Flashback Friday: Does an Apple a Day Really Keep the Doctor Away?

Flashback Friday: Does an Apple a Day Really Keep the Doctor Away?
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Which would save more lives: a prescription to eat an apple a day, or statin drugs?

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

Does an apple a day really keep the doctor away? That’s “a public health message” that’s been around since 1866, but is it true? You don’t know, until you put it to the test: “The association between apple consumption and physician visits,” published in the AMA’s internal medicine journal. “Objective: To examine the relationship between eating an apple a day and keeping the doctor away.”

“Promoted by the lay media and powerful special interest groups including the US Apple Association”—so powerful that Big Apple recently spent a whopping $7,000 lobbying politicians— “the beneficial effects of apple consumption” may include a facilitation of “weight loss,” protection of the brain, “cancer suppression, a reduction in asthma symptoms, and improved cardiovascular health.” So, apple consumers ought to require less medical care, right? “Although some may jest, considering the relatively low cost of apples…, a prescription for apple consumption could potentially reduce national health care spending if the aphorism holds true.”

So, they compared daily apple-eaters to non-apple-eaters, and asked if they had been to the doctor in the last year, been hospitalized, seen a shrink, or took a prescription medication within the last month. 8,000 individuals surveyed, and only about one out of ten reported eating an apple over the last 24 hours. And, the “[e]vidence does not support that an apple a day keeps the doctor away…” So, maybe it takes more than an apple a day. Maybe we need to center our whole diet around plant foods. “[H]owever, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications.” So, maybe the proverb should be updated to clarify that, if anything, “apple eating may help keep the pharmacist away.”

But, hey, based on the average medical prescription cost, the difference in “annual prescription medication cost per capita between apple eaters…and non-apple eaters” could be hundreds of dollars. So, “[i]f all US adults were apple eaters,” we could save nearly $50 billion. Of course, if you factor in the cost of the apples themselves, we’d only get a net savings of like $19 billion. If this all seems like a bit of tongue-in-cheek-apple-polishing, you’ll note this was published suspiciously close to April Fool’s day. And, indeed, this was in the tradition of the British Medical Journal’s annual Christmas issue that features scientifically rigorous yet light-hearted research, which itself took on the apple issue “[t]o model the effects on…[stroke and heart attack] mortality of all [older] adults being prescribed either a [cholesterol-lowering] statin [drug] or an apple a day.

Basically, they took studies like this, where you see this nice dose response where the more fruit you eat, the lower your stroke risk appears to fall. And, similar data for heart disease, compared to the known drug effects, and concluded that “[p]rescribing…an apple a day…is likely to have a similar effect on population [stroke and heart attack] mortality” as giving everyone statin drugs instead. And, hey, apples only have good side effects. “Choosing apples rather than statins may avoid more than a thousand excess cases of [muscle damage] and more than 12 000 excess diabetes diagnoses,” because statins increase the risk of diabetes, and this was in the UK. Here in the U.S., one would expect five times those numbers—though, ironically, “[t]he…cost…of apples [is] likely to be greater than [that] of statin…[drugs].” Generic Lipitor is only like 20 cents a day.

So, yes: “With similar reductions in mortality, the 150 year old health promotion message of an apple a day is able to match modern medicine and is likely to have fewer side effects.” But, apples are a few pennies a day more expensive, not to mention the increased time and difficulty associated with consuming an apple compared to a statin. Just one gulp with the drug, compared to all that “time consuming” chewing.

Please consider volunteering to help out on the site.

Image credit: Fischer Twins via Unsplash. Image has been modified.

Motion graphics by Avocado Video.

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

Does an apple a day really keep the doctor away? That’s “a public health message” that’s been around since 1866, but is it true? You don’t know, until you put it to the test: “The association between apple consumption and physician visits,” published in the AMA’s internal medicine journal. “Objective: To examine the relationship between eating an apple a day and keeping the doctor away.”

“Promoted by the lay media and powerful special interest groups including the US Apple Association”—so powerful that Big Apple recently spent a whopping $7,000 lobbying politicians— “the beneficial effects of apple consumption” may include a facilitation of “weight loss,” protection of the brain, “cancer suppression, a reduction in asthma symptoms, and improved cardiovascular health.” So, apple consumers ought to require less medical care, right? “Although some may jest, considering the relatively low cost of apples…, a prescription for apple consumption could potentially reduce national health care spending if the aphorism holds true.”

So, they compared daily apple-eaters to non-apple-eaters, and asked if they had been to the doctor in the last year, been hospitalized, seen a shrink, or took a prescription medication within the last month. 8,000 individuals surveyed, and only about one out of ten reported eating an apple over the last 24 hours. And, the “[e]vidence does not support that an apple a day keeps the doctor away…” So, maybe it takes more than an apple a day. Maybe we need to center our whole diet around plant foods. “[H]owever, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications.” So, maybe the proverb should be updated to clarify that, if anything, “apple eating may help keep the pharmacist away.”

But, hey, based on the average medical prescription cost, the difference in “annual prescription medication cost per capita between apple eaters…and non-apple eaters” could be hundreds of dollars. So, “[i]f all US adults were apple eaters,” we could save nearly $50 billion. Of course, if you factor in the cost of the apples themselves, we’d only get a net savings of like $19 billion. If this all seems like a bit of tongue-in-cheek-apple-polishing, you’ll note this was published suspiciously close to April Fool’s day. And, indeed, this was in the tradition of the British Medical Journal’s annual Christmas issue that features scientifically rigorous yet light-hearted research, which itself took on the apple issue “[t]o model the effects on…[stroke and heart attack] mortality of all [older] adults being prescribed either a [cholesterol-lowering] statin [drug] or an apple a day.

Basically, they took studies like this, where you see this nice dose response where the more fruit you eat, the lower your stroke risk appears to fall. And, similar data for heart disease, compared to the known drug effects, and concluded that “[p]rescribing…an apple a day…is likely to have a similar effect on population [stroke and heart attack] mortality” as giving everyone statin drugs instead. And, hey, apples only have good side effects. “Choosing apples rather than statins may avoid more than a thousand excess cases of [muscle damage] and more than 12 000 excess diabetes diagnoses,” because statins increase the risk of diabetes, and this was in the UK. Here in the U.S., one would expect five times those numbers—though, ironically, “[t]he…cost…of apples [is] likely to be greater than [that] of statin…[drugs].” Generic Lipitor is only like 20 cents a day.

So, yes: “With similar reductions in mortality, the 150 year old health promotion message of an apple a day is able to match modern medicine and is likely to have fewer side effects.” But, apples are a few pennies a day more expensive, not to mention the increased time and difficulty associated with consuming an apple compared to a statin. Just one gulp with the drug, compared to all that “time consuming” chewing.

Please consider volunteering to help out on the site.

Image credit: Fischer Twins via Unsplash. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

Should we be seeing our doctors every year regardless? See my videos Is it Worth Getting Annual Health Check-Ups? and Is it Worth Getting an Annual Physical Exam?

Like the thought of taking a more food-based approach to treatment? You’ll love lifestyle medicine: Lifestyle Medicine: Treating the Causes of Disease.

Sadly, Physicians May Be Missing their Most Important Tool.

What about apples for joint pain? See Apple Peels Put to the Test for Chronic Joint Pain

What about dried apples? See Dried Apples vs. Cholesterol.

What about apple cider vinegar? Check out: Does Apple Cider Vinegar Help with Weight Loss?

And what about head-to-head vs. açai berries? See The Antioxidant Effects of Açai vs. Apples.

And For Flavonoid Benefits, Don’t Peel Apples

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

The original video aired on June 4th 2018.

131 responses to “Flashback Friday: Does an Apple a Day Really Keep the Doctor Away?

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  1. Statins increase diabetes risk. That’s my takeaway from this one. The second or third time I’ve seen it. I shared that tidbit.

    Love the Fuji apples. I eat a bag a week when I can find them.

    1. That’s true. However, the conventional view is that the benefits of statin therapy (reductions in cardiovascular events including death) far outweigh the risks.

      ‘The risk of statin-induced newly diagnosed diabetes mellitus is ≈0.2% per year of treatment, depending on the underlying risk of diabetes mellitus in the population studied. In patients with cerebrovascular disease, statins possibly increase the risk of hemorrhagic stroke; however, they clearly produce a greater reduction in the risk of atherothrombotic stroke and thus total stroke, as well as other cardiovascular events./
      https://www.ahajournals.org/doi/full/10.1161/ATV.0000000000000073

      ‘“Whenever you prescribe a statin to a patient, you should talk to them about lifestyle changes. Statins are adjunct to diet in the labels. They are not meant to be prescribed without a discussion about the importance of a healthy lifestyle.” – Connie B. Newman, MD, adjunct professor of medicine, Division of Endocrinology, Diabetes, and Metabolism, New York University School of Medicine, New York, N.Y.’
      https://endocrinenews.endocrine.org/statins-and-diabetes-how-big-is-the-risk/

      There was also an interesting report earlier this week that suggested that statins are protective against severe Covid – 19 infection
      https://www.sciencedaily.com/releases/2020/09/200923164603.htm

      1. Thanks Fumbles, as always. It would be very unfortunate if people came away thinking an apple is as good as a statin. I say that as a person who consistently eats 2 apples per day (and no, they do zero for my high cholesterol levels).

        For myself, I get a huge benefit from the statin, baby aspirin and bp meds collectively, as my cardiologist has pointed out.
        These are effective on top of maintaining correct body weight, exercising daily and wfpb eating.

        1. ACCORDING TO HEALTHLINE:

          The most common side effects of statins include nausea, vomiting, and aches and pains in the muscles and joints. You may also have constipation, gas, or diarrhea.

          Some more serious side effects include:

          type 2 diabetes or higher blood sugar
          confusion and memory loss
          liver damage
          muscle damage
          kidney damage

          Not everyone who takes a statin has side effects. According to the Mayo Clinic, you’re more likely to experience side effects if you:

          are female
          are 65 or older
          have type 1 or 2 diabetes
          take multiple medications to lower your cholesterol
          have a smaller body frame
          have liver or kidney disease
          consume too much alcohol

          1. RB

            Yes. I had liver damage from statin therapy several decades ago. Subsequently, I tried self-medicating with niacin (B3). That caused liver damage also. On a positive note though, it was that experience which propelled me into making radical dietary changes by adopting a WFPB diet.

            Previously to that, I had stopped frying food and reduced my consumption of meat and eggs. That clearly wasn’t enough to achieve worthwhile results in my case. Adopting a totally vegetarian WFPB diet was necessary to achieve significant reductions in cholesterol and blood pressure. The weight came off too without any need for a special weight control diet or portion control.

        2. Barb,

          The following may be useful as adjunct in addition to your medications. You may already be well aware of the following. If not, there may be something that may be worth your consideration.

          On the subject of apples and cholesterol –

          If you are going the Esselstyn no fat route or the Ornish very low fat route, the following may not apply.

          But if you are a person who does eat limited fat – say 10-20% fat calories – nuts and/or avocado and/or high concentration chocolate (I like half a square of organic 100% Baker’s chocolate along with a food that is slightly sweet – they balance each other out – but this is an acquired taste) and/or a little high quality extra virgin olive oil here and there – consider always eating some fat with your apples. I target 30-90 fat calories. Apple with nuts. Apple with a half square (35 fat calories) of chocolate. That sort of thing,

          The fat tends to close off the pyloric sphincter, induces gastric peristalsis, and holds the apple in the stomach for several hours – enabling the gastric acid to fully do its job in digestion of the apple and leaving one with a sensation of fullness for that time – satisfaction – satiation.

          Once released from the stomach, the fat in the chyme causes release of bile salts from the gallbladder into the chyme as the chyme passes into the duodenum. Think of the bile salts as “soap” – bile makes the fat in the chyme water soluble. This bile is sequestered by the soluble fiber in the apple and escorted out of the body in the process of defecation, instead of the bile being resorbed into the body via normal process of the enterohepatic circulation if soluble fiber is not present – remember that ~95% or so of bile is otherwise normally resorbed. Conserved.

          Your goal is to reduce this bile resorption.

          Why is this of any interest to you?

          “Bile acids are amphipathic molecules synthesized from cholesterol in the liver. Bile acid synthesis is a major pathway for hepatic cholesterol catabolism. ”

          This cholesterol is “escorted” out of the body via sequstration via soluble fiber. Not by insoluble fiber. The liver then grabs more cholesterol from the blood stream to make more bile.

          Reducing serum cholesterol.

          That is the natural process.

          The more soluble fiber you eat – fruit, legumes, oats and barley are all high in soluble fiber – the greater the effect. That is what the whole oat bran craze was about circa 1988 – but soluble fiber is naturally present in all sorts of real whole food – oat bran is just one minor source. I do not bother with oat bran.

          Note that wheat and rice are high in insoluble fiber, but low in soluble fiber. They don’t work.

          The issue – a small amount of fat is necessary for this process to work. Without the fat – the food just zips through the stomach. That is why dieters’ salads with no-fat dressing are so unsatisfying. Little pyloric sphincter closure. Little gastric acid exposure. Little churning. Little initial digestion. No extended sensation of satiation. No bile squirt from the gall bladder into the duodenum.

          This is one reason you see gallstones in low fat dieters – no bile squirt that you would normally get to deal with the normal presence of fat in the duodenum. Bile then concentrates within the gallbladder – water is actively resorbed by the gall bladder wall, concentrating the bile – until, like rock crystal candy formed in a supersaturated medium, bile crystals form in the gall bladder – which then try to pass through the smaller bile ducts. Sphincter of Oddi is not happy. Yellow eyes and skin. Ouch, ouch, ouch. And then – meet your very own surgeon. Who knows

          “The only way to heal is with cold steel.”

          Samuel Shem.

          Also – avoid cold (particularly iced) drinks. The stomach does not like ice cold – so it empties out immediately. Sabotaging this whole natural digestion process. That is one reason restaurants encourage iced drinks – they cause your stomach to empty over-quickly so that you then have lotsa room for that tempting desert.

          But you don’t properly digest your restaurant food that way. And you are soon ready – even craving – more.

          Ditto carbonated beverages.

          Ice cold carbonated beverages?

          Why not just shoot yourself in the foot?

          Different peoples’ physiologies are different, of course. For many, practicing the simple techniques above will help reduce serum cholesterol significantly – e.g., such tactics helped bring my total cholesterol from 256 -> 149 without medication. For others – the amount (and types) of fat involved may backfire – causing increased serum cholesterol from the fat intake without sufficient counterbalancing by increased bile outflow – it’s the luck of the genetic draw. Very often – these techniques do work. But not uncommonly – they don’t

          When they do not work – going extremely low fat may be appropriate instead.

          But there you run into the gallstone issue. Heck. Gee. Rock vs. hard place. Frying pan vs. fire.

          For some – the medication route may be the best option. Adjunct strategies may or may not then prove helpful. Trial and error – with monitoring – may prove helpful.

          Be aware of how it all works – and do what is best for you.

          Barb.

          All the best,

          Vivamus

            1. Ricardo,

              Good for you!

              The studies out there supporting nut intake for health tend to range from one (1) to one and a half (1 1/2) ounces of nuts a day.

              1 – 1 1/2 ounces / day.

              ~Four to seven days a week. Nothing in the literature (that I saw last time I looked, anyway) about any benefit at higher amounts.

              If some is good – more is not necessarily better.

              You can count them out but that gets tedious. I just went ahead and bought a small digital kitchen scale. These scales come in handy for other things, as well. ~$20 from Walmart et. al., ~$10 from China via eBay if you are willing to wait for a month’s shippin’.

              Go organic with nuts! Insecticides + Miticides + Fungicides = not a happy camper. We are doing this for our health.

              And they taste good, too.

              Pears have ~ twice the fiber of apples. All the other fruits you can name have lotsa soluble fiber. Do not fixate on apples. Variety and moderation: I do this with apples, pears, grapes, plums, pineapple, muskmelon, watermelon, pomegranates, whatever.

              Never have gotten the “king of fruits.” Durian. Anybody?

              Fiber typically comes mixed – i.e., foods will have both soluble and insoluble fiber. For this purpose, your focus is on soluble fiber – that’s what sequesters bile. Insoluble fiber, however, does not negate the good effects of soluble fiber – insoluble fiber has it’s own ineluctable charms – adds bulk and such, easing – ahem – how to say it gracefully? The journey. Whole grains such as hulled barley (the superstar) and oats (not too shabby) have both soluble and insoluble fiber. Rice and wheat contain primarily insoluble fiber.

              Avoid fiber added foods – fiber cereals and such – unless you like eating sawdust. Yum. Sawdust. Love the stuff! Detailing that issue would take another post – but not worth the effort. Just run away unless you have reason otherwise. Then run away, anyway.

              There is a five-to-one “rule” on fiber floating about out in the ether. When I ran the math – none of the excellent fiber foods I ran it on – 100% whole wheat flour and such – made the cut. But the artificial added fiber foods did. It looked to me like a false rule instigated by the artificial fiber additive industry and then taken up by the gullible. But that was just a quick look and a quick gut reaction – I looked into the matter no further – seemed like a waste of time. When you hear that “rule” – do the math, yourself. Remain skeptical. It may work for some things – I dunno – but do not allow it to force you into eating artificially processed fiber-added foods in order to meet the “rule.” It didn’t work for real food for me. And if you are eating largely unprocessed WFPB – you need not concern yourself with such fiber rules, anyway – ’cause you are already gettin’ fiber out the kazoo without having to think about it – no need to count your winnings.

              Avoid peanuts – among the most pesticided foods on the planet. Farm family. Trust me.

              Avoid nut butters.

              Aflatoxin – avoid peanuts. Minimize Brazil nuts – four a month (one small study only – never reproduced) or none at all. If you have lotsa energy – web search aflatoxin and parrots – them’s big canaries in the mine. Bonus feature – Teflon and parrots.

              Ricardo.

              There ya go –

              Vivamus

              1. The 5 to 1 fibre rule only applies to packaged foods which, if we are on a WFPB diet, we shouldn’t be eating anyway. And it doesn’t come from the artificial fibre industry either.

                ‘An accompanying editorial to a fiber and heart disease meta-analysis implored doctors to “enthusiastically and skil[l]fully recommend that patients consume more dietary fibre”––which means a lot of whole plant foods. If we do buy something packaged, however, the first word in the ingredients list should be “whole.” But, even if it is, the rest of the ingredients could be junk. A second strategy is to look at the ratio of grams of carbohydrates to grams of dietary fiber. We’re looking for about 5 to 1 or less.’
                https://nutritionfacts.org/2018/05/08/follow-the-5-to-1-rule-for-packaged-foods/

                1. Thank you Mr Fumblefingers. Much appreciated!

                  (1) Lesee – I just ran 100% whole wheat flour nutrition facts through this calculation for the first three web sites that popped up on the following search string – 100% whole wheat flour nutrition.

                  https://nutritiondata.self.com/facts/cereal-grains-and-pasta/5744/2
                  https://www.eatthismuch.com/food/nutrition/100-whole-wheat-flour,162167/
                  https://www.fatsecret.com/calories-nutrition/king-arthur-flour/100%25-whole-wheat-flour

                  Scores of 5.97:1, 6.0:1, and 5.75:1. No 100% whole what flour broke the 5:1 barrier of the “5:1 rule.” I.e., none scored at of below below 5:1

                  You make 100% whole wheat bread out of 100% whole wheat flour.

                  100% whole wheat flour is sold in packages. People package 100% whole wheat bread.

                  As per the 5:1 rule – 100% whole wheat bread is not good enough.

                  It does not make the 5:1 cut.

                  That looks pretty silly to me.

                  (2) I just ran oatmeal through this calculation for the first three web sites that popped up on the following search string – oatmeal nutrition.

                  https://www.healthline.com/nutrition/foods/oats#nutrients
                  https://www.goodhousekeeping.com/health/diet-nutrition/a31028145/oatmeal-benefits/
                  https://nutritiondata.self.com/facts/breakfast-cereals/1597/2

                  Scores of 6.25:1, 6.75:1, and 6.82:1. None broke the 5:1 barrier of the “5:1 rule.” I.e., none scored at of below below 5:1.

                  Oatmeal is sold in packages.

                  Oatmeal did even “worse” – if you are foolish enough no credit the 5:1 rule – than 100% whole wheat flour.

                  (3) Fiber One cereal – search string – Fiber One cereal nutrition:

                  https://www.fiberone.com/products/cereal-original-bran/

                  Scores a smashing success at 1.8 – easily beating out both 100% whole wheat and oatmeal.

                  But take a good look at the ingredient list: WHOLE GRAIN WHEAT, CORN BRAN, MODIFIED WHEAT STARCH, GUAR GUM, COLOR (CARAMEL COLOR AND ANNATTO EXTRACT), CELLULOSE GUM, SALT, BAKING SODA, SUCRALOSE, NATURAL FLAVOR.

                  (their capitals)

                  The way that Fiber One makes the 5:1 rule is by including junk fiber: MODIFIED WHEAT STARCH, GUAR GUM, CELLULOSE GUM – and by sweetening with SUCRALOSE, an artificial sweetener.

                  —————————–

                  So – the 5:1 rule teaches us that 100% whole wheat and that oatmeal are both unhealthy.

                  But that a product made with MODIFIED WHEAT STARCH, GUAR GUM, CELLULOSE GUM – with SUCRALOSE – is the healthier alternative.

                  You believe that if you wish to – that’s not my problem.

                  But it looks to me that the 5:1 rule is worse than useless.

                  It leads directly to wrong choices.

                  Which is likely it’s intent.

                  It should be discarded in it’s entirely by those who prefer eating healthy Whole Foods over those who prefer eating chemistry sets.

                  The math is simple. The math is stark.

                  All the best –

                  Vivamus

                  1. Thanks Vivamus. None of those things is a whole food though. McDougall however comments

                    ‘I am often asked if there is any harm in using a home-bread-machine to make bread—after all, nothing is added or removed in the processing. For most people whole grain breads are an excellent choice, but it is not the same as eating whole grains. Beating the whole grain more than 1000 times with the whirling steel blade of the bread machine converts the kernel into a powder, known as flour. The intact cell wall of the kernel has been destroyed and now the digestive enzymes (amylase) easily digest the inner nutrients. In addition, the flour has a much larger surface area to volume ratio than did the whole grain, making digestion and absorption much more rapid. For you this physical change may translate into easier weight gain, and higher blood levels of glucose, triglycerides, and cholesterol. The amount of insulin released by the pancreas into the blood is also increased as grains are processed from whole grains to cracked grains to coarse flour to fine flour.23 More insulin can mean more weight gain, and maybe, more risk of diabetes and heart disease. However, compared to animal-foods, free-oils, and plant-parts processed beyond recognition, whole wheat bread is definitely health food.’
                    https://www.drmcdougall.com/misc/2008nl/jan/grains.htm

                    Is it an ‘excellent choice’ compared to intact whole grains? Probably not.

                    I don’t use the 5 to 1 rule myself but it seems like a perfectly sensible rule of thumb if used on an ‘all other things being equal’ basis. None of the examples you gave were on an ‘all other things being equal’ basis. That said, I agree with your basic point if people are using it as their sole metric but surely no one here is silly enough to do that? In deciding between say whole meal bread and Ezekiel bread it might be a useful guide. Personally I find it a bit confusing because fibre is a type of carb. Is the calculation to be done including fibre in the carbs total or not? In other words, a product that contains 5 grammes of fibre and 25 grammes of other carbs would meet the rule on a 25 to 5 basis but not on a 30 to 5 basis.

                    As far as I know, the 5 to 1 rule came from the BMJ not the food industry. That doesn’t mean the food industry doesn’t try to exploit it just like they did with the ‘reduce fat and reduce cholesterol consumption’ guidance by producing alternative foods that were high in sugar etc. Again, ‘all other things being equal’ needs to be understood in nutrition matters as everywhere else.

                    1. Mr Fumbelfingers,

                      Interesting that you should bring Dr McDougall up in a discussion of the 5:1 rule.

                      I have the highest respect for Dr. McDougall. Dr. McDougall is able to take the medical literature and temper it with the wisdom of his own Clinical Experience to distill the two together skillfully with experience and ensuing wisdom into a coherent whole. Something one cannot achieve by study of the literature, alone.

                      The guy knows what he is doing.

                      As I am sure you are aware, Dr. McDougall’s emphases include complex carbohydrates – what he prefers to call “Starch.” Hey – he has earned the right to call it anything he wants to. Dr. McDougall has written knowledgeably on Starch and bases his diet on Starch.

                      Dr McDougall knows starches inside and out, all around and upside-down.

                      Carbohydrates – starches – are what the 5:1 rule is all about.

                      Please note bene – Dr. McDougall does not make use of the 5:1 rule. Apparently has no use for it. Which may give you further insight into it’s worth.

                      I have never seen it in his writing or heard it in his speaking. I find no reference to it on a search of his site. I find no result with the search string – 5:1 rule McDougall.

                      If he ever has used it – it has been extremely low profile.

                      —————————————————

                      “I don’t use the 5 to 1 rule myself but it seems like a perfectly sensible rule of thumb if used on an ‘all other things being equal’ basis.”

                      The 5:1 rule is garbage.

                      Any rule that suggests that healthy food is unhealthy – and industrial fake fiber frankenfood is healthy – is garbage.

                      Mr Fumblefingers.

                      I believe that you and I may disagree on this matter.

                      Life would be dull if we all agreed on everything.

                      We would all want the same girl. There would be much trouble.

                      And there would be no horse races.

                      I wish you all the best –

                      Vivamus

                    2. Thanks Vivamus.

                      Let’s agree to disagree then. From my perspective, you’re throwing the baby out with the bathwater. Greger doesn’t use the 5 to 1 rule himself either from what I can make out. He’s just reporting interesting tidbits of nutrition research. In actual fact though, the rule for bread is somewhat different from the rule for cereals

                      ‘Persuading patients to eat whole grains is particularly challenging. Whole grains include barley, bulgur, millet, quinoa, brown rice, rye, oats, and whole wheat. Guidelines suggest that at least half of the daily grain input should be from whole grains. Current food labelling does not make it easy for consumers to identify which foods are whole grains, especially when consuming baked goods and cereals. One strategy is to identify food products with whole grain listed as the first ingredient. Another strategy is to teach patients to look for the ratio of grams of carbohydrates to grams of dietary fibre. Breads with ratios of less than 10:1 and cereals with ratios of 5:1 are consistent with a higher fibre product.’
                      https://www.natap.org/2013/HIV/122213_01.htm

                      Oh, and the whole meal bread I buy here in the Philippines meets not just the 10 to 1 rule but the 5 to 1 rule also. I’d never bothered checking before but you got me to wondering..

          1. Thank you Vivamus for your detailed and very practical guide. It’s my guess (from seeing the questions people have raised) that many NF fans will find your notes helpful in tweaking their menus.

            In my case, prior to menopause I had no issues with high cholesterol, even as a meat/egg/dairy consumer. Postmenopause is where the problems began. There is a familial aspect also.

            I do have gall bladder issues – spent last week in emergency, and surgery pending. But I also have gastroparesis and this causes me misery at times with wfpb. I have used rx domperidone in the past to speed digestion. Only in past months did I discover carbonated spring water which I love because I felt so much better.

            My whole diet is built around anti inflammatory and soluble fiber foods. I have eaten oat bran for decades every morning. Apples are my ‘dessert’ . (If you like jazz apples, you may like Ambrosia apples too.) I wouldn’t mind trying pectin as a supplement if I hear of the right product and dosage.

            Esselstyn allows 1 tbsp flax /day only, and Ornish allows only 2 tsp ground flax, or 1 walnut, or 6 peanuts. Very teenie amounts. But I have eaten 1 apple after oatbran with flax in the a.m. so maybe I have been unwittingly following your suggestion all along.

            Thank you again!

            1. Barb, its ok if too personal a question but I ask only for interest in my own future health. You have mentioned your medical conditions here and I am wondering are you WPF or wfpB? And have you always done this and the conditions appeared in spite of the healthy choices, or is your diet a progressive reaction to the conditions as they began to appear?

              Honestly we do, some of us, have the impression that eating in this way, WPF, little SOS,, especially starting out in this way as a kid, one can be generally “optimized” and need not encounter the many ailments which set upon us in our 50’s.

              I wonder if others here wish to share their story of how they arrived here and if they are wfpB (still eating animal proteins but making sure to get plants in the diet), or are really just eating plants (with commensurate supplementation).

              For me: Since December I became WFP and I got here accidentally. No medical issues to speak of, but I’d anecdotally met an Indian couple on a plane from Paris, and they offered me a potato chip. I declined saying it would destroy my keto diet. Turns out they were both doctors, and they suggested I watch the film, “Game Changers” on netflix. So I did, as well as “Forks over Knives”, and “What the Health” etc… It all lead me to this type of diet. Sure, I’d practiced a vegan diet in my early 20’s, (about a year) while living in a coastal sea town with plenty of musicians and vegans, and I knew a lot about this already, and had read and listened to Gary Null, and I had also read books like: “Your Colon and You” which I might add isn’t a great topic at parties when trying to socialize with the opposite sex lol etc…Thank god I’m great looking. (I jest)

              So my finalized interest in dietary change from the airport event was built on the previous weeks events, just before Id left France. My buddy, an Italian jazz drummer from Napoli comes in and says in a super thick Italian English accent:
              “Man, you gotta ave a somma ma tomatoes from a ma garden!”

              I replied that it would mess up my ketosis and he looked at me as if I had 3 heads.

              “But a whatta you talkin’ about! ………..Its a tomato!” (how could something so organic, and healthy and beautiful be bad for somebody? Its like telling a Scott that I cant listen to bagpipes because it may make me tone deaf.)

              Those events, one on top of the other, plus watching the films which reacquainted me with what Id already known deep down, inspired me to make the change back to plantsville, for good. (we will see, but doubt I will go back to eating from hoofs, gills, wings, or faces of any kind)

              Finding this site was a bonus. Thanks Dr Greger, for all.

              1. JB, I have always eaten healthy.. always. As a kid I had a very strong interest in the specifics of good nutrition. I eat whole plant foods with the exception of soy milk, bouillion (better than bouillion veg in the jar), and the occassional salad dressing. I use canned beans and tomatoes. Sometimes I will use Wasa bread or tortilla wraps but I do not care for them. Powdered, plus dried or fresh herbs/spices. Most of my food I get at the outdoor market. I have eaten this way for a long long time. In the long past I would have rarely included fish or shrimp, or even rarer still I would have soup with a bit of meat.

                For women, menopause can cause cholesterol to rise as estrogen decreases. I am speculating that fish proteins can indirectly cause a small rise in estrogen and that’s why cholesterol will go down. Stomach issues came up in the last 15 years, while I am eating this way.

                My diet is not a response to my “condition”. Even with statins my cholesterol won’t go where it needs to. As for stomach issues, not eating at all is one of the best things I can do for relief and healing. There is an elimination diet I do to reset on occasion but it isn’t a good time.

                One thing that I have to watch too is too much blood thinning. Many common herbal teas will cause bleeding issues as will spices, herbs, some supplements. Just a heads up….

            2. Ambrosia apples: I will keep my eyes peeled.

              —————————————————————-

              “I do have gall bladder issues – spent last week in emergency, and surgery pending.”

              I hope all goes well. Rootin’ for ya!

              I try to get this information to people before gallstones hit.

              When it’s late – it’s late.

              And – you may have more complex issues.

              —————————————————————-

              “I have eaten oat bran for decades every morning.”

              If it works for you . . . but does it?

              My point is that the soluble fiber issue that brought oat bran to the table is actually everywhere in WFPB diet – beans, fruit, and some whole grains. And these WHOLE FOODS add nutrition while they are at it.

              Oat bran removes some bile – truth – but does not add nutrition in the process. And the removal of some bile from the normal enteroheptaic circulation is likely removing some nutrients dissolved within the bile, as well. So I prefer the ADDED nutrition route of soluble fiber in WHOLE foods – and avoid the null nutrition route of processed oat bran.

              WFPB diet. WHOLE FOODS is what it’s all about. Not powdered food components. Or processed “food” dust.

              YMMV.

              —————————————-

              “But I also have gastroparesis and this causes me misery at times with wfpb. I have used rx domperidone in the past to speed digestion.”

              Life throws us all some curves.

              I am always happy to defer to your locally licensed M.D.

              —————————————-

              “Only in past months did I discover carbonated spring water which I love because I felt so much better.”

              Always listen to your own body. As with the flu vaccine issue – go with what actually works for you.

              Barb.

              Always a pleasure –

              Vivamus

              1. Vivamus, your comments are so good and so helpful, for those who may be reading along too. Through the years I have seen many posts from women who also experienced raised cholesterol, lower thyroid function, gastroparesis, ibs, increased allergies etc etc post menopause. Maybe this conversation may inspire them to try something or ask their md about it.

                So, re the oat bran question of whether it works or not….. well, after experimenting AND testing, I can say it probably does little to nothing in lowering cholesterol, but neither does amla, 4 brazil nuts, soy milk, apples, pure powdered inulin, or a dozen other things I have tried in my own portfolio collection. What does (temporarily) lower cholesterol is losing weight, even if I didn’t need to lose weight.
                Whole organic large flake oats are every bit as good, and I eat them often too.

                What I have learned from this exercise over past years is, don’t guess,….test. I get blood tests twice a year (more often in the past giving me the luxury to experiment ), and same with symptoms.. getting a confirmed diagnosis and treatment rather than guessing what symptoms may mean.

                For me, the value of a whole foods plant diet may lie in the high fiber, the antioxidants and anti inflammatory properties. All good. Plus, I am not out there eating restaurant food or processed foods.

                1. “So, re the oat bran question of whether it works or not….. well, after experimenting AND testing, I can say it probably does little to nothing in lowering cholesterol”

                  Then why in the world are you doing it?

                  ——————————————————-

                  “neither does amla, 4 brazil nuts, soy milk, apples, pure powdered inulin, or a dozen other things I have tried in my own portfolio collection”

                  Yup.

                  There’s a lot of credulous advice flung out around here.

                  Without adult supervision.

                  Really pretty presentations, though.

                  It is probably best to remain skeptical.

                  Still – there is more good here than ill.

                  ————————————-

                  “What does (temporarily) lower cholesterol is losing weight, even if I didn’t need to lose weight.”

                  Yup.

                  Losing weight trumps all other factors as far as lipid lab tests are concerned. But that is just a limitation of the lab tests – it has nothing to do with human longevity.

                  That is why even the keto people can “prove” that keto is the way to go. Great lab tests while they are losing weight. But the maintenance . . .

                  I have a sneaking suspicion – a feelin’, a hunch, an intuition – that knowledge about optimal cholesterol levels obtained on the basis of population-wide studies may not apply that well to all individuals.

                  Which is to say – is a total serum cholesterol of 250 in a skinny person on a high quality low fat WFPB diet who exercises and sleeps well and is doing everything she can right – is it the same thing as a total cholesterol of 250 in an overweight person on a SAD diet doing everything wrong? And should we treat it as the same thing medically – or are these two entirely different people needing two different approaches?

                  I don’t think we really know the answer to that question.

                  Perhaps one should be treated – and one not.

                  These are idle speculations – speculations which could be fatally wrong.

                  As of now – I am happy to accept conventional wisdom.

                  I’ll bet you a nickel that conventional wisdom about this will change over time – but I won’t bet your life on it.

                  ———————————————————————-

                  “What I have learned from this exercise over past years is, don’t guess,….test. I get blood tests twice a year (more often in the past giving me the luxury to experiment ), and same with symptoms.. getting a confirmed diagnosis and treatment rather than guessing what symptoms may mean. ”

                  Yup.

                  That is why “advice” against yearly check-up so amuses.

                  “If you don’t take a temperature, you can’t find a fever.”

                  (Shem)

                  But, again – not my concern.

                  ———————————–

                  “For me, the value of a whole foods plant diet may lie in the high fiber, the antioxidants and anti inflammatory properties. All good. Plus, I am not out there eating restaurant food or processed foods.”

                  By Jove, I think you’ve got it!

                  Barb.

                  All the best –

                  Vivamus

            3. “Esselstyn allows 1 tbsp flax /day only, and Ornish allows only 2 tsp ground flax, or 1 walnut, or 6 peanuts. ”

              Yup.

              They both seem to have long been in denial over the gall bladder issues of extreme low fat eating.

              Anyone the least bit familiar with gall bladder issues could set them straight. But they are actively not listening.

              Not my problem.

              ———————————–

              If you are staring down death in the short term from cardiovascular issues you make the judgement call: cardiovascular trumps gall bladder. No issue.

              But for daily maintenance you take your foot off the accelerator and you slow down – and go with variety and moderation.

              Ignore counterclaims of the joys of extreme diet measures as silly rhetoric. Cicero 101.

              And we all remember what happened to Cicero.

              ——————————————————————

              Subject your body to extremes and your body will bite back in time.

              Slow and steady wins this race.

              ——————————————–

              Health maintenance on a population-wide basis – adjust as appropriate to yourself:

              Variety and Moderation. WFPB diet: vegetables, fruit, beans, unground whole grains. Low Na (500-1200 mg / day), low fat (10-20% by calories – nuts, avocado, 100% baking chocolate, extra virgin olive oil – fatty cold water fish low on the food chain), low added sugars (less that 6 tsp/day – preferably none – honey and date sugar preferred). Unadulterated whole herbs and whole spices – avoid powders and flakes, you don’t know what’s in them – no one does. Foods organic as available and affordable – otherwise, follow the Dirty Dozen / Clean Fifteen. Consider Novel Cornonavirus issues in obtaining food and in bringing food into your home in the current era. Slow digestion: no smoothies or juices. Water. Slow and steady – no fasting – fasting strips protein. B12. Vitamin D via sunlight as available. Avoid other supplements, powders, essences and flakes. Listen to your body and adjust as appropriate. Adjust as per medications and the guidance of your locally licensed M.D. If longevity is the primary interest -pursue animal flesh ~five times a month. If ideology prevents animal food intake – understand and gracefully accept the trade-off of longevity reduction with eyes wide open. BMI – 21 is a good population target – adjust as appropriate to yourself. Waist / hip ratio targets: .95 or less for males, .85 or less for females. Waist / height ratio target of 50% or less. 1/2 hour of walking a day is a good population target – adjust as appropriate to yourself. Sleep. Human connection. Grace. Kindness.

              All the best –

              Vivamus

              1. ‘They both seem to have long been in denial over the gall bladder issues of extreme low fat eating.’

                I am not aware that gall stones were ever a problem for Esselstyn’s or Ornish’s patients. Or for people eating traditional Okinawan, African or Asian diets (all very low fat) for that matter.

                It was always my impression that they were a consequence o0f high fat diets not low fat diets

                ‘Gallstones are a Western diet–induced disease affecting 20% of women and 8% of men older than 40 years. Twenty million Americans have gallstones. Each year 1 million more develop gallstones. More than 300,000 cholecystectomies are performed each year for gallstones. Gallstones are risk factor for gallbladder (GB) cancer. Bile components are bile salts, bilirubin, cholesterol, phospholipids, fatty acids, water, electrolytes, other organic and inorganic substances. Gallstones arise when solubilized bile components become supersaturated and precipitate.’
                https://www.sciencedirect.com/topics/medicine-and-dentistry/gallstone

              2. ‘If ideology prevents animal food intake – understand and gracefully accept the trade-off of longevity reduction with eyes wide open.’

                I am not aware of any credible evidence that well-planned completely vegetarian diets decrease longevity. Certainly the US Dietary Guidelines and the Academy of Nutrition and Dietetics have concluded that such diets are healthy

                https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/appendix-5/
                https://www.eatrightpro.org/~/media/eatrightpro%20files/practice/position%20and%20practice%20papers/position%20papers/vegetarian-diet.ashx

            4. https://nutritionfacts.org/video/more-than-an-apple-a-day-preventing-our-most-common-diseases/

              Barb,
              Hope you get to feeling better. I reviewed some of Dr. Greger’s above video which addresses many issues including digestion.
              I hope also you are still able to enjoy your bike rides. This is a nice time of year. I saw over 40 pelicans in flight this morning. They are real goof balls and fly every which way and at different elevations. I really enjoy watching them. I call them free loaders because they run up the bill so much.

          2. Thank you Vivamus. I’m sure I said “wow” out loud 5 or more times while reading your explanations. You just answered and/or confirmed multiple processes and recommendations that I have wondered about. Now I know the specific “why?” …in layman’s terms (thank you!).

            1. Not medical advice. Merely informational. For medical advice, see your locally licensed M.D.

              Khalifa,

              Fantastic name!

              Irish?

              Bizarre question! Neato!

              Answer to your question – I dunno. Never considered the matter or even heard of the concept before.

              So let’s work through this together . . . for what it is worth . . .

              My gut reaction – and nothing more – is run away.

              Instant gut response:

              The goal is to reduce cholesterol and reduce bile. Not increase.

              Bathing in the bile bubble salts while inhaling them while drinking 80-proof bile liquor cocktails (three parts gin, stirred, olive) between injecting bile salts and using them as an eyewash, shampoo and toothpaste – and food flavoring and preservative – seem inadvisable.

              So the short answer to your question is probably: “No.”

              And an oblique semantic note: you never, ever, ever want to “trick” your body. That path leads always to failure.

              Short term gains. Long term failure.

              You want to work with your body – listen to it and give it what it needs and all will benefit.

              The goal is harmony. Not trickery.

              The Atkins diet is trickery. It is everything that is wrong about the science of nutrition.

              We are working toward harmony.

              Soapbox off.

              ———————————————

              To reduce serum cholesterol: the following often works. It sometimes fails. We are all put together differently from one another. I have had good luck with this, but some have had no luck at all. Best to do this under the wing of an M.D. advising you and monitoring your serum lipids:

              (1) If overweight, get down to a BMI of 21 or so (adjust as you think best for yourself – may go less if you are a mere wisp of a lass, but you probably want to stay above 19 or so. Adjust to your needs. Avoid all fasting – fasting just dumps protein – ignore anyone who says differently – don’t even argue – they are just wasting your time.

              (2) Limit absorption of cholesterol from food <– minimize animal foods, particularly eggs and shrimp.

              (3) Limit production of cholesterol crystallization – > calculus formation. Reduced oil-soluble nutrient absorption. Keep it up for a while and – God help you.

              I can’t.

              ————————————————

              Well – Khalifa – that was a little spontaneous intellectual adventure.

              Any and all advice above is worth what it cost you.

              All the best –

              Vivamus

              ———————————

              Clunton and Clunbury,
              Clungunford and Clun,
              Are the quietest places
              Under the sun.

              Housman
              1896

              1. Oops – a whole lot of that post did not post – missing points three and four.

                The overall result is incomprehensible gibberish. No unity. Might as well ignore the whole thing.

                Sorry about that – dunno what happened.

                I must have goofed. Dunno if I will try to reconstruct.

                It was spontaneous (fun) – reconstruction would be no fun (tedious).

                Life is hard –

                Vivamus

                1. Khalifa,

                  Further on oral bile salts. I did a little looking around the Internet.

                  I have never seen this used nor had I ever heard of it. Here gall bladder patients tend to go to surgery.

                  But if you have people with experience who know what they are doing – go with the wisdom of your locally licensed M.D who knows you.

                  My apologies for earlier spreading my ignorance in this matter.

                  Vivamus

        1. https://nutritionfacts.org/topics/apple-juice/

          In this article, Dr. Greger states that consuming pureed apples (similar to apple sauce, I presume) leads to insulin spikes.

          I recall an article/study (probably in ncbi) stating this about applesauce and apple juice, but that whole apples do not; likely, because mastication doesn’t separate the fiber and “sugar” as much as processing the apples, leading to a lower “glycemic index”.

          That’s all I have for ya, George.

            1. Volunteer, spring03.
              Thanks for all your responses. Please pass on that a topic needs to be written about Is ‘blood thinners’ , the newer ones like Eliquis , you can’t come off them as you can have a stroke, there are no dietary restrictions. There are no reversal agents but Adnexa , have to be cautious with any surgery and dental extractions. Need the approval of MD to have simple extraction and just teeth cleaning. It’s a whole new topic that needs to be addressed from wfpb foods and the avoidance of greens due to vitamin k.

          1. Stephen, I believe that tart Granny Smith apples are the preferred variety for anyone concerned with diabetes risk, due to a lower glycemic index than other apple varieties. Moreover, “a team of researchers from Washington State University … found that the tart Granny Smith had the most beneficial effect on good gut bacteria that helps aid with digestion and serves as a barrier to protect our immune systems. In fact, Granny Smith apples, which are high in non-digestible dietary fiber and low in carbs, helped balance out the good bacteria that is often off balance in obese patients. …Researchers also found that eating Granny Smith [apples] can help combat against chronic inflammation, which can lead to diabetes.” Remember to buy organic Granny Smith apples if your store carries them and your budget permits.

            Since consumers generally prefer sweet foods, the tart Granny Smith apple is an unusual choice for applesauce, and most applesauce contains added sugar. “The Cincinnati Children’s Hospital Medical Center tells patients on a low glycemic index diet to avoid sugar-sweetened applesauce.” Also keep in mind that “a food’s glycemic index is based on your blood sugar reaction when you consume it on an empty stomach. Applesauce will have less of an effect on your blood sugar if you eat it with [high fiber meals] than if you consume it plain as a snack.”

            I am helping my husband work on plaque reversal with an Ornish/Esselstyn diet. As part of the diet I give him 2 tablespoons chia seed and 3 tablespoons ground flax seed together with a container of unsweetened applesauce, dried cranberries, and three tablespoons of uncooked oats or multigrain cereal with oats, barley and rye. His bloodwork last month showed A1c is 5.0 and CRP 0.3 mg/L .so this apparently does not spike his blood sugar or cause inflammation. His cardiologist prefers lifestyle change over statins, so the plan is to keep LDL in the below-70 reversal range (his LDL is now in the 60’s) for an extended period of time, and then gradually wean him off statins.

        2. Thanks, Gengo.

          I was reading today that Houston has a strain that is highly, highly contagious.

          Not more deadly but it is so contagious that even masks and handwashing aren’t enough to prevent getting it.

          We don’t know what the winter strains will be like yet.

          It seems like the saying, “One false step” could be “One false mutation” and we might have a doozie of a winter.

          The good news is that the deaths have started coming down. Slightly in the USA so far.

          We are still close to 1000 people dying per day but the weekends now are reporting low and yesterday was only in the 900’s, so we are getting there.

          1. Deb, I actually live in Houston, and can assure you that there is no need to worry about us here. Only one person in my zip code zone has died since the beginning of the epidemic, despite a large number of people in assisted living facilities. Reported recent surges in Houston cases reported by the mainstream media were due to the city and county dumping old results that they had sat on for months, claiming that they had inadequate resources to update cases online. Both negative and positive cases peaked at the beginning of July (as the state began to reopen and testing ramped up) and have decreased dramatically since then. For the most recent date the breakdown is available, Sept 17, there were 232 positive cases and 3,700 negative cases. For today’s result there are 599 “old cases” just being reported now, and only 315 “new cases.” To date there have been only 1,778 deaths countywide. These numbers are for a population of almost 5 million people in Harris County, which includes Houston. Google reports 23,785 deaths for about 8 million people in NYC. There are all sorts of theories about the reason for this difference.

            The Houston mayor and Harris County commissioner are fanning the flames of panic, in order to keep people from reporting to work and to keep schools closed, hoping that this will help their slate of candidates in the coming election.

          1. Deb, yes the treatment makes sense. Some docs here adding thiamine to prevent sepsis.
            Hydroxychloroquine most likely worked, the trials on that were a joke. But for the same reason macrolide class drugs will work as they also are zinc ionophores. Good for Florida. Here, where doctors are allowed to do their jobs w/o interference the fatality rate of hospitalized patients is 1.2%.

    2. “Love the Fuji apples. I eat a bag a week when I can find them.”

      Wade,

      My brother was in town and it was time to hit the grocery store – while there we bought one each of the eight different organic apples available at the health food co-op that day during apple season – sat down at a table and cut slices onto paper towels – and did our own little informal apple test.

      The test was neither randomized nor blinded. And we were both talkin’ and tellin’ tall tales . . . But I think the test still worked out pretty well.

      It seems that we are both crisp apple aficionados – so the “Delicious” apples instantly failed our informal test. No crunch – way too mushy.

      The winner, by far, was the new (to us) “Jazz” apple – neither of us had ever previously heard of it – super crisp, very flavorful, wonderful aroma. Apple perfection. If you have a chance, you might want to give it a whirl.

      Otherwise we favored Honeycrisps – lotsa crunch but not near as much flavor – which did not compare to the Jazz. Third up – Gala – less crunch, but still good – but more flavor.

      I spoke of this later to an orchardist who clued me in – the Jazz apples are a monopoly item – he cannot get them.

      As I recollect, bred since the 1980s in New Zealand. Licensed. Controlled. But at least – not a gene manipulation thing.

      And he explained to me – different apples ripen at different times during apple season – early, medium, late – so our sampling was a snapshot in different apples’ different ripening times. The quality of the apples we sampled may have varied considerably had we had run our experiment two weeks earlier or two weeks later.

      My thought – if you have a farmer’s market handy, consider talking to the orchardist if he is there – not just someone selling his apples for him – and tell him what qualities you care about in an apple and he will likely be happy to guide you through the entire season.

      Consider the joys of the open mind.

      Bon appétit –

      Vivamus

      1. ‘ the “Delicious” apples instantly failed our informal test. No crunch – way too mushy.’

        That’s interesting. I’ve been eating Delicious apples since the 1980s in both the UK and Australia because they were the crispiest and crunchiest apples around. However, here in the Philippines the only Delicious apples to be found are imported from Washington and you are right – they fail the test. At least half of them are ‘floury’. I’d always assumed that this was due to transport and storage issues though since all the ones I ate in the UK and Australia were wonderful-tasting apples.

        I’ve been reduced to eating Fuji apples here. They too are imported but they are famous for their long storage life and I’ve never encountered a floury one.

  2. What about unsweetened, unflavored apple sauce? Obviously, they, without the peel, wouldn’t be as healthful as whole apple. But does apple sauce have any benefit other than the fiber?

    1. George, not sure why my reply wasn’t placed under your question. That was my first time responding to someone, though I’ve been reading Dr. Greger’s posts for several years. Cheers!

  3. An apple a day may keep the pharmacist away is a very good saying.

    It makes me wonder if the apple a day saying used to be true in the years before statins.

    And it makes me wonder if the apple a day saying would be true for people who refuse to take statins.

    The older generations were sometimes like ninjas with these quirky little sayings that meant something.

    They didn’t pause after the little ditties to explain the science but it surprises me when the science backs up the sayings.

  4. Everyone I know has developed problems with most apples sold in stores. They now cause digestive problems.

    The produce you buy in the supermarket or grocery store is not fresh. With many items, like spinach, the leaves may have been plucked no more than a few weeks ago. But with many others, like apples, the fruit probably sat in cold storage for a year before making its way to the supermarket. Here in the U.S. apples generally ripen between August and September. They pick the apples when they’re slightly unripe, treat them with a chemical called 1-methylcyclopropene, wax them, box them, stack them on pallets, and keep them in cold storage warehouses for an average of 9-12 months.

    Aside from dietary fiber and sugar, apples are a rich source of polyphenols — antioxidants that can help fight cancer and improve post-workout recovery by reducing muscle fatigue.

    Yet according to this study, antioxidant activity in apples gradually drops off after three months of storage in the cold. An apple stored for nearly a year? It will have almost no antioxidants remaining in it whatsoever.
    https://pubs.acs.org/doi/abs/10.1021/bk-2007-0956.ch020

    The only apples I have found that do not cause a strong laxative effect are either fresh at a farmers market or Costco’s ‘new crop’ apples that have never been in long term storage.

    1. RB,

      That is very interesting. We are still in apple season. Guess I had better go out and get some now.

      We invented something and fix equipment regularly for an apple farm, so I had better go over there and ask if I can get some before they are treated with anything.

      1. Deb, unfortunately the most of the apples sold right now were picked last year. The apples picked now won’t be available until next year. The only way I have found to avoid this is farmers markets or ‘new crop’ apples which are marketed as such to account for the higher price.

    2. Part of the problem is that we have fewer varieties of apples, and the few we have are much sweeter than in past centuries. But it seems that apples were harvested nearly year round in the past. From a book published more than a century ago (The 1896 Boston Cooking-School Cookbook): “Apples are obtainable nearly all the year, and on account of their variety, cheapness, and abundance are termed queen of fruits.” Fanny Farmer, the author, says that fruit should always be offered with breakfast, you should never eat unripe fruit, and if for some reason you cannot eat fruit raw, you should eat it cooked.

      Here is an interesting article discussing cold storage methods for apples: https://www.abc.net.au/news/science/2018-07-17/apple-storage-how-kept-crisp-and-crunchy-explained/9997870 “So how long can an apple be stored? With cold storage, you’re looking at about three months of storage, Dr James said.
      Controlled atmosphere stretches this out to six to eight months. Dynamic controlled atmosphere and 1-MCP will add another couple of months. …But the apple varietal, harvest maturity and seasonal conditions play all a significant role in storage length, Dr James added. A Granny Smith will always store better than a gala. …What will improve apple storage markedly, he added, is what happens to the fruit before it’s picked. Tree wellbeing and orchard sanitation will help ensure that the fruit that goes into storage is of the highest quality possible.”

      1. This article claims that with correct cold storage methods, there is little loss of quality in apples: http://www.nationalapplemuseum.com/book19.html

        In the 1950s, Wenatchee native Archie Van Doren introduced Controlled Atmosphere (CA) storage to the Washington apple industry. The Apple Industry had found out that by storing the apples in a reduced oxygen atmosphere, that respiration slows down. They do this by storing them in special controlled atmosphere storage areas where they increase the level of nitrogen. Ripening apples give off carbon dioxide (CO2). Researchers figured out that increasing the amount Stubbs of carbon dioxide around the fruit, it produces a back pressure and reduces the rate of respiration. CA storage is a non-chemical process in which temperature, oxygen, carbon dioxide, and humidity levels are carefully controlled. Temperature is kept between 32 and 36 degrees Fahrenheit, humidity is held at 95%, and oxygen is replaced with nitrogen and carbon dioxide. By changing the atmosphere around the apples, the ripening process is slowed, and apples can be stored up to a year with little or no loss of quality.

        My mother described what was done in New England in centuries past, a primitive version of CA storage. Her grandmother’s home in Blandford MA, like many of the era, had been built above a spring, apparently with an arrangement of this sort for apple storage: “Gary Mount, of Terhune Orchards in Princeton, New Jersey, started out with a strikingly similar cold storage system for the apples on his 200-acre farm. A room under the farm store, with a small natural spring running through it and a vent for warmer air, kept the humidity high and the temperature low.” More perishable products (my mother mentioned butter) were actually suspended into the spring water, keeping them fresh indefinitely. Dairy cows were milked only seasonally back then, so butter needed to be stored for the rest of the year.

        1. Notice WHO wrote the article, a museum promoting apples. Sources matter when it comes to truth.

          From their website: Its goals were to create a museum facility to honor, archive, PROMOTE and display material, memorabilia, and equipment of the Apple and Fruit Industry in Adams County.

        2. All dairy cows are ‘milked seasonally’ as they must give birth to lactate. The calves are taken away and the mother rotated into the milking herd. rBGH hormone can increase milk flow. rBGH or not, production levels peak at around 40 to 60 days after calving. Production declines steadily afterwards until milking is stopped at about 10 months. The cow is “dried off” for about sixty days before artificial insemination and calving again.

      2. Grow your own apples if you live where they grow. I don’t spray my tree, only lose a few, but mostly to the birds.
        Most apples need cross-pollination from another tree. I only have one. But apparently a neighbor’s tree does the job.
        Only problem is this time of year, too big a crop every other year.
        They keep well in the crisper, and they freeze well.
        I also freeze all extra peaches for the winter. They are so easy and fast to do.

    3. “Everyone I know has developed problems with most apples sold in stores. They now cause digestive problems. ”

      RB,

      No problems here. Ever. I do buy organic, and dial back when the apples go out of season.

      I am a crisp / crunch apple person. So when the apples get old, they lose that crisp quality and I seek out other foods.

      Regards,

      Vivamus

      1. I know way too many patients and staff in my clinic that turn into salad shooters if apples are involved. It even came up at a staff board meeting and it was unanimous that apples should not be in the buffet for this very reason. Organic does not matter as the results were the same. Even organic apples are put into long term cold storage. Although 1-methylcyclopropene is not currently approved for use on organic apples, organic growers still use approved non-synthetic fungicides and controlled atmosphere cold storage to achieve a similar effect.

      2. Vivamus,

        I am a crisp/crunch apple person, too.

        I want to eat them cold and crisp (though I liked them as Apple crisp, too, but have never searched for a healthy version)

        I am very picky with fruit.

        The Save The Food people would hate me.

    4. Reality Bites – Some of your information is slightly misleading. Spinach is not picked a “couple of weeks” prior to showing up on our grocery shelves. Spinach doesn’t last more than 10-14 days total after picking before rot sets in. The only other way to keep spinach is to freeze it. As for apples – yes they are treated so that they can be stored for as long as, i.e., up to, 9-12 months as the outside parameter. They do not sit in storage for a year before being released for sale to the public. While you may be getting an older apple in May, apples are not “held back” in any way after picking and treating.

  5. Dr. Greger took the leading causes of death disease by disease. I can do the same with some improvements:
    Heart disease yellow orange vegetables
    lung cancer Soybeans, lentils (phosphorus and iron)
    asthma yellow bell pepper, red kidney beans lentils, hibsicus (Vitamin C, Molybdenum and Manganese)
    stroke bananas potatoes orange juice stroke (Silicon and Potassium)
    infections brazil nuts (Selenium has been shown to raise CD4 counts)
    diabetes sunflower seeds red kidney beans (B1, Molybdenum)
    high blood pressure sunflower seeds soybeans (iron)
    depression sunflower seeds, flaxseed meal, hibiscus tea (B1, Omega 3s, Iron)
    parkinsons red kidney beans lentils (Molybdenum)

    Thanks

      1. cinnamon for diabetes.

        Dr. Greger has a video with number of servings of vegetables and asthma and also for depression

        Broccoli sprouts and cruciferous for asthma (sulforaphane)

        Brazil nuts for lowering cholesterol

        Walnuts for stroke

            1. I think Potassium is also very good for heart disease and anthrosclerosis. So Sweet Potatoes, Swiss Chard, Potatoes, and Lima Beans for heart disease. I think it also helps with impotency related to heart disease or others to save the Chinese rain forests and creatures.

          1. Matthew actually its all already in the daily dozen app (if we include the 21 tweaks)
            Doc Greger gets there by variety, so it wouldn’t be like: eat half a brazil nut, 1/4 walnut, every 6 hours etc… too many rich foods to choose from. But sticking to his categories and mixing things up I believe all the mentioned items are there already.

            Still its nice what you and Deb are doing with the specifics, to zero in on some things we feel may help certain conditions, and maybe focus on them for a bit before going soon back to variety.

            1. Thank you. Dr. Greger’s list was salubrious and good as is. I am trying to get lists of the foods for proven mortality reduction and Hazard ratio reduction and here it is

              hot pepper 14 percent reduction
              greens 21 percent reduction
              hour exercise 14 percent reduction
              nuts 14 percent reduction
              vitamin d3 11 percent reduction-40 percent
              4 grams fiber whole grains 14 percent reduction
              10 serrvings of fruits and veg 36-40 percent reduction
              brocoli 200 grams 25 percent reduction
              berries one year longer
              50 cents daily produce 10 percent reduction
              dark chocholate one year longer
              beans per 20 grams 8 percent
              green vegetable as long as exercise
              green tea 4 percent per cup
              fiber 23 percent reduction highest intake
              ceral fiber 10 grams a day 25 percent reduction
              apple a day 35 percent reduction for women 20+ percent men
              onion 50 percent reduction
              400 grams of veggies a day 32 percent reduction.

              Yellow pepper is rich in vitamin C, that yielded a mortality benefit. Leafy greens yield a mortality benefit, maybe because of K2 and K1, and red wine has various benefits maybe because of the boron. So grape juice should be beneficial.

  6. Its not scientific, just an experience.

    I eat many apples, and have never noticed any direct correlation to my bathroom activities, other than things are just always regular. However I have noticed that when I eat apples, it does seem to work as Dr. Greger says, in the form as a dietary “pre-load” and its hard to overeat bad foods when you are full of a juicy apple. I guess even if the antioxidents the natural fiber, the chewing, the volume, the low calories, all play a role in keeping one from overeating other foods, I think.

    As far as food chain logistics RB, someone should tell the logistics firms that the seasons are opposite south of the equator and would allow for many types of crops to be delivered without first being cold packed for a year.

    This would of course, come out of profit.

  7. Valid points, Reality B. My family doesn’t have digestive problems with the apples we consume.

    I’ll grant you, in a competition between a apple recently out of the orchard and one out of long-term storage, there’s no comparison. I tend to trail off buying apples through the summer as the fruit becomes obviously well past it’s “best by” date.

    That said, do you have any ideas for providing apples to consumers beyond September? While the stored apples may be a pale shadow of their peak freshness cousins, there’s still benefit from these long term fruit. I grew up in a house with a root cellar where my parents kept crates of apples into the winter. Seems like an apples and apples comparison (sorry, I just couldn’t resist 8^)

  8. I would not consume any fresh fruit or processed fruit that comes from China. Their use of pesticides is not well controlled and what is in the soil is not known. They have a very bad record on food safety. China has a goal of being the largest apple producer in the world and with cheap labor costs–prisoners they will most likely achieve the goal. If fresh fruit does not come from the USA and with some exceptions Canada or Mexico I do without.

    1. Wolf, thats an interesting policy.

      We all know there are US agro companies using cheap labor, chemicals from use on soil from monsatnto/round up and corporate dumping in native american rivers, and bad soil from Fracking here, and of course complete non-transparancey with the american public.

      We have uranium and copper mining here which harms our soils and rivers, our sockey salmon supply, our cattle and poultry farms are impacted.

      The best part is that deregulation of laws concerning pollution from corporations, for extended profit margins does happen on our watch, so I’m suggesting the pot and kettle concept.

      I agree, we have no idea what China is doing, but if you take just a bit of time to look under our own hood, you will see we need to apply these transparency policies on all countries, including ourselves. So, don’t trust China, if you have that bent, but at least trust yourself – after looking into our own practices in an open mind not set out to prove we are superior or better.

      They alternative may be that we china bash, Russia bash, and meanwhile we could end up the unhealthiest. Unless we are awake to the realities beyond the rhetoric and propaganda.

      (I don’t say we shouldn’t be critical of other countries, just that we should include similar shortcomings back home as a means for improvement.)

  9. On a tangentially related topic: In an article about the race to redesign sugar, so that we can taste the same amount of sweetness with fewer calories:

    “People in the food industry talk a lot about “revealed preference.” In surveys, customers tell you that they want healthy choices, but analysis of purchasing patterns reveals a different hierarchy of priorities: customers care about taste above all else, and value for money to a certain extent; any other claim that a product touts, be it health benefit or environmental impact, lies far behind.” https://www.newyorker.com/magazine/2020/09/28/the-race-to-redesign-sugar

    But the article ends: “Just as the only good substitute for sugar is sugar, the only good way to eat less of it, sadly, is to eat less of it. ♦”

    1. Dr. J – I have solved the sugar problem for myself at least. The only place I like some sweetness in is my morning coffee (not a “cream” person). I use a packet of stevia. However, the taste is just not “right”. Although stevia makes it mostly sweet enough, it’s still flat. So I add just a smidgen of sugar. . . about 1/4 tsp. It’s just enough to make the flavor right. I do the same in cooking other items – use mostly stevia and just enough sugar or agave or honey (or whatever sweetener is required) to provide the correct flavor finish. It really seems to work for me. I try to use real sugar like salt – just enough to top off the flavor.

  10. I find it instructive, at times, to directly examine the original articles that Dr. Greger bases his videos upon. One learns about the authors – good or ill – motivations – the funding behind the studies – conflicts of interest – that Dr. Greger does not always bring to the fore.

    Such is the case of the BMJ article: A statin a day keeps the doctor away: comparative
    proverb assessment modelling study; Adam D M Briggs, Anja Mizdrak, Peter Scarborough;
    BHF Health Promotion Research Group, Nuffield Department of Population Health, University of Oxford, Headington, Oxford OX3 7LF, UK; BMJ 2013;347:f7267 doi: 10.1136/bmj.f7267 (Published 17 December 2013)

    People have expressed concern about the considerable time and cost of putting together a nutrition study at the level of the reputable established journals. The cost of instrumentation, alone, well . . . This particular study gives us data on just what it costs to produce studies that are of sufficient quality to be published in the BMJ – one can see why people are concerned about possible bias from funding sources.

    Here are relevant excerpts – side effects, methodology, economic considerations, conclusion, authors, funding, declared conflicts of interest:

    “No side effects were modelled for increased apple consumption;
    aside from the distress caused by a bruised apple, and the
    theoretical risk of identifying half a worm inside, apple related
    adverse events are not widely recognised.

    . . .

    On a conservative basis, we assumed apples to weigh
    100 g, although weighing of various varieties identified
    examples of up to 250 g (authors’ measurements using
    household scales and a range of apples).

    . . .

    The basic costs of apples
    are likely to be greater than those of statins; however, NHS
    prescription prices and convenience may drive people to
    purchase their apples from a store rather than through a
    pharmacy, thereby reducing direct NHS costs, or the NHS may
    be able to negotiate apple price freezes (although defrosted
    apples may not be so palatable). 2

    . . .

    Conclusions:
    We find that
    a 150 year old proverb is able to match modern medicine and
    is likely to have fewer side effects. Now to model the effect of
    inquisitiveness on feline mortality rate

    . . .

    Contributors: ADMB devised a different study involving superheroes;
    PS expanded the idea and wanted to do that one. ADMB instead devised
    this study and talked PS out of the other one. Therefore, for this study,
    PS developed the PRIME model. ADMB and AM completed the
    modelling, and ADMB drafted the manuscript. ADMB and PS contributed
    to the study design. ADMB, PS, and AM reviewed and critiqued the final
    manuscript. PS will have to wait until next year to write a paper about
    superheroes. ADMB is unlikely to help him, but AM could be talked
    around to the idea. ADMB is the guarantor.

    . . .

    Funding: No explicit funding for this work was sought. ADMB is a
    National Institute for Health Research funded academic clinical fellow
    in public health. PS and AM are funded by the British Heart Foundation.
    The funders had no role in the design, process, or reporting of this study

    . . .

    Competing interests: All authors have completed the ICMJE uniform
    disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: no
    support from any organisation for the submitted work; PS has received
    research grants from the British Heart Foundation; ADMB eats five a
    day, AM tries to, and PS is a vegetarian; all diets include apples; neither
    ADMB, AM, nor PS takes statins, and all purport to be under 50 years
    old.”

    . . .

    To you health!

    Vivamus

    1. Vivamus,

      I laughed when I got to the line:

      ADMB devised a different study involving superheroes.

      So, which superhero would you be?

      I am thinking that I would definitely be wonder woman – no caps, just someone who has a gift of wondering about a lot of things.

      I guess that would make me a sidekick.

      1. “I am thinking that I would definitely be wonder woman – no caps, just someone who has a gift of wondering about a lot of things.”

        Perfect.

        ———————————————

        “So, which superhero would you be?”

        I’ve never thought about it:

        Willy Loman

        Philemon (with Baucis)
        lines 611-727 – a foolish fiction? – you be the judge
        Metamorpheses VIII
        Ovid
        https://www.theoi.com/Text/OvidMetamorphoses8.html

        Prometheus

        Hephaestus

        Edward Fegen aboard the Jervis Bay

        Ernest E. Evans aboard the Johnston

        My Man Godfrey

        The Thin Man

        Captain Louis Renault

        Mickey – from Alan Rudolph’s 1984 classic, Choose Me

        The Vikings

        The Shadow

        The Bearer Of Evil Tidings
        https://voetica.com/voetica.php?collection=1&poet=22&poem=924

        It is difficult to know . . .

        Perhaps Hephaestus: he wrought the Shield of Achilles

        It is difficult to know.

        ———————————————

        The Shield of Achilles
        Auden
        https://www.sccs.swarthmore.edu/users/99/jrieffel/poetry/auden/achilles.html

  11. Off topic post

    ‘As advisers to the nation on all matters of science, medicine, and public health, we are compelled to underscore the value of science-based decision-making at all levels of government. Our nation is at a critical time in the course of the COVID-19 pandemic with important decisions ahead of us, especially concerning the efficacy and safety of vaccines. Policymaking must be informed by the best available evidence without it being distorted, concealed, or otherwise deliberately miscommunicated. We find ongoing reports and incidents of the politicization of science, particularly the overriding of evidence and advice from public health officials and derision of government scientists, to be alarming. It undermines the credibility of public health agencies and the public’s confidence in them when we need it most. Ending the pandemic will require decision-making that is not only based on science but also sufficiently transparent to ensure public trust in, and adherence to, sound public-health instructions. Any efforts to discredit the best science and scientists threaten the health and welfare of us all.

    Marcia McNutt
    President, National Academy of Sciences

    Victor J. Dzau
    President, National Academy of Medicine’

    https://www.nationalacademies.org/news/2020/09/nas-and-nam-presidents-alarmed-by-political-interference-in-science-amid-pandemic

    1. Tom,

      Yes, politics messing with science during a pandemic sucks.

      I more than highly suspect that politics has always messed with science and medicine and it sucked before COVID, too.

      Greed is such a powerful addiction.

      1. I suspect that actually it will turn out to be a good thing.

        Think about how many bad studies there were on this site before COVID and nobody has dealt with it.

        This might cause changes.

  12. Maybe it is naive to think governments and businesses won’t meddle with science and medicine.

    While we don’t want abuse if people…..

    https://en.m.wikipedia.org/wiki/Unethical_human_experimentation_in_the_United_States

    We can list Big pharma, Big government, Big medicine, Big supplement, Big tobacco, Big food industries, Big box stores, Big internet influencers, etc

    Coming from small business it is always frustrating that Big everything else gets such Big money by telling such Big fish tales.

  13. I am cynical about the fact that most of the data on the miracle of statins comes from the pharmaceutical industry.
    I am not buying into drugs verses diet, exercise and prevention in general.
    The only benefit of statins to me is if you have already developed significant heart disease.
    The benefits in other areas are most likely incidental findings during studies and select data.

    1. Nancy – I am sorry that I can’t provide you with where, exactly, I got this information, but I saw an interview with a Doc who didn’t think that statins were necessary for everyone that had a little bit high cholesterol, WFPB or not. Because the benefit over the side effects wasn’t completely clear, his position was that the only reason to prescribe statins would be for someone who has clearly defined heart disease or had an attack where the benefit could be clearly seen. Otherwise the decision was to not add statins. The pharmaceutical companies have suggested that statins should be put in all prepared food (or maybe water?) for everyone to consume – that thought simply horrified me! It’s possible that the Doc who shared this statin opinion might have been Dr. McDougall. I have a little cholesterol increase after menopause like many women mention on this site. But I also noticed that when I quit drinking alcohol, my cholesterol dropped remarkably. It went from 243 to 180. I don’t see the alcohol link mentioned anywhere, usually, on this site as relates to cholesterol increase. Here’s a link to some info on alcohol and cholesterol. https://www.goodrx.com/blog/does-alcohol-affect-cholesterol/

      1. As I understand it, no responsible doctor anywhere would prescribe statins simply because someone ‘had a little bit high cholesterol’ There are various risk calculators that should be used and in the UK, for example, family doctors are advised

        ‘Primary prevention

        1.3.14 Before offering statin treatment for primary prevention, discuss the benefits of lifestyle modification and optimise the management of all other modifiable CVD risk factors if possible. [new 2014]

        1.3.15 Recognise that people may need support to change their lifestyle. To help them do this, refer them to programmes such as exercise referral schemes. (See the NICE guidelines on behaviour change: individual approaches and physical activity: exercise referral schemes.) [new 2014]

        1.3.16 Offer people the opportunity to have their risk of CVD assessed again after they have tried to change their lifestyle. [new 2014]

        1.3.17 If lifestyle modification is ineffective or inappropriate offer statin treatment after risk assessment. [new 2014]

        1.3.18 Offer atorvastatin 20 mg for the primary prevention of CVD to people who have a 10% or greater 10‑year risk of developing CVD. Estimate the level of risk using the QRISK2 assessment tool. [new 2014]

        For information about implementing this recommendation, see implementation: getting started.

        1.3.19 For people 85 years or older consider atorvastatin 20 mg as statins may be of benefit in reducing the risk of non‑fatal myocardial infarction. Be aware of factors that may make treatment inappropriate (see recommendation 1.3.12). [new 2014]’

        https://www.nice.org.uk/guidance/cg181/chapter/1-Recommendations#identifying-and-assessing-cardiovascular-disease-cvd-risk-2

        Regarding alcohol and high cholesterol. they also advise doctors to

        ‘Exclude possible common secondary causes of dyslipidaemia (such as excess alcohol, uncontrolled diabetes, hypothyroidism, liver disease and nephrotic syndrome) before referring for specialist review.’

        Finally, people in this situation may want to consider the UK patient decision aid on whether or not to take statins

        https://www.nice.org.uk/guidance/cg181/resources/patient-decision-aid-pdf-243780159

        There are multiple similar guidance documents for US physicians I believe.

    1. Above: “vascular smooth muscle cells”…

      If Dr Greger’s grandma would have taken a daily cold shower, she would not have died from heart disease caused by lack of vascular fitness.

  14. Thank you for the video, is there any information on dizziness? I sometimes feel occasional and brief dizziness and recently am avoiding escalators as I feel I get dizzy, feel my legs weakened and have a falling back sensation I’ve never had before.

    1. I have no connection with the site and don’t want to appear unhelpful, but please see an MD. There are multiple possible causes of dizziness and not all can be addressed by dietary interventions.

    2. Nena,

      Tom is right about dizziness.

      Too many causes.

      Plus, vertigo, which also has a lot of causes. But there are movements that can help if it is vertigo and often simple things like magnesium can help that because calcium deposits are a big factor for that.

      Tell your doctor about the falling backward. There are a lot of things that can cause it, including age, but it is a symptom for a lot of things and sometimes we forget to say things like that when we get to the professionals because we don’t know that they are important.

    3. Nena,

      In general, don’t mess with balance problems. They can be something small but they could also be caused by things like a stroke.

      Not saying that you had one. But my step-mother started having balance problems and it turned out to be a stroke.

    4. Nena,
      Tom’s suggestion to see an MD gets your condition before a trained professional. Anecdotaly, I am interested in your falling backward problem. I started having that problem over five years ago, after a knee injury. I lost some cartilage in that knee which maybe caused some loss of balance. I limped for years.
      I also started experiencing more ailments new to me: Loss of body strength, especially during winter months accompanied with lots of sleeping and cold intolerance, rigidity (arthritis in my muscles), weight loss (or inability to gain weight). I looked like a cold turtle in slow motion.
      I countered with turning the heat up, wearing more layers of clothing, eating lots more, and increasing my exercise. I’ve walked for years and for the last several months I’ve added running. I also do lots of stretching every day to keep the arthritis at bay. I feel better now and have better balance. I can touch my toes with ease.
      I am 61 now and have figured out that good health doesn’t come easy anymore. I have to work for it.

      1. One other addition to my earlier comments: On the flip side there are many benign potentials for your symptoms so make certain to have a proper exam, not a 2 minute look by a medical assistant. Don’t forget that a physical exam can be a life saver…..

        1. Are you breathing through the mouth ? Maybe are y unconsciously hyperventilating, lowering oxygen in your brain which may create a sensation of lightheadness and dizziness. Slow nasal breathing may reverse the symptoms…

    5. Nena, if you are vegan, are taking B12 supplements. See Dr Greger’s latest videos on B12 for his updated recommendation. I feel less unsteady after adding B12 lozenges twice a weak

      1. There appears to be another Barb posting in the forum… no problem , I will change my name.

        Thanks Dan, I am feeling better. I could go another 10 years without another gallbladder attack and that would suit me fine.

        I was out riding twice today but not one pelican in sight :)
        I am jealous! Did have geese overhead and hummingbirds visit all day long. This is the first relaxing day in over a week… lots going on here, and I was walking the neighbour’s dog too 3 x day. But today is awesome.

    6. As Barb mentioned, make sure you’re taking a good B12 supplement in the dosage Dr. Greger recommends. You can actually become anemic from lacking enough B12, which can actually cause dizziness and breathlessness. In addition to seeing your doctor, if you aren’t taking a good B12 supplement, definitely start today.

  15. 8-5-2020

    Red Ruby Slippers

    Reminds me of the
    Skin of red delicious apples.
    And taste the Oz magic
    And juiciness and
    Crispness and sweetness.
    Dorothy would be proud.

    1. Red Ruby Slippers reminds me of grapefruit juice.

      You have a sweet soul.

      I visited my 90-year old relatives tonight. It was a birthday and they are so sweet and smiling and simple.

      I came back and I was thinking about the different cultures nowadays and they are a winning culture.

      I ended up watching a social experiment website where these men try asking people for money and food and then they ask the homeless for money and food and over and over again it is the homeless community who helped them. Every Sunday is a homeless roundtable and I am so impressed by so many of the homeless people. They just love and support and care so deeply.

      I wonder if it would be easier to get them to have disciplined lives and get careers that make money or get the people with money to care.

      1. Well Deb, you may be enamoured with the homeless, but I see it from another perspective…and I see it close up in real life, not life on the internet. Not sure what it all has to do with nutrition though….

        1. Many if not most homeless people are homeless due to extreme drug addiction. It’s horrifically tragic; it’s not a warm caring culture. It’s a horrible life and moreover, a ruined (hopefully not permanently) life over addiction. Obviously not all homeless people are drug addicts. There are many circumstances that can lead to homelessness and if there are a group of homeless people caring so deeply for one another, that is a beautiful thing. But there’s nothing warm or inviting about the tragedy of homelessness and for those without mental illness and addiction, I hope they all get help and get out of that horrific circumstance. For those with addiction and mental illness resulting in homelessness, I hope they all get help (will accept it as well) and get out of that horrific circumstance of not only homelessness, but what lead to it.

  16. “An apple a day keeps the doctor away” actually comes from an incident in 1892, West Virginia. There was an old man–very lively, but with a number of health conditions–who was very reluctant about getting help from anyone, especially doctors. Communities were closer back then, and his neighbors and family were concerned. So the town’s doctor would regularly go and check on him, it came to be a day by day basis. The doctor and the old man’s friends and family were unrelenting in their concern, so eventually every time the doctor came to check on the old man, he started taking an apple off the tree just outside his front door, and throwing it at the doctor. It took about 5 or 6 days, but after having an apple thrown at him (the doctor) upon his visits, he finally gave up and stopped checking on the old man. And that is how the saying came to be. True story.

    1. There’s not enough talk about herbicides and pesticides in general. I think because the benefits of eating whole plant foods far outweighs the negatives of the pesticides/herbicides if you can’t get organic–not to mention what people would be eating instead (which incidentally would likely contain even more herbicides/pesticides or at least equal and without the benefits). And so I suspect Dr. Greger worries about deterring people who can only get conventional produce and other plant foods, from eating produce and other whole plant foods. But I still see pesticides/herbicides as well as GMO’s an extremely important, and all too unexplored topic. There’s likely backlash he would get from reporting any data on GMO’s, too. These corporations are rabid, Monstanto being the biggest.
      Dr. Greger did mention in a pod cast (if memory serves) that pesticides has been linked to prostate cancer (hope I’m getting that right), but berries help significantly.

      1. However, with the whole “benefits far outweigh the risk,” thing, I actually think a lot of people take that too far. If you can get organic, GET IT ORGANIC. Pesticides and herbicides are horrible for us. Yes the antioxidants outweigh the negatives, but if you’re investing on antioxidants (so to speak) why put in more crap they have to fight against? We get enough free radicals in everyday life without eating it on (and in) our food–which could and should also be something to consider when eating animal products… they’re damaging, they defeat the purpose of eating which is to nourish.

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