Fermented or Unfermented Soy Foods for Prostate Cancer Prevention?

Fermented or Unfermented Soy Foods for Prostate Cancer Prevention?
4.61 (92.27%) 88 votes

Which appear more protective: fermented soy foods, such as miso and tempeh, or unfermented soy, like tofu and soy milk?


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

There is an enormous variation in the rates of prostate cancer around the globe, with among the highest rates in the U.S., and lowest rates in Asia, though that may be changing. The largest increase in prostate cancer rates in the world in recent decades has been in South Korea, for example: a 13-fold increase in prostate cancer deaths nationwide. They suggested the increase in animal foods may have played a role, since that was the biggest change in their diet over that period—nearly an 850% increase.

This is consistent with what we know in general about foods and the prevention and management of prostate cancer. Tomatoes, broccoli-family vegetables, and soy foods decrease risk. No clear benefit from fish, and an increased risk from meat and dairy. This may be because “[a]…diet, based [around] whole plant foods…effectively reduce[s] inflammation in the body.”

There is a genetic factor. If you have a first-degree relative with prostate cancer, you may be at three-fold higher risk. But non-genetic factors may increase your risk 300-fold. How do we know the low rates in Asia aren’t genetic? Because when they move to the United States, their rates shoot up. And, by the second generation, they’re almost caught up. This may be because of more Burger Kings and Dairy Queens, but could also be because of eating fewer protective foods, such as soy.

A systematic review of all soy and prostate cancer population studies to date confirmed soy foods “could lower the risk.” But, that’s kind of a broad category. There’s all sorts of soy foods. There’s fermented soy foods, like miso and tempeh, and unfermented foods, like tofu and soy milk. Which is more protective? Researchers sifted through the studies. And, it turns out that only the unfermented soy seemed to help. Tofu and soy milk consumption were associated with about a 30% reduction in risk, whereas there didn’t appear to be any protection linked to fermented soy foods.

Please consider volunteering to help out on the site.

Image credit: Jo via Flickr. Image has been modified.

Motion graphics by Tyler McReynolds, Teetotalin LLC

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

There is an enormous variation in the rates of prostate cancer around the globe, with among the highest rates in the U.S., and lowest rates in Asia, though that may be changing. The largest increase in prostate cancer rates in the world in recent decades has been in South Korea, for example: a 13-fold increase in prostate cancer deaths nationwide. They suggested the increase in animal foods may have played a role, since that was the biggest change in their diet over that period—nearly an 850% increase.

This is consistent with what we know in general about foods and the prevention and management of prostate cancer. Tomatoes, broccoli-family vegetables, and soy foods decrease risk. No clear benefit from fish, and an increased risk from meat and dairy. This may be because “[a]…diet, based [around] whole plant foods…effectively reduce[s] inflammation in the body.”

There is a genetic factor. If you have a first-degree relative with prostate cancer, you may be at three-fold higher risk. But non-genetic factors may increase your risk 300-fold. How do we know the low rates in Asia aren’t genetic? Because when they move to the United States, their rates shoot up. And, by the second generation, they’re almost caught up. This may be because of more Burger Kings and Dairy Queens, but could also be because of eating fewer protective foods, such as soy.

A systematic review of all soy and prostate cancer population studies to date confirmed soy foods “could lower the risk.” But, that’s kind of a broad category. There’s all sorts of soy foods. There’s fermented soy foods, like miso and tempeh, and unfermented foods, like tofu and soy milk. Which is more protective? Researchers sifted through the studies. And, it turns out that only the unfermented soy seemed to help. Tofu and soy milk consumption were associated with about a 30% reduction in risk, whereas there didn’t appear to be any protection linked to fermented soy foods.

Please consider volunteering to help out on the site.

Image credit: Jo via Flickr. Image has been modified.

Motion graphics by Tyler McReynolds, Teetotalin LLC

Doctor's Note

What about other healthy plant foods, like broccoli and turmeric? See what they can do in Best Supplements for Prostate Cancer.

Dean Ornish and his colleagues got amazing results, apparently reversing the progression of prostate cancer with a plant-based diet and lifestyle program. Do you think it could be because of the soy? It wasn’t just a vegan diet, but a vegan diet supplemented with a daily serving of tofu and a soy protein isolate powder. Find out in The Role of Soy Foods in Prostate Cancer Prevention and Treatment.

More on the number-one cancer among men:

What about soy and breast cancer? I’m glad you asked!

Who Shouldn’t Eat Soy? Watch the video to find out!

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

109 responses to “Fermented or Unfermented Soy Foods for Prostate Cancer Prevention?

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  1. Fermented soy is typically better for you. The fermenting process breaks down the harmful estrogen mimicking effects and the cultures are good for gut health.

    1. Fermented foods are all more or less unhealthy, way too much salt, some strong acid like acetic acid, sometimes alcohol, carcinogenic micotoxins and nitrates etc…Japan and China have the highest rate of stomach cancers mainly because of their high consumptions of fermented “foods”.






      1. Fermentation makes plant matter easier to digest, in addition to supplying beneficial bacteria to the bowel. It also produces B vitamins which the plants themselves lack. It is a method of food preservation as old as mankind itself.

        Interestingly, the bacteria which ferment the plant matter live on all of its surfaces; it is “self-innoculating.” Salt is used to suppress harmful bacteria while allowing lactobacillis to thrive.

      2. I would disagree with your statement. These cultures tend to use woks and hot oil for cooking which coats food with oil and the
        stomach has an impossible time digesting through that oil. I believe THAT is where the high incidence of stomach cancers come from,
        NOT from fermented foods. Fried foods, and foods cooked in hot oil, are unhealthy. Bake foods or cook them in water, not oil.
        namaste’, rachel

        1. High salt consumption found in fermented asian foods is certainly linked to a tons of stomach cancer, nitrates/nitrites and very acid acetic acid found in these fermented foods doesnt help it obviously…

        2. I lived in South Korea for 2 years and learned how to cook Korean food. They typically have a distaste for oil found in Chinese dishes. Most foods are braised rather than stir fried. Sure there is plenty of junk, but traditional cooking is healthier. The fermented food is very salty but I think that the increase in meat is really the problem with their increased cancer rather than oil.

    2. The research presented in this video literally shows the opposite of your claim. Where is the evidence that “The fermenting process breaks down the harmful estrogen mimicking effects and the cultures are good for gut health”? The idea that only fermented soy foods are good for you (and unfermented soy is bad) is a fake fact that’s been circulating on the internet for years. There’s no scientific basis for it.

      1. “. . . how a target cell responds depends on which type of estrogen receptors they have. This may be “the key to understanding the health-protective potential of soy phytoestrogens”—the existence of this newly discovered estrogen receptor, named estrogen receptor beta, to distinguish it from the classic estrogen receptor alpha. And, unlike our body’s own estrogen, soy phytoestrogens preferentially bind to the beta receptors.”

        Read more from the finest source of nutrition information available:


      2. Yes, actually, there is quite a bit of a scientific basis for it. I don’t know about the phytoestrogens, but the subject is pretty well-studied with regards to the other harmful compounds in soy and other legumes, and if you were actually interested credible information isn’t too difficult to find with a little bit of googling. Did you know that a grown person can be sent to the hospital for food poisoning and risk death simply by eating only a few raw kidney beans? The poisons in raw kidney beans (agglutinins) are exactly the same class of compounds in other legumes and seed-based foods such as soy, but much more concentrated and potent than those in, say black beans or chick peas. Wheat germ agglutinin (WGA) has a very similar behavior. Soy has some of the highest levels of toxic lectins and saponins, and many of them are heat resistant (though not as much as those in peanuts!). By combining both heavy cooking and soaking/sprouting/fermentation, you drastically reduce the digestive enzyme inhibitors, free minerals from their phytates, render inert many poisonous compounds, and increased levels of other nutrients from the microbial activity (such as B-vitamins). The protein is still of poor quality compared to animal proteins (amino acid profile and bioavailability, both), but it’s less toxic and more digestible and bioavailable and thus much less immunogenic in fermented form.

        That said, there is a lot to understand about dosage-dependent physiological interactions, especially when considering what we colloquially call the “entourage effect” of consuming different combinations of foods together. For example, consuming red meat with chlorophyll (your leafy greens!) completely eliminates the negative health risks of heme iron. Likewise, red meat consumed without grains also eliminates risks of choline/carnitine metabolism into toxic intermediaries, because regular consumption of grains alters the gut microflora in favor of the specific organisms that cause the metabolic issue.

        There is a world of difference between the nutritional value and digestibility of raw or lightly-cooked soy and soaked, cooked and fermented soy (such as natto and tempeh). Yes, there is also misinformation out there, such as the “phytates leaching minerals from your body” which is just ignorant fear mongering. Someone has to eat immense and chronic quantities of phytate-heavy foods to have a negative effect, and even then most of that negative effect is from the phytates producing molecular complexes that resist or inhibit digestion and mineral absorption in the gut. So “what’s on the label” is not a good indicator of what your body can actually use both in terms of protein and mineral content, especially with concern to all seed-based foods (yes, all of them; Nancy J. Turner gives a fantastic overview of the evolutionary pathophysiology of seed defense/nutrient storage mechanisms in the introduction to “Common Poisonous Plants and Mushrooms of North America.”)

        And, no food is “good” or “bad” for you in an absolutist sense. I get tired of hearing people ask whether something is “good” or “bad” for them. When? Where? How much? In combination with what other food(s)? Under what circumstances? One person’s health food is another person’s allergen, intolerance, or sensitivity. I strongly believe that everyone would benefit from doing an elimination diet to discover any extant/persistent food allergies, intolerances or sensitivities that might be contributing to metabolic and immunologic disorder, which we have at epidemic levels. I don’t care what you eat, just eat whatever makes you feel your best in the 2-3 days following the meal (the timeframe during which reactions can occur; keep a journal! Who remembers what they ate 3 days ago?)

    3. Not true for soy. Please see Julot’s reply below with a video link. Or read Dr Greger’s book, How Not To Die. Library, bookshop, online.

    4. Traditional fermented vegetables are made in a crock where eventually you have to skim off the scum or mold. This fermentation method creates ROTTEN food which smells/stinks; this is not healthy “fermentation”. If you want to try a better method for fermenting (not “rotting”) take a look at the http://www.pickl-it.com website. I have been using her jars/method for my ferments and they do not “rot” or smell or have scum when prepared properly. I am not affiliated with her products, I just use them.

      Pickl-It — The Original Anaerobic Fermenting Jar http://www.pickl-it.com Fill Pickl-It with fresh, clean, vegetables – sliced, whole or shredded… Add salt-water brine to the vegetables; then top with the Pickl-It Dunk’R, to hold food …

      also here is her introduction. I agree, celtic sea salt is used for fermenting and it is high in sodium. Her methods have been scientifically tested and researched, she is not simply selling a jar and method. namaste’, rachel http://www.pickl-it.com/about/our_story/

      About | Pickl-It http://www.pickl-it.com About Us. If it hadn’t been for my son, there wouldn’t have been a Pickl-It… The Greek word, diagignōskein, from which “diagnosis” is derived, means “to …

    5. The phytoestrogens are part of the beneficial effect.

      They cause negative feedback on endogenous estrogen. That is they look like estrogen, so your body produces less estrogen.

      Also they have different effects than estrogen. Our own estrogen increases risk of uterine and breast cancer in excess. Phytoestrogens do not.

    6. There are no “harmful estrogen mimicking effects” from soy. This myth refuses to die, but the fact is there are billions of Asians that eat unfermented soy on a daily basis and have no hormonal issues. This article reviews all the research done on soy and concludes that unless you’re literally consuming gallons of soy milk a day, soy will not cause hormonal problems: http://veganhealth.org/articles/soy_wth#fem

  2. I want to become a health coach – teach people in online sessions about the whole foods plant based lifestyle.
    So far, I have no accreditation. I have read most plant based books, watched almost all nutritionfacts.org videos and also participated in the nutritionfacts.org research webinar with dr. Greger.
    I am looking to getting certified to be able to practice but I cannot afford the time or the money to become a RD or MD.
    Do you have any suggestions for me? (anyone :) I have so far looked into:


    thank you

    1. There are all kinds of people with varying levels of education and training dispensing nutrition advice from personal trainers to physicians, and given the amount of training one receives in medical school, some personal trainers may very well be more qualified to discuss the topic than many MD’s.

      Option 1: My tongue in cheek answer is go get some business cards printed up proclaiming that you are Health and Lifestyle Coach, setup a YouTube channel and have at it. You won’t have any credentials, but then again as far as I know, there aren’t any requirements for becoming a health coach. There are people who operate in this manner. It’s gray and edgy, but as long as you don’t cross certain lines, or do anybody any harm, you’ll probably be okay.

      Option 2: If you’re going to dispense nutritional advice, some sort of certification would be advisable from both a legal and professional perspective, and you may not be as far away from certification as you may think. It will help protect you from liability, and it will help differentiate yourself. It sounds as if you have a passion for the subject. You owe it to yourself to do a little investigation before embarking on Option 1, although, printing business cards and setting up a YouTube channel will work swimmingly with Option 2.

      Nutritionist Certification: What It Takes to Be Certified http://www.naturalhealers.com/nutritionist/certification/

      1. Licensure or Certification does not offer liability protection. I strongly urge all practitioners to obtain & maintain malpractice insurance or at least incorporate. I agree it’s the “wild west” out there.

      2. Hee hee, option 1 sounds like my budget version of spreading the love. Been at this so long I doubt dumping a thousand plus into any certification will be worth the investment, except to have an expensive piece of paper! Not averse to learning for sure tho, just $$$. Thanks for your comments!

      3. Yes I was considering doing youtube. As far as coaching goes I want to practice online via skype – since I live in Romania – I don’t know if that changes anything. I will continue researching,
        Thank you!!

        1. This course will give you a certificate. It is not a high level course, but certainly good for learning about plant based nutrition. If you want to coach people is it good to do a health or wellness coaching course to learn how to motivate people, help them set goals and stay on track. You will need to find out the requirements in your own country – laws as to who can practice, and insurance will vary.

  3. From an Internet forum, I’ve met a couple of fellow prostate cancer patients that seem to be very well educated and knowledgeable about the research on it. They say that there is enough evidence that all soy is potentially harmful to lead them to avoid it in any form. They both have advanced disease, but I’m not sure whether their assessment would apply only to advanced patients. Is there truly any good evidence that soy should be avoided after a prostate cancer diagnosis? From this video and other sources, Dr. Gregor would appear to believe there is not and I definitely tend to trust him.

  4. This is a bit surprising considering that tempeh is myelinated whole soybeans so one would think that it has more potential nutrients than the more refined tofu, but then again perhaps the refining and/or fermentation process concentrates or removes some factor in soybeans that is beneficial for combating prostate cancer.

    I don’t believe that anything has changed regarding tempeh. It is still a good food to eat.
    Tofu vs. Tempeh: https://nutritionfacts.org/video/tofu-vs-tempeh-2/

    1. Agreed, just because it doesn’t seem to have obvious effects on prostate health doesn’t mean it isn’t healthy in general, especially when it eliminates eating dead animals!

    2. Joe Caner – are you sure you know what you’re talking about? To quote you: “tempeh is myelinated whole soybeans”. Myelin is a fatty white substance that surrounds the axon of some nerve cells, forming an electrically insulating layer. It is essential for the proper functioning of the nervous system. It is an outgrowth of a type of glial cell. The production of the myelin sheath is called myelination or myelinogenesis.

      Tempeh is not mylenated.

      Your comment is why I listen to Dr. Greger – the man in the know. And take everything else, including comments on this site, with a large grain of salt.

  5. Is Natto healthier than other fermented soy? And how does Natto specifically compare to non-fermented soy? I know it has vitamin k2… Any other thoughts?

    1. Natto is good for ME. I eat natto made with black beans. It seems to truly nourish me. I eat it with a bowl of rice and season it with mustard and tamari and green onions and… whatever I have around. It’s somewhat like a strong cheese, brie and it needs savory flavorings. Maybe it’s one of those things that grows on you… in a good way.

      I have recently been reviewing the blood type diet book because my roommates are unhealthy in various ways… and I would encourage anyone to take a peek at it because not everyone can eat the same foods and get the same results. I am a natural vegetarian, a Type A, but I can see how others might need – if not ‘meat’, then at least a vegetable substitute, which I believe dark green leafy vegetables and green juices provide. Chlorophyll contains all the nutrients that meat-eaters might be looking for in blood… but in a safer form. I don’t believe any eating system will long survive without lots and lots of greens and green juices.

    2. Natto has K2, spermidine and nattokinase. I mostly eat it for the spermidine, which is an autophagy inducer (autophagy is the mechanism by which your body clears out dysfunctional mitochondria and cells). However, there’s a Nutritionfacts video that links spermidine consumption to cellulite*; I do not have a lot of cellulite and Japanese women aren’t known for having a lot of cellulite, but perhaps spermidine contributes to it.

      Also, I know nattokinase is touted by some for its health benefits, but I don’t know much about it.

      K2 is supposed to be good stuff, but Dr. Greger has stated that if you have healthy gut flora you will probably be making it in your colon.


  6. Holistikale. Here’s a thought for you as you seem enthusiastic about WFPB. Dr McDougall and Dr. Campbell offer on-line self paced courses. They don’t take long to complete and can be used to let people know you are knowledgeable. Then,– go to very large apartment buildings and condominiums and sign up for an hour of lounge use ,(usually free) . , then post signs several weeks in advance in those buildings with ‘free’ information (let’s talk and discuss) about your favorite topic of nutrition and that this is not sales but sharing of information that can help your health. Let’s talk and share thoughts and ideas. (Eventually you might be able to turn it into health coaching, I don’t know) but this happens in my building frequently– I’ve taken advantage of chess, bridge, book clubs, cooking ideas, weight loss etc). I do think you need some kind of documented classes to help you. Yes, we are all passionate and want to convince others. Congratulate yourself for wanting to help others. Be well friend!

  7. This is disappointing, since a previous video said tempeh was more nutritious than tofu. It went: tofu -> edamame -> tempeh.

    So I’ve been eating tempeh, and have a good product with 3 ingredients: organic soybeans, water, culture.

    Plus I’ve never liked eating tofu because they all have inorganic chemical compounds in them. It just seems wrong on a common sense level to be consuming powders derived from rocks. But perhaps I’m ignorant on the science of some of those compounds being good for you.

    What about just eating edamame? It’s got the middle ground for nutrition, and it’s unfermented state provides protection against prostate cancer, right?

      1. Even for prostate cancer, it makes no sense that non fermented soy work when fermented soy does not. It is just a cherry picked selection of studies.

        1. Well, Jerry, little evidence of a different effect between fermented and non-fermented could simply mean that very few studies are done on other forms of soy… like tempeh, miso and natto. Natto increases circulation so I can’t imagine it would be bad for any organ, including the prostate.

          From https://www.ncbi.nlm.nih.gov/pubmed/15016323: “Consumption of fish, all soybean products, tofu (bean curds), and natto (fermented soybeans) was associated with decreased risk… Our results provide support to the hypothesis that the traditional Japanese diet, which is rich in soybean products and fish, might be protective against prostate cancer.”

          Now, of course, the results might be skewed due to the genetics of the participants. I looked it up and was not surprised to find that in Japan the blood type is predominantly A, which does very well with soy. On the other hand, type O will do OK with soy but not as well as A, while type B should avoid soy altogether. I am really thinking this blood type thing is an important factor in diet and health. I’m glad I kept the book.

          1. Japanese and Koreans and Asians in general live longer than Westerners. The problem is that when we copy them, we don’t do exactly the same. Such as they eat soy but fermented soy, they eat meat but joint and skin and organ while we eat lean muscle meat which is cancerous. European eat raw milk while we consume heavy processed and pasteurized milk, and so on…

  8. Sacramento County Health Dept. Has found very high levels of lead in tested tumeric. Contact their lead specialist, Debi.

      1. Thanks for your comment Jerry.

        Like I have previously stated, at NF we present the whole body of information, whether it’s in plant or animal foods. In the link attached here, you can find many of our NF videos speaking about lead contamination in various sources.

        Hope this answer helps.

  9. It does not mean all fermented soy is not healthful just because it does not seem to affect cancer progression.

    The fermented soy product, natto, for instance, offers huge benefits due to the super-high vitamin K2 content. There is a company that just does research and makes products from natto (Nattopharma), who is testing in a 2 year human study to see if they can reverse coronary calcium and thus heart disease. It is due out in 2017 end of year.

    The natto is not just any fermented product, certain bacteria must be used to make the stuff. Much has been written on it, suggest finding out more. It is hard to take in the diet for most people except certain Japanese who were raised on it. That is probably the reason Nattopharma is making extracts and testing them instead of the whole food natto. It goes back centuries in Japan, and was discovered by an army by accident. It’s benefits were so striking that it became part of their standard rations from there on. Only half of Japan eats it, and loves it, the other half thinks they are insane. Sound familiar? ;)

    1. This is the job of cuisine. I make nori natto burritos with amla to counteract the sliminess of natto. I add walnuts and craisins, and tons of green leafies, soy sauce and mustard. I love it. I add yogurt, but vegans could add soygurt. Traditional cuisine takes what you need to eat and makes it palatable. Now modern cuisine takes what is extremely profitable and tricks you into eating it. Not ok.

  10. First of all, it’s bashing and trashing of meat and dairy consumption again in the
    disguise of talking about soy. But do you think that it has more to do with eating
    processed foods and sugar and transfat that cause the increase in prostate cancer
    among other diseases? Eating clean and unprocessed animal foods causes no harm
    if not beneficial. Secondly, Greger quoted perhaps one study that shows non fermented
    soy is more beneficial but it is probably cherry picked again. In Asia, they used to
    eat a lot of fermented soy such as miso, and even tofu was done traditionally via
    fermentation. Nowadays they use chemical to speed up the process of making tofu.
    Anyway, by saying that non fermented foods can be better than fermented foods is nonsense
    and unscientific.

    1. Jerry Lewis – Would you please share with this community your professional scientific credentials? As I’m sure you know, this is a science-based website. Many of us who follow this site are scientists and enjoy the scientific basis and perspective of its mission. As you may know, scientific exploration and conclusion follows the greater preponderance of the evidence using well-designed studies (which are studies that follow certain best practice protocols).
      What many of us enjoy about this site is that the scientific method, by its nature of design, eliminates and continues to seek to eliminate undocumentable opinion and remove opinion from the discussion. So sharing your professional credentials as well as your documentation of your statements would add to the level of discussion that this site enjoys.

      1. I have the feeling Jerry is simply a troll. I am sure he is the one that gives people thumbs down rather than starting an interesting conversation. As much as I try and ignore trolls I get sucked in every so often.

    2. Thanks for comment Jerry.

      It is important to clarify a few things.

      1) NF is simply presenting the evidence, which is important for good practice. Whether the evidence goes or favours a certain product is not what NF is looking for, the mission of this website is to provide the best balance of the evidence available, which means, we cannot ignore research that has been published.

      2) I agree that most of processed food, sugar and trans fat do not seem to beneficial for human health. However, I highly recommend you to watch the following videos regarding trans fat:

      Trans Fat In Meat & Dairy

      Banning Trans Fat in Processed Foods but Not Animal Fat

      The recent AHA Presidential Advisory, in line with previous publications has indeed concluded that trans fat from ruminant sources are likely to be as harmful as industrial sources of trans fat. Therefore, it is sensible to not eat meat & dairy because of trans fat.

      Hope this answer helps.

    3. Tofu is traditionally made with coagulants; it is not fermented. One coagulant, nigari, is made from seawater. Nigari increases the calcium and magnesium content of tofu and, in my opinion, improves its nutritional value.

  11. Beware of the statistical outlier. I read over and over in the comment section where some 92 year old person smoked, ate meat, eggs, cheese, used olive oil on everything, and even drank milk and even whiskey……and they lived to a happy old ripe age of 92 or 102 or something like that. That my friend is a statistical outlier. It is an anomaly. It is an extreme exception to the rule. When it comes to deciding the best nutritional route to take in order to enhance one’s health and life in general, you CANNOT use the occasional outlier as your guide. You have to use the law of high frequency occurrence. In other words, statistically which group lives the longest and what is their diet? That is your safest model to follow in order to achieve health, not some infrequent outlier that pops up every once in awhile in the newspaper or on the news. So, I look to the Seventh Day Adventist because statistically they have the best record for longevity. Most of them are vegetarians, and many of them are at the next level of excellence by eating a whole plant food diet. Now that is food for thought.

    1. The Okinawan diet is a myth made up by the west. In reality, Okinawan eat a diet of both fat bacon and lard, seafood and vegetables and legumes. They do eat a lot of meat. Go over to Japan and check it yourself. A lot of cultures eat dairy and meat and have long life too. Processed foods are what kill people and not unprocessed animal foods.

      1. Jerry Lewis – I am so sorry that you are putting your lack of knowledge on display. Let me explain to you that this site is a scientific-based website – Dr. Greger’s mission is to go where the science leads us, in the healthy tradition of other very esteems scientists as well as the breadth and depth of our large base of scientific knowledge (which continue to elucidate our world to us in many disciplines).

        In the scientific community of diet and nutrition, when one refers to the “Okinawan Diet” or the “Mediterranean Diet”, the reference is to the diet as it existed originally within that community and culture. The reference is NOT to what the Okinawans or the Mediterraneans eat today as the understanding of the scientific community is that the diets, as they originally existed, are now changed and “polluted” from their original forms by the importation to those communities by the Standard American Diet and eating practices. So although Okinawans and Mediterraneans eat lard, bacon, etc today, the educated scientific community understands that originally these communities did not consume these products. When the Okinawan and Mediterranean diets were studied the structure was documented decades ago. Here is a link to the original “Okinawan Diet” which you so thoroughly slander:

        As you can see, 67% of their diet was actually sweet potato.

        Here is information on the ORIGINAL Mediterranean Diet also known as the Creten diet, of the 1950’s:
        o “Tom Goff Rebecca Cody • 5 days ago
        To be fair, the Cretan diet then did include a pretty high level of calories from olive oil. Unfortunately, the actual Seven Countries data are behind a paywall. However, as reported by Nestle, the slightly earlier Rockefeller Foundation study estimated the proportion of total calories coming from fat in the Cretan diet in the 1950s as about 38% with 29% coming from table oils and fats (mainly olive oil).
        So, olive oil consumption in Crete was in fact actually quite high. However, ascribing the benefits of the Cretan diet to olive oil (or wine, bread and pasta) is a step too far. It was for example a near vegetarian diet and was almost completely devoid of supermarket style processed foods. It included the same low proportion of animal foods (about 7% of total calories) as the diet in mainland Greece at that time but more than twice as much fruit and vegetables, about 38% more pulses, nuts and potatoes, and only two thirds the amount of cereals. And, as you say, exercise may be a factor also.
        Olive oil is not a factor in the Okinawan Diet for example nor does it appear to be an important factor in the diet of 7th Day Adventists. Both are famed for delivering long life and good health. So, it is unlikely that olive oil is an essential or key dietary factor.”

        We all look forward to hear from Mr. Lewis as to his professional credentials and scientific perspective I am sure. Thank you.

      1. I just “Googled” this. It’s a pie chart of an Okinawan diet. If you look carefully at the very bottom you will see that it is the diet ascribed to the population of Okinawan’s that live to the ripe old age that we all want to see—–not the general population. Pig meat is 1% of their diet and sweet potato is 70%. So the truth, as usual, is a little elusive. Not sure if Mr. Lewis is purposefully trying to muddy the waters or is just not a very accurate deliverer of his message. It’s obviously misleading to to cite a “whole” population of anything when you’re really interested in a “segment” of whatever it is. Who really cares what anybody eats except those folks that live a long and healthy life!!. Gotta go pick some of my sweet potatoes now. Bye.


  12. Just wondering how soy can be healthy for you when it’s proven to be detrimental. Especially to men, raising estrogen levels!
    This is the only site/book or other non-government sponsored forum where soy is praised! I do understand it’s help in extremely high regard in the vegetarian community, but can we please be truthful about its harm to our bodies. I’ve developed a severe allergy to soy, and it’s truly amazing how pervasive it is as an preservative today

    1. Thanks for your comment Anthony.

      I do not know what the website you have attached and I do not find it a reliable source. However, I will present scientific evidence to clarify a few points.

      A 2010 meta-analysis concluded:

      “The results of this meta-analysis suggest that neither soy foods nor isoflavone supplements alter measures of bioavailable T concentrations in men.”

      Another 2010 review concluded:

      “The intervention data indicate that isoflavones do not exert feminizing effects on men at intake levels equal to and even considerably higher than are typical for Asian males.”

      A 2016 review on soy has also concluded:

      “Two case reports describing feminizing effects that allegedly occurred as a result of soyfood consumption have been published [389,390]. However, in both cases the individuals were said to have consumed 360 mg/day isoflavones (~9-fold greater than the mean intake among older Japanese men) in the context of unbalanced and likely nutrient-deficient diets since soyfoods accounted for the vast majority of calories consumed. Furthermore, in contrast to the rise in circulating estrogen levels noted in one case [389], no effects on estrogen levels have been noted in numerous clinical studies in which men were exposed to as much as 150 mg/day isoflavones [391].
      Similarly, the drop in testosterone levels noted in the other case [390] is as already noted, inconsistent with the preponderance of the clinical data showing neither soy nor isoflavone supplements affect testosterone levels [283]. More specifically, a systematic review and meta-analysis that included 15 placebo-controlled treatment groups with baseline and ending measures and an additional 32 reports involving 36 treatment groups found no effects of soy protein or isoflavone intake on testosterone, sex hormone binding globulin, free testosterone or the free androgen index [283]. Studies published subsequent to this meta-analysis have reached similar conclusions [168,392–394]. The two aforementioned case reports simply illustrate that consuming excessive amounts of essentially any food can potentially lead to abnormalities [389,390].”

      If you do want to find the greatest sources of estrogen in our diet, please find the link below:

      Estrogen in Meat, Dairy, & Eggs

      Hope this answer helps.

  13. This is a bit off-topic but isn’t it worrying that vegans and vegetarians apparently have higher levels of plasma AGE (Advanced Glycation Endproducts)? We’ve already plugged the B12 and D3 issues (those exist to an extent in meat eaters too). This may be one of the few areas we still need to fix in order to obtain maximum benefit.

    “Enhanced plasma AGE levels in vegetarians in comparison to omnivores are herein presented for the first time.”

    Given that meat eaters tend to have lower levels despite far higher intake of AGE, perhaps endogenous AGE production is reduced. Certain elements in meat like Taurine, Carnitine (the TMAO heart disease connection seems less clear now) and Carnosine may also counteract their effect. These aren’t the most vegan/vegetarian friendly options though and there may be potent plants to reduce this effect.

    “Dearlove and colleagues [19] demonstrated that polyphenols found in culinary herbs like sage, marjoram, tarragon, and rosemary are potent inhibitors of fructose-mediated protein glycation. Spice extracts, such as cloves, ground Jamaican allspice, and cinnamon, were also found to be glycation inhibitors, even stronger than herb extracts [19]. Since foods mainly composed of carbohydrates (e.g., starches, fruits, vegetables, and milk) contain the lowest AGE concentrations, another strategy to reduce dAGE intake consists in implementing the use of these healthy foods instead to eat full-fat cheeses, meats, and highly processed foods.”
    ^^^I wish they clarified if Ceylon cinnamon is also effective (the regular cinnamon can quickly become toxic).

    It’s also unclear to me whether this applies to vegans eating a low-fat plant heavy diet (such as an 80% carb, 10% protein, 10% fat composition). There are many ways to be vegan. In fact, there are some vegans getting over half their calories from fat because they love avocados, hummus, nuts etc. Considering that AGE are mainly from the combination of protein and oxidized lipids, a low-fat vegan diet may be protective. This also means you shouldn’t let avocado sit exposed to the air for long (or perhaps put some lemon juice on them). Anyone up for some blood tests to compare with the studies? :D

    “AGEs” in the diet are generated primarily, not by glycation reactions, but by interactions between oxidized lipids and protein; such reactions are known to give rise to certain prominent AGEs, such as epsilonN-carboxymethyl-lysine and methylglyoxal. Although roasted nuts and fried or broiled tofu are relatively high in AGEs, low-fat plant-derived foods, including boiled or baked beans, typically are low in AGEs.”

    1. hi Alex, I am in a rush this morning but your post caught my eye. If you google the words ” advanced glycation end products and a guide to their reduction in the diet” you will find a link to a paper on the topic (pdf file) that contains a listing of the age values for many foods in many categories. As a person that eats wfpb, with no oil, nuts , (except 1 walnut 3 x week, and 1 tbsp flax) and no packaged food, I was reassured to see that my AGE levels would be very low on a daily basis. Even my beloved coffee barely registers on the scale. Cooking methods DO count. Big difference between eating tofu cubes in a soup, and eating grilled tofus kabobs.
      http://r.duckduckgo.com/l/?kh=-1&uddg=http%3A%2F%2Fwww.marshfieldceliac.weebly.com%2Fuploads%2F2%2F5%2F5%2F7%2F2557865%2Fada_ages_in_food_reduction1.pdf I tried to copy the link but not sure it will work.

      Nutritionfacts.org has great videos/articles on this topic. All the best to you!

    2. Thanks for your comment.

      Very interesting points.

      Although it this study was not conducted on healthy young subjects, a vegetarian diet in haemodialysis patients, the skin autofluorescence (SAF) – a measure of tissue AGE – seemed to be lower in vegetarians than omnivores.

      On the other hand, if we put it in perspective, AGEs appear to increase the risk of inflammatory or chronic diseases, but vegetarians are at reduced risk of all these diseases. So, perhaps, the overall diet may be protective against the higher strange AGE levels found in that 2001 study you cited? I am simply hypothesising but it’s interesting to note.

      Hope this answer helps.

    1. Thanks for your question Nanette.

      I tried to find some studies but the evidence seems limited. According to one publication:

      “As dietary exposure to unfermented soy continues to increase in the US it is important to correctly analyze the bene ts and risks associated with unfermented soy exposure. Much how the US federal funding agencies have recently required funding applicants to report inclusion of male and female cells and animals in preclinical studies in all funding applications [17], to help clarify sex di erences in scienti c studies, inclusion of both fermented and unfermented soy in scienti c studies examining the risks and bene ts of dietary sources of soy exposure in breast cancer is warranted.”

      1. Txs Darchiterd. I thought Dr Greger had an article before that soy is good for breast cancer prevention. Just wondering if it matters whether fermented or not. Txs again.

        Sent from my Samsung Galaxy smartphone.

    1. Thanks for your comment.

      According to this publication,

      “Soy and milk based products fermented by yoghurt culture YC-381 alone or in combination with two probiotic cultures (Bifidobacterium animalis subsp. lactis BB 12 and Bifidobacterium bifidum CCDM 94) were prepared.”

      Hope this answer helps.

  14. I’ve had prostate cancer, I agree that an unhealthy diet may contribute to contracting cancer, but I also believe there are other factors at work too. I have a theory that having a vasectomy increases the chances of prostate cancer, I have friends that have had a vasectomy and friends that have not and every single one of us that have had a vasectomy have had some form of prostate problem either enlargement or cancer whereas the guys that have not had a vasectomy seem to have escaped any of these issues. The chaps I am talking about are between late fifties and early sixties.
    Anyone else out there that has the same theory as myself?

  15. Sorry about the goofy formatting on the previous post. (Wouldn’t it be nice if we could edit? , ) Here is the link to the page I cited:

  16. I would love to know more about the Doctors Notes referring to soy protein isolate powder reversing the progression of prostate cancer. The link to the video doesn’t work. I also see soy protein isolate powder mentioned in the “how much soy is too much” video. Is soy protein isolate powder a yellow or red light product??

  17. Hi Ronnie,

    I am a volunteer for Dr. Greger. I do not believe that a summary booklet for the book exists, from what I know.

    But the regular book itself is well-worth the read!

  18. I am confused about the benefits of soy. The American Nutrition Assoc. states that there is a downside to its consumption, that being anti-nutrients. They are not of a problem if soy is fermented, but what edamame beans, for instance, which I used to eat regularly. Are anti-nutrients something to worry about? Thank you.

    1. Mary P., please check all the videos and blog entries on soy on this website. Dr Greger has likely already answered your question.

  19. Actually it’s thought that the lower rates of prostate cancer in these countries is related to the lower rates of obesity and increased Vitamin D as well as diet.

    There is a lower incidence of prostate cancer in the southern U.S. vs the northern U.S. and this is thought to be related to sunlight and Vitamin D production.

    I’m sure that diet is important and soy consumption may have an affect on the incidence of prostate cancer, but I’m not sure it’s as simple as Dr. Greger is making it out to be.

  20. By way of a brief background, I was diagnosed with intermediate-stage (2 of 13 cores on right side with Gleason 7 and my PSA is around 3.5) prostate cancer in January of 2017. I’m 70 years old, 6′ 2″ and 170 lb. and in generally good health overall and I exercise regularly. My doctors felt I would do fine with either surgery or radiation, but didn’t “push” me into treatment due to my age. I also had a Prolaris genetic test done and it came back with a 5.6% 10-year mortality risk for my cancer – which is likewise in the intermediate range. I did a fair amount of research on my cancer and read in a couple of books what the impact of diet can have. Then having Dr. Greger’s book “How Not To Die” recommended to me, I’ve been doing my best to follow it as closely as possible (no dairy, poultry, meat, added sugars. etc. and now eating lots of berries, cruciferous vegetables, flax seed, etc. I started the diet in May and have noticed the mild arthritis I have had in my right hand has been virtually absent for several months now, my lifelong battle with constipation is long gone and I just generally feel better and am in a better mood. While I should have known this might happen, I was only thinking about slowing or possibly reversing my cancer. That brings me to my question. My oncologist recommended that I redo a biopsy late summer or early fall to see if the diet is helping. I’m wondering if it’s too early to do so as I want to be sure to give the diet enough time to do it’s work (if it’s going to at all). I realize that if my cancer has for some reason spread and turned more aggressive I’d want to know sooner than later, but as I understand this cancer, that seems highly unlikely this soon after the original biopsy just 7 months ago. I also see this a long-term commitment and would think the longer I’m adhering to this diet the better my chances of the success – is this thinking correct?

    Many thanks for a wonderful ministry. Ed

    1. Hello, Ed,

      regarding reversing cancer, please see this:


      And if it’s too early? Well I’m afraid we can’t help you. You should consult this with your oncologist as he knows your condition best. There are multiple variables and your oncologist should evaluate them and tell you when it’s best to perform the biopsy. Of course, it’s best to know if your cancer spread, but there are also risks involved in cancer biopsy as this can cause the cancer spread () please note that the risk is very small and new study actually denied the risk (): “patients who received a biopsy had a better outcome and longer survival than patients who did not have a biopsy.”

      1. Thank you very much for such a prompt reply Adam. I just didn’t know if it took a certain number of months to see some effect on my cancer since I’ve only been on the diet for about 3 months. If the diet is to be effective at all, should it start to have an impact after 3 months – that’s why I thought of waiting a few more months?

  21. Does Natto, which is also a type of fermented soy, not seem to be protective
    for prostate cancer? What about other cancer or deseases? Does that work
    and how?

    1. Can read more about it here:

      While vitamin K is required, it is fat soluble so can be taken to excess. It should not be used as a drug with the logic of “it’s required for strong bones so if I take more then my bones will get stronger.” This is absolutely not true. If you eat a Whole Food Plant Based diet, you’ll get all the vitamin K you need.

      Dr. Ben

    1. Hi Ali, all of the sources used for this video can be found under the Sources Cites button right below the video. Hope that helps!

  22. Almost a year ago I was diagnosed with Stage4 lung cancer. I am receiving great treatment of the disease (the symptom) from my oncologist by taking Tagrisso, but want to boost my health and immune system in preparation for when the cancer outsmarts the med. I am seeing a wholistic doctor who told me to investigate Haelen 951, a fermented soy, organic, non-GMO nutritional aid to help boost DNA repair and apoptosis. I am currently on a plant-based, whole food diet. Do you know anything about this product? It touts Isoflavones, Protease Inhibitors, Saponins, Phytoestrogens and Phytic Acid Compounds. Can a whole food, plant-based diet accomplish similar goals?

    1. Renee, I’ve no idea whether a plant based whole foods lifestyle will do anything, other than aid immensely in returning your body to its most natural equilibrium. I am highly suspect of any single ingredient, especially a man-made supplement that has purported claims to greatness.
      As Dr G has explicitly stated, inferred and called out on numerous occasions, follow the loot/$$$/money.

  23. Thank you so much. My Dad got prostate cancer and killed him back in 2015. When he got the cancer initially I found your site and other doctors speaking about similar diets.
    I changed my diet immediately. I did have cheese if I was at one of my kids or their friends birthdays and starving .
    I would do that maybe for 6 months then learned to cook and fill up before those parties.
    I also fill up before going to friends parties as well and my wife will usually make something for me to eat there.
    I weighed myself the other day and was 170 lbs. I was about 175 in Highschool and College. I ran a lot.
    I do exercise by playing quite a bit. I unicycle, juggle, run and skateboard as well as keeping up with my kids.
    I thank you for your videos because they have allowed me to do those things.
    Most of my meat eating friends don’t do much physical activity and some have some of the issues you talk about.
    When i first started I talked a lot about it to friends but they where drinking friends so …..
    I did get a couple coworkers to switch to a plant based or mostly plant based diet.

  24. so much information. I really just want to know. Should i eat soy or not? Want to maintain current PSA or decrease numbers, so want to make sure on whether to do tofu or soy protein to help. Can I get that simple answer reliably or is it just a sea of confusion out there?

  25. Tofu is likely fine for you, but when you get confused, and you’re in doubt, keep it simple: just eat unprocessed plants. That means from farm to mouth with no factories or machinery in between. Also get adequate sun exposure, adequate exercise and take a B12 supplement. That’s your lowest risk proposition as long as you have no underlying health problems. If you’re in doubt about that, appoint with your doctor.

    1. thank you for the direction. Really want to add soy to the diet for increase to protein intake , and to take advantage of the positive health aspects. Just so confusing with a watch on PSA levels as to whether it is truly safe or not.

  26. What about Natto? I’ve seen a lot of videos about tofu and tempeh, but wouldn’t natto be less processed than tempeh? It’s consumed daily in many Asian countries, and typically is just made with starter and water if you make it from scratch- Is there any studies about this food? I’m wondering as I know it’s not always the case that something that seems healthy is healthy (the difference between Water kefir and kombucha for instance illustrates this).

  27. Hi, Laura! Natto is about the same as tempeh in terms of processing. Both are traditional, fermented soy foods. Natto is an acquired taste. Not everyone likes it. If you do, I am not aware of any reasons not to enjoy it. There are some studies about natto, but that topic has not been covered here on NutritionFacts. I have passed along a request to cover it in the future. Please be aware that we receive many such requests daily, and it takes time to research and produce videos. I hope that helps!

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