Flashback Friday: Evidence-Based Medicine or Evidence-Biased?

Flashback Friday: Evidence-Based Medicine or Evidence-Biased?
4.81 (96.27%) 75 votes

Evidence-based medicine may ironically bias medical professionals against the power of dietary intervention.

Discuss
Republish

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.

Dr. Esselstyn’s landmark study showing even advanced triple vessel coronary artery disease could be reversed with a plant-based diet has been criticized for being such a small study. But the reason we’re used to seeing such large studies is they typically show such small effects. Drug manufacturers may need to study 7,000 people in order to show a barely statistically significant 15% drop in ischemic events in a subsample of patients, whereas Esselstyn got a 100% drop in those who stuck to his diet—all the more compelling given that those 18 participants experienced “49 coronary events [such as heart attacks] in the 8 years before” they went on the diet. And these were the worst of the worst—most of whom having already failed surgical intervention. So, when the effects are that dramatic, how many people do you need?

Before 1885, symptomatic rabies was death sentence until July 6th, when little Joseph Meister became the first to receive Pasteur’s experimental rabies vaccine. “The results of this [and one other] case were so dramatic compared with previous experience” that the new treatment was accepted with a sample size of two. So dramatic, compared with previous experience, no randomized controlled trial was necessary. “Would you—having been infected by a rabid dog—be willing to participate in a randomized controlled trial…when being in the control group had a certainty of a ‘most awful death’?” Sadly, such a question is not entirely rhetorical.

In the 1970s, a revolutionary treatment for babies with immature lungs called ECMO, extracorporeal membranous oxygenation, “transformed mortality in these [babies] from 80 per cent [down] to 20 percent, nearly overnight”—from 80% dead to 80% alive. Despite this dramatic success, they felt forced to perform a randomized controlled trial. They didn’t want to. They knew they’d be condemning babies to death. “They felt compelled to perform [such] a trial, because their claim that ECMO [worked] would, they judged, carry little weight amongst their medical colleagues unless supported by a [randomized controlled] trial.”

And so, at Harvard’s Children’s Hospital, 39 infants were randomized to either get ECMO or not—just get conventional medical therapy. They decided to stop the trial after the fourth death, so as not to kill too many babies. And, that’s what they did. The study “was halted after the fourth [conventional medical therapy] death,” at which point nine out of the nine ECMO babies had survived. Imagine being the parent of one of those four dead children—just as one can imagine being the child of a parent who died from conventional medical or surgical therapy for heart disease.

“Medical students in the United States are taught [very] little about nutrition. Worse yet, their training [actually] biases them against the studies that show the power of dietary approaches to managing disease,” by encouraging them “to ignore any information that does not come from…double-blind, randomized controlled trial[s]. Yet human beings cannot [easily] be blinded to a dietary intervention.” They tend to notice what they’re eating. As a result, physicians [may be] biased [in favor of] drug treatments and against dietary interventions for the management of chronic disease.”

“Evidence[-based medicine] is a good thing. However, the medical profession [may be] focusing too much on one kind of evidence, to the exclusion of [all] others”—degenerating into a “ignoring-most-of-the-truly-important-evidence[-based] medicine.”

And heart disease is the perfect example. On a healthy-enough plant-based diet, our #1 cause of death may “simply cease…to exist.” The Cornell-Oxford-China Study showed that even “small amounts of animal-based foods [was] associated with small, but measurable increases in [the] risk of [some of these chronic] disease[s].”

“In other words, the causal relationship between dietary patterns and coronary artery disease was already well established before…Ornish…and…Esselstyn…undertook their clinical studies. The value of their studies was not so much in providing evidence that such a dietary change would be effective, but in showing that physicians can persuade their patients to make such changes,” and also providing interesting “data on the speed and magnitude of the change in severe atherosclerotic lesions as a result of dietary therapy.”

So, “[a]ny complaints that these studies were small or unblinded are simply irrelevant. Because the evidence of the role of diet in causing atherosclerosis is already so overwhelming, assigning a patient to a control group [eating the Standard American Diet could be considered a] violation of research ethics.”

“Evidence of the value of…plant-based diet[s] for managing [chronic disease] has been available in the medical literature for decades.” Kempner at Duke; John McDougall; The Physician’s Committee for Responsible Medicine. “Denis Burkitt warned us” that the Standard American Diet “is the standard cause of death and disability in the Western world,” for decades. “Yet physicians,…in the [U.S.], are still busily manning the ambulances at the bottom of the cliff instead of building fences at the top.

Please consider volunteering to help out on the site.

Images thanks to Wandering Eyre via flickr

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.

Dr. Esselstyn’s landmark study showing even advanced triple vessel coronary artery disease could be reversed with a plant-based diet has been criticized for being such a small study. But the reason we’re used to seeing such large studies is they typically show such small effects. Drug manufacturers may need to study 7,000 people in order to show a barely statistically significant 15% drop in ischemic events in a subsample of patients, whereas Esselstyn got a 100% drop in those who stuck to his diet—all the more compelling given that those 18 participants experienced “49 coronary events [such as heart attacks] in the 8 years before” they went on the diet. And these were the worst of the worst—most of whom having already failed surgical intervention. So, when the effects are that dramatic, how many people do you need?

Before 1885, symptomatic rabies was death sentence until July 6th, when little Joseph Meister became the first to receive Pasteur’s experimental rabies vaccine. “The results of this [and one other] case were so dramatic compared with previous experience” that the new treatment was accepted with a sample size of two. So dramatic, compared with previous experience, no randomized controlled trial was necessary. “Would you—having been infected by a rabid dog—be willing to participate in a randomized controlled trial…when being in the control group had a certainty of a ‘most awful death’?” Sadly, such a question is not entirely rhetorical.

In the 1970s, a revolutionary treatment for babies with immature lungs called ECMO, extracorporeal membranous oxygenation, “transformed mortality in these [babies] from 80 per cent [down] to 20 percent, nearly overnight”—from 80% dead to 80% alive. Despite this dramatic success, they felt forced to perform a randomized controlled trial. They didn’t want to. They knew they’d be condemning babies to death. “They felt compelled to perform [such] a trial, because their claim that ECMO [worked] would, they judged, carry little weight amongst their medical colleagues unless supported by a [randomized controlled] trial.”

And so, at Harvard’s Children’s Hospital, 39 infants were randomized to either get ECMO or not—just get conventional medical therapy. They decided to stop the trial after the fourth death, so as not to kill too many babies. And, that’s what they did. The study “was halted after the fourth [conventional medical therapy] death,” at which point nine out of the nine ECMO babies had survived. Imagine being the parent of one of those four dead children—just as one can imagine being the child of a parent who died from conventional medical or surgical therapy for heart disease.

“Medical students in the United States are taught [very] little about nutrition. Worse yet, their training [actually] biases them against the studies that show the power of dietary approaches to managing disease,” by encouraging them “to ignore any information that does not come from…double-blind, randomized controlled trial[s]. Yet human beings cannot [easily] be blinded to a dietary intervention.” They tend to notice what they’re eating. As a result, physicians [may be] biased [in favor of] drug treatments and against dietary interventions for the management of chronic disease.”

“Evidence[-based medicine] is a good thing. However, the medical profession [may be] focusing too much on one kind of evidence, to the exclusion of [all] others”—degenerating into a “ignoring-most-of-the-truly-important-evidence[-based] medicine.”

And heart disease is the perfect example. On a healthy-enough plant-based diet, our #1 cause of death may “simply cease…to exist.” The Cornell-Oxford-China Study showed that even “small amounts of animal-based foods [was] associated with small, but measurable increases in [the] risk of [some of these chronic] disease[s].”

“In other words, the causal relationship between dietary patterns and coronary artery disease was already well established before…Ornish…and…Esselstyn…undertook their clinical studies. The value of their studies was not so much in providing evidence that such a dietary change would be effective, but in showing that physicians can persuade their patients to make such changes,” and also providing interesting “data on the speed and magnitude of the change in severe atherosclerotic lesions as a result of dietary therapy.”

So, “[a]ny complaints that these studies were small or unblinded are simply irrelevant. Because the evidence of the role of diet in causing atherosclerosis is already so overwhelming, assigning a patient to a control group [eating the Standard American Diet could be considered a] violation of research ethics.”

“Evidence of the value of…plant-based diet[s] for managing [chronic disease] has been available in the medical literature for decades.” Kempner at Duke; John McDougall; The Physician’s Committee for Responsible Medicine. “Denis Burkitt warned us” that the Standard American Diet “is the standard cause of death and disability in the Western world,” for decades. “Yet physicians,…in the [U.S.], are still busily manning the ambulances at the bottom of the cliff instead of building fences at the top.

Please consider volunteering to help out on the site.

Images thanks to Wandering Eyre via flickr

Doctor's Note

This is one of my favorite videos of the year so far. If you’re not familiar with Dr. Esselstyn’s work, I touch on it in:

And, in fact, he just released a much larger study. Read it here.

Sadly, medical students learn little about these powerful tools:

If you haven’t heard of Pritikin, I introduce him here: Engineering a Cure

An intro to Dr. Ornish: Convergence of Evidence

Dr. Burkitt: Dr. Burkitt’s F-Word Diet

The Cornell-Oxford-China Study: China Study on Sudden Cardiac Death

And more on Dr. Walter Kempner’s work at Duke coming soon!

Since this video came out in 2014, I published that series on Dr. Kempner’s work:

And a recent series on lifestyle medicine program that draws its inspiration of these pioneers:

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

107 responses to “Flashback Friday: Evidence-Based Medicine or Evidence-Biased?

Comment Etiquette

On NutritionFacts.org, you'll find a vibrant community of nutrition enthusiasts, health professionals, and many knowledgeable users seeking to discover the healthiest diet to eat for themselves and their families. As always, our goal is to foster conversations that are insightful, engaging, and most of all, helpful – from the nutrition beginners to the experts in our community.

To do this we need your help, so here are some basic guidelines to get you started.

The Short List

To help maintain and foster a welcoming atmosphere in our comments, please refrain from rude comments, name-calling, and responding to posts that break the rules (see our full Community Guidelines for more details). We will remove any posts in violation of our rules when we see it, which will, unfortunately, include any nicer comments that may have been made in response.

Be respectful and help out our staff and volunteer health supporters by actively not replying to comments that are breaking the rules. Instead, please flag or report them by submitting a ticket to our help desk. NutritionFacts.org is made up of an incredible staff and many dedicated volunteers that work hard to ensure that the comments section runs smoothly and we spend a great deal of time reading comments from our community members.

Have a correction or suggestion for video or blog? Please contact us to let us know. Submitting a correction this way will result in a quicker fix than commenting on a thread with a suggestion or correction.

View the Full Community Guidelines

  1. Want more proof, look around America. People are literally eating themselves to death and fatter than ever. Doctors or anyone who dares to say one word about it are instantly berated because the gluttonous are ENTITLED to do whatever they want, even if it is be a massive drain on the nations health care system by their own hand. Then they not only want but EXPECT there to be one tiny pill once a day to make it all go away so they can continue. No sense of personal accountability whatsoever. There are two kinds of people I find, those with internal control and those with external. The internal control people see that they have a choice how to respond to everything. The external control people see themselves as victims of life and happenstance and refuse to see how they affect themselves. Much easier to play the victim than to bother actually taking control of ones life.

    1. Excuse me, but blaming the patient for the failure of modern medical education to put any to little credence in dietary interventions, is neither warranted nor helpful. The entire system has brainwashed doctors into just what Dr. Greger notes in the video, and also brainwashed patients into believing that only their doctor is trained to know best and that they need to do what the doctor says, period

      I have 2 relatives that are physicians. One a gastroenterologist MD and the other a pediatrician DO, and let me tell you what they think about dietary intervention for disease! Hogwash and then some, and they are so brainwashed to the pharmaceutical drug model, no amount of facts can dissuade them their beliefs. The gastro relative put himself on statin drugs convinced that they were the key to not having him die of heart disease. He went from having a normal cholesterol (and by normal I mean around 200) and absolutely no clogged arteries as evidenced by tests) at all, to lowering his cholesterol to the new ridiculously set levels and clogged arteries to the max, and now under the care of a cardiologist who insists that the statins were no the cause (when studies show statins can, in fact, stimulate atherosclerosis and as well promote heart failure. https://drlalithmendisblog.wordpress.com/2018/04/11/statins-promote-atherosclerosis/). As you can well guess, I am not a big fan of the failed cholesterol theory. Having said that however, I firmly believe in a plant-based (not plant only!) diet the main defense against all manner of disease and disability. My physician relatives routinely show that they will believe in drug-based medicine no matter what the consequences, even when the evidence is right in front of their own eyes.

      1. You have obviously been brainwashed by cranks if you can seriously talk about ‘the failed cholesterol theory’.

        Anybody who make such a statement clearly doesn’t understand what a scientific theory is in the first place.

        You also have to explain why major national reviews in the US, the UK and elsewhere have shown significant reductions in adverse events including death as a result of statin use.

        And why the independent Cochrane Reviews show benefits from statin use in primary and secondary prevention of heart disease.

        May I suggest that you review the European consensus statement on LDL cholesterol before making your mind up on this issue. Dr Greger also has a video on this which is worth watching.
        https://academic.oup.com/eurheartj/article/38/32/2459/3745109
        https://nutritionfacts.org/video/how-do-we-know-that-cholesterol-causes-heart-disease/

        1. First name name calling and bashing another point of view is inappropriate behavior. Very reputable scientists disagree with the cholesterol theory of heart disease and for very evidence-based reasons.

          Have you actually analyzed any of these drug company sponsored statin studies in terms of relative risk vs absolute risk? Drug companies prefer to use relative risk numbers because they make a treatment seem vastly more effective than it really is. Then there is the concept of numbers needed to treat. Statin drugs fail over 99% of those who take them. And the side effects (if you can call them that) are horrendous! Not worth it. I would not take a zilliion bucks to ever take one statin pill. I suggest you read 2 books: “The Statin Disaster” by David Brownstein, MD, and “How Statin Drugs Really Lower Cholesterol: And Kill You One Cell at a Time.” by James B Yoseph. and Hannah Yoseph, MD., and then come back and tell me how Statin Drugs save lives (cough cough)!

          1. The evidence is set out in muliple studies and reports by panels of national and international experts. I referred you to the European consensus report earler and also to the independent Cochrane Reviews. The UK’s National Health Service (NHS) has also looked at this issue in detail. That country’s National Institute for Health and Care ExcellenceNICE) reviewed this issue a while ago. Since the NHS pays wholly or in large part for all prescription drugs, primary and hospital health care services in that country, it has a strong vested interest in discovering whether statins are not only effective in reducing adverse events but also whether they are cost-effective (ie do the benefits outweigh the side effects). They concluded that, for appropriate target groups, they are. I suggest that you read its report instead of relying on books by a minority of MDs, which pander to conspiracy theorists, the naive and the credulous..
            https://www.nice.org.uk/guidance/CG181

            As for absolute and relative risk, yes we all know about the difference. Doctors aren’t fooled by pharmaceutical companies stressing relative risk and ignoring absolute risk. Going back to the UK again, its patient decision aid on whether or not to take a statin to reduce cardiovascular risk spends a lot of time going over this sissue. Incidentally it also states

            ‘Improving your diet, stopping smoking, reducing your alcohol intake, reducing your weight and taking more exercise can help reduce your risk of cardiovascular disease. NICE recommends that most people should try doing these things before thinking about taking a statin.’
            https://www.nice.org.uk/guidance/cg181/resources/patient-decision-aid-pdf-243780159

            I am sure that there must be similar reports and guidance in the US eg
            https://www.lipid.org/practicetools/guidelines/national

            As for calling cholesterol denialists ‘cranks’, that seems a pretty factual description to me. An overly polite one perhaps given how many people have likely died, suffered heart attacks and strokes because they have believed a minority of highly vocal people who deny the science. I see no reason to consider such people as representing a scientifically valid position any more than anti-vaxxers or evolution deniers.

            As I wrote before, read the scientific reports before simply believing books by opinionated cranks, or the thousands of websites run by kooks that seem to infest the internet.

  2. It would be good if people could be given a choice by their doctors. Switch to whole foods plant based diet or have their drugs. Right now, there aren’t enough doctors who know about whole foods plant based nutrition to even off the choice.

    1. Kathy,

      It is worse than that.

      Doctors actively tell people that it isn’t dietary.

      My sister-in-law said that the doctors told my brother straight out that his cancer would not be related to his diet. She said that the cells were too far away from normal and they said that diet wouldn’t have caused it and I had him eating WFPB every lunch and half of his dinners, but their sentences stopped the process.

      1. Deb,
        How is he doing post surgery?
        I know you must be frustrated after trying so hard to change his eating habits and cooking meals for him.

        1. Lida,

          He is doing well. His cancer was contained within the kidney. It was large enough that he had to lose his whole kidney, but he looks good.

          I just wish the doctors had ANY sense that it might be a good time to get him eating better.

          Dr. McDougall talks about slowing the doubling time and I would have loved it if they got him eating more cruciferous even.

          They stopped him from looking at nutrition.

          I hate that.

          He did keep Boca burgers. Not exactly WFPB, but better than eating meat every single meal.

            1. Dr. T. Colin Campbell considers tofu to be whole-food, plant-based as it is minimally processed with no added fat. This quote is from his website: “The term “whole” in WFPB describes foods that are minimally processed. This includes as many whole grains, fruits, vegetables, and legumes as you want. It also includes, in moderation: nuts, seeds, avocados, natural sweeteners, and certain soy or wheat products that don’t contain added fat (e.g., tofu).”

          1. Stick with it, Deb. Don’t give up. I sent my brother “The China Study” and numerous emails. He stayed with me one Christmas and said his sugar was good while he was here, although he did go out and get some steaks at one point. Sadly, we lost him at age 61. He always said to me, (and I’m 9 years older than he,) “Just wait till you get diabetes!” One of his carotid arteries was blocked. I tried to get him on the phone and he sounded drunk, although he was dry at the time. I sent the police to his house for a wellness check. He must have popped a candy in his mouth to answer the door. They said he was fine. Sadly, he passed away that night. I always figured since I was older, I’d go first, and told him so. It was shocking and devastating to me to lose my baby brother. It hurt so much to get his birth certificate with his little baby feet on it–so sad.

            Keep at it with your brother. Don’t give up.

            1. Liisa,

              That is so devastating. Utterly devastating that they did a wellness check and missed what you were attuned to.

              Family members always notice more. They see the subtle differences.

              Both of my brothers have health problems.

              My sister-in-law doesn’t believe that my brother will be alive 5 years from now, but she doesn’t believe in trying to do anything outside of medical model. She is “facing reality” of the likelihood of his death, but does not have a reality in her mind where he lives.

              I was so surprised by her saying things like that.

              She wants me to understand not to “count on” his being around and she is someone who is so independent that she will be “okay” even though they have been together as a couple since they were teenagers.

              I tried to talk about diet, but the doctors telling them that diet wasn’t involved is what they believe. They are medical model. All of my relatives are medical model, except for me.

              I am devastated for you. I am devastated by doctors thinking the way they do.

              1. The doctors told them that it was a 50% chance that he would get it back and they now have such a strong, “There is nothing really we can do about it.” belief system.

                He doesn’t even have a tumor right now.

                Right now, he just has a flip a coin view of the future.

                Heads he lives 5 years.

                Tails he dies.

              2. Deb, the last couple years I’ve been trying to get the cousins together once a month. Two of them have MS; they live in a belt near an industrial situation. So I thought I’d “work” on them, in particular–get them to read “The China Study” or to see “Forks Over Knives.” Sadly, I didn’t realize one of the other cousins was waiting for open heart surgery and she passed away before I heard anything about her needing surgery. I could have talked with her, but didn’t know. You and I are warriors for the ones we love.

    2. I agree with you, Kathy. But I suspect that even doctors who are knowledgeable about dietary/lifestyle healing might be reluctant to recommend it to their patients. People of our modern, technological times have so deified “science” that we may be conditioned to think modern pharmaceutical research is the most “scientific” way to deal with diseases. I think if a physician suggested to a patient with congestive heart disease that he/she could mitigate or even reverse disease through lifestyle and diet changes….. well, my guess is that patient might seek out another physician who would stick with the conventional regimen – the one that everybody else is doing.

      Might be easier if every physician in America had a copy of How Not To Die in the waiting room. =]

      1. It would even be better if physicians treated patients according to the current guidelines For exaple te latest joint American Collge of Cardiology and American Heart Association guidelines on the prevention of crdiovascular disease state

        ‘ Dietary patterns associated with CVD mortality include—sugar, low-calorie sweeteners, high-carbohydrate diets, low-carbohydrate diets, refined grains, trans fat, saturated fat, sodium, red meat, and processed red meat (such as bacon, salami, ham, hot dogs, and sausage). All adults should consume a healthy plant-based or Mediterranean-like diet high in vegetables, fruits, nuts, whole grains, lean vegetable or animal protein (preferably fish), and vegetable fiber, which has been shown to lower the risk of all-cause mortality compared to control or standard diet. Longstanding dietary patterns that focus on low intake of carbohydrates and a high intake of animal fat and protein as well as high carbohydrate diets are associated with increased cardiac and noncardiac mortality. ‘
        https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2019/03/07/16/00/2019-acc-aha-guideline-on-primary-prevention-gl-prevention

        That sounds like a prescription for a whole food plant based diet to me. It seems to me that many practising physicians are simply not aware of, or choose not to follow, the science presented in the latest evidence-based guidelines.

        1. M,

          My brother, who reversed his excess weight (by 70 lbs), T2 diabetes, high BP, high cholesterol, and a few other conditions, for which he was taking several meds, by a plant based diet and exercise, switched from one doctor who wasn’t to another who was supportive of his plant based eating. It was either his PCP or cardiologist; I can ask him. And he did a search online to find this doctor near him, though again, I can’t recall where.

          Maybe more of us should do the same. My doctors remain non-committal about my eating habits — it’s sort of a “no-judgment” attitude. Definitely not a “that’s the best way to go!” Attitude. Also, my husband’s PCP never checked his B12 levels, even though she know he was eating PBWF — because he told her. (She never asked about what he was eating. Why don’t doctors ask about diet?) She also never asked him if he was taking a B12 supplement. Instead, when his RBC levels decreased slightly, she sent him to a hematology oncologist — who did check his B12 levels! But by that time, he had started taking B12 supplements (due to his nagging wife, armed with the evidence on this site), and his B12 levels were normal, and his RBC levels had increased into the normal range. So, a lot of doctors are ignorant about the effects of diet on health, IMHO. Especially PCPs, I guess.

          1. I am confused. The subject line says Dr. J replies to Tom but Dr. J addresses the post to “M” which suggests it was meant for me.

            Anyway, if it was intended for me you are barking up the wrong tree. I continue to eat probably 90% of my calories from plant based whole foods.
            I’ve learned some things from Dr. Greger and I’ve learned some things from Dr. Attia and many other doctors as well.

            Even though the vegans on this blog seem to have a strong dislike for Dr.
            Attia I watched a video where he said he eats a huge salad bowl (about the volume of his head) every day and some wild salmon. He eats one meal a day as of the time of the video, maybe he has changed. Apparently he experiments a bit.

            Since I am here writing, when I’d prefer to be outside cycling, I may as well say that I was a vegan for 3 months and it didn’t work for me but I continue to eat mostly PBHF with wild Salmon and a few eggs instead of beans.

            Unlike your brother I was very fit when I changed to a vegan diet. I’m 63 years old, 5 feet 8 inches (plus a little, don’t want to cheat myself) and weighed about 138 to 140 pounds with a 31 inch waste. After 3 months of veganism I gained about 3 or 4 pounds (online vegan doctors indicated I’d lose weight), my pants go tighter and my blood glucose went up (online vegan doctors said it would go down). Blood pressure stayed about the same.

            I have now gone back to my old diet but only eat twice a day, instead of 3, and I am down to 133 to 134 pounds, have a 30 inch waste and my blood sugar as dropped dramatically and doesn’t fluctuate like it did on a vegan diet and blood pressure remains about the same.

            So… online vegans doctors confidently proclaim weight loss and better glucose readings but obviously that depends on the individual and it didn’t happen for me so I am disappointed in the vegan doctors and vegan community for their over promising and under delivering. They give some great advice at times but have the short-comings and biases as well.

            1. Well said Mike. I too am plant based but not vegan, and never can be for reasons I will not go into here. As a nutritionist I see way too many unhealthy vegans and paleo followers, as well as SAD diet adherents. Nutrition is about obtaining the full spectrum of nutrients, nto about dietary belief systems. What works for one person simply may not work for another.

            2. My name is Tom and that’s in my email address but I post here as Mr Fumblefingers or sometimes M. (because I accidentally deleted most of the Mr F moniker) to reflect the huge number of typos in my posts.

              Dr J’s post was a reply to me not you.

              As I think I have mentioned to you before, by and large vegan diets are no better or healthier than most other diets.

              https://www.youtube.com/watch?v=q7KeRwdIH04

              Eating a whole food plant based diet may benefit you. But it’s important to do it right. Wholegrain breads may promote weight gain so can nut butters, oils and avocadoes, 100% fruit jams etc. So can eating processed ‘vegan’ foods and frying one’s food.
              https://www.youtube.com/watch?v=1udAyTEtT8k

              I am the one person on this site who is particularly cautious about Attia’s claims but I am not a vegan. The terms ‘vegan’ and WFPB diet are not synonomous. There are important differences even if some ‘vegan’ diets are also WFPB diets. Most ‘vegan’ diets aren’t.

  3. It isn’t just “bias against things which can’t be studied by double-blind studies.

    It is that they also feel threatened by nutritional outcomes and how it will affect their jobs.

    I could even see the sense of threatening by my dog’s vet.

    I found ways to heal my dog without his products and when I don’t use the products, my dog’s lab reports become normal, and when his labs are normal, he doesn’t need check-ups. It threatens his wallet from so many directions.

    1. I know that I worded that poorly.

      My dog’s vet felt threatened and started acting authoritatively and then I felt threatened.

      He is an amazing man and is so loving with the animals.

      1. Deb, I agree. Doctors have very little time with patients. One physician friend said he would never become a GP. It would be too frustrating. The local clinic has a sign that says your visit is either a check-up, or for one problem. However, often it’s the totality of symptoms that is the clue to what is really wrong. But many visits mean more money going to the clinic.
        In the past doctors resided in the community, many times dealing with quite a few members of a family. There was a personal connection. They cared about their patients. Now, the person in front of them is a stranger, and in less than 10 minutes there will be another in that chair. It’s just easier to get out the prescription pad. And they won’t get sued for doing what every other doctor does. Also, the patient has to keep coming back for more prescriptions, something the clinic owners encourage.
        We have to face the fact that Medicine has become a big, impersonal business. The products they sell are drugs and surgery.
        Anything else is threatening.

        1. My GP of 13 yrs told me he could only spend 15 min w me on my first appt after changing to Medicare. I dumped him and found a much nicer doctor, a female, who does not treat me (or treat me) w a lack of empathy.
          Oddly, I fall into the normal parameters for most things..but am ill more often than I’m well. The only integrative doctors I’ve found are outrageously, prohibitively expensive.

  4. One might include Dr. Kim Williams in the doctors we should listen to. He used to be the head of the cardiologists’ association (academy, I believe) but even he couldn’t convince the heart doctors to work on this. Every hospital should have a plant-based unit to offer in-patient and out-patient care and support for patients who agree to try. It shouldn’t take long for doctors to realize that the plant based patients have way better outcomes than their own surgically modified patients. Not that I think that we will get through to them that way, but at least the patients have a better chance.

    1. I don’t think it is a case of plant-based patients vs ‘surgically modified patients’ , or vs pills for that matter. To me it’s more of how much better plant-based patients do than those who choose to continue with their alcohol, tobacco, rx pain drug, sugar, fast food, processed food or street-drug addictions, and refusal to exercise. Surgery and medications can be a lifesaver for some, especially those who choose to persue whole foods, exercise and healthy attitudes in general. Even ‘bad patients’ will grow corollary blood vessels in the heart (some better than others) aleviating pain and discomfort, or preventing it from occuring at all.

      1. I don’t think it will be that people can convince doctors of it.

        It is insurance, which has to be convinced.

        I have a friend who needs surgery, but they won’t do it unless she loses 100 pounds and she is not someone who is capable of doing it without serious help. I have spoken to her about WFPB, but she needs a real medical-based program.

  5. I can’t help but wonder if 100% plant based diet is best for everyone. Perhaps Dr. Greger is overlooking something? If you listen to all sides and you have no biases it isn’t such a “slam dunk” case as Dr. Greger says. Listen to Dr. Peter Attia, he is about the most knowledgeable, objective researchers I’ve listened to and he explores strategies that increase lifespan, healthspan and well-being and he is not vegan (was for about 6 months) but also so as not to misrepresent him he hates the “tribalism” regarding diet and nutrition so I don’t believe he wants to be put in a “tribe” or category. Also listen to Dr. Ronda Patrick, who does research and doesn’t just read research and she is not vegan. Both, if you listen, are smart and appear to genuinely want to find the optimal life including optimal nutrition.

    1. I listened to Dr. Rhonda Patrick today and she said to find ways to “triple your intake of vegetables” and I have listened to the Keto people, like Dr. Berg, and they are recommending 10 servings of vegetables and calorie restriction and lowering animal product intake.

      Most doctors are in agreement to eat 5% or fewer calories from animal products.

      There are very few people promoting old-school Atkins.

      There are people who are, but most of those people are lay people.

      1. Yes, of course, eat lots and lots of veggies. I did not say otherwise nor did I say any doctors say otherwise.

        However you can read online Dr. Patrick’s diet and she also eats eggs, salmon roe, chicken and fish. Eat whatever you want and whatever you do not want.

        My point, which apparently does not apply to you since you listen to non-vegans, is to stay fluid in your thinking and continue to learn from multiple sources. In my opinion anyone who only reads one particular point of view, whether it is nutrition, religion, politics or whatever are doing themselves a disservice.

    2. Thank you for your reminder to remain open-minded about diet science, and to avoid tribal-mindedness (note to Elizabeth Warren). In that spirit, I checked out your main man, Dr. Peter A, as in athletic.

      While I’m sufficiently credulous so as to have taken a look at the website of your Dr. Attia, I might just agree with you that he might be “the most knowledgeable, objective researchers [sic]…[who]…explores strategies that increase lifespan, healthspan [sic] and well-being,” when, on his website, in discussing nutritional ketosis, he describes his eating during “two tough bike rides on consecutive days.” Here’s what healthy foods he ate, that day:

      “So what did I eat that day?

      Breakfast (pre-ride): 5 scrambled eggs, 2 sausage links, 3 pieces of bacon, coffee with cream.

      In ride nutrition (I spread this out over 6 hours): 14 oz (not a typo) of salted cashews, 2 Quest bars, 1 peach, 1 apple, 6 bottles of Biosteel High Performance Sports Drink, water. (Since I know someone will ask, I did not consume super starch this day since I was craving cashews as my carbohydrate source and was craving more sodium, given the 90+ degree temperature.)

      Late lunch/early dinner (post-ride): 2 oz ham, 3 oz pulled pork, large salad with oil and vinegar dressing, 2 slices of cheddar cheese, 6 mini hamburger patties, 2 tomatoes.”

      Frankly, “listening to both sides” has given me an appetite. Maybe another few ounces of pulled pork will help. In the meantime, I’m throwing away all that stupid vegan stuff I’ve been using; I’ll be stocking up on healthy eggs, pork, beef, ham (I know it’s pork), bacon (ditto), and cream. I wonder what Dr. Attia thinks of chicken and lamb…are they the Bad Meats?

      Thanks again for directing me to my new lifestyle; without your input, I’d still be vegan.
      The internet is such a blessing.

    3. Mike Evans,

      I’ve been an ovo-lacto vegetarian for almost 50 years, primarily for sustainability and environmental reasons (eating plant based foods uses about 1/10 the resources of a meat based diet, in terms of land, water, fossil fuel inputs, etc, and it is far less degrading to the environment). Most of that time, I was worried that it might not be a healthy diet — so I was thrilled to discover that not only is it healthy, but that it may be one of the healthiest diets. Based on the evidence presented here and elsewhere, I stopped eating dairy products and eggs for health reasons — but, the good news is, that it’s even more sustainable and environmentally friendly. Plus, it involves far less cruelty to animals and workers in the “meat industry,” and contributes less to the development of antibiotic resistance.

      Even if “animal products” were somehow healthier, for ME, I still couldn’t eat them, because they’re far less healthy for the EARTH. As it is, on our current course we heading toward a collision with disaster.

      1. Thanks Doc.

        Sounds like a great diet that I’d be interested in. May I ask how many eggs you eat in one week? Do you consume yogurt, milk or any whey protein?

        1. Mike Evans,

          I’m not sure if your comments are directed to me. But I currently don’t eat any eggs or dairy products. I haven’t for over 2 years. For the 3 years before that, I slowly stopped eating these foods. I used to eat about 2-3 eggs a week. I used milk for cooking and baking. I started making my own yogurt at home – to avoid all the additives in commercial dairy yogurt – at least 6-8 years ago, but switched to making soy yogurt from commercial soy milk (made from water and soybeans only, with no additives). I also make my own soy milk for other uses (I don’t filter it, so it doesn’t make good yogurt). I try to avoid processed foods, such as protein isolates.

          So I don’t eat any animal products at all, no meat, eggs, or dairy. I also cook from whole foods while minimizing my use of processed foods and of added oil, salt, and sugar. I try to eat like this when I go out; I can avoid animal products, but not always processed foods or added oils, salt, and sugar. But I always ask.

          1. Any conventional soy is most likely GMO-based, and must be avoided if your goal is to get healthy. Look for organic, fermented soy (such as in tempeh) ….

    4. According to the American College of Cardiology and the American Heart Association (and pretty much every credible health authority around the globe) low carb diets like those promoted by Attia are associated with increased risk of death.

      ‘ Dietary patterns associated with CVD mortality include—sugar, low-calorie sweeteners, high-carbohydrate diets, low-carbohydrate diets, refined grains, trans fat, saturated fat, sodium, red meat, and processed red meat (such as bacon, salami, ham, hot dogs, and sausage). All adults should consume a healthy plant-based or Mediterranean-like diet high in vegetables, fruits, nuts, whole grains, lean vegetable or animal protein (preferably fish), and vegetable fiber, which has been shown to lower the risk of all-cause mortality compared to control or standard diet. Longstanding dietary patterns that focus on low intake of carbohydrates and a high intake of animal fat and protein as well as high carbohydrate diets are associated with increased cardiac and noncardiac mortality. ‘
      https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2019/03/07/16/00/2019-acc-aha-guideline-on-primary-prevention-gl-prevention

      1. There has been a gross misunderstanding. I am not promoting a diet. I am promoting intellectual unbiased pursuit of health. I’ve watched and listened to 2 videos with Dr. Attia and I’ve watch maybe hundreds with Dr.
        Greger and many of other vegan doctors. My point is that there is something to be learned from many sources and to keep an open mind. I used my Saturday morning finding the linked to video listed below of an interview with Dr. Attia. If you go to the 28:00 mark and listen through to the 31:00 mark you’ll discover he is not against you (Vegans). People have reacted very harshly to my mentioning him but in the 2 videos I have watch he has refused to discuss the various diets and does not recommend any particular one and yet you guys google his alleged eating preferences and then demonize him. Do yourself and Dr. Attia a favor and listen to the entire video but at least if you have even a slight interest in truth go to the 28 minute mark and listen to the 31 minute mark, that is 3 minutes of your time. He is not against you, he is for you and he is happy if you are vegan and so am I. Here is the link….

        https://www.youtube.com/watch?v=Ee1sSr4rfvc

        1. Sorry but you don’t appear to understand what this site is about. I am not a vegan nor are many others here.

          The site is not about veganism. In fact there are all sorts of vegan keto dieters and vegan low carbers out there. There are quite a few sites catering for them. Just Google it In fact this site and Dr Greger have pointed out that many ‘vegan’ diets are unhealthful Whether Attia is for or against veganism, or indifferent to it, is neither here nor there

          As noted earlier, I am not a vegan nor are a number of other people who follow the site. However, many are and Dr Greger himself appears to be a vegan. This probably explains the misunderstanding.

          The point is that everybody here tries to follow or is interested in, a whole food plant based (WFPB) diet This can include small amounts of animal foods or not.

          As for Attiia, I watched a number of his videos some years ago. He appeared to be just another YouTube low carb guru who selectively presents and misrepresents the evidence to suit his opinions just like low carb acupuncturist Chris Kresser. I suggest you watch Plant Positive’s videos on Attia before simply taking his claims on trust. They are quite old now but still highly relevant I think And if you really do believe in getting both sides of the argument, they are essential watching.
          http://plantpositive.com/a-very-serious-low-carber-nusi/
          http://plantpositive.com/display/Search?moduleId=19496100&searchQuery=attia

          The advantage of this site is that it provides the citations and references so that we can fact check the statements made in the videos and blog posts here. I have found over the years that most low carbers (vegan and non vegan) simply make statements that are factually incorrect, eg the claims about Ancel Keys that are endlessly repeated by such people. Attia may now claim to be uninterested in diet ……. but a lot of his low carb stuff is still out there and he still associates with the low carb community eg Kresser ….. possibly because the studies funded in his NuSi adventure pretty much disproved his and Taubes’ claims. Attia has never retracted those claims AFAIK. Far easier to change the topic I suppose And does his current concentration on a single biomarker (blood glucose) sound reasonable or balanced to you? He’s clearly a very bright and articulate individual but he swallowed a number of Taubes’ terinological inexactitudes wholesale without fact-checking them. Consequently I distrust his judgement (TBH he has also always seemed a bit flakey me but that may just be bias on my part).

          Rather than spending my time watching videos by such people I now prefer to read scientific reports by panels of expert scientists and papers in the professional journals. This site and Greger’s videos are consequently pretty much the only exceptions to this rule although I do watch Ronda Patrick’s and UCTV videos frome time to time In my experience Sturgeons’s Law is true with knobs on when it comes to health ‘information’ found on YouTube. However personable, persuasive and plausible Attia (or Kresser or Berg etc) may be, his and their claims appear to be among the 90% referred to by Sturgeon. Charm and passion are no substitute for factual accuracy or addressing all the evidence not just some of it.

          https://apps.who.int/iris/bitstream/handle/10665/42665/WHO_TRS_916.pdf;jsessionid=7E060E673AB63DEF370B4755DC440B2B?sequence=1
          https://health.gov/dietaryguidelines/2015-scientific-report/0000000000
          https://www.wcrf.org/dietandcancer

        2. Just Google it In fact this site and Dr Greger have pointed out that many ‘vegan’ diets are unhealthful Whether Attia is for or against veganism, or indifferent to it, is neither here nor there

          As noted earlier, I am not a vegan nor are a number of other people who follow the site. However, many are and Dr Greger himself appears to be a vegan. This probably explains the misunderstanding.

          The point is that everybody here tries to follow or is interested in, a whole food plant based (WFPB) diet This can include small amounts of animal foods or not.

          As for Attiia, I watched a number of his videos some years ago. He appeared to be just another YouTube low carb guru who selectively presents and misrepresents the evidence to suit his opinions just like low carb acupuncturist Chris Kresser. I suggest you watch Plant Positive’s videos on Attia before simply taking his claims on trust. They are quite old now but still highly relevant I think And if you really do believe in getting both sides of the argument, they are essential watching.
          http://plantpositive.com/a-very-serious-low-carber-nusi/
          http://plantpositive.com/display/Search?moduleId=19496100&searchQuery=attia

          The advantage of this site is that it provides the citations and references so that we can fact check the statements made in the videos and blog posts here. I have found over the years that most low carbers (vegan and non vegan) simply make statements that are factually incorrect, eg the claims about Ancel Keys that are endlessly repeated by such people. Attia may now claim to be uninterested in diet ……. but a lot of his low carb stuff is still out there and he still associates with the low carb community eg Kresser ….. possibly because the studies funded in his NuSi adventure pretty much disproved his and Taubes’ claims. Attia has never retracted those claims AFAIK. Far easier to change the topic I suppose And does his current concentration on a single biomarker (blood glucose) sound reasonable or balanced to you? He’s clearly a very bright and articulate individual but he swallowed a number of Taubes’ terinological inexactitudes wholesale without fact-checking them. Consequently I distrust his judgement (TBH he has also always seemed a bit flakey me but that may just be bias on my part).

          Rather than spending my time watching videos by such people I now prefer to read major scientific reports by panels of expert scientists and papers in the professional journals. This site and Greger’s videos are consequently pretty much the only exceptions to this rule although I do watch Rhonda Patrick’s and UCTV videos frome time to time In my experience Sturgeons’s Law is true with knobs on when it comes to health ‘information’ found on YouTube. However personable, persuasive and plausible Attia (or Kresser or Berg etc) may be, his and their claims appear to be among the 90% referred to by Sturgeon. Charm and passion are no substitute for factual accuracy or addressing all the evidence not just some of it.

          1. Bugger. The first few lines of my post disappeared. Here they are

            ‘Sorry but you don’t appear to understand what this site is about. I am not a vegan nor are many others here.

            The site is not about veganism. In fact there are all sorts of vegan keto dieters and vegan low carbers out there. There are quite a few sites catering for them.’

            1. Mike

              Thanks. Yes but thus is a review by the notorious Denise Minger – not exactly an unbiased person herself! Amusingly she accuses Greger of cherry picking when this is a tactic she herself has long employed.

              Healthline is a commercial site which absorbed another site grandiously called ‘authority nutrition’. In fact that was a site which was actually established by a Scandinavian personal trainer (apparently with a very high opinion of his own nutritional knowledge) to promote high fat low carb diets. Many of the people associated with authoritynutrition now work for healthline and I am therefore always a bit wary of claims emanating from healthline.

              If you really want to get a yardstick to measure Greger’s statements, I’d suggest national health authorities and other credible sources rather than low carb or keto advocates, cholesterol and saturated fat cranks etc. Compare for example the US National Institutes of Health’s statements about kidney stones with Greger’s rather than comparing Greger’s with Minger’s opinions.

              https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/eating-diet-nutrition

              I started out by listening to all the cholesterol and saturated fat ‘sceptics’ (including Attia) when I first began investigating nutrition and health. However, the more I fact checked their claims the more convinced I became that not only did they actively misrepresent the facts but they deliberately ignore most of the relevantevidence on the subjects they pontificate about because it refutes their claims. Taking the claims and statements made by such people on trust is unwise IMHO.

              Fact-check their claims and fact-check Greger’s claims. That’s what I do. By and large, I find that Greger’s better match what the science actually shows. That’s one reason why virtually every major scientific report on nutrituon and health seems to state that the healthiest diets are based on fruits, vegetables and whole grains. In other words whole food plant based diets even if they don’t use that exact term.

  6. Dr. Gregor and team, love the videos and books. Would you ever consider talking with Sam Harris on the Making sense podcast? He has had a lot of past experience with vegan or vegetarian diets (likely based more on not harming animals more than to be as healthy as possible). But with your wide variety of information and with him being a neuroscientist, it could be a very interesting conversation.

    1. I think it would simply be valuable if Dr. Greger could reach out to Harris to share nutrition advice, probably even better if it’s not restricted to podcast format. (Greger’s ebullience mixed with Harris’s monotone would make for some very strange listening …)

      I haven’t listened to Harris in a while, but he previously tried to go plant based for ethically-related reasons. He had little background knowledge in nutrition and expressed anxiety about the change. My recollection is that he went plant based by loading up on refined grains (yikes), found some of his blood values got worse, and gave up. It would be great if Dr. Greger could help him understand the health benefits of WFPB and how to make the switch sensibly. The evidence based, peer reviewed, put-it-to-the-test approach should appeal to the logic-minded Harris (and subsequently to Harris’ listeners).

      If Sam Harris can make an evidence based transition to a healthy WFPB diet, I think the benefits would extend to his own large audience, many of whom might be helped by WFPB.

      1. Can you also try to get Dr. Greger on Joe Rogan’s podcast? If you understand what he’s saying he keeps on referencing Dr. Greger lately since those Toxoplasmosis videos came out.

  7. Oh, also, my doctor gives me choices and in fact he discourages the use of pills. When I asked him about diet he quoted Dr. Michael Pollan who said something like “eat food (that is whole foods), not too much, mostly plants.” Nobody is hassling my doctor, not that I am aware of, and my doctor is fine with a vegan diet. I went off of a vegan diet because I do not digest legumes well which is the primary, though not exclusive, source of protein for vegans.

    1. “I went off of a vegan diet because I do not digest legumes well which is the primary, though not exclusive, source of protein for vegans.”
      How about corn, oats, wheat, potatoes, asparagus, broccoli, tomatoes, pumpkin and all leafy greens? Just curious; What would be an example of a 2500 calorie WFPB diet that didn’t contain legumes but was deficient in protein?

      Make sure you get your protein. Just don’t get kidney disease.
      https://nutritionfacts.org/topics/protein/

    2. Vegans test higher in protein than animal eaters.

      Pritikin and others said that it is nearly impossible to be protein deficient if you are eating enough calories to maintain your weight.

      Protein just isn’t that big an issue.

      1. “Vegans test higher in protein than animal eaters.”
        ———-

        “Higher”? Deb, can you post a link where you found that statement?

      2. Gorillas don’t eat legumes. Nor do elephants or rhinos. I’m not aware that any of those have protein deficiency problems.

        1. You just demonstrated just how unscientific you are. You have no idea about me, no medical records, no lab results, no blood test, but a rhino can live without legumes therefore I can eat only plants and avoid legumes and be optimally healthy. I could go on but I have go to bed, you are not looking out for my best interest, just own vegan agenda.

          1. It’s like talking to a brick wall. How many times do I have to tell you that I am not a vegan?

            In any case, wasn’t your point that legumes are ‘the primary source of protein for vegans’. . They may be for some ‘vegans’ but there’s no evidece that they are for all ‘vegans’ or that ‘vegans’ who don’t eat legumes are protein deficient which was the implication of your claim.

            Incodentally, it’s not all about you or your welfare. the factual acciracy of statements made here is just as important if not more important than you.

            1. I’m still waiting for Deb to tell me where she got this startling information: “Vegans test higher in protein than animal eaters.” Tested by whom? (She probably meant WFPB, but still……)

              As we know, some “vegans” are apt to scarf down total garbage.

            2. Tom, you need to understand a few things. I live a very busy life and work weekends quite often so I don’t have the time to track what each poster is and is not and unfortunately I may not structure my post with completely perfect terminology that is expressing my thoughts so some of the misunderstanding I’ll take responsibility for.

              My complaint was that the vegan diet did not work for me and I was disappointed because the vegan doctors recommend the vegan diet universally without knowing the individual “patient” and whatever health issues they may or may not have. I also stated that I am happy for all the vegans that are doing well and I understand that it is not all about me. But you replied to me based upon my comment that I do not digest legumes so keeping things* in context it was about me*, you then expand the post to be applicable to everyone and I understand that completely but again my post was about my personal experience, not everyone’s.. When you reply that rhinos do well without legumes it was easy to associate you with veganism (but you are not a vegan got it now and for the rest of my life I’ve got).
              But like I said I live a busy life and don’t have time to track your history of blogging as I got many things to do, a job that requires long hours and I had many responses from many different people. So back to your analogy of using other species was absolutely ridiculous. Lions do quite well on a carnivore diet and dung beetles eat dung (along with other stuff) so if rhinos and whatever other species you mentioned do well without legumes it is equally unrelated to what diet is optimal for any human and since my post was about my problems it was specifically irrelevant to me. It so happens I also have a problem with lots of nuts as well.

              I do not and never have exported what I think is optimal nutrition for me onto another person or the vegan community. I have a friend, a good friend, who is a Keto Vegan, so I assume he does not eat legumes since they are high in carbs. Now that I am writing this I think I will ask him.
              Again, keeping things in context my post was about me so when you reply you are replying to me so your comment that I cut and pasted below…

              “Incodentally, it’s not all about you or your welfare. the factual acciracy of statements made here is just as important if not more important than you”

              Was rude, hurtful and again out of context.

              I also know the difference between WFPB diet and veganism but because of time constraints I don’t have time to unpack the details and offer perfect responses.

              By the way, you are not polite and no fun to correspond with either.

              1. It’s not about entertainment. It’s about trying to get to the facts or at least some common understanding of what key issues might be.

                As for not being being polite, your complaint that ‘You just demonstrated just how unscientific you are’ wasn’t exactly intended to be polite either. You shouldn’t really complain when people respond in kind. And your constant insistence on calling me and everybody here ‘vegans’ is irritating as is your constant conflation of ‘veganism’ with WFPB diets despite being corrected multiple times, makes discussing things with you no fun either. Pots and kettles………….

                Just for the record, my personal opinion is that a healthy WFPB diet can include some animal foods (just what % is consistent with optimal health is simply not known). Nevertheless, I personally try to eat a 100% plant diet for ethical and environmental reasons but in practice eat dairy on a regular basis. I also eat wholegrain bread daily but, for some bizarre reason where I live, all whole grain breads are made with milk and egg.. However, I personally think the best animal foods to include in a WFPB diet are several small oily fish meals weekly. I acknowledge that most mainstream nutritional advice also recommends including low fat dairy (or soy/plant alternatives – not an option for you) in one’s diet. For these reasons and the fact that i still own leather shoes, belts, chairs and woollen clothes, I reject the description ‘vegan’

                Incidentally, another reason why I nevertheless think that Greger’s advice is generally sound is that mainstream nutritional authorities consider that well-planned ‘vegan’ diets are healthful eg

                https://health.gov/dietaryguidelines/2015/guidelines/appendix-5/
                https://www.eatrightpro.org/~/media/eatrightpro%20files/practice/position%20and%20practice%20papers/position%20papers/vegetarian-diet.ashx

                No credible authority anywhere in the world says any such thing about the types of diet promoted by the like of Attia and the unfortunately-named Minger.

                1. Ok, fair enough, sorry about that unscientific comment.

                  Regard Dr. Greger, yeah, sure, I have already said that I’ve learned some good stuff from him nonetheless others, like Office for Science and Society also write that he “cherry picks” his reports and overlooks others that are not to his liking.

                  I mentioned before that I am busy so I didn’t track who claims to be what.
                  It is a vegan doctor writing to his community so it doesn’t seem like a big issue and it certainly isn’t an insult; others used some unclear wording or expressed vague thoughts and I let it go since it is only a blog and not some peer review scientific submission.

                  And yes, I have always understood that some vegans don’t eat legumes but most do and if I recall one of the vegan docs recommended everyone eat beans at every meal. So it is a significant calorie load for many vegans and if you remove the beans or legumes, whatever, the protein can be replaced with other stuff but you lose a lot of other nutrients that maybe missed. Anyway it gets messy and I didn’t feel like diving into the issue.

                  1. OK, thanks. My bad – I assumed you were just repeating the vegan, veganism and vegan agenda arguments to be difficult.

                    Since he is only human, sure Greger is probably biased if only unconsciously. Aren’t we all.

                    However, if the AHA/ACC can recommend that all adults should consume a healthy plant based diet because it has been shown to lower the risk of all-cause mortality, and the National Comprehensive Cancer Network can state that there is strong evidence that a plant based diet cuts the risk of cancer overall, then it’s clear that it’s not just vegan bias that is behind his recommendations. The last time I checked, the AHA, the ACC and NCCN weren’t exactly famous for being vegan front organisations. Nor is the US Government and its dietary guidelines for that matter. See my other posts on this page for references/links to the AHA/ACC/NCCN/US dietary guidelines statements on these points. This is an uncomfortable fact that his meat eating/paleo/keto/low carb critics never actually mention when accusing him and this site of bias.

                    1. Ok, I think we can be friends.

                      Yes, definitely, we all have biases although I would hope certain professions to be held to a higher standard than the average bear.

                      One thing I did forget to write because as mentioned, I am very cramped for time, is the ambiguity of the acronym WFPB because I have heard it used in a context when it meant two different things. Some vegans have used it so as to distinguish a healthy vegan diet from vegan diet that uses lots of packaged but albeit vegan ingredients. Then some people used the acronym WFPB to mean they eat mostly but not entirely a whole food plant based diet. So, the acronym is used in a way that makes it a subset of veganism and sometimes not. For clarity there should be WFMPB which of course be Whole Foods Mostly Plant Based diet

                      Best wishes…

                    2. Yes, you are right. Some people insist that a WFPB diet is exclusively vegetarian. To my mind this only shows that they must have flunked English Comprehension at school since plant-based clearly doesn’t mean the same thing as exclusively plant.

                      I’d suggest distinguishing between whole food plant diets (WFP) and whole food plant based diets (WFPB) …… although I accept that WFP diets are a subset of WFPB diets.

            1. Somehow I’ve noticed lately that I do better if I follow up my oatmeal and fruit with some legumes. I frankly don’t know if it’s the extra calories or the “protein.”

              1. I’ve never noticed that personally. However, if I don’t eat legumes and oats for a week or so, say when I am travelling, then a cold sore outbreak is likely. I assume this is due to a lysine deficiency (both legumes and oats are good lysine sources). A lysine supplement or a couple of days back on the oats and legumes usually stops the cold sore outbreak dead in its tracks. Some flax/chia/chopped nuts added to the oatmeal might substiture for the legumes in the protein stakes though.

    3. Mike Evans,

      Eat whole foods, mostly plants IS what Dr. Greger promotes.

      Yes, Dr. Greger points to studies where the benefits of going all the way over to vegan can be even better for things like heart protection and getting rid of cancer and kidney function and Diabetes and reversing telomere damage, etc.

      But, he is not a perfectionist at all.

      He is, “Do your best” oriented.

      He would probably be mellower about what you are doing than your doctor is.

      My friends and family members were all pointed either toward Keto or away from diet having any usefulness at all by their doctors. Not one of them have been steered toward Whole Food Plant Based and they don’t have the “mostly plants” concept at all.

      I took care of people who had cancer and people who had dementia and who had heart problems and have walked alongside a relative who has kidney problems and “low sodium” is the only dietary intervention any of the doctors have recommended. My cousin had them talk about things like eating jelly beans and not eating any fresh fruits or almost any healthy foods.

  8. I’m currently involved in an n-1 Case study, being both the researcher and the researched. The length of this study of interventions for longevity, is a lifetime study and will hopefully go on for decades, if not centuries. ‘-)

  9. After reading these comments, I am reminded that Dr. John McDougall says: “People love to hear good news about their bad habits.”

  10. I have an unrelated question. Is olive oil as good for excess ear wax as some people suggest? I would like to see a nutritionfacts video on this

    1. Hi ez – Thanks for your question! Dr. Greger does not have any videos on this but I did some research and came across a 2018 systematic review article that concluded “there was no evidence of a difference in efficacy between oil‐based and water‐based active treatments.” (Source: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012171.pub2/abstract).

      Also, a 2013 experimental study actually found that olive oil use increased the amount of ear wax over time (https://www.magonlinelibrary.com/doi/abs/10.12968/pnur.2013.24.4.191). It therefore does not appear that olive oil is well-supported by research as a treatment for ear wax removal.

      I hope this helps give some insight!
      -Janelle RD (Registered Dietitian & NutritionFacts.org Health Support Volunteer)

  11. In the UK doctors are afraid of suggesting anything other than the established ways. I asked a doctor for a prescription for mahonia aquifolium cream a preferable palliative for psoriasis he said he could not.I contacted the local health authority (england) they advised he could prescribe what he liked but would not risk doing so for a product that he was not covered by medical insurance to prescribe I guess the same applies in other countries. The company producing the cream told me to have the cream accredited would be prohibitively expensive. We find talking to the practice nurse is better they are far more forthcoming. UK NHS doctors receive high salaries,have little time, prescribe a pill if that does not work then another one,if the symptoms indicate anything serious you are immediately referred for hospital specialist attention. We now tend to avoid the whole system like a plague! My wife successfully dealt with breast cancer alternatively,help of canceractive .com much appreciated, she gave up speaking to the arrogant primadona oncologist. The doctor will not speak of her former cancer ‘more than my jobs worth you have an oncologist! There is fear here that Trump will force American companies access to the NHS for a trade deal .they are already here the whole system is a largely profit driven cartel,as always to understand how things work ‘follow the money’. As health minister Nye Bevin said when setting up the UK NHS he had to fill the consultants mouths with gold!

    1. Well I haven’t lived in the UK for years but all of the NHS doctors I consulted during my 40 years there did a lot more that just prescribe pills

      Even today the National Institute for Health and Care and Excellence (NICE) lays down guidelines which require GPs and the oncologists to behave in certain ways and offer patients options eg
      https://www.nice.org.uk/guidance/conditions-and-diseases/cancer/breast-cancer

      It would be interesting to know if your wife was formally diagnosed as having breast cancer following a biopsy

      The reason I write that is because more than half of all breast cancers detected by mammography alone seem to disappear on their own
      https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70250-9/fulltext
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320224/

      It’s pretty easy in such circustances (after rejecting the conventional care pathway) to believe that some weird and wonderful ‘cure’ found on the intrnet caused the cancer to go away if, like most of them, it does

      Also US health care companies with UK subsidiaries already can and do provide health care services under the NHS It’s just a lot more difficult for them to make fat profits when the purchaser is a governententity that has a lot more purchsing power and options than hapless individual patients in the US do

      1. Tony and Tom,

        I am someone who understands that issue from both sides.

        Tom, yes, half of the tumors detected by mammogram just disappear on their own.

        And, yet, the doctors often want to do radical mastectomies – sometimes even after the tumor did disappear on its own.

        Tony, my dog is still alive over a year after his diagnosis with Hemangiosarcoma and my dog’s vet will not acknowledge ANY of the things I spent hours and hours and hours researching and implementing and he will never recommend any of it to anyone.

        He totally pooh-poohs water fasting and turkey tail mushrooms and didn’t understand the logic for Whole Food Plant Based and other things I used.

        I don’t need him to get on the alternative cancer bandwagon, but he has never had ANY dog live this long. He hasn’t had them live longer than a month and I am not asking for a pat on the back. He just isn’t willing even to look at what I did or why I did it and he intentionally has said straight out that none of the things I did made a difference and I have not said back, “How do you know?” How can he possibly know if he never looks things up on PubMed and tries to follow the logic?

        And, Tom, with that case, vets give ZERO hope and I tell people all the time what I did and my dog’s vet already has done your position that it is likely an outlier and that I shouldn’t be seeing it as a legitimate healing.

        Well, if his medical pathway had ever worked for any dog at all, I might have listened to him, but he has had ZERO success. I still like him as a person and I still respect that, clearly, I can’t say, “Water fasting will heal every dog” but water fasting and turkey tail mushrooms are things to try when there aren’t any other options.

        1. Thanks Deb.

          However, it’s worth remembering that whole plant food diets, fasting and exercise are all recognised by mainstream experts and national medical authorities as useful therapies in both treating cancer and preventing cancer ….. even if individual practitioners aren’t aware of this or choose not to follow professional
          guidelines.

          ‘there is strong evidence that a plant-based diet cuts the risk of cancer overall.’
          https://www.nccn.org/patients/resources/life_after_cancer/nutrition.aspx

          ‘If you have been recently diagnosed with cancer or are undergoing treatment, it’s important to take special care of yourself. Studies show that one of the best ways to do this is to stay physically active.’
          https://www.nccn.org/patients/resources/life_with_cancer/exercise.aspx

          Calorie restriction and fasting are not yet formal recommendations by mainstream cancer authorities but there is increasing recognition by specialists and other experts that it can improve treatment outcomes eg

          ‘Of particular note, the strategy of calorie restriction that was first observed to restrict the growth of tumors and their recurrence more than a century ago (81, 82) has again become a topic of increasing interest. Several different approaches to calorie restriction are now being investigated at various stages of the cancer pathway and measures of IGFs are the most favored intermediate biomarkers to monitor response (135).’
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380210/

          https://www.ncbi.nlm.nih.gov/pubmed/27557543

          I should also add that lack of competence or ignorance of the latest studies by some medical practitioners is not proof that alternative ‘cures’ are effective. What you have done seems to be conventional evidence-based medical treatment even if your vet wasn’t aware of it.

      1. I mostly don’t like the way vegsource misrepresents what people say. I have seen him do it so many times now.

        He clearly hates Dr. Fuhrman and Dr. Greger and it is so personal.

  12. I don’t see it that way actually. I am keenly interested in finding out about the question of dha supplements. 10 days ago I asked my doctor if I should supplement and he said no, not to bother, and that there just wasn’t the science there to justify it. So, Im happy to see some light shed on the question in that video.

      1. Glad I watched it again.

        A significant improvement in executive function after 6-1/2 months of supplementing is exactly what I am looking for.

          1. Barb,

            If you are vegan, there is a 2/3rds chance that you are low, and if you are low your brain will structurally shrink more if you don’t supplement.

            Nearly two-thirds of vegans may fall below 4, suggesting a substantial number of vegans have an omega-3 status associated with accelerated brain aging.

            The Framingham Study is the one Dr. Greger and Dr. Fuhrman refer to. Dr. Fuhrman has said that with his multiple years of clinical experience, the people who choose vegan who don’t get enough DHA often end up with brain problems.

            Which brings me back to a classic older Dr. Greger video about a study where vegans died at the same rate as other people. The Adventist vegan women were beaten both by the fish eaters and by the dairy eaters. Nuts were the main factor in that community for those who lived longer. I am still waiting for someone who has seen the full study to tell me what the vegan women did wrong.

            https://www.youtube.com/watch?v=q7KeRwdIH04

              1. Barb,

                We might not need to, but people who did supplement had improvement in executive function and brain structure and some of us want that.

                Dr Greger pointed out that vegans convert ALA less well as they get older.

                Some of us are getting over serious brain problems and would definitely err on the cautious side.

                I have listened to so many brain doctors and they all are for supplementation. All the ones I can think of.

                1. I don’t like how he communicates at all and I feel that he twists information.

                  I am not talking about Dr Fuhrman even. I felt that before the Dr Fuhrman incident.

              2. Okay, well I watched it and the fact that I almost never remember my flaxseeds and that I eat avocado every day and that has been helping my brain, I don’t think my omega 3’s probably will ever get above my omega 6’s, particularly because I only remember to supplement once or twice a week.

                Again, he misquotes Dr Greger whose advice is to a portion of vegans who test low, particularly as they get older.

                Yes, he makes it so the testing doesn’t count and he is only giving advice for the super healthy thin vegans where Dr Greger gives advice for a wider audience.

                Most of the people here aren’t vegans and many of them eat nuts and avocado and Dr Greger gave a particular dosage for a modest improvement where Jeff believes that even if you are deficient that it doesn’t matter.

                1. The thing he does is act like Dr Greger would give high doses of things.

                  For instance, in the nuts ones, Dr Greger did the 4 Brazil nuts per month study and said that it wasn’t a high quality study but 4 Brazil nuts per month was easy to try to see if they got the amazing results they got in the study, but Dr Greger said don’t go too much higher because it could cause toxicity from too much selenium.

                  Then, Jeff ignores everything Dr Greger actually said and Jeff said that Dr Greger exaggerated the weak study and that it was irresponsible recommending (4 nuts per month) because it could cause selenium toxicity.

                  Over and over again he ignores that Dr Greger is talking to people who are deficient.

                  He did the same proccess about Vitamin D and Dr Greger gave advice based on different age, different skin color, obesity versus being thin, where people live etc.

                  I have worn short sleeves two times since September and it finally stopped raining every day, but it immediately turned 90 degrees and I have had 5 minutes of sunlight since August and I asked Jeff if he meant his don’t take the supplement advice for everybody even with 50 studies showing a mortality improvement even the most recent one and he thinks it is okay to be institutionally deficient.

                  1. Jeff rejects the whole community of Adventist’s who lived longer by eating nuts.

                    And gives anecdotal evidence that it is okay to be symptomatically deficient rather than use modest supplementation, as long as you do your diet the way he says.

                    He rejects the study which Dr Greger used because the women weren’t thin enough to make it a fair study and I think that Dr Greger gave both sides of each of these arguments fairly and Jeff is throwing the Adventist longevity study under the bus.

              3. Barb,

                Sorry for putting it so strongly.

                I did listen to Jeff. He is saying that if you are low enough fat and if you are doing calorie restriction, and have a low enough BMI, that you can not worry about the reality that people convert less ALA to DHA and EPA when they get older. Dr. Greger has given that a high percentage of vegans test very low and if the Framingham study has validity, supplementing will increase executive function. Jeff is pointing to studies which used fish oil and is pointing out that they can increase prostate cancer in males. That is something to watch. Dr. Greger warns not to use fish oil and I don’t use fish oil or eat fish. I also only eat flaxseed in oatmeal or in Mary’s Gone Crackers and I haven’t eaten oatmeal, except once in the past 8 months, so I know that I am more in danger of being low in Omega 3’s and being on the wrong side of the Omega 3/6 ratio. I also am trying to improve my executive function and am recovering from serious brain problems, and I am not worried about getting cancer without eating animal products or oils. I am trying to remember if the cancer studies were really of Whole Food Plant Based males getting prostate cancer. If the vegan Whole Food Plant Based males really are getting cancer without taking fish oil, then I would be moving over to Jeff’s side, at least for males. Was it a vegan Whole Food Plant Based study? Or was it a general study? The thing is, the women vegans in the Adventist study didn’t even best the Lacto Ovo Vegetarians or Fish eaters. Plus, the older study Dr. Greger spoke about, the vegans died of Alzheimer’s and that is more likely what I am trying to reverse. I am not using any supplement to reverse heart disease. Did the vegans Whole Food Plant Based community really die of heart attacks because they took an Omega 3 supplement? Those are the questions I have. You see, the women’s study is one where the brain had an improvement. If Jeff is saying that the Whole Food Plant Based people were getting heart disease and cancer from vegan Omega 3, then it might not be worth trying to improve the brain, but if it is “just a waste of money” with the Framingham study being vegan women just like me and their brains improved, then it is worth it trying it. Dr. Fuhrman talking about it said that from the vegans in his group, a lot of them get dementia if they don’t supplement when they are young enough. That is why he sells it. Jeff would say, “They just have to stop eating nuts and avocado” but not everybody will do low fat with calorie restriction in the first place. He is aimed at a very specific audience. You probably can follow him. If you aren’t eating nuts and are doing calorie restriction and aren’t having brain problems.

  13. Okay, I am past Jeff’s effect on my brain and now I am looking at whether he was right.

    Can we just go off of nuts and avocado and does that counter the trend that people don’t convert ALA as well when they get older?

    So far, I have learned that:

    Conversion of ALA to EPA and DHA is less than 5 to 10 percent for EPA and 2 to 5 percent for DHA and that some people believe that the conversion rate is less than that based on studies with women where supplementing ALA didn’t raise levels of DHA.

    The conversion of ALA to EPA and DHA is inhibited by food sources of plant-based omega-6, nutrient deficiency, including things like iron and zinc, which are 2 things vegans tend to test much lower in, genetics where some genotypes can’t convert ALA to DHA as well, health concerns like hypertension, diabetes, metabolic syndrome don’t convert it as efficiently, and gender – there is an interesting thing, in studies males convert zero percent of ALA to DHA. Zero percent. Yes, they are the ones in greater danger of getting Prostate cancer from supplements, but I ask again, is that true for Whole Food Plant Based Vegans or people who eat 5% or less of their calories from animal products? I ask because ZERO percent DHA seems a little low.

    1. The men may have had hypertension or something.

      Well, I have just started learning it.

      I haven’t figured out how low the rate of conversion goes in older people.

      1. Dr Fuhrman had pointed out that Dr Ornish used fish oil.

        Did his patients get prostate cancer? Or heart disease?

        Or did they have the results he got in the studies?

        I believe Dr. Fuhrman was talking about the studies.

        If so, then, did any of them get worse in the Prostate Cancer study?

        Did they not reverse their heart disease?

        1. Can some of us suggest a video response?

          Did Dr. Ornish really have men supplementing Omega 3 during the prostate cancer study?

          That would be THE ANSWER for vegan males.

          It would be SO NICE to have a real answer.

          1. Okay and the Adventist women

            Did they eat nuts?

            Did they supplement DHA?

            Those 2 studies together would be all I need to know what I should be doing as a woman.

  14. With so much evidence and proof frol science WHY don’t wealthy people from America TAKE TO COURT their doctor, their hospital and their medical institutions, for a judgment trial and asking for financial reparations, having them failed to prevent, stopped or reversed and cured their patients who paid them and ask for help…

    This is a real QUESTION, as the institution is corrupted by lobbies and pharmaceutical, meat-milk-egg industries… Which financed publicity in scientific journals, programs in universities, campaigns and revolving doors in public institutions…

    And the population should ask for a real ANSWER…

    Meanwhile, whoever read this and know about Doctor Greger Charitable Dedication, doesn’t have the same ISSUE as the rest of milions of people, because they(we) know how to treat ourselves with beneficial food…

    Good luck for the others, until this reality of corruption and fraud becomes mainstreaming, and the average MORALITY of a nation ask for truth and safe food and medicine…

    Blessings to Michael Greger, the saver of thousands of thousands, already… But how much is enough, when still one or two are remaining out if the luck and are lead to suffering, illness, chronic pain and bankruptcy and deaths…

    Love Love Live Light
    Patrick from France

Leave a Reply

Your email address will not be published. Required fields are marked *

Pin It on Pinterest

Share This