them. Because thylakoids are where the chlorophyll is, the greener the leaves, the more potent the effect. So, go for the darkest-green greens you can find; where I shop that’s the lacinato (a.k.a. dinosaur) kale.

Now, if you overcook greens too long…you know how they turn that drab olive brown…that’s the thylakoids physically degrading, but blanched for fifteen seconds or so in steaming or boiling water, you know greens get an even brighter green—that actually translates into a boost in the fat-blocking ability. So, you can gauge thylakoid activity in the grocery store, in your kitchen with your own two eyes by going for the green.

Though thylakoids eventually get broken down, fiber makes it all the way down to our colon. While it’s technically true that we can’t digest fiber, that’s only applicable to the part of us that’s actually human. Most of the cells in our body are bacteria. Our gut flora, which weigh as much as one of our kidneys, are as metabolically active as our liver, has been called our “forgotten organ,” and it’s an organ that runs on MAC, Microbiota-Accessible Carbohydrates. So, when you see me write “Eat Lots of Big MACs” I don’t want anyone to get the wrong idea. MAC is just another name for prebiotics, what our good gut flora eat, in other words, fiber. There’s that fiber again.

What do our good bacteria do with the fiber? We feed them and they feed us right back. They make short-chain fatty acids that get absorbed from the colon into our bloodstream, circulate through our body, and even make it up into our brain. That’s like the way our gut flora communicates with us, dialing down our appetite, all the while increasing the rate at which we burn fat and boosting our metabolism at the same time. All thanks to fiber.

Check this out. Put people in a brain scanner and show them a high-calorie food like a donut and the reward centers in their brains instantly light up. But, if you repeat the experiment, and this time, secretly deliver fiber-derived short-chain fatty acids directly into their colon, you get a blunted reward center response and subjects report that high-calorie foods just seemed less appetizing, and subsequently ate less of an all-you-can-eat meal. But fiber supplements like Metamucil don’t work, which makes sense because they are nonfermentable, meaning our gut bacteria can’t eat it; so, yeah, they can improve bowel regularity but can’t be used by our good bacteria to make those compounds that can block our cravings. For that, we have to actually eat real food.

Our good gut bugs are trying to help us, but when we eat a diet deficient in fiber, we are in effect starving our microbial self. Less than 5 percent of Americans reach even the recommended minimum daily adequate intake of fiber, no surprise since the number one sources are beans and whole grains, and 96% of Americans don’t even reach the recommended minimum intake of legumes (which are beans, split peas, chickpeas, and lentils), and 99% don’t reach the recommended daily minimum for whole grains.

Most people don’t even know what fiber is. More than half of Americans surveyed think that steak is a significant source of fiber. However, by definition, fiber is only found in plants. There is zero fiber in meat, eggs, or dairy, and typically little or no fiber in processed junk, and therein lies the problem.

But wouldn’t at least the protein in that steak fill you up? Surprisingly, even a review supported by the meat, dairy, and egg industries acknowledged that protein intake does not actually translate into eating less later on, whereas you eat a fiber-rich whole grain for supper, and it can cut your calorie intake more than 12 hours later at lunch the next day! You feel full a hundred calories quicker the following day because, by then, your good gut bugs are feasting on the same bounty and dialing down your appetite.

Today, even our meat could be considered junk food. For more than a century, one of the great goals of animal agriculture has been to increase the carcass fat content of farm animals. Take chicken, for example. A hundred years ago, the USDA determined chicken was about 23 percent protein by weight and less than 2 percent fat. Today, chickens have been genetically manipulated through selective breeding to have about ten times more fat. Chicken Little has become Chicken Big and may be making us bigger too.

Meat consumption in general is associated with weight gain, but poultry appeared to be the worst. Even just an ounce a day—that’s like a single chicken nugget, or like one chicken breast every ten days, was associated with weight gain compared to eating no chicken at all.

You know, it’s funny, when the meat industry funds obesity studies on chicken, they choose for their head-to-head comparison, foods like “cookies and sugar-coated chocolates.” This is a classic drug industry trick to try to make your product look better by comparing it to something worse. (Apparently, just regular chocolate wasn’t enough to make chicken look better.) But what happens when chicken is pitted against a real control, like chicken without the actual chicken? Chicken chickens out.

Both soy-based proteins and Quorn, which is a plant-based meat made from the mushroom kingdom, were found to have stronger satiating qualities than chicken. Feed people a chicken and rice lunch, and four-and-a-half hours later, they eat 18 percent more of a dinner buffet than had they instead been given a chicken-free chicken and rice lunch. These findings are consistent with childhood obesity research that found that meat consumption seemed to double the odds of schoolchildren becoming overweight, compared to the consumption of plant-based meat products. Whole-food sources of plant protein such as beans did even better though, associated with cutting in half the odds of becoming overweight. So, that’s why I consider these kinds of plant-based meats more of a useful stepping stone towards a healthier diet, rather than the end-game goal / ideal.

Part of the reason plant-based meats may be less fattening is that they cause less of an insulin spike. A meat-free chicken like Quorn causes up to 41 percent less of an immediate insulin reaction. It turns out animal protein causes almost exactly as much insulin release as pure sugar. Just adding some egg whites to your diet can increase insulin output as much as a 60 percent within four days. And fish may be even worse.

Why would adding tuna to mashed potatoes spike up insulin levels, but adding broccoli instead cut the insulin response by about 40 percent? It’s not the fiber, since giving the same amount of broccoli fiber alone provided no significant benefit. So, why does animal protein make things worse but plant protein makes things better?

Plant proteins tend to be lower in the branched-chain amino acids which are associated with insulin resistance, the cause of type 2 diabetes. You can show this experimentally. Give some vegans branched-chain amino acids, and you can make them as insulin resistant as omnivores. Or, take some omnivores and put them through even a “48-hour vegan diet challenge,” and, within two days, you can see the opposite—significant improvements in metabolic health.

Why? Because decreased consumption of branched-chain amino acids improves metabolic health. Check this out. Those randomized to restrict their protein intake were averaging literally hundreds more calories a day; so, they should have become fatter right? But no, they actually lost more body fat. Restricting their protein enabled them to eat more calories, while at the same time they lost more weight. More calories, yet a loss in body fat. And this magic “protein restriction”? They were just having people eat the recommended amount of protein. So, maybe they should have just called this group the normal protein group, or the recommended protein group, and the group that was eating more typical American protein levels and suffering because of it, the excess protein group.

Given the metabolic harms of excess branched-chain amino acid exposure, leaders in the field have suggested the invention of drugs to block their absorption, to “promote metabolic health and treat diabetes and obesity without reducing caloric intake.” Or, we can just try not to eat so many branched-chain amino acids in the first place. They are found mostly in meat, including chicken and fish, dairy products, and eggs, perhaps explaining why animal protein has been associated with higher diabetes risk, whereas plant protein appears protective. So, defining the “appropriate upper limits” of animal protein intake “may offer a great chance for the prevention of T2D and obesity,” but it need not be all or nothing. Even an intermittent vegan diet has been shown to be beneficial.

If there was one piece of advice that sums up the recommendations in my upcoming book it would be: “Wall Off Your Calories.” Animal cells are encased only in easily digestible membranes, which allows the enzymes in our gut to effortlessly liberate the calories within a steak, for example. Plant cells, on the other hand, have cell walls that are made out of fiber, which present an indigestible physical barrier; so, many of the calories remain trapped. Now, processed plant foods, like fruit juice, sugar, refined grains, even whole grains if they have been powdered into flour have had their cellular structure destroyed, their cell walls cracked open and their calories are free for the taking. But when you eat structurally intact plant foods, chew all you want—you’re still going to end up with calories completely surrounded by fiber, which then blunts the glycemic impact, activates the ileal brake, and delivers sustenance to your friendly flora. So, bottom line, try to make sure as many of your calories as possible—your protein, carbs, and fat—are encased in cell walls, in other words from whole, intact plant foods.

That’s what nature intended to happen. Millions of years before we learned how to sharpen spears and mill grains and boil sugar cane, our entire physiology is presumed to have evolved in the context of eating what the rest of our great ape cousins eat: plants. The Paleolithic period, when we started using tools, only goes back about two million years. We and other great apes have been evolving since back in the Miocene era, more like twenty million years ago. So, for the first 90 percent of our hominoid existence, our bodies evolved on mostly plants. It’s no wonder then that our bodies may thrive best on the diet we were designed to eat. So, maybe we should go back to our roots. [clears throat]

With enough portion control, anyone can lose weight. Lock someone in a closet, and you can force them to lose as much body fat as you want. Chaining someone to a treadmill could probably have a similar effect. But what is the most effective weight-loss regimen that doesn’t involve calorie restriction or exercise—or a felony? I scoured through the medical literature and all the randomized controlled trials and the single most successful strategy to date is a diet of whole plant foods. The single most effective weight loss intervention like that ever published in the peer-reviewed medical literature, a whole food, plant-based diet. That works better than anything else studied to date. And, no wonder given what we just learned about fiber and branched-chain amino acids.

We’ve known for more than forty years that those eating predominantly plant-based diets weigh, on average, about thirty pounds less than the general population, but you don’t know if it’s the diet itself, until you put it to the test.

In 2017, a group of New Zealand researchers published the BROAD study, a twelve-week randomized controlled trial in the poorest region of the country with the highest obesity rates. Overweight individuals were randomized to receive either standard medical care or semi-weekly classes offering advice and encouragement to eat a low-fat diet centered around fruits, vegetables, whole grains, and legumes. And that’s all it was, just empowerment, and information, empowerment with knowledge. No meals were provided, the intervention group was merely informed about the benefits of plant-based living and encouraged to fit it into their own lives at home.

No significant change in the control group, but the plant-based intervention group, even though there were no restrictions on portions and being able to freely eat all the healthy foods they wanted, lost an average of nineteen pounds by the end of the three-month study. Nineteen pounds is a respectable weight loss, but what happened next? At the end of those twelve weeks, class was dismissed, and no more instruction was given.

The researchers were curious to see how much weight the subjects had gained back after being released from the study; so, everyone was invited back at the six-month mark to get re-weighed. The plant-based group had left the three-month study nineteen pounds lighter on average. But, six months later they were only down about…  twenty-seven pounds! They got better. The plant-based group had been feeling so good both physically and mentally… and had been able to come off so many of their medications, that they were sticking to the diet on their own and the weight continued to come off.

What about a year later? Even in studies that last a whole year, where people are coached to stay on a particular diet for the entire years’ time, by the end of the year, any initial weight lost typically tends to creep on back. The BROAD study only lasted three months, yet after it was all over, those who had been randomized to the plant-based group not only lost dozens of pounds, but they kept it off.

They not only achieved greater weight loss at six and twelve months than any other comparable trial—that was months after the study had already ended! A whole food, plant-based diet achieved the greatest weight loss ever recorded compared to any other such intervention published in the scientific literature. You can read the record-breaking study yourself for free, in full, at nature.com/articles/nutd20173 or you can just point your phone camera up at the screen and pick off the QR code.

Any diet that results in reduced calorie intake can result in weight loss. Dropping pounds isn’t so much the issue. The problem is keeping them off. A key difference between plant-based nutrition and more traditional approaches to weight loss is that people are encouraged, on plant-based diets, to eat ad libitum, meaning eat as much as they want. No calorie counting, no portion control—just eating. The strategy is to improve the quality of the food rather than restricting the quantity of the food.

If you put people on a diet packed with fruits, vegetables, whole grains, and beans and allow them to eat as much as they want, they end up eating about 50% fewer calories than they might have otherwise. Just as full on half the calories. How can you keep people satisfied cutting more than a thousand calories from their daily diet? By eating more high-bulk, low-calorie-density foods (vegetables, fruits, whole grains, and beans) and fewer calorie-dense foods, like meats, cheeses, sugars, and fats.

But it may not just be the calories-in side of the equation; those eating more plant-based appear to be effectively be burning more calories in their sleep. The resting metabolic rate of those eating more plant-based may be 10% higher, or more; a boosted metabolism that can translate into burning off hundreds of extra calories a day more without doing a thing. Eating more plant-based you burn more calories just existing. So, no wonder why those who eat more plant-based tend to be slimmer. Start packing your diet with real foods that grow out of the ground, and the pounds should come off naturally, taking you down towards your ideal weight.

OK, so that’s what I spent the first half of the book doing, laying out the optimum weight-loss diet, “Plant Yourself.” Then I spend the second half of the book on all the tools I unearthed to drive further weight loss for any stubborn pounds that remain.

We already learned that a calorie is not necessarily a calorie. A hundred calories of chickpeas has a different impact than a hundred calories of chicken or Chiclets, based on factors like absorption and appetite, but in the second half I go a step further and explore how even the exact same foods eaten differently can have different effects. Even if you eat the same amount, even if you absorb the same amount, a calorie may still not be a calorie. It’s not only what we eat, but how and when.

Just to give you a taste, the exact same number of calories at breakfast are significantly less fattening than the same number of calories at dinner. What?! That’s just mind-blowing. Same calories, different weight loss. A diet with a bigger breakfast causes more weight loss than the same diet with a bigger dinner. So, my recommendation to stop eating after 7 PM is not just because, you know, I’m afraid people are mindlessly snacking on the couch or something. The same snack at night is literally more fattening than eating the exact same snack during the daytime, all thanks to our circadian rhythms, our “Chronobiology.” Something I spend a whole chapter on.

Some of the sleep data is really crazy too. Overweight adults were randomized to eight weeks of either a calorie-restricted diet or the same diet combined with five days a week of just one less hour of sleep a night. Now, they ended up sleeping an hour later on the weekends. So, overall, they just cut three hours of sleep out of their week. Now, surely 3 hours a week of sleep difference is not going to change how much weight they lost, right? And on the scale that was true. But in the normal sleep group, 80 percent of the weight loss was fat, whereas in the group missing just a few hours of sleep, it was the opposite, with 80 percent of the loss being lean body mass. So, you snooze you lose—fat! A few hours of missed sleep seemed to totally flip fat loss on its head, but just looking at the scale you wouldn’t know it.

It’s like when people fast. Stopping eating completely for a week or two can cause more weight loss than just restricting your calories, but paradoxically, it may actually lead to less loss of body fat. Wait, how can eating fewer calories lead to less fat loss? Because during fasting your body starts cannibalizing itself and burning your own protein for fuel.

The scale made it look as though they were doing better when they were fasting, but the reality is they were doing worse. They would have lost more body fat if they had kept eating; they would have lost more body fat, eating more calories. Short-term fasting can interfere with body fat loss, not accelerate it, and you see the same thing, with the keto diet.

Body fat loss actually slows down when you switch to a ketogenic diet. Just looking at the bathroom scale, though, the keto diet seems like a smashing success, losing less than a pound a week on a regular diet to boom—three-and-a-half pounds in seven days after switching to keto, but what was happening inside their bodies told a totally different story. On the ketogenic diet, their rate of body fat loss was slowed by more than half; so, most of what they were losing was water, but they were also losing protein, they were also losing lean mass. That may help explain why the leg muscles of CrossFit trainees placed on a ketogenic diet can shrink as much as 8 percent within two months.

Of course, even if keto diets worked, the point of weight loss is not to fit into a skinnier casket. People whose diets even tend to trend that way appear to significantly shorten their lives. On the other hand, even just drifting in the direction of eating more healthy plant foods is associated with living longer. Those going the other way, though, those who start out more plant-based but then add meat to their diet at least once a week not only appear to double or triple their odds of diabetes, stroke, heart disease, and weight gain, but may also suffer an associated 3.6-year drop in life expectancy. That’s going from no meat to just once-a-week meat or more.

Low-carb diets have been shown to impair artery function and worsen heart disease. Whereas, whole food, plant-based diets have been shown to actually reverse heart disease – that’s what Ornish used. So, what appears to be the most effective weight-loss diet just so happens to be the only diet ever proven to reverse heart disease in the majority of patients. If my grandma didn’t have to die like that, no one’s grandma has to die like that. If that’s all a plant-based diet could do—reverse the number-one killer of men and women—shouldn’t that be kind of the default diet until proven otherwise? And the fact that it can also be so effective in treating, arresting, and reversing other leading killers, like type 2 diabetes and high blood pressure, would seem to make the case for plant-based eating simply overwhelming. Only one diet has ever been shown to do all that: a diet centered around whole plant foods. You don’t have to mortgage your health to lose weight. The single healthiest diet also appears to be the most effective diet for weight loss.

After all, permanent weight loss requires permanent dietary changes—healthier habits just have to become a way of life. And if it’s going to be life-long, you want it to lead to a long life. Thankfully, the single best diet proven for weight loss may just so happen to be the safest, cheapest way to eat, for the longest, healthiest life. Thank you.

[Applause]

Why don’t we give a big, warm welcome to Dr. Michael Greger?!!

[Applause]

Surely, if there was some safe, simple, side-effect-free solution to the obesity epidemic, we would know about it by now, right? I’m not so sure.

It may take up to 17 years before research findings make it into day-to-day clinical practice. To take one example that was particularly poignant for my family: heart disease.  You know, decades ago, Dr. Dean Ornish and colleagues published evidence in one of the most prestigious medical journals in the world that our leading cause of death could be reversed with diet and lifestyle changes alone—yet, hardly anything changed. Even now, hundreds of thousands of Americans continue to needlessly die from what we learned decades ago was a reversible disease. In fact, I had seen it with my own eyes. My grandmother was cured of her end-stage heart disease by one of Dean’s predecessors, Nathan Pritikin, using similar methods.

So, if effectively the cure to our number-one killer of men and women could get lost down some rabbit hole and ignored, what else might there be in the medical literature that could help my patients, but that just didn’t have a corporate budget driving its promotion? Well, I made it my life’s mission to find out. That’s why I became a doctor in the first place and why I started my nonprofit site, NutritionFacts.org.

Everything on the website is free. There are no ads, no corporate sponsorship. It’s strictly noncommercial, not selling anything. I just put it up as a public service, as a labor of love, as a tribute to my grandmother. [Applause] New videos and articles nearly every day on the latest in evidence-based nutrition—what a concept.

Ok, so, what does the science show is the best way to lose weight? If you want testimonials and before-and-after pictures, you have come to the wrong place. I’m not interested in anecdotes; I’m interested in the evidence. When it comes to making decisions as life-and-death-important as the health and well-being of yourself and your family, there’s really only one question: What does the best available balance of evidence show right now?

The problem is that even just sticking to the peer-reviewed medical literature is not enough as, “False and scientifically [misleading] unsupported beliefs about obesity are pervasive” even in scientific journals. The only way to get at the truth, then, is to dive deep into the primary literature and read all the original studies themselves. But, who’s got time for that? There are more than half a million scientific papers on obesity with a hundred new ones published every day. Even researchers in the field might not be able to keep track beyond their narrow domain. But that’s what we do at NutritionFacts.org. We comb through tens of thousands of studies a year so you…don’t have to. Very nice!

And indeed, we uncovered a treasure trove of buried data, like today I’ll cover simple spices, for example, proven in randomized, double-blind, placebo-controlled trials to accelerate weight loss for pennies a day, but with so little profit potential, it’s no wonder those studies never saw the light of day. The only profiting I care about, though, is your health. That’s why 100 percent of the proceeds I receive from all of my books, and DVDs, and speaking engagements are all donated to charity. I just want to do for your family what Pritikin did for my family.

              But wait, isn’t weight loss just about eating less and moving more? I mean, isn’t a calorie a calorie? That’s what the food industry wants you to think. The notion that a calorie from one source is just as fattening any other is a trope broadcast by the food industry as a way to absolve itself of culpability. Coca-Cola itself even put an ad out there emphasizing this “one simple common-sense fact.” As the current and past chairs of Harvard’s nutrition department put it, this “central argument” from industry is that the “overconsumption of calories from carrots would be no different from overconsumption of calories from soda….” If a calorie is just a calorie, why does it matter what we put in our mouths?

Let’s explore that example of carrots versus Coca-Cola. It’s true that in a tightly controlled laboratory setting, 240 calories of carrots (10 carrots) would have the same effect on calorie balance as the 240 calories in a bottle of Coke, but this comparison falls flat on its face out in the real world. You could chug those liquid candy calories in less than a minute, but eating 240 calories of carrots would take you more than two-and-a-half hours of sustained constant chewing. [Laughing] Not only would your jaw get sore, but 240 calories of carrots is like five cups—you might not even be able to fit them all in.

Our stomach is only so big. Once we fill it up, stretch receptors in our stomach wall tell us when we’ve had enough, but different foods have different amounts of calories per stomachful. Some foods have more calories per cup, per pound, per mouthful than others. This is the concept of calorie density, the number of calories in a given amount of food. Three pounds is about what the average American eats in a day. As you can see, for example, oil, has a high calorie density, meaning a high calorie concentration, lots of calories packed into a small space. Drizzling just a tablespoon of oil on a dish adds over a hundred calories. For those same calories, you could have instead eaten about two cups of blackberries, for example, a food with a low calorie density. So, these two meals have the same number of calories. You could swig down that spoonful of oil and not even feel anything in your stomach, but eating a couple of cups of berries could start to fill you up. That’s why yes, biochemically a calorie is a calorie, but eating the same amount of calories in different foods, can have different effects.

The average human stomach can expand to fit about four cups of food; so, a single stomachful of strawberry ice cream, for example, could max out our caloric intake for the entire day. For the same two-thousand calories, to get those same two thousand calories from strawberries themselves…you’d have to eat forty-four cups of berries. That’s eleven stomachfuls. As delicious as berries are, I don’t know if I could fill my stomach to bursting eleven times a day. Some foods are just impossible to overeat. They are so low in calorie density, you just physically couldn’t eat a enough to even maintain your weight. In a lab, a calorie is a calorie, but in life, far from it.

Traditional weight-loss diets focus on decreasing portion size, but we know these “eat less” approaches can leave people feeling hungry and unsatisfied. A more effective approach may be to shift the emphasis from restriction to positive “eat more” messaging of increasing intake of healthy, low-calorie-density foods, but you don’t know, until you… put it to the test.

Researchers in Hawaii tried putting people on more of a traditional, Hawaiian diet with all the plant foods they could eat, unlimited quantities of fruits, vegetables, whole grains, and beans. And, the study subjects lost an average of seventeen pounds in just twenty-one days. Calorie intake dropped by 40 percent, but not because they were eating less food. They lost seventeen pounds in three weeks eating more food, in excess of four pounds a day. How could that be? Because whole plant foods tend to be so calorically dilute, you can stuff yourself without getting the same kind of weight gain. They lost seventeen pounds in three weeks eating more food. That’s why in my upcoming book, How Not to Diet, which I am very excited about, [clears throat], that’s why “Low in Calorie Density” is on my list of the 17 ingredients for an ideal weight loss diet.

As noted before, Americans appear to average about three pounds of food a day. So, if you stuck with mostly these foods, you can see how you can eat more food and still shed pounds.

A landmark study set to be published next month found that, even when presented with the same number of calories, and the same salt, sugar, fat, fiber and protein, processed foods led to weight gain, two pounds gained over two weeks; and unprocessed foods led to weight loss, two pounds down in the same two weeks. Here’s one of their processed food meals…which is probably healthier, actually, than what most people eat. Non-fat Greek yogurt, baked potato chips, sugar-free diet lemonade with a turkey sandwich, has the same number of calories as this…what the unprocessed-meal-food folks were eating, kind of a southwest entrée salad with black beans, avocados, nuts…that’s the calorie density effect. Same calories but there’s just more food, no wonder it satisfied their hunger.  And they ended up four pounds lighter in two weeks eating more food.  So, how can you decrease the calorie density of your diet? Well, just a quick peek at the two extremes should suggest two methods: abandon added fats and add abandoned vegetables.

Method number one: Covertly put people on a relatively low-fat diet, and they tend to lose body fat every day even though they can eat as much as they want. If you instead give those same people the same meals, but this time sneak in enough extra fats and oils to change it to a high-fat diet, they gain body fat every day.

            In fact, in a famous prison experiment in Vermont, lean inmates were overfed up to ten thousand calories a day to try to experimentally make them fat. This turned out to be surprisingly difficult. Most starting dreading breakfast and involuntarily threw it up. The researchers learned how difficult it was to have people to gain weight on purpose— unless, you feed them lots of fat. To get prisoners to gain thirty pounds on a regular diet, it took about 140,000 excess calories per certain amount of body surface area. To get the same thirty-pound weight gain just by adding fat to their diets, all they had to do was feed them about an extra 40,000 calories. When the extra calories were in the form of straight fat, it took as many as a hundred thousand fewer calories to gain the same amount of weight. A calorie is not a calorie—it depends what you eat. In this case, lowering fat content effectively made up to 100,000 calories, disappear. That’s why “Low in Added Fat” is on my list of ideal weight loss ingredients as well.

There are, however, two important exceptions. Processed foods with “reduced-fat claims” are often so packed with sugar that they can have the same number of calories as a higher fat product. SnackWell’s fat-free cookies, for example, at seventeen hundred calories per pound are as calorie-dense as a cheese danish.

The other exception is to the low-fat rule is that vegetables are so calorically dilute that even a high-fat veggie dish, like some oily broccoli with garlic sauce, tends to be less calorie dense overall, which brings us to the second strategy for lowering calorie density: instead of sneaking out fat, sneak in vegetables.

The biggest influence on calorie density is not fat, but water content. Since water adds weight and bulk without adding calories, the most calorie-dense foods and the most calorie-dense diets tend to be those that are dry. Some vegetables, on the other hand, are more than 95 percent water, and not just iceberg lettuce. Cucumbers, celery, turnips, cooked napa cabbage, bok choy, summer squash, zucchini, bean sprouts, and bamboo shoots can top out at 95 percent water. They’re basically just water in vegetable form. A big bowl of water-rich vegetables is practically just a big bowl of trapped water. The effect on calorie density is so dramatic the food industry wants in on the action. They figure they could use nanotechnology to “structure a solid processed food similar to a celery stalk with self-assembled, water-filled, …nanocells or nanotubes.” No need, as Mother Nature beat you to it.

When dozens of common foods, pitted head-to-head for for their ability to satiate appetites for hours, the characteristic most predictive was not how little fat or how much protein it had, but how much water it had. That was the number one predictor of how filling a food is. That’s why “High in Water-Rich Foods” is on my list, too.

Water-rich foods like vegetables, topping the charts with most more than 90% water by weight, followed by most fresh fruit, coming in around the 80s. Starchier vegetables, whole grains, and canned beans are mostly 70s, meaning three-quarters of their weight: pure water. In general, when it comes to water-rich foods, most whole plant foods float towards the top, most animal foods fall somewhere in the middle, and most processed foods sink to the bottom.

In a famous series of experiments, researchers at Penn State decided to put water-rich vegetables to the test. Study subjects were served pasta and told to eat as much or as little as they’d like. On average, they consumed about 900 calories of pasta. What do you think would happen if, as a first course, you gave them a hundred calories of salad composed largely of lettuce, carrots, cucumber, celery, and cherry tomatoes? Would they go on to eat the same amount of pasta and end up with a thousand calorie lunch, 900 plus 100? Or would they eat a hundred fewer calories of pasta, effectively canceling out the added salad calories? It was even better than that. They ate more than 200 fewer calories of pasta. Thanks to the salad, a hundred calories in, 200 calories out. So, in essence, the salad had negative 100 calories. Preloading with vegetables can effectively subtract a hundred calories out of a meal. That’s how you can lose weight by eating more food.

Of course, the type of salad matters. The researchers repeated the experiment, this time adding a fatty dressing and extra shredded cheese, which quadrupled the salad’s calorie density. Now, eating this salad as a first course didn’t turn the 900-calorie meal into one with less than 800 calories. Instead, it turned it into a meal with calories in the quadruple digits. It’s like preloading pizza with garlic bread—you could end up with more calories overall.

So, what’s the cut-off? Studies on preloading show that eating about a cup of food before a meal decreases subsequent intake by about 100 calories; so, to get a “negative calorie” effect, the first course would have to contain fewer than a hundred calories per cup. As you can see in this chart, this would include most fresh fruits and vegetables, but having something like a dinner roll wouldn’t work.

But, hey, give people a large apple to eat before that same pasta meal, and rather than consuming two hundred calories less, it was more like three hundred calories less. So, how many calories does an apple have? It depends on when you eat it. Before a meal, an apple could effectively have about negative 200 calories.

You can see the same thing giving people vegetable soup as a first course. Hundreds of calories disappear. One study that tracked people’s intake throughout the day even found that overweight subjects randomized to pre-lunch vegetable soup not only ate less lunch, but deducted an extra bonus hundred calories at dinner, too, a whole seven hours later. So, the next time you sit down to a healthy soup, you can imagine calories being veritably sucked out of your body with every spoonful.

Even just drinking two cups of water immediately before a meal caused people to cut about 20 percent of calories out of the meal, taking in more than 100 fewer calories. No wonder overweight men and women randomized to two cups of water before each meal lost weight 44 percent faster. Two cups of water before each meal, 44 percent faster weight loss. That’s why so-called “Negative Calorie Preloading” is on my list of weight loss boosters: all the things I could find that can accelerate weight loss regardless of what you eat the rest of the time. Negative calorie preloading just means starting a meal with foods containing fewer than a hundred calories per cup. That would include many fruits, vegetables, soups, salads, or simply, a tall glass of water.

Anything we can put on that first-course salad to boost weight loss even further? In my “Amping AMPK” section I talk about ways to activate an enzyme known as the “fat controller.” Its discovery is considered one of the most important medical breakthroughs in the last few decades. You can activate this enzyme through exercise, fasting, and nicotine, but is there any way to boost it for weight loss without sweat, hunger, or the whole dying-a-horrible-death-from-lung-cancer thing?

Big Pharma is all over it. After all, obese individuals may be “unwilling to perform even a minimum of physical activity,” wrote a group of pharmacologists, “thus, indicating that drugs mimicking endurance exercise are highly desirable.” So, “it’s crucial that oral compounds with high bioavailability are developed to safely induce chronic AMPK activation” for “long-term weight loss and maintenance….” But, there’s no need to develop such a compound since you can already buy it any grocery store. It’s called vinegar.

When vinegar—acetic acid—is absorbed and metabolized, you get a natural AMPK boost. Enough of a boost to lose weight at the typical dose you might use dressing a salad? Vinegar has evidently been used to treat obesity for centuries, but only recently has it been…put to the test.

A randomized, double-blind, placebo-controlled trial on the effects of vinegar intake on the reduction of body fat in overweight men and women. The subjects were randomized to drink a daily beverage containing one or two tablespoons of apple cider vinegar or a controlled drink developed to taste the same as the vinegar drink, but prepared with a different kind of acid so it didn’t have actual vinegar in it. Three months in, the fake vinegar group actually gained weight (as overweight people tend to do), whereas the genuine vinegar groups significantly lost body fat, as determined by CT scan. A little vinegar every day led to pounds of weight loss achieved for just pennies a day without removing anything from their diet. That’s why one of my 21 tweaks to accelerate weight loss, is two teaspoons of vinegar with each meal, either sprinkled on your salad or even just added to tea with some lemon juice.

The beauty of the vinegar studies is that they were not just randomized, controlled trials, but placebo-controlled trials. Some studies aren’t controlled at all. Women asked to eat a ripe tomato before lunch every day for a month lost about two pounds, but without a control group you don’t know if the tomato had anything to do with it. Just being enrolled in a weight-loss study where you know they’re going to come back and weigh you again in a month can have people to change their diets in other ways. I mean it’s certainly possible. A tomato is 95 percent water; so, you’d be filling up a fist-sized portion of your stomach with only about fifteen calories before a meal, it’s certainly possible, but we’d need a better study to prove it for weight loss.

Stronger studies have control groups. At least, for example, randomize people to a weight-loss diet with or without one to two cups of low-sodium vegetable juice and those drinking the vegetable juice lose significantly more weight. Or split people into two groups and give half about two tablespoons of goji berries a day, and forty-five days later, the goji group appeared to cut two-and-a-half inches off their waistline compared to no change in the control group. But any time you have one group do something special, you don’t know how much of the benefit is due to the placebo effect. In drug trials it’s easy: you give half the people the actual medication and the other half an identical-looking sugar pill placebo. Both groups are then doing the same thing—taking identical-looking pills—and so, if you see any difference in outcomes, we can suspect it’s the due to the actual drug. But what would placebo broccoli look like? That’s the problem.

You can’t stuff cabbage into a capsule, but there are some foods so potent that you could actually fit them into a pill to pit them against placebos: spices. Want to know if garlic can cause weight loss? Give people some garlic powder compressed into tablets versus placebo pills. And? Garlic worked, resulting in both a drop in weight and in waistlines within six weeks. They used about a half teaspoon of garlic powder a day, which would cost less than four cents.

Four cents too steep? How about two cents a day? A quarter teaspoon of garlic powder a day, about a hundred overweight men and women were randomized to a quarter teaspoon worth of garlic powder a day or placebo, and those unknowingly taking the two cents worth of garlic powder a day lost about six pounds of straight body fat over the next fifteen weeks.

Now if you can splurge up to three cents a day, there’s black cumin. A meta-analysis of randomized, controlled trials shows weight-loss efficacy again just a quarter teaspoon a day. Not regular cumin, this is a completely different spice known as black cumin. What is black cumin? You obviously haven’t been reading your bibles. Described as a “miracle herb,” besides the weight loss, there are randomized controlled trials showing daily black cumin consumption significantly improves cholesterol and triglycerides…significantly improves blood pressure… and blood sugar control. But I use it, just cause it tastes good—I just put black cumin seeds in a pepper grinder and grind it like pepper.

With more than a thousand papers published in the medical literature on black cumin, some reporting extraordinary results like dropping cholesterol levels as much as a statin drug, why don’t we hear more about it? Why weren’t we taught about it in medical school? Presumably because there’s no profit motive. Black cumin is just a common, natural spice. You’re not going to thrill your stockholders selling something that you can’t patent, that costs, three cents a day.

Or you can use regular cumin, the second most popular spice on Earth. Those randomized to a half of a teaspoon at both lunch and dinner over three-months lost about four more pounds and an extra inch off their waist, found comparable to the obesity drug known as orlistat. That’s the “anal leakage” drug you may have heard about, though the drug company evidently prefers the term “fecal spotting” to describe the rectal discharge it causes. The drug company’s website offers some helpful tips, though, “it’s probably a smart idea to wear dark pants and bring a change of clothes with you to work.” You know, just in case their drug causes you to crap your pants at work. I think I’ll stick with the cumin.

Cayenne pepper can counteract the metabolic slowing that accompanies weight loss and accelerate fat burning as a bonus. Ginger powder! Over a dozen randomized controlled trials starting at just a quarter teaspoon of ground ginger a day showing significantly decreased body weight for just pennies a day. Proven in placebo-controlled trials to work, but you probably never heard about any of this because they can’t make enough profit. Don’t get me started.

But let me go back to the Coke versus carrots example. A calorie is not a calorie because drinking this, is not the same as eating this. But even if you consumed the same number of calories, chewed for hours to pack in all those carrots, a calorie may still not be a calorie, because it’s not what you eat, it’s what you absorb. As anyone who’s ever eaten corn can tell you, some bits of vegetable matter can pass right through you. A calorie may still be a calorie circling your toilet bowl, but flushed calories aren’t going to make it onto your hips.

That’s where fiber comes in. If you bump people’s fiber intake up, even to just the recommended minimum daily fiber intake they start losing weight, because they experience about a 10% drop in daily caloric intake. Why should more fiber mean fewer calories? Well first, it adds bulk without adding calories. Cold-pressed apple juice, for example, is basically just apples minus fiber. And you could chug a bottle of juice in a couple of seconds, but to get the same number of calories, you would have to eat about five cups of apple slices. That’s the difference fiber can make, but it’s not just a calorie density thing.

Imagine what happens next: The apple juice would get rapidly absorbed as soon as it spilled out of your stomach into the gut, spike your blood sugars, whereas the sugar trapped in the mass of chewed apple slices would be absorbed more slowly along the length of your intestines. Nutrients can only be absorbed when they physically come in contact with the side of your intestine, with your gut wall. Fiber never gets absorbed; so, it can act as a carrier to dilute or even eliminate calories out the other end. And fiber doesn’t just trap sugars. It acts as a fat- and starch-blocker, too.

Those on a Standard American Diet lose about 5 percent of their calories through their waste every day, but on a higher-fiber diet we can double that. It’s not what you eat, but what you absorb; so, you can lose weight on a high-fiber diet eating the exact same number of calories simply because some of those calories get trapped, get flushed down the toilet, and never make it into your system.

And it’s not just the calories in the high-fiber foods themselves that are less available. High-fiber foods trap calories across the board. So, eat a Twinkie on a high-fiber diet and you absorb fewer Twinkie calories. It’s like every calorie label you look at gets instantly discounted when you are eating lots of fiber-rich foods, which is why it makes it onto my list.

My section on other fat-blocking foods starts out with a command to “Eat Your Thylakoids”, doctor’s orders. What on earth is a thylakoid? Just the source of nearly all known life—and, the oxygen we breathe, no biggie. Thylakoids are where photosynthesis takes place, the process by which plants turn light into food. Thylakoids are the great green engine of life, microscopic sac-like structures composed of chlorophyll-rich membranes concentrated in the leaves of plants.

When we eat thylakoids, when we bite into a leaf of spinach, for instance, those green leaf membranes don’t immediately get digested. They last for hours in our intestines and that’s when they work their magic. Thylakoid membranes bind to lipase.  Lipase is the enzyme that our body uses to digest fat; so, you bind the enzyme – you slow fat absorption.

If all the fat is eventually absorbed, what’s the benefit? Location, location, location. There’s a phenomenon known as the ileal brake. The ileum is the last part of the small intestine before it dumps into your colon. When undigested calories are detected that far down in your intestines, your body thinks “I must be full from stem to stern,” and puts the brakes on eating more by dialing down your appetite. This can be shown experimentally. If you insert a nine-foot tube down people’s throats and drip in any calories: fat, sugar, or protein, and you can activate the ileal brake. Sit them down to an all-you-can-eat meal and, compared to the placebo group who had only gotten a squirt of water through the tube, people eat over a hundred calories less. You just don’t feel as hungry. They feel just as full, eating significantly less. That’s the ileal brake in action.

This can then translate into weight loss. Randomize overweight women on a diet to “green-plant membranes” (in other words, just covertly slip them some powdered spinach) and they get a boost in appetite suppressing hormones, a decreased urge for sweets. Yes indeed, spinach can cut your urge for chocolate. And boom, accelerated weight loss. All thanks to eating green, the actual green itself, the chlorophyll-packed membranes in the leaves.

Now, the researchers used spinach powder just so they could create convincing placebos, but you can get just as many thylakoids eating about a half cup of cooked greens, which is what I recommend people eat two times a day in my Daily Dozen checklist of all the healthiest of healthy things I encourage people to fit into their daily routine.

In the journal of the Society of Chemical Industry, a group of food technologists argued that given their fat-blocking benefits, “thylakoid membranes could be incorporated in functional foods as a new promising appetite-reducing ingredient”—or you can just get them in the way Mother Nature intended.

Which greens have the most? You can tell just by looking at them. Because thylakoids are where the chlorophyll is, the greener the leaves, the more potent the effect. So, go for the darkest-green greens you can find; where I shop that’s the lacinato (a.k.a. dinosaur) kale.

Now, if you overcook greens too long…you know how they turn that drab olive brown…that’s the thylakoids physically degrading, but blanched for fifteen seconds or so in steaming or boiling water, you know greens get an even brighter green—that actually translates into a boost in the fat-blocking ability. So, you can gauge thylakoid activity in the grocery store, in your kitchen with your own two eyes by going for the green.

Though thylakoids eventually get broken down, fiber makes it all the way down to our colon. While it’s technically true that we can’t digest fiber, that’s only applicable to the part of us that’s actually human. Most of the cells in our body are bacteria. Our gut flora, which weigh as much as one of our kidneys, are as metabolically active as our liver, has been called our “forgotten organ,” and it’s an organ that runs on MAC, Microbiota-Accessible Carbohydrates. So, when you see me write “Eat Lots of Big MACs” I don’t want anyone to get the wrong idea. MAC is just another name for prebiotics, what our good gut flora eat, in other words, fiber. There’s that fiber again.

What do our good bacteria do with the fiber? We feed them and they feed us right back. They make short-chain fatty acids that get absorbed from the colon into our bloodstream, circulate through our body, and even make it up into our brain. That’s like the way our gut flora communicates with us, dialing down our appetite, all the while increasing the rate at which we burn fat and boosting our metabolism at the same time. All thanks to fiber.

Check this out. Put people in a brain scanner and show them a high-calorie food like a donut and the reward centers in their brains instantly light up. But, if you repeat the experiment, and this time, secretly deliver fiber-derived short-chain fatty acids directly into their colon, you get a blunted reward center response and subjects report that high-calorie foods just seemed less appetizing, and subsequently ate less of an all-you-can-eat meal. But fiber supplements like Metamucil don’t work, which makes sense because they are nonfermentable, meaning our gut bacteria can’t eat it; so, yeah, they can improve bowel regularity but can’t be used by our good bacteria to make those compounds that can block our cravings. For that, we have to actually eat real food.

Our good gut bugs are trying to help us, but when we eat a diet deficient in fiber, we are in effect starving our microbial self. Less than 5 percent of Americans reach even the recommended minimum daily adequate intake of fiber, no surprise since the number one sources are beans and whole grains, and 96% of Americans don’t even reach the recommended minimum intake of legumes (which are beans, split peas, chickpeas, and lentils), and 99% don’t reach the recommended daily minimum for whole grains.

Most people don’t even know what fiber is. More than half of Americans surveyed think that steak is a significant source of fiber. However, by definition, fiber is only found in plants. There is zero fiber in meat, eggs, or dairy, and typically little or no fiber in processed junk, and therein lies the problem.

But wouldn’t at least the protein in that steak fill you up? Surprisingly, even a review supported by the meat, dairy, and egg industries acknowledged that protein intake does not actually translate into eating less later on, whereas you eat a fiber-rich whole grain for supper, and it can cut your calorie intake more than 12 hours later at lunch the next day! You feel full a hundred calories quicker the following day because, by then, your good gut bugs are feasting on the same bounty and dialing down your appetite.

Today, even our meat could be considered junk food. For more than a century, one of the great goals of animal agriculture has been to increase the carcass fat content of farm animals. Take chicken, for example. A hundred years ago, the USDA determined chicken was about 23 percent protein by weight and less than 2 percent fat. Today, chickens have been genetically manipulated through selective breeding to have about ten times more fat. Chicken Little has become Chicken Big and may be making us bigger too.

Meat consumption in general is associated with weight gain, but poultry appeared to be the worst. Even just an ounce a day—that’s like a single chicken nugget, or like one chicken breast every ten days, was associated with weight gain compared to eating no chicken at all.

You know, it’s funny, when the meat industry funds obesity studies on chicken, they choose for their head-to-head comparison, foods like “cookies and sugar-coated chocolates.” This is a classic drug industry trick to try to make your product look better by comparing it to something worse. (Apparently, just regular chocolate wasn’t enough to make chicken look better.) But what happens when chicken is pitted against a real control, like chicken without the actual chicken? Chicken chickens out.

Both soy-based proteins and Quorn, which is a plant-based meat made from the mushroom kingdom, were found to have stronger satiating qualities than chicken. Feed people a chicken and rice lunch, and four-and-a-half hours later, they eat 18 percent more of a dinner buffet than had they instead been given a chicken-free chicken and rice lunch. These findings are consistent with childhood obesity research that found that meat consumption seemed to double the odds of schoolchildren becoming overweight, compared to the consumption of plant-based meat products. Whole-food sources of plant protein such as beans did even better though, associated with cutting in half the odds of becoming overweight. So, that’s why I consider these kinds of plant-based meats more of a useful stepping stone towards a healthier diet, rather than the end-game goal / ideal.

Part of the reason plant-based meats may be less fattening is that they cause less of an insulin spike. A meat-free chicken like Quorn causes up to 41 percent less of an immediate insulin reaction. It turns out animal protein causes almost exactly as much insulin release as pure sugar. Just adding some egg whites to your diet can increase insulin output as much as a 60 percent within four days. And fish may be even worse.

Why would adding tuna to mashed potatoes spike up insulin levels, but adding broccoli instead cut the insulin response by about 40 percent? It’s not the fiber, since giving the same amount of broccoli fiber alone provided no significant benefit. So, why does animal protein make things worse but plant protein makes things better?

Plant proteins tend to be lower in the branched-chain amino acids which are associated with insulin resistance, the cause of type 2 diabetes. You can show this experimentally. Give some vegans branched-chain amino acids, and you can make them as insulin resistant as omnivores. Or, take some omnivores and put them through even a “48-hour vegan diet challenge,” and, within two days, you can see the opposite—significant improvements in metabolic health.

Why? Because decreased consumption of branched-chain amino acids improves metabolic health. Check this out. Those randomized to restrict their protein intake were averaging literally hundreds more calories a day; so, they should have become fatter right? But no, they actually lost more body fat. Restricting their protein enabled them to eat more calories, while at the same time they lost more weight. More calories, yet a loss in body fat. And this magic “protein restriction”? They were just having people eat the recommended amount of protein. So, maybe they should have just called this group the normal protein group, or the recommended protein group, and the group that was eating more typical American protein levels and suffering because of it, the excess protein group.

Given the metabolic harms of excess branched-chain amino acid exposure, leaders in the field have suggested the invention of drugs to block their absorption, to “promote metabolic health and treat diabetes and obesity without reducing caloric intake.” Or, we can just try not to eat so many branched-chain amino acids in the first place. They are found mostly in meat, including chicken and fish, dairy products, and eggs, perhaps explaining why animal protein has been associated with higher diabetes risk, whereas plant protein appears protective. So, defining the “appropriate upper limits” of animal protein intake “may offer a great chance for the prevention of T2D and obesity,” but it need not be all or nothing. Even an intermittent vegan diet has been shown to be beneficial.

If there was one piece of advice that sums up the recommendations in my upcoming book it would be: “Wall Off Your Calories.” Animal cells are encased only in easily digestible membranes, which allows the enzymes in our gut to effortlessly liberate the calories within a steak, for example. Plant cells, on the other hand, have cell walls that are made out of fiber, which present an indigestible physical barrier; so, many of the calories remain trapped. Now, processed plant foods, like fruit juice, sugar, refined grains, even whole grains if they have been powdered into flour have had their cellular structure destroyed, their cell walls cracked open and their calories are free for the taking. But when you eat structurally intact plant foods, chew all you want—you’re still going to end up with calories completely surrounded by fiber, which then blunts the glycemic impact, activates the ileal brake, and delivers sustenance to your friendly flora. So, bottom line, try to make sure as many of your calories as possible—your protein, carbs, and fat—are encased in cell walls, in other words from whole, intact plant foods.

That’s what nature intended to happen. Millions of years before we learned how to sharpen spears and mill grains and boil sugar cane, our entire physiology is presumed to have evolved in the context of eating what the rest of our great ape cousins eat: plants. The Paleolithic period, when we started using tools, only goes back about two million years. We and other great apes have been evolving since back in the Miocene era, more like twenty million years ago. So, for the first 90 percent of our hominoid existence, our bodies evolved on mostly plants. It’s no wonder then that our bodies may thrive best on the diet we were designed to eat. So, maybe we should go back to our roots. [clears throat]

With enough portion control, anyone can lose weight. Lock someone in a closet, and you can force them to lose as much body fat as you want. Chaining someone to a treadmill could probably have a similar effect. But what is the most effective weight-loss regimen that doesn’t involve calorie restriction or exercise—or a felony? I scoured through the medical literature and all the randomized controlled trials and the single most successful strategy to date is a diet of whole plant foods. The single most effective weight loss intervention like that ever published in the peer-reviewed medical literature, a whole food, plant-based diet. That works better than anything else studied to date. And, no wonder given what we just learned about fiber and branched-chain amino acids.

We’ve known for more than forty years that those eating predominantly plant-based diets weigh, on average, about thirty pounds less than the general population, but you don’t know if it’s the diet itself, until you put it to the test.

In 2017, a group of New Zealand researchers published the BROAD study, a twelve-week randomized controlled trial in the poorest region of the country with the highest obesity rates. Overweight individuals were randomized to receive either standard medical care or semi-weekly classes offering advice and encouragement to eat a low-fat diet centered around fruits, vegetables, whole grains, and legumes. And that’s all it was, just empowerment, and information, empowerment with knowledge. No meals were provided, the intervention group was merely informed about the benefits of plant-based living and encouraged to fit it into their own lives at home.

No significant change in the control group, but the plant-based intervention group, even though there were no restrictions on portions and being able to freely eat all the healthy foods they wanted, lost an average of nineteen pounds by the end of the three-month study. Nineteen pounds is a respectable weight loss, but what happened next? At the end of those twelve weeks, class was dismissed, and no more instruction was given.

The researchers were curious to see how much weight the subjects had gained back after being released from the study; so, everyone was invited back at the six-month mark to get re-weighed. The plant-based group had left the three-month study nineteen pounds lighter on average. But, six months later they were only down about…  twenty-seven pounds! They got better. The plant-based group had been feeling so good both physically and mentally… and had been able to come off so many of their medications, that they were sticking to the diet on their own and the weight continued to come off.

What about a year later? Even in studies that last a whole year, where people are coached to stay on a particular diet for the entire years’ time, by the end of the year, any initial weight lost typically tends to creep on back. The BROAD study only lasted three months, yet after it was all over, those who had been randomized to the plant-based group not only lost dozens of pounds, but they kept it off.

They not only achieved greater weight loss at six and twelve months than any other comparable trial—that was months after the study had already ended! A whole food, plant-based diet achieved the greatest weight loss ever recorded compared to any other such intervention published in the scientific literature. You can read the record-breaking study yourself for free, in full, at nature.com/articles/nutd20173 or you can just point your phone camera up at the screen and pick off the QR code.

Any diet that results in reduced calorie intake can result in weight loss. Dropping pounds isn’t so much the issue. The problem is keeping them off. A key difference between plant-based nutrition and more traditional approaches to weight loss is that people are encouraged, on plant-based diets, to eat ad libitum, meaning eat as much as they want. No calorie counting, no portion control—just eating. The strategy is to improve the quality of the food rather than restricting the quantity of the food.

If you put people on a diet packed with fruits, vegetables, whole grains, and beans and allow them to eat as much as they want, they end up eating about 50% fewer calories than they might have otherwise. Just as full on half the calories. How can you keep people satisfied cutting more than a thousand calories from their daily diet? By eating more high-bulk, low-calorie-density foods (vegetables, fruits, whole grains, and beans) and fewer calorie-dense foods, like meats, cheeses, sugars, and fats.

But it may not just be the calories-in side of the equation; those eating more plant-based appear to be effectively be burning more calories in their sleep. The resting metabolic rate of those eating more plant-based may be 10% higher, or more; a boosted metabolism that can translate into burning off hundreds of extra calories a day more without doing a thing. Eating more plant-based you burn more calories just existing. So, no wonder why those who eat more plant-based tend to be slimmer. Start packing your diet with real foods that grow out of the ground, and the pounds should come off naturally, taking you down towards your ideal weight.

OK, so that’s what I spent the first half of the book doing, laying out the optimum weight-loss diet, “Plant Yourself.” Then I spend the second half of the book on all the tools I unearthed to drive further weight loss for any stubborn pounds that remain.

We already learned that a calorie is not necessarily a calorie. A hundred calories of chickpeas has a different impact than a hundred calories of chicken or Chiclets, based on factors like absorption and appetite, but in the second half I go a step further and explore how even the exact same foods eaten differently can have different effects. Even if you eat the same amount, even if you absorb the same amount, a calorie may still not be a calorie. It’s not only what we eat, but how and when.

Just to give you a taste, the exact same number of calories at breakfast are significantly less fattening than the same number of calories at dinner. What?! That’s just mind-blowing. Same calories, different weight loss. A diet with a bigger breakfast causes more weight loss than the same diet with a bigger dinner. So, my recommendation to stop eating after 7 PM is not just because, you know, I’m afraid people are mindlessly snacking on the couch or something. The same snack at night is literally more fattening than eating the exact same snack during the daytime, all thanks to our circadian rhythms, our “Chronobiology.” Something I spend a whole chapter on.

Some of the sleep data is really crazy too. Overweight adults were randomized to eight weeks of either a calorie-restricted diet or the same diet combined with five days a week of just one less hour of sleep a night. Now, they ended up sleeping an hour later on the weekends. So, overall, they just cut three hours of sleep out of their week. Now, surely 3 hours a week of sleep difference is not going to change how much weight they lost, right? And on the scale that was true. But in the normal sleep group, 80 percent of the weight loss was fat, whereas in the group missing just a few hours of sleep, it was the opposite, with 80 percent of the loss being lean body mass. So, you snooze you lose—fat! A few hours of missed sleep seemed to totally flip fat loss on its head, but just looking at the scale you wouldn’t know it.

It’s like when people fast. Stopping eating completely for a week or two can cause more weight loss than just restricting your calories, but paradoxically, it may actually lead to less loss of body fat. Wait, how can eating fewer calories lead to less fat loss? Because during fasting your body starts cannibalizing itself and burning your own protein for fuel.

The scale made it look as though they were doing better when they were fasting, but the reality is they were doing worse. They would have lost more body fat if they had kept eating; they would have lost more body fat, eating more calories. Short-term fasting can interfere with body fat loss, not accelerate it, and you see the same thing, with the keto diet.

Body fat loss actually slows down when you switch to a ketogenic diet. Just looking at the bathroom scale, though, the keto diet seems like a smashing success, losing less than a pound a week on a regular diet to boom—three-and-a-half pounds in seven days after switching to keto, but what was happening inside their bodies told a totally different story. On the ketogenic diet, their rate of body fat loss was slowed by more than half; so, most of what they were losing was water, but they were also losing protein, they were also losing lean mass. That may help explain why the leg muscles of CrossFit trainees placed on a ketogenic diet can shrink as much as 8 percent within two months.

Of course, even if keto diets worked, the point of weight loss is not to fit into a skinnier casket. People whose diets even tend to trend that way appear to significantly shorten their lives. On the other hand, even just drifting in the direction of eating more healthy plant foods is associated with living longer. Those going the other way, though, those who start out more plant-based but then add meat to their diet at least once a week not only appear to double or triple their odds of diabetes, stroke, heart disease, and weight gain, but may also suffer an associated 3.6-year drop in life expectancy. That’s going from no meat to just once-a-week meat or more.

Low-carb diets have been shown to impair artery function and worsen heart disease. Whereas, whole food, plant-based diets have been shown to actually reverse heart disease – that’s what Ornish used. So, what appears to be the most effective weight-loss diet just so happens to be the only diet ever proven to reverse heart disease in the majority of patients. If my grandma didn’t have to die like that, no one’s grandma has to die like that. If that’s all a plant-based diet could do—reverse the number-one killer of men and women—shouldn’t that be kind of the default diet until proven otherwise? And the fact that it can also be so effective in treating, arresting, and reversing other leading killers, like type 2 diabetes and high blood pressure, would seem to make the case for plant-based eating simply overwhelming. Only one diet has ever been shown to do all that: a diet centered around whole plant foods. You don’t have to mortgage your health to lose weight. The single healthiest diet also appears to be the most effective diet for weight loss.

After all, permanent weight loss requires permanent dietary changes—healthier habits just have to become a way of life. And if it’s going to be life-long, you want it to lead to a long life. Thankfully, the single best diet proven for weight loss may just so happen to be the safest, cheapest way to eat, for the longest, healthiest life. Thank you.

[Applause]

Doctor's Note

I’m so excited to be bringing you my new live presentation!

I used to do annual reviews of the medical literature, but that was before the success of How Not to Die. Realizing just how many people (and in 33 languages!) I’m now able to reach with my books, I set out to write a new book every three years. The downside is that now I’m just barely able to keep up making new videos for NutritionFacts.org and so I just have time to create one new presentation per book. This one, I am proud to announce, is based on my upcoming book How Not to Diet, which comes out next month.

If you find this presentation helpful, please share it with others by sharing the link to this page. It’s also available as a digital download or DVD

And if you want to be among the first to grab my new book, please consider pre-ordering How Not to Diet to help me bump it high on the bestseller list the week it launches in hopes of exposing more people to evidence-based weight loss.

If you haven’t yet, you can subscribe to my videos for free by clicking here and to my audio podcast here (subscribe by clicking on your mobile device’s icon).

186 responses to “Evidence-Based Weight Loss – Live Presentation

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    1. From the link:
      He noted, however, that the findings don’t give us license to slack off on all of our good habits throughout life. For those of us who aren’t fortunate enough to have exceptional longevity genes, lifestyle choices still count.

      “It’s very important to understand that it’s not that if you want to live to be 100, you can smoke and not exercise,” Barzilai explains. “It’s that there are rare people who are going to be 100, and for them it doesn’t matter — they get there anyhow.”

      There are some limitations to the study, such as the fact that the cohort of Ashkenazi Jews and that of the NHANES sample do not make a perfect comparison. Additionally, there are likely to be other environmental or socioeconomic factors affecting longevity that were beyond the measuring capacity of the scientists. There are also the ever-present inaccuracies associated with self-reporting.

      So in case you’re not among the lucky ones with golden long-life genes, you’d probably be wise to hedge your bets. It’s still a smart idea to eat right, move your body regularly, avoid smoking and drink in moderation. That’s advice that will last a lifetime.

      1. “Thank You!” to NutritionFacts for posting Dr Greger’s presentation for How Not to Diet. I thoroughly enjoyed the talk, and look forward to the book release next month. I am also very excited for the millions of people soon to discover the amazing health benefits of eating ‘food as grown’. Thank you Dr Greger.

        1. Barb,

          I like your enthusiasm, but I think your optimism is totally misplaced.

          I’ve been learning that knowledge is NOT power. For example, I know smart, educated people who know all about whole food plant based eating — but they themselves don’t eat that way, even though they are overweight and desperately want to lose weight. What changes the behavior of such folks?

          I also know people who comment “Oh, I shouldn’t eat that,” before they proceed to do just that. What inspires them not to eat that? To change their eating habits?

          I know people who claim to be too busy to grocery shop and cook at home. I know of overweight diabetics who, when learning about PBWF eating and see the positive results in person, still want nothing to do with it — even though they eventually suffer terribly from their disease.

          I have heard lots of excuses, maybe even lots of denial. So what motivates folks to actually change their eating habits?

          That’s the book I’m looking for. In the meantime, does anyone have any ideas?

          Because I’m beginning to see everywhere the truth of: “You can lead a horse to water, but you can’t make him drink.”

          1. Of course Dr J, what was I thinking? ! I had lunch with a nurse practitioner friend today and we talked about how people can hear the latest and best info, then actively choose to do otherwise. (and hold a pity party along the way) The friend of mine that was seeing a dietition and podiatrist monthly for support about diabetes issues went for supper at DQ last night. smh

            I still can hardly wait for the book. It’s going to rattle some people for sure, but that’s ok. People will be talking about it.

            1. That book has been written. It is called The Pleasure Trap by Doug Lisle and Alan Goldhamer. Their videos on you tube are outstanding and explain it all. Highly recommended to explain why it is so difficult and even better, what we can do to become healthy.

          2. Is it food addiction? I think we need more support networks to deal with food addiction. I was so thrilled when I came across this website (not at first: I started looking at everything “wait, fish can’t be bad…oh no! Don’t take away my eggs!! Why eggs was the hardest for me to accept, we’ll never know) however when I introduced my mom to the year in review vids, at the end of one of the videos, she had a very grave look in her eyes. She couldn’t imagine life without the fun foods. There’s a huge social aspect tied to how we eat (my family especially, we can’t really vacation or splurge on outings so have friends or family over for dinner IS the event). But she and my dad started doing two vegan days a week at first. If my dad weren’t on board, it wouldn’t have flown, but he’s a reasonable guy and likes science. Now they eat many more plants, not vegetarian yet but WAY better and their minds are more open than they were. My bf also thought he would never switch to plant milk bc cow milk is so much richer tasting, but he kept plant milk in hand for me. One day he just stopped buying cow milk and announced to me he’s switched over, his taste adjusted and it was worth it for the calorie cost…it was completely unexpected. Lol. So I think many people need a little bit of time to see HOW plant foods CAN fit into their lives and habits and as far as motivation, maybe the people you meet need to know how much they are loved and needed for them to put in the effort to stick around. I switched my diet cold turkey to set an example for my family, especially my parents and brothers (genetically terrible cholesterol) that one can thrive and live off plants, but it wasn’t primarily for my benefit, though I also reap the benefits. If it were for myself, I think the short term social and time factors would have me cheating all the time…and maybe I wouldnt even care bc as a young person I’m “healthy enough”

          3. A grass roots movement is about our only hope in the face of billions of dollars every year spent on marketing of bad foods and enabling drugs not only to grown ups, but also to little helpless children. We have to work one person at a time. What motivated me was a total hip replacement surgery and a need to lose weight to make the hip last longer. I couldn’t think of literally *any other way* to lose weight while I was unable to exercise. The benefits have been so substantial that eating only whole plant foods has become my life and it is now one of my life’s purposes to show other people how this can change their lives.

          4. From my understanding of the evidence, even people who sign up for intensive lifestyle management of of T2DM classes or programs, the results are disappointing at best. I think the reason people behave this way ( overindulgence of SAD) is akin to trying to help people who smoke to quit. We do not have any intervention that helps people who smoke to want to quit, but once they decide in their own mind that they are going to quit, we can help them with medical interventions to be successful. I have seen many ( but not nearly enough) patients who make that decision and eat healthy foods and exercise, lose weight and get off their bp meds and reduce their dm meds to just metformin. They feel great, look great and all the stats for long term health are improved. But even though I warn them, almost all of them relapse within 2 years or less. It’s hard to lose weight but it may be harder to keep it off. We need more studies and programs focusing on maintaining the benefits of substantial lifestyle changes.

            1. Hi, Primary Care Physician…

              You wrote, “We need more studies and programs focusing on
              maintaining the benefits of substantial lifestyle changes.”

              A sales trainer once told me that all the action, sales-wise,
              is in the benefits… that it’s the benefits you learn to sell.

              I am two months into my 3rd year of WFPBNO.

              On the anniversary of the end of my 2nd year, I decided
              to finally “give in” to the craving for cheese that has been
              my constant companion ever since I started on this journey.

              I wanted to see if it was anything like I remembered…
              to get some data because, as W. Edwards Deming said,
              “without data, I’m just another person with an opinion.”

              It’s one of the reasons I love Dr. Greger’s site so much:
              He makes such an effort to provide *proof* of what he says.

              Anyway, the anniversary of my start date was also my birthday,
              so I bought one of those 8-ounce packets of Philadelphia
              cream cheese so I’d be ready to “celebrate” having
              gotten through my 2nd WFPBNO year successfully.

              If you’re thinking that this was a really stupid thing to do,
              you’re right.

              It was.

              About as stupid as an alcoholic deciding to celebrate with some booze!

              Cheese is one of those fat-sugar-salt combinations like Snickers
              Bars that fire up the “pleasure centers” of our brains and result
              in our becoming so addicted to it that we can’t leave it alone.

              Plus, cheese has its hooks so deep into our culinary culture
              that it pops up in front of us in every direction we turn
              and makes it even harder to resist.

              Who scrapes the cheese off their pizza?!!

              Anyway…

              …while I was nibbling on that packet of cream cheese on my
              birthday/2ndWFPBNO anniversary and letting it melt in my mouth
              so I could extract every last scintilla of deliciousness from it…

              …the data presented by Drs. Campbell and Esselstyn in the “Forks
              Over Knives” documentary about how scientists are now able to
              turn cancer growth on and off simply by adding or subtracting
              cheese to or from the diets of their test subjects…

              …kept playing in my mind and reminding me that I’m turning on
              my cancer switch more and more and more with every mouthful.

              Dr. David Kessler, retired former head of the FDA, characterized
              these fat-sugar/starch-salt combinations like cream cheese and
              candy bars and french fries, as “edible food-like substances”…

              …*not* food.

              …not in the sense that Dr. Greger’s “as-grown” food is food.

              ~

              Did I “enjoy” my celebratory 8 ounces of cream cheese?

              Not really.

              First off, I was shocked by how *salty* it tasted.

              For two years, I’d been following a recommendation by
              Dr. John McDougall to refrain from cooking with salt because
              it’s too easy to consume too much that way and, instead,
              to sprinkle a little bit of salt on top of my food at the table
              so I can enjoy the pleasure of actually tasting it on my tongue.

              Our bodies only need about 180 milligrams of sodium a day,
              he says, and we get that naturally in the whole foods we eat,
              so anything we add over that amount causes our kidneys to
              work harder than they normally would in order to eliminate it.

              Philadelphia cream cheese contains 91 milligrams of sodium
              per ounce and I ate 8 ounces so that’s 728 milligrams
              or *way* over my “minimum daily requirement.”

              Dr. McDougall also says that the real demon, here, is the *fat*
              rather than the salt. He says that, if you take the salt out,
              the bacon or the cheese or whatever is just going to be this
              disgusting lump of tasteless fat that nobody in their right mind
              would be tempted to eat.

              Sugar added in cooking works works in a similar way, he says,
              so you’re better off sprinkling a little sugar on top of
              your oatmeal than adding it during cooking.

              Anymore these days, I don’t even bother with either salt or sugar
              because it’s just easier and less worrisome to use flavorful herbs
              and delicious fruits instead…

              …but on the day I “celebrated” the end of my 2nd WFPBNO year
              with 8 oz of cream cheese, all that salt and grease overwhelmed
              my body to the point where it took me three (3) whole days to
              recover from the worst of it and a lot longer than that to recover
              from the rest of it.

              Never again!

              Recently I read about a guy who got so frustrated with relapsing
              and eating stuff he knew was not good for him that he concluded
              the only really viable solution for him was total abstinence,
              so he ate only potatoes for an entire year…

              …and emerged victorious!

              …addiction free!

              And I think there’s something to be said for that approach.
              In some ways, discovering that you’ve been doing it all wrong
              all this time is like having a bomb dropped on your life.

              Nothing is the same from that day forward!

              Everything has to be all re-figured out!

              What-oh-what shall we have for dinner!

              Help me God!

              Faced with the monumental task of converting all your “SAD”
              food-sourcing-buying-storing-preparing-serving processes to
              WFPBNO, who wouldn’t find a potatoes-only diet appealing!

              An alcoholic can *not* drink.

              A drug user can *not* use.

              But a food eater can *not* not eat!

              And if you’re *not* the one in your family who normally does all
              the food-sourcing-buying-storing-preparing-serving processes,
              you have it *all* to figure out…

              …so if it’s a choice between only-potatoes and pizza,
              by all means, choose only-potatoes!

              …without grated cheese and bacon bits heaped on top!

              ~

              As for me…

              …well, aside from feeling sick as a dog after eating an entire
              half pound of cream cheese, I woke up the next morning with my
              eyelids so swollen up with retained water that I could hardly
              open them enough to see. It took my kidneys three (3) days
              to process those 728 milligrams of sodium out of my system
              and get my eyelids back to looking “normal” again.

              …also, my face and back positively glistened with all the
              saturated fat that was trying to get out of my body through
              the pores in my skin. It took a month or thirty (30) days
              for things to get back to normal, skin-wise.

              …also also, it probably took a quarter or ninety (90) days
              for my body to clean out other fat-storage sites like arteries
              and stomach, hips and thighs. As Dr. McDougall is fond of saying,
              “the fat you eat is the fat you wear!”

              ~

              What is “normal”?

              How would you know that puffy eyelids aren’t normal unless,
              like mine, yours had become un-puffy over the course of a
              couple of years’ worth of whole-food, plant-based eating?

              How would you know that oily skin shiny with excess fat
              isn’t normal unless, like mine, yours had become soft and
              moist and well-hydrated with water rather than greasy with fat?

              How would you know that it’s not normal for you to start losing
              your eyesight and your hearing because your red blood cells
              aren’t able to elongate themselves in the tiny vessels to
              your eyes and ears because those vessels are sticky
              with too much fat from your diet?

              Drs. Lisle and Goldhammer in their book, *The Pleasure Trap*,
              characterize as “highly palatable foods” those foods that
              Dr. David Kessler in his book, *The End of Overeating:
              Taking Control of the Insatiable American Appetite*
              characterizes as “edible food-like substances.”

              Sure…

              …what’s not to like about chocolate-chip cookies?!!

              With a lot of fat, sugar/flour and salt, any yahoo could
              make any “edible, food-like substance” taste good.

              Even the chefs of the best restaurants will say
              “When in doubt, add bacon and cheese!”

              Fast forward three (3) decades and we’ve got heart disease,
              cancer, diabetes and other metabolic-syndrome horrors
              to show for it.

              My mother died a horrible death of cancer.

              *Her* mother died an even more horrible death of cancer.

              And *her* mother—my great grandmother—died of diabetes
              after both her legs had been amputated.

              I’d rather have only-potatoes,
              thank you very much!

              I’d rather have both my legs.

              And my eyesight and my hearing.

              And all the other “benefits” that are ours for the eating
              of plant-based foods in as whole a form as feasible…

              …the wholer, the better!

              ~

              The truth is…

              …most of the things we’ve learned to like aren’t good for us.

              That’s the bad news.

              The good news is that only-potatoes are *fabulous* for us and,
              what’s more, we can eat all we want of only-potatoes and reap
              all the benefits of good health that those hucksters of highly
              palatable foods like burgers and fries and pizza and cookies
              and ice cream would steal from us.

              Big Processed Food is as much our enemy as Big Meat, Big Dairy
              and all the other “Bigs” that make billions by turning our brains
              against our best interests with those “highly palatable, edible
              food-like substances” cited by Drs. Lisle, Goldhammer and Kessler.

              Fortunately for anyone who’s willing to re-figure their
              food-sourcing-buying-storing-preparing-serving processes,
              Drs. Greger, McDougall, Campbell, Esselstyn and others are
              standing by to assist us in the achievement of that goal.

              We have so much to be thankful for!

              warmest regards…

              Elizabeth :)

          5. If you’re a health professional, you can use a technique called Motivational Interviewing to help clients increase their motivation to change behaviors. I believe that Rollnick and Miller, who developed and tested MI, also have a self-help book. For those who are motivated enough to make changes, Dr Gregor’s information gives them the knowledge they need.

          6. Dr. J…… you’re hitting the nail on the head. I’m an emergency physician that blends lifestyle medicine/coaching with emergency care. I recommend this book frequently and have used it personally. Check it out…. Well Designed Life: 10 Lessons in Brain Science & Design Thinking for a Mindful, Healthy, & Purposeful Life (Kyra Bobinet MD MPH).

          7. Very valid comments and I agree most wholeheartedly with them. Somehow I hope the research will show that it is that brain gut interplay which creates that inner dialogue that often derails our resolve to do the best for our own health. I also hope there is some genetically inherent switch that as a result of a reset mechanism, is triggered when our resolve is weak, and we eat badly, that somehow potentiates a health defence protective effect in us. After all, we are only human.

      2. I was saw an 88 year old woman who had smoked her entire adult life. I told her she was the oldest smoker I had ever met. She died about 3 months later.. Mostly I see smokers in their 60’s who look and function like they are in their 80’s and smell like an ashtray. I can’t really recommend it.

        1. The human body is so brilliantly resistant to our abuse. The body ability to heal it self, I feel is the very reason it is so hard to get people to change their eating habit. If they got cancer a week after smoking, or heart attack (an MI) a week after ingesting that steak or burger, it would be so much easier to converse people to stop abusing their body. We are all living under Grace given to us by the creator
          Sharon

    2. Omg… They are REALLY showing their desperation in trying to keep people on an unhealthy lifestyle… That’s what happens when there’s profit to be lost and by SO many industries no less.

      1. This is why we the people are so powerful in producing change when we with hold our dollars and only spend on ideas and product that are supporting a healthy, intelligent sustainable society, which demonstrates a love for humanity and all living things.

  1. This post is off-topic and dedicated to Reality Bites.

    Remember all that hullabaloo a short earlier this month when Dr Klaper said he was stopping recommending use of omega 3 supplements? He announced that he had been convinced to stop recommending omega 3 supplementation by Jeff Nelson who pointed to a rather odd 2013 study that found an association between high serum DHA levels and prostate cancer (mortality. I write ‘rather odd’ because 1) it also found that high trans fatty acids appeared protective, and 2) the authors assumed for no apparent good reason that the association was causal (and high DHA ’caused’ increased cancer risk).

    This was odd because previous studies had found omega 3s protective against prostate cancer. Odd but it certainly made headlines.

    I am it seems not the only one who found it odd. A team of researchers decided to investigate Their study – published just a few days ago – found no link between serum DHA levels and prostate cancer risk.
    https://www.sciencedaily.com/releases/2019/11/191117165610.htm

    https://www.sciencedaily.com/releases/2019/11/191117165610.htm

    1. Big Science just can’t make up its silly little mind, can it!

      According to the photo, Dr. G. was feeling all green and leprechaun-ie today. :-)

    2. This comment is dedicated to all of the Darwin Award contenders. Asking for free off topic medical advice on the internet, disrespecting the doctor who runs/owns this blog and its users, while getting ‘advice’ from anonymous commenters playing doctor online (or bots for all you know) is not something an intelligent adult would do.

      1. The site explicitly welcomes off-topic posts as well you know RB. Strangely, that doesn’t stop you from claiming that they ‘disrespect’ the site’s founder.

        You also seem unable to distinguish between ‘advice’ and ‘information’.

        That doesn’t sound very intelligent to me.

            1. YR,

              Quit picking on Dr. G.

              This is a non-profit site and the money from the books and speaking engagements go to charity.

              There are plenty of for-profit people out there you could be picking on.

              1. Okay, my bad. I thought Dr. G. would at least make some money from the many views (*hits*) he gets with his blogs and videos. Apparently not. Well, so long as he finds some cash to pay for his home utilities and to put food on his table. :-)

                But there are certainly other generous folks out there. For instance, with Newman’s Own products, “100% profits go to charity.” https://newmansown.com/

                And our President does not draw a salary. We can’t take it with us, they say. :-)

                (Den Mother Deb, quite scolding me!)

                1. YR, it isn’t a secret how it goes with this, and similar sites. The charity IS NutritionFacts… monies derived from the sale of books, cd’s etc (not sure about public speaking fees, but expenses would be covered) go to the running of the website, publishing materials, salaries… and Dr G does draw a salary from NutritionFacts. For many years he did not as I recall, but in the last couple of years , he has – deservedly so.

                2. YR, re: “And our President does not draw a salary.”

                  It never ceases to amaze me that the US finally gets a philanthropist non-politician for a President and all the Media and his enemies do is continually bash him! He could have retired and be living the life of luxury instead of taking this abuse. Are his enemies jealous because he is doing what they promised the people, but then refused to do? By attacking him, they are indirectly attacking “we the people” who elected him! What’s going on here?

                  1. “Yes, Denmother Deb is now coming back to give you a motherly hug.”
                    – – – –

                    *sniff* Well……okay. *sniff*

                    “DenMother Deb” suits you well, I think. :-)

                    1. YR, Isn’t this a fun comments group :-) And we actually get to learn a little nutrition in the comments, too!

      2. RB, you could learn a lot from the ‘off-topic’ comments if you just stop posturing and check them out. This news about the link between DHA and prostrate cancer is very important. The disrespectful person is the one you see in the mirror.
        Thank you Fumbles for following up on this.

        1. Marilyn & Fumbles, I guess I’ll weigh in and second your “Thank You” to Fumbles. I agree that any legitimate news about nutrition and cancer or any other major disease should be brought to light in this comments section.

        2. Indeed, Marilyn Kaye. Lots of valuable information here. I found Fumbles’ post and link to be particularly important as it’s addressing yet ANOTHER false headline confusing the public with poor so-called data and explains and corrects it. These things cannot be posted enough, so in reality, it was very important he share it and we should all thank people for this kind of evidence-based information.

      3. Reality Bites,

        People are discussing the most contentiously debated issues in WFPB on Dr. Greger’s site because of respect for him. He covers topics that people are interested in and allows people to debate and discuss topics and to post off-topic posts.

        I am sure that he also appreciates it when people stay on-topic somewhat, but he used to tell people specifically to post topics they are interested in within the comment section. He has said it in his Q&A’s and in the doctor notes section and he has posted it in the comment section itself back when he participated more often.

        The concept of “free medical advice” is probably more that there is so much advice from so many doctors even within WFPB. People listen to all of these doctors and then do want Dr. Greger to weigh in and also then need to process the new studies and whether they change the answers.

        Honestly, this is such a passionate audience and it shows up every day to discuss health and nutrition and that is special.

    3. Mr. F.,
      what I found odd was that someone as wise and well respected as Dr Klaper would give Jeff Nelson the time of day. You are right, It was an old study and newer research supports DHA supplementation. My source: Dr Joel Kahn, esteemed wfpb cardiologist. (never Jeff Nelson).

      1. Linda

        Yes, I was surprised too. However, Nelson is very persistent and perhaps Klaper didn’t have the time to do his ‘due diligence’ on Nelson’s claims.

        The latter is clearly an advocate for his beliefs, rather than a dispassionate analyst of the data, and would not have presented the other side of the issue. I get the impression that his ideology is that an entirely vegetarian whole food diet is optimal and any and all supplements are at best useless and at worst harmful. He uses scientific studies to promote his beliefs but ignores those that contradict or fail to support them.

        1. David,

          Yes, the advice about Omega 3 goes back and forth with each study.

          And each of those men will change if the science changes.

          That much I know.

          Sometimes it seems like we skewer them for the reality that when the answers are confusing, everybody needs to do some educated guessing.

          We forget about the 90% they do agree upon, and that there is a huge process to deciding what to believe.

          Dr. McDougall reserved the right to change his mind over and over and over again about B-12.

          Because as the science changes, his answer changes is the way things work.

          There are 100,000+ studies every single year and no one human being can keep up with all of it and still be a doctor/public figure.

          1. Dr. Ornish, Greger, Furhman and the Adventists are pro-omega 3’s.

            Dr. Ornish’s studies where he reversed heart disease and prostate cancer included it.

            Dr. Esselstyn and McDougall are against it and they all worry about supplements and rightly so.

            Dr. Klaper just switched to being against it.

      1. Here are the types of comments used to describe him:

        He is a professional vegetarian.

        He was the Armour meatpacking empire’s principal heir. Now firmly anti-meat, Nelson is also the co-author of Sue the Bastards!, a how-to book on filing ad hominem lawsuits, as well as a book about handwriting analysis, called, Handwriting Analysis: Putting It to Work for You

        He is a speaker at events by people like John McDougall and is Dr. McDougall’s very good friend.

        He just threw Dr. Fuhrman so far under the bus and takes Dr. Greger so far out of context about things like nuts and Vitamin D supplements and Omega 3.

        He believes that it is okay to be so deficient in nutrition that you are symptomatic as long as you are a low-fat vegetarian.

        He is crazy anti-nuts, and anti- supplements.

        He considers the Adventist’s study a scam.

        And he is an all-around rabble-rouser who considers himself a journalist.

        1. Deb, you made some comments that are inaccurate. Everyone is entitled to their opinion, but it isn’t good to misquote folks. Jeff Nelson likes nuts… he eats some walnuts and other nuts everyday and says so in his ‘nuts’ videos. Other wfpb docs are anti-nuts though. Also, he does NOT believe it’s ok to be deficient. He DID cite the actual study of the Okinawans where the study described the people to have a few apparent deficiencies. His point was that these people were still among the longest living communities in the world in spite of not having absolutely perfect bloodwork. ( I agree in principal that we don’t have to be perfect, just consistent in avoiding the bad food/habits) He does not consider the Adventist study a scam. There are many Adventist studies… if you mean the walnut studies sponsored by the California Nut Association (or whoever they were lol), then yes, he generally believes that industry sponsored studies are not the best level of evidence.

          1. He did not quote a study about the Okinawans. He described symptoms and said that he believed their longevity implied that it was okay to be deficient. He wasn’t quoting a researcher. He said that.

            Yes, you are right. After he reamed Dr. Greger and Dr. Fuhrman for their view on nuts, he later said that he eats them.

              1. He also accused Dr. Greger of knowing that Dr. Fuhrman’s patient in an anonymous survey had died before the information was posted online and that woman had switched after serious health problems with cancer and heart attacks, but her dying 15 years after being Nutritarian, he used to negatively compare Dr. Fuhrman’s diet to a SAD diet. Even if in the documentary she was used as a proof of WFPB being the way to go because she was supposed to die long ago.

                1. Barb,

                  I went to him months before that and my specific question to him back then was if he believed that it was okay to be deficient even to the point of being symptomatic and I took that Okinawan point as him answering me, and he did answer me back on his older video and the Okinawan sentences were in line with what he said back then.

                  I am not trying to put him down by that. I am trying to articulate his belief system.

                  1. I had challenged him back then that if he takes a leadership role then he is responsible if people follow him and I felt that he was not acknowledging deficiency. This was long before those videos.

              1. Yes.

                I worry about the vegan community because of things like the low B12 causing things like spinal rot and even death.

                And because Omega 3’s seem to help people who don’t eat fish and because of the study with the brain where there was less shrinkage if people did supplement.

                I watch all these vegans leaving veganism and going carnivore for their nutrition and it was a huge phenomenon last year and they talked about things like being low in Vitamin D and B12 and having other issues and I did challenge him because he has a following and it was that he didn’t mind people being symptomatically deficient. People get MS and high Homocysteine and Alzheimer’s and people die.

                On his behalf, he is listening to a lot of doctors and his viewpoint to not supplement is one that is becoming more popular.

                For me, I can look at the black community and Vitamin D and Omega 3 and they get such a huge benefit and there are groups such as obese people and even the opposite extreme – the fruitarian group has so many people get in trouble.

                Jeff is an influential person and I just do worry that the particular group that follows him is the same particular group that is prone to get in trouble and he doesn’t tend to mention the opposing side. Dr. Greger does. He tells the pros and cons.

                1. I ended up finding an Okinawan study about nutrition and they had through the roof high levels of nutrition of almost everything and the list didn’t even include the minerals in their water or the fact that B12 has been found in seaweed and fermented soy products and shitake mushrooms, all of which they ate, plus, they ate meat once per month. Their study also didn’t include the D found in mushrooms.

                  For most nutrients, they were 160 to 230% over the Japanese daily allowance and they acknowledge the levels leave parts of their diet out and it is an underestimation.

                  They considered them low in D from food, but didn’t include their monthly meat intake or mushrooms or sunlight when they said how much Vitamin D they got, and they acknowledged that they had sufficient sunshine and good enough weather to get their D from the sun, so deficient in Vitamin D is questionable.

                  As far as B-12 goes, they said a very low amount, but again, didn’t include their meat or that B-12 is found in seaweed, which they eat, fermented soy products, which they ate, and in shitake mushrooms, which they also ate.

                  I looked up a Korean Centurian study in which they found out that people had multiple non-meat sources of B-12 which they didn’t know contained B-12 until that study and they got theirs from seaweed and fermented soy and mushrooms.

                  Anyway, the real deficiency they had was that the Okinawans were low in Riboflavin, but that also didn’t count things like the monthly meat. About 10% of them were symptomatic.

                  With all the rest of their nutrition, they were over-flowing.

                  They had almost 300% more folate and vitamin c and potassium than the Japanese RDA.

                  Vitamin E and B6 were closer to 200% more than the Japanese RDA
                  Magnesium and Vitamin K were closer to 150% more than the Japanese RDA
                  Phosphorous, Thiamine, and Iron were closer to 100% more than the Japanese RDA
                  Calcium was slightly low, but they said that they didn’t include the calcium and minerals in the water.

                  In the USA, 24% of vegetarians are B2 deficient, but it is found in some seaweed and only 10% of their people were symptomatic, so they may have gotten enough from something in one of their monthly ceremonies or something.

                  The study with it was mostly about calorie restriction and they said

                  Only one long-term epidemiologic study has linked Calorie restriction to human longevity reporting a weak trend for lowerall-cause mortality in healthy never-smoking Japanese–American men whose caloric intake was 15% lower than the cohort average in mid-life had the lowest late-life mortality risk, but here was higher risk for mortality when caloric intake dropped below 50% of the group mean.

                  1. Looking at the Okinawan’s nutrition, I wonder if their calorie restriction being ultra-high in nutrition is anything near what most people would get with calorie restriction.

                    They weren’t falling short except in riboflavin and only 10% of them were sympathetic and I can’t find how that 10% fared versus the rest of the Okinawan’s.

                    Do we know that The symptomatic people had the same longevity as the others?

                    I do notice that there wasn’t a lot of anemia and no rotting spine mentioned so the B12 wasn’t seeming to be an issue..

                    1. There was a weak trend supporting calorie restriction was their sentence.

                      I look at the absence of bad food and the over abundance of nutrition and would have been focused more on those factors than the 10% fewer calories.

                2. Starch deficiency is most likely the cause of a lot of people stopping eating plant-based or not succeeding at eating healthy, because they ear all those doctors pushing them to eat nothing but veggies in their plate…

                  Bullying white potatoes as “unhealthy” is clearly not going to help.

      2. cp

        He runs a YouTube channel called Vegsource which is highly critical of Dr Fuhrman and Dr Greger.

        The balance of evidence supports Drs Fuhrman and Greger but Nelson’s position is that all supplements are bad full stop. Which is OK. However, in debating the issue he doesn’t play nicely with the other children so to speak.

      3. VegSource (google his videos.) He’s very contentious and has done a good job of influencing folks against Dr. Fuhrman. Dr. Fuhrman, understandably, tried to defend himself and his teachings but that just made Nelson work harder to discredit him. He tried to bait Dr. Greger, as well but Dr Greger wisely rose above Nelson’s cheap shots and just ignored him.

    4. Thanks for diggin’ deep Fumbles! I still am of the opinion that Mr Nelson is speaking the mindset of Dr McDougall in this and other issues, but what do I know.
      Anyway, thanks again

      1. Fumbles, here is the latest one btw. https://m.youtube.com/watch?v=xlsImUMUyLg
        He looks at the VITAL study in this video.

        I’m back to watching Dr G’s presentation again. I was pleased to see my granny got it partly right when she advised us “if you’re going to eat apple pie, eat it in the morning!” I would have loved apple pie for breakfast, but no luck there…

        1. Thanks Barb.

          The VITAL study found no significant association between fish oil supplementation and prostate cancer risk. There was a non-significant association though and Nelson runs hard with this. It’s a pretty slender thread from which his argument dangles though.especially since there a non-significant reduction in cancer among those taking a vitamin D supplement If he thinks a non-significant association is enough to conclude PUFA supplements are harmful in men, then he should also conclude that vitamin D supplements are beneficial in men and women. He doesn’t apparently.

          The Brasky study by the way wasn’t about supplement use. It was about blood DHA levels.

          Note too that VITAL only looked at people with no prior history of CVD, cancer or diabetes.

          Nelson is correct that there is no observed benefit from omega 3 supplements in the prevention of CVD This is also Dr G’s position and the AHA’s position. However, secondary prevention is another thing altogether The AHA therefore thinks supplementation is ‘reasonable’ in certain classes of people:

          ‘the recommendation for patients with prevalent CHD such as a recent MI remains essentially unchanged: Treatment with omega-3 PUFA supplements is reasonable for these patients. Even a potential modest reduction in CHD mortality (10%) in this clinical population would justify treatment with a relatively safe therapy. We now recommend treatment for patients with prevalent heart failure without preserved left ventricular function to reduce mortality and hospitalizations (9%) on the basis of a single, large RCT.’
          https://www.ahajournals.org/doi/full/10.1161/cir.0000000000000482

          There is also an unanswered question about whether more recent studies have not found a benefit for supplementation in CVD prevention (whereas older studies did), is a consequence of widespread use of eg statin therapy, BP therapy etc That is, supplementation provides no added benefit in those circumstances but leaving open whether they might be beneficial in people not on such medications. There is no conclusive answer on this yet..

          As a woman though, I wonder why you find this arguments of Nelson’s compelling. The non-significant association was only found in one specifically male cancer (and other studies have found fish oil supplements to be protective). There is no evidence whatsoever for harm in women, that I know of.

          Yes, my impression too is that Nekson champions (or at least rides on the coattails of) McDougall and Colin Campbell. He is much more aggressive and combative than either of those though. I think his attacks on Fuhrman are particularly unpleasant since the latter is simply expressing the conventional scientific view on very low fat diets.

          1. Some of the posts by Nelson’s followers are pretty unpleasant too.

            Looking through the comments underneath that Jeff Nelson video you linked to, I noticed one by someone using Dr Greger’s name and photo to post sycophantic praise of Nelson and trash Dr Greger’s work.

          2. Thanks Fumbles, I always appreciate your feedback! I don’t think we have heard the last out of the VITAL study… the website says more is to come in the next year or so.
            I actually don’t find Nelson’s arguments compelling at all. I think Dean Ornish has been consistent in his recommendations as has Esselstyn, and both have done great things for their patients even though they do not agree.

            I have a similar view to yours in that if my doctor offers me something that may garner a 10% benefit with little downside, I’ll take it ! I figure they all add up – and they have, as my recent battery of tests have proven.
            Some of the things I consider are side effects, compatability with current meds, cost, availability, and the opinion of my cardiologist and neurologist. The neurologist says dose and quality matter and talked about enteric coated capsules.

    5. When asked I recommend people steer away from supplement for two reasons, you don’t know how they were manufactured and second if you eat a well balanced plant based diet you will get everything you need. The supplement I do like to recommend, is that people grown their own food. We have depleted our soil so much that if they, farmers grow organic the soil has been striped of it’s nutrient. Just start with sprouting it’s fun and easy and can be done inside your home

  2. Great video. Great information. Question. Black cumin has been described as B. bulbocastanum or Nigella sativa. In his opinion, which is he talking about with regards to weight loss.
    Keep on keeping on. His information is great….just know there are a lot of us out there supporting him…. We NEEDED him.

    Big hugs.

  3. Dr. Greger offers a sneak PEEK, not peak. :-)

    This is my new favorite website. I share with everyone. Thanks so much for all the hard work everyone puts into it!

      1. Wow dr. Greger is in the house! First time I see doctor Greger here, in the comment section, since the early days of this site! Hooray! – which is why reply here now [ never do anywhere else online] hoping that he/you see this:

        Dr. GREGER – Please accept my deepest appreciation for the fact that you are dedicating your life for our lives [very Jesus-y of you, and I’m not even religious – hack, I’m not even christian]- some people dedicate their bodies after they are gone – you dedicate your entire existence while you’re still alive – that’s true sacrifice and contribution to humanity [ if you don’t get the Nobel Peace Prize at some point – it should be canceled for all I care – and I’m not one prone to hyperbole], plus it is obvious this sacrifice is being made we the utmost dedication and pure intent – it is the ultimate alignment of one to one’s calling – which is the ultimate way to live a purposeful life and in service of others – and I know I’m speaking for millions of people who follow the science you lay before us, while, on the way, making us astute and discerning regarding not only methodology and conflicting interest, but also the bigger picture of Big pharma / sugar / salt Etc –

        For some years now you have become part of my morning ritual: I do not start my day without revisiting even videos I have seen before – just to make sure about something I forgot or wonder about, and to myself attuned the best healthy life I could possibly have – thanks to the knowledge you bestow on all of us.

        I have changed many aspects of my diet thanks to you [ and I was a vegan before I found this website] and I never make a dietary or culinary [ the third way of cooking broccoli, anyone?] step without consulting with you first – and thanks to you I am now seeing baby-steps positive change towards WFPB with my close family and friends

        [ personally I prefer: “Whole food plant” diet. period. Without the “based” when talking about healthy veganism, because the other term suggests animal products in one’s diet, but I do recognize that for most of the world it still applies which makes this term factually correct – though gladly rapidly changing]

        and thanks to you I can always say to them: It is not me – and it is not even dr. Greger’s opinion – it’s the science, through the most unbiased and untarnished lens only someone who is crazy enough to give up on the millions he could have made from his books and other information products [seriously – do you really need to give MORE to charity??? Isn’t all this enough??? What are you on, dude???] – I could go on singing your praises – but this is getting embarrassing, so let me just sum up: If there is anything beyond this world, grandma Frances is smiling on you and all of us, beaming with pure and immense Naches (נחת) !!!!!!!!!!!!!!!!!!

        [a Yiddish word that means “pride” or “joy.” Typically one that a child – or grandchild, in this case – brings a parent]

        1. A.C.,

          I like your phrase: “Whole food plant” diet. I think I may start using it. It’s shorter. It’s snappier. And it’s the way I eat. So, thank you.

          I also like “whole food plant” eater/eating. Or “whole plant food” diet/eater/eating. I’m dropping the “based” for sure!

          1. Great Dr. J – hopefully others will follow! It represents the healthy and desirable graduation [no quotation marks needed] from an omnivore/flexitore [that’s what I call flexitarian] diet, when one still consumes animal and processed products to a WFP one: dropping the B is a mental and practical graduation.
            [On a personal level – I truly appreciate you taking the time to write this as I find that to be a really important linguistic tweak I’m promoting within the healthy vegan community – representing the mental and practical evolution, which en-capsules one’s graduation]

          2. “Health food diet” is the right term. You can’t use the term plant because 10 years ago I got an allergy test and there were over 90
            wonderful wholesome plant type goodies on the test that could be a potential problem for some individuals.
            You have to find out what works best for you.
            You can call me by my real name Jim Nasium ….. and that’s where I’m going right now.
            Exercise was not tested by the Allergist.

          1. Yerky never has, and never will copy and paste anything from the internet. That’s for others to do.
            For the last 6 decades he uses his right and left eye, and his right and left ear in person to gather health information.
            It is a contrast to what the ivy leagues do. You put them both together and you get the best of both worlds.

            It’s like Jack Lalanne said, “Exercise is king, and nutrition is queen, you put them together and you have a kingdom.”

            1. “It’s like Jack Lalanne said, “Exercise is king, and nutrition is queen, you put them together and you have a kingdom.”
              – – – –

              Ol’ Jack was wrong. You put them together and you have a kingqueen.

              1. Love your quote from Jack LaLanne. He had the first gym I went to and the first juicer I bought. The man is very significant in the world of healthyliving

    1. Thanks, YR, I laughed at the concept that people forget roughly one tenth of a word per year.

      What would that look like in a sentence?

      I los my keys.

  4. Dr. Michael Greger my congratulations !
    This is the most spectacular video in your website so far.
    Your work and message are getting better and better, razor sharp and crystal clear.
    Thank you for all you are doing to humanity.
    Admiring all your work and contributions, my best regards, Nestor Barazarte, Barcelona Spain

  5. Bravo, Dr. Greger! This is incredible work. I agree with Nestor, you’re getting even better at unearthing and delivering this vital information. You’ve blown me away with your latest presentation. It’s entertaining, fascinating and engrossing. And the information is so helpful and usable. And life-saving! I can’t wait to read your new book. I think your latest work will have great impact. From the bottom of my heart, thank you for all you do for me, my family and the whole world.

  6. Hey Dr Greger, I was wondering if you have heard of this weight loss program before? https://cutt.ly/PeZKk2V It looks like a great program to help people lose weight, I was just looking for some opinions before I made my decision. By the way I love the video!

  7. I love Dr Greger and all his videos. I can see all the work he puts into them and all the studies he looks at. I myself am on a plant based diet for health and for the animals. However, I don’t find it necessary to always cite our ancient ancestors and what they ate because of the amount of years science says they go back. I personally don’t believe the earth is billions of years old nor do I think the big bang is a good explanation of how it came into existence . These things have not been proven, so let’s just stick with the proven science, and not what a lot of people that don’t believe in a creator say to try to pass as science. They are mostly just guessing.

  8. There are so many pearls in this!

    The sleep one and the eating before 7 pm kills me.

    Some of us don’t get home before 7 almost ever.

    It gives me answers though to why things have been so challenging.

    The processed food study is interesting.

    A landmark study set to be published next month found that, even when presented with the same number of calories, and the same salt, sugar, fat, fiber and protein, processed foods led to weight gain, two pounds gained over two weeks; and unprocessed foods led to weight loss, two pounds down in the same two weeks.

    I am still trying to wrap my mind around that one because they had the same salt, sugar, fat, fiber AND protein.

    Same Fat?
    Same Fiber?
    Same Sugar?

    Oh, my, that is confusing.

    1. Deb

      Why is it confusing?

      It’s not so much how many calories we eat, as how many we absorb, that is important. Another factor is the energy cost of extracting and absorbing those calories.

      Cooking and even simple things like chopping, pounding, grinding etc etc will improve absorption and reduce the amount of processing that our teeth, saliva, digestive system etc need to do.

      Highly processed foods make it much easier for the body to absorb calories and at a lower energy cost to us personally

      1. Well, I guess it is the fact that they kept the fiber to me doesn’t make it as processed. I don’t know how they kept the fiber.

        Plus, it was the same fat, so unless one was oil and the other was avocado, or nuts.

        Well, if it was nuts, then the metabolism goes up, so that would make sense.

        1. Tom,

          I realize that when I think of processed foods, I think “added sodium” “added sugar” “removed fiber” “added fats and oils” and “added calories” this study had the same sodium and the same sugar and the same fat and the same calories and the same fiber.

          When I look at the breads for the 5 to 1 ratio, I don’t mentally process the information as, “The fiber may be the same but this is processed and I might gain weight.”

          I think thoughts like, “Okay this goes in the 5 to 1 fiber ratio and the sodium isn’t that bad. Then, I look at the calories and buy it.

          It isn’t a good example because I don’t have bread very often at all, but bread and the burritos I have had are in my “processed foods” and I can use the burrito.

          Calories would be 320
          Total Fat 9g. 14%
          Saturated Fat 3.5g. 18%
          Trans Fat 0g.
          Cholesterol 0mg.
          Sodium 370mg. 15%
          Total Carbohydrate 45g. 15%
          Dietary Fiber 7g. 28%
          Sugars 5g.

          So, if I saw my friend eating one, do I say, “You may gain 2 pounds because that is processed food” and I know that they will look at the wrapper and think, “370 mg sodium isn’t too bad” and they may not like all the fat, but it says 14%, but that percent category means nothing at all because it could either make you gain or lose weight depending on whether it is a processed food or not, so basically the food journals online don’t really mean that much.

          1. Mentally, I understand how to put calories, sodium, fats, sugars, fiber into my computer.

            I don’t know if I can look at my no-oil salad dressing or Ark cauliflower with cheeze sauce or a Lara bar or whatever processed food I might eat and know whether it is processed enough for me to gain weight or lose weight.

            1. If I eat a salad with a processed dressing and drink a coffee with processed plant milk mentally I wonder whether the gains weight cancels out the loses weight.

                1. Mr. Fumblefingers,

                  Good article.

                  To Deb I would say: My husband and I use a scale to determine the effect of what we eat; my husband weighs himself once a day, at the same time (when he gets up), and writes it down. I weigh myself about once a week; I used to keep a record, but my weight has now pretty much stabilized, so I know about where I like to be. When we were trying to lose weight, we would tweak our diets so that our weights would gradually decrease. Initially, we each practiced portion control and made healthier choices. Recently, we switched to eating whole plant foods (dropping dairy products and eggs, and avoiding most processed food), and our weight fell further. We use Dr. Greger’s Daily Dozen for guidance (we finally eat lots of beans, but probably not yet enough greens), and we stopped adding oil, salt, and sugar to our foods (and try to avoid them when eating out, which is not too easy). We grocery shop and cook most meals at home. In other words, we don’t sweat the details. It worked for us.

                  Btw, I’m learning (as suggested by many others) that vinegar makes a kick-ass salad dressing, with some added spices (I like ground black pepper and garlic powder); we use balsamic vinegar and brown rice vinegar. Sometimes apple cider vinegar. We also now drink our coffee black, and have come to prefer it that way. We grind our beans and brew our coffee at home, which I think makes better coffee. The AeroPress is a good little coffee maker that makes tasty coffee, is pretty quick and easy to use, and costs about $30.

                  1. Dr J,

                    Congratulations!

                    That is such an inspiring testimonial!

                    I am still not sure what will work for me.

                    I don’t understand much yet, after a full two years of being here and 3+ years of trying to fix my eating.

                    No matter what I change, I don’t gain or lose.

                    How did I go from junk food to cauliflower with cheeze, salad and no-oil hummus and not lose weight?

                    Obviously it is too much salad dressing and plant milk, but there isn’t oil in either of those.

                    I know that I lose way more than 3 hours per sleep per week and that I don’t get home until late, so my dinner is probably closer to 9 or 10 PM. I don’t eat breakfast.

                    Today, I had McDougall soup, lower sodium version, cauliflower and cheeze, green beans, no-oil hummus and some WASA crisp bread, 2 Brazil nuts, and a cup and a half or two cups plant milk. No salad dressing today.

                    Honestly, my hands have been full for days and I was so focused that I wasn’t hungry at all, but I feel bloated for some reason, as if I gained a few pounds.

                    1. “I know that I lose way more than 3 hours per sleep per week and that I don’t get home until late, so my dinner is probably closer to 9 or 10 PM. I don’t eat breakfast.”
                      – – —

                      And therein could be one of your problems. It’s best to let three hours go by after dinner before hitting the sack, as you probably know. If you don’t do so, not only will you not digest your food properly, but you’ll toss and turn the hours you ARE in bed.

                      When do you have to get up and face the day again? Or do you sleep until 9 o’clock or so? Am thinking, also, that you’re always doing research about this or that (usually health-related) that your mind is certainly active enuf, but the rest of your bod is not.

                      If you have any Libra planets (I think your sun is in Libra), you should strive for balance in your life. Give your physical body some quality-time exercise. It yearns to be active!

                      Just my penny’s worth. :-)

                2. Thanks, Tom!

                  It looks interesting.

                  I am going to try not to read it until tomorrow to see if my brain gets more silent.

                  I am getting so much work done both at work and at home.

                  I am so happy with my brain.

                  I even think my depth perception has improved by 10,000%.

                  For a few days, I have been putting a thousand very tiny pieces into 1000 very, very tiny places and nobody, including me, thought I could even possibly do it, but it has been so easy-peasy as if I had depth perception.

                  I am somebody who spent an hour trying to thread a needle as a young person because I don’t have depth perception.

                  One of the projects I have been working on is like taking something smaller than those sugar balls on cupcakes and putting it into something like the stirring straws places give for coffee.

                  I had tried it a while back and failed miserably, but I succeeded 1000 times and was able to be seriously helpful.

                  The person running the project only expected to get 350 done and I am so happy. I could really be helpful.

                  Yay to brain plasticity!

  9. Honestly, I think this diet book will be one of the most interesting diet books ever written because of studies like the prisoners and that one.

    It changes paradigms.

    It is going to change people’s lives.

    Man, I wish I could sleep at night.

  10. Just wanted to say thank you to Dr G, for this video. He is such a good communicator and demonstrates why diet matters.

    To me this is my favorite format.
    Thanks again!

    1. David,

      Yeah, I love the longer formats, too.

      Look at how many things he fit into one talk!

      I also think that when he has a lot of information to share, he doesn’t get as focused on the performance end of things and he nails it when he is more natural.

      Mostly, I have been watching “every doctor on the internet” plus all the bloggers and he found fresh and new information.

      I am so pleased.

  11. Dr. G, I love your first book and have ordered the second one. Question on this video – you say to stay away from eating Branch Chain Amino Acids. This is confusing me. I know main sources are animal-based, but aren’t BCAAs also in quinoa and some other plants? Are those still bad? I thought BCAA included essential amino acids that we can’t make ourselves. I use a major name brand vegan, pea-based powder to supplement sometimes, that claims it has BCAAs. Is that bad, if they are actually made from plants?

  12. Many people suffer from thyroid disorders but it is difficult to find any credible information in regard to what foods interfere with or support the thyroid and which ones interfere with thyroid medication and how much time one has to go without which foods before and after the thyroid medication – I see anywhere from 1 hour to 4 hours of no food on either side of the thyroid medication. Dr. Greger and nutritionfacts.org is the only credible authority on nutrition. Can you please offer those of us suffering from thyroid disease nutritional advice please on the following questions: 1) what foods promote thyroid health and which ones hurt thyroid health; 2) what is the recommendation for which foods to take or avoid near to taking thyroid medication; 3) for how long much no food be consumed before or after thyroid medication – 1 hour either side? 4 hours either side? 4) what is a “synthroid-friendly” breakfast and how soon after taking the medication can I eat it? Thank you so much!! Also, if there are any recommendations for credible sources of information on thyroid health that are up to date with the best current research, those would be useful too. Thank you!

    1. I am glad to read that you are finding Dr. Greger and this website provide credible information for you. You have received some helpful information from commenters, but may I suggest these additional credible sites that will speak to timing and breakfast as well as information specifically on taking thyroid medication. Dr Greger’s video also will help guide you on promoting thyroid health by being aware on iodine needs as well.
      https://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-6-issue-11/vol-6-issue-11-p-4/
      https://nutritionfacts.org/video/avoiding-iodine-deficiency-2/
      https://www.mayoclinic.org/diseases-conditions/hypothyroidism/expert-answers/hypothyroidism-diet/faq-20058554
      https://www.synthroid.com/starting/taking-synthroid-the-right-way

  13. Really amazing presentation. I’m surprised Dr Greger doesn’t mention De novo lipogenesis though and how it’s more difficult to gain weight on carbs than on fat; he mentions the Vermont prison study but doesn’t seem to go further.

    1. Hi, Shyrose! The main cause of kidney stones is actually animal protein. This is likely due to the acid load provided by the high content of sulfur-containing amino acids in animal protein. High sodium intake has also been associated with an increased risk of kidney stones. Recommendations to prevent kidney stones include drinking 10 to 12 cups of water per day, decreasing animal protein intake, decreasing sodium consumption, increasing fiber and magnesium consumption, and adding more vegetables and fresh fruit into the diet. Phytates, found in beans, grains, nuts, and seeds have also been shown to prevent kidney stone formation. For more information, check out this video on preventing and treating kidney stones with diet: https://nutritionfacts.org/video/flashback-friday-how-to-prevent-and-treat-kidney-stones-with-diet/ as well as the kidney stones topics page: https://nutritionfacts.org/topics/kidney-stones/.

            1. Anyone think the smartphone has improved peoples health? If so how?
              The general population is more overweight and in worse health than they were 50 years ago. I wonder why?

              1. Oh the phone and technology addiction is a horrific epidemic, probably more sociological and psychological than anything else, but certainly kids seem to be way less active than just a little while ago… and violent.

  14. Nutrient density weight loss and health maintenance is not anything new. Dr Roy L Walford first wrote about it in 1983 with his book Maximum Lifespan, followed by three more books on extensive studies. Nutrient-dense low-calorie eating has been a way of life for anyone who sought out the information seeking to improve their health, just as it is now. Perhaps the doctor who promotes it for his book in 25 years when it comes around again will be kind enough to at least mention Dr Greger.

    Also I want to announce this is my last visit to this website until it is better moderated. In my honest opinion it has become overtaken by hypochondriacs and medical conspiracy theorists who cyberbully, completely ignore the topic of videos they post under, and make these comment sections useless chatter. At the very least require a registration with confirmation before allowing people to post, and allow people to block having to view a users posts by account name so the repeat offenders can be ignored and not fill most of the comment sections.

    1. Jimbo, credible scientific evidence shows that people can very often be a royal pain in the ass. We try to soldier on with them, despite this fact. Grin ‘n bear it and all that.

    2. Jimbo, please don’t leave on my account! I will restrain my posting to 2 or 3 comments/day if they annoy you.

      Many, many complaints have been lodged in the last couple of years but nothing is done. It’s unfortunate since the comment section used to be one of the strongest assets of NF. Many valued commenters (including those with medical and science backgrounds ) have simply given up and moved on. NF dropped the ball on this one to their own detriment imo.

  15. Shyrose Keshvani,

    There is a search bar at the top of the pages on this site; if you type in “kidney stones” you will see a list of videos addressing this topic. Including this one: https://nutritionfacts.org/video/flashback-friday-how-to-prevent-and-treat-kidney-stones-with-diet/. “To summarize, here are the five types of kidney stones. And the most important things we can do diet-wise are to drink 10 to 12 cups of water a day, and reduce animal protein, reduce salt, eat more vegetables, and more vegetarian.”

    Also, my husband used to get frequent bladder stones (about every 2-3 years); since becoming a vegetarian 11 years ago (and a whole plant food eater recently, dropping the dairy products and eggs), he hasn’t had one. This is an anecdote, but pretty powerful to me (and much less painful for him!).

  16. With regards to salt intake, there are post and pre workout drink brands that claim to help with hydration, but also have high percentages of salt in them. Is salt something that should be consumed after workouts such as long runs?

  17. Hi. This link is “Hirsh E, Halberg E, Halberg F, et al. Body weight change during 1 week on a single daily 2000-calorie meal consumed as breakfast (B) or dinner (D). Chronobiologia. 1975;2(suppl 1):31-2.” is wrong in the “sources cited”. It leads me back again and again. Please fix it for us.

    Oh my gosh. You, guys are doing an amazing work. Thanks for every one of you for all of the things you are doing for us.

  18. Thanks, Dr Greger! Excellent info. Waiting for delivery of pre-ordered, soon-to-be, another Best Seller. Great work you and your team accomplish. And, it is ALL much appreciated. Happy Holidays and safe journeys to you.

  19. Mind blown by Dr. Greger showing up here. Hello Doctor! Thank you.

    Troubled by the study (as was intended I’m sure) that shows eating animals as few as once per week causes measurable problems with health and longevity. Anecdotally, cutting back to once or less per week has done me a fantastic bit of health and made me into a tireless crusader for the WFPB way of life (5 years).

    I’d like to hear more about the study/studies mentioned in this “annual report”. In the light of such evidence, I’ll consider my method of 5/2 or 6/1 -WFPB days/free anything days- to be a TRANSITIONAL period much like folks should only consider the manufactured fake meat foods to be transitional foods or less-toxic-options in some limited cases.

    Thanks again for your site, information, and publications. I did not think I needed “How Not to Diet” but see there is much more in there than I’d expected. I have no weight to lose, but I can surely help others with “tricks” and maybe get them started on the track to health by food.

    I do have one couple that listened to my rantings and took my advice and are down 30 pounds each and 56 years old and loving it just as I. Hope to convert dozens upon dozens more.

    My breakfast knocked out 10 of the 24 daily dozen!

    1. “Anecdotally, cutting back to once or less per week has done me a fantastic bit of health and made me into a tireless crusader for the WFPB way of life”

      Well that’s unsurprising, though, because even just adding vegetables to a persons SAD shows health improvements. Obviously the less of the bad stuff and the more of the good stuff, you’re going to experience improvements. But it is intensely interesting and alarming to see such studies… It just goes to show.

  20. This presentation was awesome, thank you for posting it! It was great to get so much useful information immediately PLUS I am now so intrigued by all this science I can’t wait to read “How Not To Diet” whereas honestly, the topic itself didn’t peak my interest so I wasn’t planning on purchasing or reading it. Will be so much fun getting all the new information!!

    Btw, I remember him saying things like metamucil didn’t accomplish the same weight loss benefits as whole plant food fiber and he gave a quick explanation but I can’t remember what it was, does anyone remember or remember the time frame in the presentation? I tried to find it and I don’t want to watch the whole thing again. Thanks!!

  21. @NutritionFacts video (25:20) mentions a variety of benefits of black cumin related to this videos topic, but there’s also been excellent results in regard to the Anticancer Activities of Nigella Sativa (aka, black seeds or black cumin) for Cancer Prevention & Treatment. As the abstract states (link follows), “more research works should be emphasized behind this because it is a safe & promising anti-cancer agent!”

    http://bit.ly/32xuXkn

  22. Dr G talks (45 mins in) about how his number one tip would be to eat as many calories as possible from in tact foods. How does this apply then to some of his recipes such as processing fruit in the food processor for “nice cream”? Please tell me I can carry on with my nice cream addiction!!

    1. Derek,

      It’s all about some form of balance between the unprocessed to a bit more processed foods. The nice part of using a food processor is the consistency of the food is changed however the nutrients remains intact.

      Some nice cream should be fine….the “addiction” hmmmm… makes me wonder how much are you using ? :)

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

    2. What matter may not be so much the calories than the actual appetite. Steamed potatoes may not deliver the same appetite as mash potatoes or puree. But you can also make a potato soup by adding more water to your puree and that will dilute the calories. Frozen puree can also make a good nicecream for celebrations.

  23. I started losing some excess weight I gained following a trip in Greece. I stopped eating flour and sugar 500+ days ago but added a huge cut in animal products in August. Since August and the reduction of animal products? I lost 7 lbs and according to my bod pod, I lost 6 Lbs of it in muscle. I am pretty upset. I assume the muscle loss is due to reduction in animal Meat. This is not cool since I am 50 and need muscle. I am eating a huge amount of veggies, beans lentils and tofu. I eat 3 fruits a day and 2 healthy carb servings. I can’t keep losing muscle. Any ideas. I have been running since last January and yoga for 1.5 years. No change there.

  24. Excellent post, as usual. But optimism (‘good news’) that diet can affect the development of atherosclerosis should be tempered. Please please please do a post concerning the effect and outlook of Lp(a) – a special kind of Low density lipoprotein, containing a protein called apolipoprotein(a). This is genetically conferred, is a very small particle that easily penetrates the endothelium, and creates atherosclerosis regardless of diet or current medication. We need to hear from you on this!

  25. Lab research like Lp(a) levels conferring a risk for premature atherosclerosis via the apo(a) gene is all very fascinating, but please don’t forget that these genetics, for the most part, are adaptations for survival, not premature death. I.e. we have evolved to heal. This is born out in the vast amount of compelling, long term clinical research that clearly shows that eliminating dietary cholesterol and reducing dietary fat has profound effects on serum cholesterol levels, including LDL, which results in reduced risk of disease and premature death. Yes there are some people, about 1:250 – 1:500 that have genetic familial hypercholesterolemia and require a statin to reduce their cholesterol, but most people don’t. Furthermore, Dr. Ornish has shown, in well founded published research, that consuming a WFPB diet has profound epigenetic effects (i.e.the expression of many (if not most) genes in a beneficial way.)

  26. I have a guilty admission to make … I downloaded your cookbook for free Dr. Greger. There’s a lot of poor quality resources out there so I wanted to ensure this book was worth my time investment. I was so impressed (and guilty) that we completely revamped our meal repertoire and made a donation to your non-profit of 3.5x the price of the book.

    Thank you for what you do! Thank you for being you!

    I cannot wait for this latest book.

  27. The real health problem nowadays is not weight loss, it is that the ideal body image for women is to be very skinny and the ideal body image for men is to be very muscular.

    That leads to anorexy and muscular hypertrophy, two major health issues human beings are actually facing, and that a lot of people even seek consciously as a result of distorted body images ideals.

    Think about that: anorexy and muscular hypertrophy, two medical conditions, are today considered as body images ideals in the society. Just google image or youtube the words “fashion” and “bodybuilding”, and you will see.

    Obesity is just the consequence of those deviant body images for men and women, promoted by the fashion industry and the fitness/bodybuilding industry.

    When you set up wrong body image standards for a whole society, it creates in reaction food disorders leading to obesity in people who consciously or unconsciously recognize those ideals as unsafe goals and unsafe body images for them.

    Obese people are sane people in a word of mannequins and bodybuilders in which the food supply has been compromised by false body images standards.

    They are just sane people whom one gave the wrong foods: the foods of mannequins and bodybuilders, leading to the vicious circle of obesity, and the yoyo between the mannequin diet and the bodybuilder diet, none of which are adequate to them.

  28. Thank you Dr. Greger for all the time and energy you put into researching nutrition and communicating your findings to the public. You are truly making a difference in so many lives.

  29. I would like to do a plant based diet for a year as an experiment. I would like to get a blood test and a physical exam to determine my health before I start and also after I’m done in a year. I am generally healthy 40 years old man that exercises regularly and eat healthy omnivorous foods. I want to see how plant based diet will effect my health and would it be significant enough to change my diet permanently. I do have to mention that I’m currently on a Low FODMAP diet. I need a recommendation on what to test for when I order a blood panel.

  30. Thanks to Dr. Gregor, his team, and all the sincere and knowledgable contributors to this forum. My question stems from the fact that I exercise a lot (at least sometimes). I run, bike, swim, play tennis and paddle tennis, ski and do triathlons “for fun” (I don’t win or try to). I realize that’s not a reason not to eat healthily (just the opposite) and I commend Dr. Gregor for giving exercise a place in his books. I also acknowledge that more is not necessarily better when it comes to exercise and that exercise is not the focus of NutritionFacts.org. I simply would love to see a nod in more videos and blogs about the impact that vigorous exercise — or just an active lifestyle — could have on the topic. For example, intermittent fasting or time-restricted eating. Studies that show benefit or harm based on overweight or even “normal” subjects don’t necessarily translate the same to especially fit/active people, or do they?

  31. Hello Peter, and thank you for your comments/questions,

    I am a family doctor and also a volunteer for Dr. Greger on this website. You are correct that exercise has myriad benefits, which have been well documented in peer-reviewed medical literature. These include: improved sleep, improved immune function, lower blood pressure, improvements in anxiety and depression — mainly due to increased release of endorphins during exercise, faster bowel transit time — leading to decreased constipation and lower rates of bowel cancer, help in losing weight, decreased risk of dementia (especially for running, in particular), improvements in arthritis (unless you are overdoing the running).

    But I think the reason why Dr. Greger focuses more on diet than on exercise is that dietary change is even more powerful than exercise in terms of preventing death and disability. In Greger’s words: “Actually, physical inactivity ranks down at number five in terms of risk factors for death in the United States, and number six in terms of risk factors for disability. And, inactivity barely makes the top ten, globally. As we’ve learned, diet is by far our greatest killer, followed by smoking.” [This is from: https://nutritionfacts.org/video/how-much-should-you-exercise/%5D

    In terms of weight loss, diet also gives you more bang for the buck: https://nutritionfacts.org/video/diet-or-exercise-whats-more-important-for-weight-loss/

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

  32. I own and love the book “How Not to Diet”. Also, I was at the conference in November. One question, why promote Quorn products as they contain egg whites? All Quorn foods contain mycoprotein as an ingredient, which is derived from the Fusarium venenatum fungus and is grown by fermentation. In most Quorn products, the fungus culture is dried and mixed with egg albumen, which acts as a binder, and then is adjusted in texture and pressed into various forms.

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