Flashback Friday: Food as Medicine: Preventing & Treating the Most Dreaded Diseases with Diet

Flashback Friday: Food as Medicine: Preventing & Treating the Most Dreaded Diseases with Diet
4.66 (93.16%) 79 votes

Dr. Greger has scoured the world’s scholarly literature on clinical nutrition and developed this presentation based on the latest in cutting edge research exploring the role diet may play in preventing, arresting, and even reversing some of our most feared causes of death and disability.

Discuss
Republish

Good evening.

For those of you unfamiliar with my work, every year I read through every issue of every English-language nutrition journal in the world so you don’t have to. Every year, my talks are brand new, because every year the science is brand new.

I then compile all the most interesting, the most groundbreaking, the most practical findings to create new videos and articles, every day, for my nonprofit site, NutritionFacts.org.

Everything on the website is free. There are no ads, no corporate sponsorships; it’s strictly noncommercial, not selling anything. I just put it up as a public service, as a labor of love. There are new videos and articles every day on the latest in evidence-based nutrition.

In my 2012 year-in-review, I explored the role a healthy diet may play in preventing, arresting, and reversing our deadliest diseases. In 2013, I covered our most common conditions. And, in 2014, I went through our leading causes of disability. This year, I thought I’d address some of our most dreaded diseases, and cancer tops the list.

The #1 cancer killer in the United States, of both men and women, is lung cancer. But, if you look at the rates of lung cancer around the world, they vary by a factor of ten. If there were nothing we could do to prevent lung cancer, if it just happened at random, you’d assume that the rates everywhere would be about the same. But, since there’s such a huge variation in rates, you assume there’s some contributing cause. Indeed, we now know smoking is responsible for 90% of lung cancer cases. So, if we don’t want to die of the #1 cancer killer, by just not smoking, we can throw 90% of our risk out the window.

Colorectal cancer is our second leading cause of cancer death, for which there’s an even bigger spread. So, it appears colon cancer doesn’t just happen; something makes it happen. Well, if our lungs can get filled with carcinogens from smoke, maybe our colons are getting filled with carcinogens from food. Why do African Americans get more colon cancer than native Africans? Why study Africans? Because colon cancer is extremely rare in native African populations; like more than 50 times lower rates than Americans, white or black.

We used to think it was all the fiber they were eating, however, the modern African diet is highly processed, low in fiber, and yet there has been no dramatic increase in colon cancer. And we’re not just talking low fiber intake, we’re talking United States of America-low, down around half the recommended daily allowance. Yet colon disease still remains rare in Africa; still 50 times less colon cancer.

Maybe it’s because they’re thinner and exercise more? No, they’re not, and no, they don’t. If anything, their physical activity levels may now be even lower. So if they’re sedentary like us, eating mostly refined carbs, few whole plant foods, little fiber—like us, why do they have 50 times less colon cancer? Well, there is one big difference. The diet of both African-Americans and Caucasian-Americans is rich in meat, whereas the native Africans’ diet is so low in meat and saturated fat they have total cholesterol levels averaging 139, compared to over 200 in the U.S.

So yes, they don’t get a lot of fiber anymore, but they continue to minimize meat and animal fat consumption, supporting evidence that perhaps the most powerful determinants of colon cancer risk are the levels of meat and animal fat intake. So, why do Americans get more colon cancer than Africans? Maybe, the rarity of colon cancer in Africans is associated with low animal product consumption.

But why? Did you ever see that take-off of the industry slogan, “Beef: It’s What’s For Dinner” – “Beef, It’s What’s Rotting in Your Colon”? I saw this on a shirt once with some friends, and I was such the party pooper—no pun intended, explaining to everyone that meat is fully digested in the small intestine, and never makes it down into the colon. It’s no fun hanging out with biology geeks —but, it turns out, I was wrong!

It turns out, up to 12 grams of protein a day can escape digestion, and when it reaches the colon, it can be turned into toxic substances, like ammonia. This degradation of undigested protein in the colon is called putrefaction; so, a little meat can actually end up putrefying in our colon. The problem is that some of the by-products of this putrefaction process can be toxic.

The same thing happens with other animal proteins. If you eat egg whites, for example, some of that can putrefy, too. But, there’s protein in plants as well. The difference is that animal proteins tend to have more sulfur-containing amino acids like methionine (which is found most concentrated in fish and chicken, and then eggs, less in beef and dairy, and much less in plant foods), which can be turned into hydrogen sulfide in our colon.  Hydrogen sulfide is the rotten egg gas that, over and above its objectionable odor, can produce changes in the colon that increase cancer risk.

Now, there is a divergence of opinion as to whether it’s the animal fat, cholesterol, or animal protein that is most responsible for the increased cancer risk, as all three have been shown to have carcinogenic properties. But, it may not really matter which component is worse, as a diet rich in one is usually rich in the others.

The protein does more than just putrefy, though. Animal protein consumption causes an increase in blood levels of a cancer-promoting growth hormone called IGF-1. But, remove meat, egg whites, and dairy proteins from our diet, and our bloodstream can suppress cancer cell growth about eight times better. An effect so powerful that Dr. Ornish and colleagues appeared able to reverse the progression of prostate cancer without chemo, surgery, or radiation; just a plant-based diet and other healthy lifestyle changes.

The link between animal protein and IGF-1 may help explain why those eating low-carb diets tend to die sooner, but not just any low-carb diet; specifically, those based on animal sources, whereas vegetable-based low-carb diets are associated with a lower risk of death. But low-carb diets are high in animal fat as well as animal protein, so how do we know it wasn’t the saturated fat and cholesterol that were killing people off, and it had nothing to do with the animal protein?

What we would need is a study that just follows a few thousand people and their protein intake for 20 years or so, and sees who lives longest, who gets cancer, and who doesn’t? But, there’s never been a study like that…until now.         

6,000 men and women over age 50, from across the U.S, were followed for 18 years, and those under age 65 with high protein intake had a 75% increase in overall mortality and a fourfold increase in the risk of dying from cancer. But, not all proteins.  Specifically, animal proteins. These associations were either abolished or attenuated if the proteins were plant-derived. This all makes sense, given the higher IGF-1 levels in those eating excess protein. Eating animal protein increases IGF-1 levels, which increases cancer risk.

The sponsoring university sent out a press release with a memorable opening line: “That chicken wing you’re eating could be as deadly as a cigarette,” explaining that eating a diet rich in animal protein during middle age makes you four times more likely to die of cancer than someone with a low-protein diet—a mortality risk factor comparable to smoking. And when they say low-protein diet, what they actually mean is just getting the recommended amount of protein.

Almost everyone is going to have a cancer cell or pre-cancerous cell in them at some point. The question is: does it progress? That may depend on what we eat. See, most malignant tumors are covered in IGF-1 receptors, but if there’s less IGF-1 around, they may not be able to progress.

And, it wasn’t just more deaths from cancer. Middle-aged people who eat lots of proteins from animal sources were found to be more susceptible to early death in general. Crucially, the same did not apply to plant proteins like beans, and it wasn’t the fat, but the animal protein, that appeared to be the culprit. 

What was the response to the revelation that diets high in meat, eggs, and dairy could be as harmful to health as smoking? One nutrition scientist replied that it was wrong, and potentially dangerous. Not the discovery that animal protein might be killing people, but the way they were telling people about it; it could damage the effectiveness of important public health messages. A smoker might think: “Why bother quitting smoking if my cheese and ham sandwich is just as bad for me?”

This reminds me of a famous Philip Morris cigarette ad that tried to downplay the risks by saying, “You think secondhand smoke is bad, increasing the risk of lung cancer 19%. Drinking one to two glasses of milk every day may be three times as bad—62% higher risk of lung cancer. Or, doubling the risk by frequently cooking with oil, or tripling your risk of heart disease by eating non-vegetarian, or multiplying your risk sixfold by eating lots of meat and dairy.” So, they conclude, let’s keep some perspective; the risk of lung cancer from secondhand smoke may be well below the risk reported for other everyday activities.

That’s like saying, “Don’t worry about getting stabbed, because getting shot is much worse.” Uh, how about neither? Two risks don’t make a right.

The heme in the ham may also play a role. Heme iron is the form of iron found in blood and muscle, and may promote cancer by catalyzing the formation of carcinogenic compounds within our bodies. Cancer has been described as a ferrotoxic disease: a disease, in part, of iron toxicity.

Iron is a double-edged sword. Iron deficiency causes anemia; however, excessive iron may increase cancer risk, presumably by acting as a pro-oxidant, generating free radicals that may play a role in a number of dreaded diseases like stroke. But, only the heme iron, the blood and muscle iron, not the nonheme iron that predominates in plants. Same with heart disease—only the heme iron, and same with diabetes—only the heme iron, and same with cancer.

In fact, you can actually tell how much meat someone is eating by looking at their tumors. To characterize the mechanisms underlying meat-related lung cancer development, they asked lung cancer patients how much meat they ate and examined the gene expression patterns in their tumors, and identified a signature pattern of heme-related gene expression. Although they just looked at lung cancer, they expect these meat-related gene expression changes may occur in other cancers as well.

The safest form of iron, then, is non-heme iron, found naturally in abundance in whole grains, beans, split peas, chickpeas, lentils, dark green leafy vegetables, dried fruits, nuts, and seeds. How much money can be made on beans, though? So, the food industry came up with a blood-based crispbread made out of rye, and cattle and pig blood, one of the most concentrated sources of heme iron—about two-thirds more than chicken blood. If blood-based crackers don’t sound appetizing, there’s always cow-blood cookies and blood-filled biscuits. The filling “ends up a dark-colored, chocolate flavored paste with a very pleasant taste.” Dark-colored because spray-dried pig blood can have a darkening effect on the food product’s color. But the worry is not the color or taste; it’s the heme iron, which, because of its potential cancer risk, is not considered safe to add to foods intended for the general population.

This reminds me of nitrosamines, a class of potent carcinogens found in cigarette smoke. They are considered so toxic that carcinogens of this strength in any other consumer product designed for human consumption would be banned immediately. If that were the case, they’d have to ban meat.

One hot dog has as many nitrosamines and nitrosamides as five cigarettes. And these carcinogens are also found in fresh, unprocessed meat as well: beef, chicken, and pork. But practice Meatless Mondays and you could wake up Tuesday morning with nearly all of these carcinogens washed out of your system.

So, toxic nitrosamines should be banned immediately, but are still allowed for sale in cigarettes and meat because the carcinogens are found there naturally, just like the heme iron. Not safe enough to expose the general population to, but allowed for sale at the deli counter.

The irony is that the iron and the protein are what the industry boasts about—those are supposed to be the redeeming qualities of meat: protein and iron, but, sourced from animal foods, they may do more harm than good. And that’s not to mention all the other stuff: the saturated fat, industrial pollutants, and hormones, which may play a role in our third leading cancer killer, breast cancer.

Steroid hormones are unavoidable in food of animal origin, but cow milk may be of particular concern. The hormones naturally found in even organic cow’s milk may have played a role in the studies that found a relationship between milk and other dairy products and human illnesses, such as teenagers’ acne; prostate, breast, ovarian, and uterine cancers; many chronic diseases that are common in Western societies; as well as male reproductive disorders.  Other dangers of high hormone levels in food range from increased risk of early puberty to endometrial cancer in older women, but they are particularly dangerous in the case of vulnerable populations, such as young children and pregnant women.  To this critical population, even a small hormonal intake could lead to major changes in the metabolism.

Look, dairy milk evolved to put a few hundred pounds onto a calf within the first few months of life. But the consequences of lifetime human exposure to the growth factors in milk have not been well studied. We know milk consumption increases IGF-1, which is linked to cancer, and we’re milking cows while they’re pregnant, resulting in particularly high levels of hormones.

Although dairy products are an important source of hormones, other products of animal origin must be considered as well. This may help explain why women can cut their breast cancer risk not just by being normal weight and limiting alcohol, but also by eating mostly foods of plant origin. To help differentiate the effects of diet from other lifestyle behaviors—like smoking and drinking—on overall cancer incidence, Adventists were compared to Baptists. Both discourage alcohol and tobacco, but the Adventists go further, encouraging a reduction of meat. In general, the Adventists had less cancer than the Baptists, and within Adventist populations, the vegetarians did even better, and those eating the most plants did the best.

All edible tissues of animal origin contain estrogen. This may explain why women avoiding all animal products have a twinning rate which is one-fifth that of vegetarians and omnivores. It appears that vegan women have five times fewer twins, presumed to be because they’re not exposed to all these hormones. Why is that a good thing? Because twin pregnancies are risky pregnancies, both for the mom and the babies, who may be ten times more likely to die at birth. To avoid these complications, women attempting conception may want to consider avoiding milk and other dairy products.

And this isn’t even talking about the synthetic hormones that are fed, injected, or implanted into farm animals. In 1979, an epidemic of breast enlargement was noted in Italian children. Poultry or veal were suspected, given that estrogens may be fed to farm animals to accelerate their weight gain. After this episode, Europe banned the use of anabolic growth promoters in agriculture and has banned the importation of American meat ever since, because we continue to inject animals with drugs like Zeranol, sold as Ralgro Magnum.

You drip Zeranol-containing blood from implanted cattle onto normal human breast cells in a Petri dish, and you can transform them into breast cancer cells within 21 days. But people are not Petri dishes.

Because these anabolic growth promoters in meat production are by far the most potent hormones found in human food, we should really be testing people, especially children, before and after eating this meat. Until then, we have no idea what kind of threat they may pose, though the fact that Zeranol is as potent as DES should concern us. DES is another synthetic estrogen marketed to pregnant women—until 1971 when it was shown to cause cancer of the vagina in their daughters. But few know it was also used in meat.

In the absence of effective federal regulation, the meat industry uses hundreds of animal feed additives, with little or no concern about the carcinogenic and other toxic effects. Illustratively, after decades of misleading assurances of the safety of DES in the meat supply, the United States finally banned its use some 40 years after it was first shown to be cancer-causing. The meat industry then promptly switched to other potentially carcinogenic additives, such as Ralgro Magnum.

When girls started dying from vaginal cancer, DES-treated meat was subsequently banned in Europe. However, misleading assurances, including the deliberate suppression of residue data, managed to delay a US ban on DES in the meat supply for eight years.

Today, virtually the entire U.S. population consumes—without any warning, labeling, or information—unknown and unpredictable amounts of hormonal residues in meat products over a lifetime. If all hormonal and other carcinogenic feed additives aren’t banned immediately, the least we could do is label them along with hormone residue levels in all meat products, including dairy and eggs.    

Speaking of eggs, the next on the list of dreaded diseases is heart disease. Eggs are the #1 source of choline, which can be converted by gut bacteria into a toxin that increases the risk of stroke, heart attack, and death. Eggs are also the #1 source of cholesterol.

Why does it matter if we have lots of cholesterol circulating in our bloodstream? Cholesterol doesn’t just infiltrate our arteries and help form inflamed pockets of pus in our arterial walls, but may play an active role in the final fatal plaque rupture. Cholesterol crystals may actually pop the plaque. If you look at ruptured plaques from autopsies, they are filled with cholesterol crystals protruding out from the plaque. Cholesterol in the plaque may get so supersaturated that it reaches a point that it crystallizes, like rock candy. The growing crystals may then burst the plaque open.

Here’s a cholesterol crystal shooting out the top of a test tube, and when you look at the tips of the cholesterol crystals under a microscope, they are sharp jagged needles. They placed a thin membrane over the top of the test tube to see if the cholesterol needles would poke through, and indeed, the sharp tips of the cholesterol crystals cut through the membrane. So, they showed that as cholesterol crystallized, the peak volume can increase rapidly within minutes, and sharp-tipped crystals can cut through and tear membranes—suggesting that the crystallization of supersaturated cholesterol in atherosclerotic plaques can induce rupture.

And that’s what you see on autopsy. All patients who died of acute heart attacks had perforating cholesterol crystals, like this, sticking out of their plaques. But no crystals were found perforating the arteries of people who had severe atherosclerosis but died first of other, non-cardiac, causes. This can explain why dramatically lowering cholesterol levels with diet (and drugs if necessary) can reduce the risk of fatal heart attack, by pulling cholesterol out of the artery walls, decreasing the risk of crystallizing these cholesterol needles that may pop the plaques in your arteries.

High cholesterol can also cause what’s called nonalcoholic fatty liver disease, our next global chronic disease epidemic. Fatty deposits in the liver can trigger inflammation, and result in liver cancer, failure, and death.

And again, it may be these crystals, cholesterol crystals, triggering the progression of fatty liver into serious hepatitis. We’re talking dietary cholesterol, the cholesterol people eat in eggs and other animal products. A strong association was seen between cholesterol intake and hospitalization and death from cirrhosis and liver cancer. And beyond just the crystals, dietary cholesterol may oxidize and directly cause toxic and carcinogenic effects.

It was not appreciated until recently that the average cholesterol level in the United States, the so-called “normal” level, was actually abnormal, accelerating the blockages in our arteries and putting a large fraction of the normal population at risk. Having a normal cholesterol in a society where it’s normal to die of a heart attack is not necessarily a good thing. Normal cholesterol levels may be fatal cholesterol levels.

In respect to cholesterol lowering, moderation kills. Even if all Americans kept their total cholesterol below the recommended 200, millions would develop coronary artery disease. Strong evidence shows we need to keep our total cholesterol under 150 to stem the epidemic. What kind of evidence? Well, in many cultures, coronary disease is practically unheard of when total serum cholesterol levels are under 150. And here in the U.S., in the famous Framingham Heart Study, few of those with levels below 150 developed heart disease, and none died from it.

We cannot continue to have public and private organizations on the forefront of health leadership recommending to the public a dietary plan that guarantees that millions will perish from the very disease the guidelines are supposed to prevent. The reason given by health authorities to not tell people the truth, for not advocating what the science shows is best, was that it might frustrate the public, who may have difficulty getting their cholesterol levels that low.  But maybe the public’s greatest frustration would come from not being informed of the optimal diet for health. Heart disease can be reversed with a plant-based diet. The evidence justifies igniting a social movement—let the people lead, and eventually the government will follow.

Some criticize plant-based diets as extreme or draconian. You want extreme, though?  Check out the consequences of our present diet. Having a breastbone sawed in half for bypass surgery or a stroke that renders one a mute can be construed as extreme, or having a breast, prostate, colon, or rectum removed to treat cancer—that’s extreme. Eating a bean burrito is easy.

Instead of just bypassing the problem—literally— you can treat the cause, arrest and reverse heart disease, our #1 killer, with a whole food, plant-based diet.

Next on the list is arthritis, such as rheumatoid arthritis, a chronic systemic inflammatory disorder that causes progressive destruction of the joints. As many as 80% become disabled, and it may cut up to 18 years off one’s lifespan. There are drugs you can take, but unfortunately they’re often associated with severe side effects including blood loss, bone loss, immune suppression, and toxicity to the liver and eyes. There’s got to be a better way.

Well, populations that eat more meat do seem to have higher rates of rheumatoid arthritis, and there have been some dramatic case reports of rheumatoid arthritis attacks triggered by the consumption of animal foods. These attacks started six to ten hours after ingestion of animal protein and lasted a few days, but they stopped when the patients stopped ingesting animal products. The researchers suggest that immune complexes formed by the body attacking animal proteins may promote autoimmune reactions in the joints themselves. And indeed, those with rheumatoid arthritis have striking elevations in antibodies to foods like fish, pork, egg whites, dairy proteins, and even some cereals. But it could also possibly be a pro-inflammatory property of meat fats or free radicals from the iron accumulating in the joints, or other mechanisms. But case reports and country-by-country analyses can be used only to raise questions. To prove cause-and-effect, you need an interventional study to put it to the test.

And here we go: a 13-month-long randomized controlled trial of plant-based diets for rheumatoid arthritis.  Patients were put on a vegan diet for three and a half months, and then switched to an egg-free vegetarian diet for the remainder of the study. Compared to the control group, who didn’t change their diet, the plant-based group had a significant improvement in morning stiffness within the first month, cutting the number of hours they suffered from joint stiffness in half. A drop in pain. A drop in disability. They reported subjectively feeling better, significant improvement in their grip strength, fewer tender joints, less tenderness per joint, and less swelling. They also had a drop in inflammatory markers in the blood: sed rate, C-reactive protein, and white count; highly significant and clinically relevant findings.

What about osteoarthritis? Osteoarthritis is the most frequent cause of physical disability among older adults, affecting more than 20 million Americans, with 20% of us affected in the coming decades, and becoming more and more widespread among younger people.

Osteoarthritis is characterized by loss of cartilage in the joint. We used to think it was just mechanical wear and tear, but it is now generally accepted as an active joint disease with a prominent inflammatory component. If the loss of cartilage is caused by inflammation, maybe if we put people on an anti-inflammatory diet, it could help; like with rheumatoid arthritis. Using optimal nutrition and exercise as the first-line intervention in the management of chronic osteoarthritis could well constitute the best medical practice.

Where’s the best science on what optimal nutrition might look like? The China Study is a prime example, showing the serious health consequences of high consumption of pro-inflammatory foods—meat, dairy, fat, and junk—and low consumption of anti-inflammatory plant foods—whole grains, vegetables, fruits, beans, split peas, chickpeas, and lentils. The unnatural Western diet contributes to low-grade systemic inflammation, oxidative stress, tissue damage, and irritation, placing the immune system in an overactive state, a common denominator of conditions such as arthritis.

Next on the list are stroke and high blood pressure, which go together, since high blood pressure is the #1 risk factor for stroke. The PREDIMED study found that a Mediterranean diet with nuts could cut stroke risk nearly in half, though they were still having strokes. Half as many strokes, but it was still a diet that promoted strokes and heart attacks.

That’s what Dr. Ornish noted when he wrote in: “There was no significant reduction in the rates of heart attack, death from cardiovascular causes, or death from any cause,” just that stroke benefit. But hey, that’s something. A Mediterranean diet is certainly better than what most people are consuming, but even better may be a diet based on whole plant foods, shown to actually reverse heart disease, not contribute to it. That may be true, the authors of the study replied, but the major problem with Ornish’s diet is that it doesn’t taste good, and so, hardly anyone sticks to it.

But it’s not true. Ornish got extraordinary adherence in his studies with no difference in any of the acceptability measures; same enjoyment compared to their regular diet. They even got success in barbecue country, rural North Carolina. See, stricter diets may meet greater acceptance among patients than more modest diets because they may work better. Greater adherence means greater disease reversal.

But you don’t have to be facing certain death. Even those who are young and healthy with no health problems had no problem sticking to a plant-based diet. In fact, it worked a little too well. This was a crossover study where they asked people to eat plant-based for a few months and then switch back to their baseline diet to note the contrast, but people felt so good eating healthy some refused to go back to their regular diet, which kind of messes up the study. They were losing weight with no calorie counting or portion control, they had more energy, their periods got better, better digestion, better sleep—many were like no way, we’re not going back.

But if doctors just presume people won’t eat this way, it may end up being a self-fulfilling prophecy. Just like smoking doctors are less likely to tell their patients to stop smoking, and couch potato docs are less likely to counsel exercise or things like more fruits and vegetables, we need to role model healthy behavior. This greatly enhances our credibility and effectiveness. Gone are the days of traditional authority when the fat physician, dropping cigarette ash down his gravy-stained vest, could credibly prescribe a change in behavior.

One reason why plant-based diets could save so many millions is because the #1 killer risk factor in the world is high blood pressure, laying to waste nine million people every year. And in the United States, killing off more than a thousand people a day; 400,000 Americans dead every year.

High blood pressure affects nearly 78 million Americans—that’s one in three of us, and as we age, our pressures get higher and higher, such that by age 60, it strikes more than half. If it affects most of us when we get older, maybe it’s less a disease and more just a natural, inevitable consequence of aging? No. We’ve known for nearly a century that high blood pressure need not occur. Researchers measured the blood pressure of a thousand people in rural Kenya who ate a diet centered around whole plant foods. Whole grains, beans, vegetables, fruit, and dark green leafy vegetables. Up until age 40, the blood pressures of rural Africans were about the same as Europeans and Americans, down around 120 over 80, but as Westerners age, their pressures creep up such that by age 60 the average person is hypertensive, exceeding 140 over 90. But what about those eating plant-based? Their pressures improved with age; not only did they not develop hypertension, their blood pressures actually got better.

The whole 140 over 90 cut-off is arbitrary. Just like studies show that the lower the cholesterol the better; there’s really no safe level above about 150. Blood pressure studies also support a “lower the better” approach to blood pressure reduction. Even people starting out with blood pressure under 120 over 80 appear to benefit from blood pressure reduction. So, the ideal blood pressure, the no-benefit-from-reducing-it-further blood pressure, is actually 110 over 70. But is it possible to get blood pressures down to 110 over 70? It’s not just possible; it’s normal for those eating healthy enough diets.

Over two years at a rural Kenyan hospital, 1,800 patients were admitted. How many cases of high blood pressure did they find? Zero. Wow, so they must have had low rates of heart disease. No, they had no rates of heart disease. Not low risk, no risk. Not a single case of arteriosclerosis, our #1 killer, was found.

Rural China too; about 110 over 70 their entire lives. Africa and China have vastly different diets, but they share the common theme that they are plant-based day-to-day, with meat eaten only on special occasions. Why do we think it’s the plant-based nature of their diets that was so protective?

Because in the Western world, as the American Heart Association has pointed out, the only folks really getting down that low are strict vegetarians, coming in at about 110 over 65. So, does the American Heart Association recommend a strict vegetarian diet? No, they recommend the DASH diet.

The DASH diet has been described as a lactovegetarian diet, but it’s not. It emphasizes fruits and vegetables and low-fat dairy, but just a reduction in meat. Why not vegetarian? We’ve known for decades that food of animal origin was highly significantly associated with blood pressure. In fact, you can take vegetarians and give them meat and you can watch their blood pressures go up.

So, when the DASH diet was created, were they just not aware of this landmark research, done by Harvard’s Frank Sacks? No, they were aware. The Chair of the Design Committee who came up with the DASH diet was Frank Sacks. In fact, the DASH diet was explicitly designed with the #1 goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet containing enough animal products to make it palatable to the general public. In fact, Sacks found that the more dairy the lactovegetarians ate, the higher their blood pressures went; but they had to make the diet acceptable.

A recent meta-analysis showed that vegetarian diets were good, but strictly plant-based diets may be better. Vegetarian diets in general confer protection against cardiovascular disease, some cancers and death, but completely plant-based diets seem to offer additional protection for obesity, hypertension, type 2 diabetes, and heart disease mortality. Based on a study of 89,000 Californians, those eating meat-free diets appeared to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free had 75% lower risk.

If, however, you’re already eating a whole foods plant-based diet, and you’re still not hitting 110 over 70, there are a few plants recently found to offer additional protection. A randomized placebo-controlled trial showing that a cup of hibiscus tea with each meal significantly lowers blood pressure. In fact, tested head-to-head against a leading blood-pressure drug, Captopril, two cups of strong hibiscus tea every morning were as effective as the drug.

Another randomized placebo-controlled trial found that a few tablespoons a day of ground flaxseeds induced one of the most potent antihypertensive effects ever achieved by a dietary intervention—two to three times more powerful than instituting an endurance exercise program (though, of course, there’s no reason you can’t do both).

Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? And the answer is both, though raw may work better. Kiwifruit didn’t seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with this study showing that raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy! They know the Big Pharma trick of choosing the right control group.

Next on the dreaded list is diabetes and vision loss, which go together, since diabetes is the leading cause of preventable middle-aged blindness. Even with intensive diabetes treatment—at least three insulin injections a day with the best modern technology, like implantable insulin pumps—the best we can offer is usually just a slowing down of the progression of the disease. So, we can slow down your blindness, but a half-century ago, Kempner at Duke proved you could reverse it with an ultra-strict plant-based diet of mostly rice and fruit. 44 consecutive patients with diabetic retinopathy, and in 30% of the cases, their eyes improved. From like this, to this. That’s not supposed to happen. Diabetic retinopathy had been considered a sign of irreversible damage. What does this mean in real life? Going from being unable to even read headlines to normal vision.

How do we treat diabetic retinopathy these days? With steroids and other drugs injected straight into the eyeball. And if that doesn’t work, there’s always pan-retinal laser photocoagulation, in which laser burns are placed over nearly the entire retina. Surgeons literally burn out the back of your eyeball. Why would they do that? The theory is that by killing off most of the retina, the little pieces you leave behind may get more of the remaining blood flow.

When I see this, along with Kempner’s work, I can’t help but feel like history has been reversed. Like, can you believe 50 years ago the best we had was this barbaric burn-out-your-socket surgery, but thank goodness we’ve since learned that through dietary means alone, we can sometimes reverse the blindness. Instead of learning, medicine seems to have forgotten.

The most efficient way to avoid diabetic complications is to eliminate the diabetes in the first place, and this is often feasible with a healthy enough diet.

A plant-based diet beat out the conventional American Diabetes Association diet in a head-to-head randomized controlled clinical trial, without restricting portions; no calorie or carb counting. A review of all such studies found that those following plant-based diets experience better improvements compared to those following diets that include animal products—but this is nothing new.

The successful treatment of type 2 diabetes with a plant-based diet was demonstrated back in the 1930s, showing that a diet centered around vegetables, fruits, whole grains, and beans was more effective in controlling diabetes than any other diet.

Randomized controlled trial: after five years, no big change in the control group, but in the plant-based group, insulin needs were cut in half, and a quarter ended up off of insulin altogether. Now, this was a low-calorie diet, though; maybe their diabetes just got better because they lost weight?

To tease that out, what we would need is a study where they switch people to a healthy diet, but force them to eat so much food that they’d actually maintain their weight. Then, we could see if a plant-based diet had benefits independent of all the weight loss. We’d have to wait 44 years, but here it is. Subjects were weighed every day, and if they started losing weight, they were made to eat more food. In fact, so much food some of the participants had trouble eating it all, but they eventually adapted; so, there were no significant alterations in body weight despite restricting meat, dairy, eggs, and junk.

So, with zero weight loss, did a plant-based diet still help? Here are the before-and-after insulin requirements of the 20 people they put on the diet. This is the number of units of insulin they had to inject themselves with before and after going on the plant-based diet. Overall insulin requirements were cut about 60%, and half were able to get off insulin altogether, despite no change in weight. How many years did this take? Was it five years like the other study? No, 16 days.

So, we’re talking diabetics who’ve had diabetes as long as 20 years, injecting 20 units of insulin a day and then, as few as 13 days later, they’re off insulin altogether, thanks to less than two weeks on a plant-based diet. Diabetes for 20 years, then off all insulin in less than 2 weeks. Here’s patient 15: 32 units of insulin on the control diet and then 18 days later on none. Lower blood sugars on 32 units less insulin; that’s the power of plants.

And as a bonus, their cholesterol dropped like a rock—in 16 days to under 150.  Just like moderate changes in diet usually result in only modest reductions in cholesterol,  asking people with diabetes to make moderate changes often achieves equally moderate results.  Which is one possible reason why most end up on drugs, injections, or both.

Everything in moderation may be a truer statement than people realize. Moderate changes in diet can leave one with moderate blindness, moderate kidney failure, and moderate amputations—maybe just a few toes. Moderation in all things is not necessarily a good thing.

The more we as physicians ask from our patients, the more we are likely to get. The old adage “shoot for the moon” seems to apply. It may be more effective than limiting patients to small steps that may sound more manageable but are not sufficient to actually stop the disease.

The only thing better than reversing diabetes is to not get it in the first place. That study that purported to show that diets high in meat, eggs, and dairy could be as harmful to health as smoking supposedly suggested that people under 65 who eat lots of meat, eggs, and dairy are four times as likely to die from cancer or diabetes. But if you look at the actual study, you’ll see that’s not true. Those eating a lot of animal protein didn’t have just four times more risk of dying from diabetes, they had 73 times higher risk of dying from diabetes.

As one eats more and more plant-based, there appears to be a stepwise drop in the rate of diabetes down to a 78% lower prevalence among those eating strictly plant-based. Protection building incrementally as one moved from eating meat daily, to less than daily, to just fish, to no meat, and then, to no eggs and dairy either. A similar pattern was found for the leading cause of vision loss among the elderly—cataracts. This suggests that it’s not all or nothing; any steps we can make towards eating healthier may accrue benefits.

But why? Why is total meat consumption associated with higher risk for diabetes, and especially processed meat, particularly poultry?

Well, there’s a whole list of potential culprits in meat. Yes, it may be the animal protein, but maybe it’s the animal fat; maybe it’s the cholesterol; maybe it’s the iron leading to free radical formation, which could lead to chronic inflammation. Advanced glycation end products (AGEs) are another problem. They promote oxidative stress and inflammation, and food analyses show that the highest levels of these so-called glycotoxins are found in meat. Here are the 15 most glycotoxin contaminated food sources: chicken, pork, pork, chicken, chicken, beef, chicken, chicken, beef, chicken, turkey, chicken, fish, beef, and… McNuggets—I don’t know if you can call those chicken.

Though other foods from animal sources can also harbor these pro-oxidant chemicals.  In this study, they fed diabetics foods packed with glycotoxins, like chicken, fish, and eggs, and their inflammatory markers shot up, like tumor necrosis factor and C-reactive protein. Thus, in diabetics, dietary AGEs promote inflammatory mediators, leading to tissue injury. The good news, though, is that restricting these kinds of foods may suppress these inflammatory effects. So these glycotoxins may be a missing link between the increased consumption of animal fat and meats and the subsequent development of type 2 diabetes in the first place, as well as Alzheimer’s disease, the final disease on our dreaded list.

Dietary AGEs appear to be important risk factors for Alzheimer’s disease as well. If you measure the urine levels of glycotoxins flowing through the bodies of older adults, those with the highest levels went on to suffer the greatest cognitive decline over the subsequent nine years, as well as the greatest brain shrinkage (it’s called cerebral atrophy), all helping to explain why those who eat the most meat may have triple the risk of getting dementia compared to long-time vegetarians. The bottom line is that the same diet that may help prevent the other dreaded diseases—cancer, heart attack, arthritis, stroke, high blood pressure, diabetes, and vision loss—may also help prevent brain loss and Alzheimer’s as well.

One disease that’s not on the list is ALS, or Lou Gehrig’s disease, a dreaded disease that strikes healthy, middle-aged people seemingly at random, and holds little hope for treatment and survival. Although mental capabilities stay intact, ALS paralyzes people, often from the outside in, and most patients die within three years when they can no longer breathe or swallow. At any given time, an estimated 30,000 Americans are fighting for their lives. We each have about a 1 in 400 chance of developing this dreaded disease. And it appears to be on the rise around the world. What causes it?

Well, there’s a neurotoxin produced by blue-green algae in our rivers, lakes, and oceans that ends up in seafood, which is currently a strong contender as the cause of, or at least a major contributor to, ALS and maybe Alzheimer’s and Parkinson’s as well. Researchers in Miami found this BMAA neurotoxin in the brains of Floridians who died from sporadic Alzheimer’s disease and ALS; significant levels in 49 out of 50 samples from Alzheimer’s and ALS patients. The same thing was found up in the Pacific Northwest and in the brains of those dying from Parkinson’s disease. You can also apparently pick up more of this neurotoxin in the hair of live ALS patients compared to controls.

So, is BMAA present in Florida seafood? Yes, in both freshwater fish and shellfish, like oysters and bass, and out in the bay. And not just in Florida – on up the Eastern seaboard, and out into the Midwest. This could explain ALS clusters around lakes in New Hampshire, or fish in Wisconsin, or blue crabs from the Chesapeake, or seafood eaters in France, or in Finland’s Lakeland district, or around the Baltic Sea, building up particularly in fish, mussels, and oysters.

There is a general consensus that these harmful algal blooms are increasing worldwide thanks in part to industrialized agriculture, which may increase exposure to this neurotoxin, leading to a possible increased incidence of these horrible neurodegenerative diseases. With substantial and ever growing evidence that BMAA does play a role in the onset and progression of neurodegenerative diseases, the most important question is “What mode of activity does BMAA exert?” What? No, it’s not! The most important question is “How do we reduce our exposure?”

We know that the presence of BMAA in aquatic food chains could be a significant human health hazard. So, until more is known, it may be prudent to limit exposure of BMAA in the human diet.

There are neurotoxins in the dairy supply too, which may explain the link between milk consumption and Parkinson’s. High levels of organochlorine pesticide residues are found in milk and in the brains of Parkinson’s patients, and other pollutants, like tetrahydroisoquinoline, which is what scientists actually use to try to induce the disease in primates found in the milk supply, particularly cheese.  So, maybe the dairy industry should require toxin screenings of milk.

You could always just not drink it, but then what would happen to your bones? That’s a marketing ploy; if you look at the science, milk does not protect against hip fracture risk, whether drinking milk during your adult years, or drinking milk during your teen years. If anything, milk consumption was associated with a borderline increase in fracture risk in men. This suggests a partial explanation for the longstanding enigma that hip fracture rates are highest in populations with the greatest milk consumption.

This enigma irked a Swedish research team, puzzled because studies again and again had shown a tendency for higher risk of fracture with higher milk consumption. Well, there is a rare birth defect called galactosemia, where babies are born without the enzymes needed to detoxify the galactose found in milk. So they end up with higher levels of galactose in their blood, which can cause bone loss. So maybe, the Swedish researchers figured, even in normal people who can detoxify the stuff, it might not be good for the bones to be drinking it every day. And galactose doesn’t just hurt the bones; that’s what scientists use to cause premature aging in lab animals. They slip them a little galactose, and can shorten their lifespan, cause oxidative stress, inflammation, and brain degeneration—just with the equivalent of like one to two glasses of milk’s worth of galactose a day. We’re not rats, though—but given the high amount of galactose in milk, recommendations to increase milk intake for prevention of fractures could be a conceivable contradiction; so, they decided to put it to the test, looking at milk intake and mortality, as well as fracture risk, to test their theory.

A hundred thousand men and women followed for up to 20 years, and milk-drinking women had higher rates of death, more heart disease, and significantly more cancer for each daily glass of milk. Three glasses a day was associated with nearly twice the risk of death. And they had significantly more bone and hip fractures too. More milk, more fractures.

Milk-drinking men also had a higher rate of death, but for some reason you never see any of this in any of the milk ads.

OK, so where does that leave us? What are the common threads? If you look at four of the major dietary quality scoring systems, which have all been associated with extending lifespan and lowering heart disease and cancer mortality, they all share only four things in common: more fruit, more vegetables, more whole grains, and more nuts and beans. They are all built on a common core of diets rich in plant foods, whereas opposite food patterns, rich in animal foods and poor in plant-based foods (in other words, the Western diet), are associated with higher risks. So, we need to optimize the food environment to support whole grains, vegetables, fruit, and plant-based sources of protein.

Taking the diet quality indexes to their logical conclusion, the most plant-based diet would be the most healthy diet. But again, it doesn’t have to be all or nothing. We now have evidence that simple advice to increase the consumption of plant-derived foods with reductions in the consumption of foods from animal sources confers a survival advantage.

And boy do we need it. In terms of life expectancy, the U.S. is down around 27th or 28th out of the 34 leading free-market democracies. The people of Slovenia live a year longer than citizens of the United States. Why? Most deaths in the United States are preventable and related to nutrition. According to the most rigorous analysis of risk factors ever published, the #1 cause of death in the U.S., and the #1 cause of disability, is our diet, which has bumped tobacco smoking to #2. Smoking now kills only about a half a million Americans every year, but diet now kills hundreds of thousands more.

Let me end with a thought experiment. Imagine yourself a smoker in the 1950s. The average per capita cigarette consumption was about 4,000 cigarettes a year. Think about that. In the 1950s, the average American smoked a half a pack a day.

The media was telling you to smoke and famous athletes agreed. Even Santa Claus cared enough about your throat to want you to smoke. I mean, you want “to keep fit”, and “stay slender”, so you make sure to smoke and eat hot dogs to keep trim, and lots of sugar to stay slim and trim, a lot less fattening than that apple, I mean sheesh. “Though apples do connote goodness and freshness”, reads one internal tobacco industry memo, which brings up many possibilities for making youth-oriented cigarettes. Shameless!

In addition to staying fit and slender and soothing your throat, “for digestion’s sake”, you smoke. I mean, “No curative power is claimed for Phillip Morris— but, an ounce of prevention is worth a pound of cure.” So, better safe than sorry, and smoke.

Like eating, smoking was a family affair. “Gee, Mommy, you sure enjoy your Marlboro.” “You’re darn tootin’.”  “Just one question, Mom, can you afford not to smoke Marlboros?” Your kids were giving you cigarettes in the 50s; even your dog was giving you cigarettes.

“Blow in her face, and she’ll follow you anywhere.” “No woman ever says no.” After all, they’re “so round, so firm, so fully packed!”

After all, popular, handsome John Wayne smoked them—until he got lung cancer and died.

Even the paleo folks were smoking, and so were the doctors.

This is not to say there wasn’t controversy within the medical profession. Yes, some doctors smoked Camels, but other physicians preferred Luckies; so, there was some disagreement. Eminent doctors, on high and impartial medical authority, call for Phillip Morris. Even the specialists could not agree which cigarette was better for your throat; so, best to stick to the science, and more scientists smoke this brand.

This should not be rocket science—but even the rocket scientists had their favorite: “For the man who thinks for himself.”

What was the government saying? Smoke Luckies. I mean who wouldn’t want to give their throat a vacation. Not a single case of throat irritation. How could your nose and throat be adversely affected— when cigarettes are “just as pure as the water you drink.”

And if you do get irritated, no problem; your doctor can write you a prescription for cigarettes. This is an ad from the Journal of the American Medical Association. After all, “Don’t smoke is advice hard for patients” to swallow. Reminds me of the recent survey of doctors that found the #1 reason doctors don’t prescribe heart-healthy diets today was their perception that patients fear being deprived of all the junk they’re eating. After all, Philip Morris reminded us, we want to keep our patients happy, and “to make a radical change in habit…may do harm.” You’re a doctor; you don’t want to harm your patients.

The tobacco industry gave medical journals big money to run ads like these. Not a problem, though, Phillip Morris claims come from “completely reliable sources” based on studies conducted by recognized authorities published in leading medical journals. Even kindly offering to send free packs of cigarettes to doctors so they can test them out themselves. So, join us at the next AMA convention.

What did the American Medical Association have to say for itself? Like most other medical journals, they accepted tobacco ads. They have yet to see an autopsy with a single lesion that had a Marlboro label on it. So, when mainstream medicine is saying that smoking may on balance be beneficial, when the American Medical Association is saying that, where could you turn back then if you just wanted the facts? What’s the new data advanced by science? She was “too tired for fun, and then she smoked a Camel.”

Babe Ruth spoke of “proof positive” medical science, that is when he still could speak, before he died of throat cancer.

Now, some of the science did leak out, causing a dip from about 11 cigarettes a day per person down to 10, but those who got scared could always choose “the cigarette that takes the fear out of smoking,” or even better, choose the cigarette that “gives you the greatest health protection.”

Now, if by some miracle, there were a SmokingFacts.org website back then that could deliver the science directly to the people, bypassing commercially corruptible institutional filters, you would have become aware of studies like this: an Adventist study in California in 1958 that showed that nonsmokers may have at least 90% less lung cancer. But this wasn’t the first.

When famed surgeon Michael DeBakey was asked why his studies published back in the 30s linking smoking and lung cancer were ignored, he had to remind people about what it was like back then. We were a smoking society; it was in the movies; medical meetings were one “heavy haze of smoke.”  It’s like the debates over cigarettes and lung cancer in Congress taking place in smoke-filled rooms. Makes me wonder what’s served at the Dietary Guidelines Committee meeting breakfast buffets to this day.

A famous statistician by the name of Ronald Fisher railed against what he called propaganda to convince the public that cigarette smoking was dangerous.

Fisher made invaluable contributions to the field of statistics, but his analysis of lung cancer and smoking was flawed by an unwillingness to examine the entire body of data available. His smokescreen may have been because he was a paid consultant to the tobacco industry, but also because he was himself a smoker. Part of his resistance to seeing the association may have been rooted in his own fondness for smoking, which makes me wonder about some of the foods nutrition researchers may be fond of to this day.

It always strikes me as ironic when vegetarian researchers come forward and list their diet as a potential conflict of interest, whereas not once in the 70,000 articles on meat in the medical literature have I ever seen a researcher disclose their non-vegetarian habits, because it’s normal. Just like smoking was normal.

So, back to our thought experiment. If you’re a smoker in the 50’s in the know, what do you do? With access to the science, you realize that the best available balance of evidence suggests that your smoking habit is probably not good for you. So, do you change your smoking habits or do you wait? If you wait until your physician tells you, between puffs, to quit, you could have cancer by then. If you wait until the powers that be officially recognize it, like the Surgeon General did in the subsequent decade, you could be dead by then.

It took 25 years for the Surgeon General’s report to come out. It took more than 7,000 studies and the deaths of countless smokers before the first Surgeon General’s report against smoking was finally released in the 1960’s. You’d think maybe after the first 6,000 studies, maybe they could have given people a little heads up or something? It was a powerful industry. One wonders how many people are currently suffering needlessly from dietary diseases. Maybe we should have stopped smoking after the 700th study like this.

With so much money and personal habit at stake, there will always be dissenters. But given the seriousness of these diseases and the sum total of evidence, we shouldn’t wait to put preventive measures in place.

As a smoker in the 50s, on one hand, you had all of society, the government, and the medical profession itself telling you to smoke. And, on the other hand, the science (if you were lucky enough to know about studies like this).

Now, fast forward 55 years. There’s a new Adventist study out of California, the Adventist Health Study 2, warning America about the risks of something else they may be putting in their mouth. And it’s not just one study; according to the latest review, the total sum of evidence suggests that mortality from all causes put together, and many of our dreaded diseases—ischemic heart disease, and circulatory and cerebrovascular diseases like stroke—were significantly lower in those eating meat-free diets, in addition to less cancer and diabetes.

So, instead of going along with America’s smoking habits in the 50s, imagine you or someone you know going along with America’s eating habits today. What do you do? With access to the science, you realize that the best available balance of evidence suggests that your eating habits are probably not good for you. So, do you change your eating habits or do you wait? If you wait until your physician tells you, between bites, to change your diet, it may be too late. In fact, even after the Surgeon General’s report, the medical community still dragged their feet. The AMA actually went on record withholding endorsement of the Surgeon General’s report. Could that have been because they had just been handed ten million dollars from the tobacco industry?

We know why the AMA may have been sucking up to the tobacco industry, but why weren’t individual doctors speaking out? There were a few gallant souls ahead of their time writing in, as there are today, standing up against industries killing millions; but why not more? Maybe it’s because the majority of physicians themselves smoked cigarettes, just like the majority of physicians today eat foods that contribute to our epidemic of dietary disease. What was the AMA’s rallying cry back then? “Everything in moderation.” Sound familiar? “Extensive scientific studies have proved that smoking in moderation is OK.”

Today, the food industry uses the same tobacco industry tactics: supplying misinformation and twisting the science.

The same scientists-for-hire paid to downplay the risks of secondhand smoke and toxic chemicals are the same hired by the National Confectioners Association to downplay the risks of candy, and the same hired by the meat industry to downplay the risks of meat.

Consumption of animal products and processed foods cause at least 14 million deaths around the world each year. 14 million deaths. 14 million people dead every year. This is not a failure of individual willpower, says the Director-General of the World Health Organization. This is a failure of political will to take on big business, which is a formidable opposition. Few governments are willing to prioritize health over big business. As we learned from experience with the tobacco industry, a powerful corporation can sell the public just about anything.

If there’s one thing we’ve learned from the tobacco experience, wrote one district judge, it’s how powerful profits can be a motivator, even at the cost of millions of lives and unspeakable suffering.

It may have taken 25 years for the Surgeon General’s report to come out, and longer still for mainstream medicine to get on board, but now there are no longer ads encouraging people to “inhale to your heart’s content!” Now, there are ads from the CDC fighting back.

Food-wise, there was “meat…for health defense,” or “nourishing bacon,” or “doctors prescribe… meat”, or soda for that matter. “Trix are habit-forming, thank heavens!”

Now, just like there were those in the 30s, 40s, and 50s on the vanguard trying to save lives, today there are those turning ads about what you can do with pork butt to what the pork can do to your butt:  The Physicians Committee for Responsible Medicine’s “Meat is the new tobacco” campaign. As Dr. Barnard tried to get across in an editorial published in the American Medical Association Journal of Ethics, plant-based diets can now be considered the nutritional equivalent of quitting smoking.

How many more people have to die, though, before the CDC encourages people not to wait for open heart surgery to eat healthy, as well? How long’s that going to take, though?

Just like we don’t have to wait until our doctor stops smoking to quit ourselves, we don’t have to wait until our doctor takes a nutrition class or cleans up their own diet before choosing to eat healthier. It’s not your doctor’s fault, writes a group of prominent physicians. There is a severe deficiency of nutrition education at all levels of medical training. We were just never taught it.

We know a whole food plant-based diet has been proven to reverse our #1 killer, and protect against type 2 diabetes and cancer. So how has this knowledge affected medical education? It hasn’t. Despite the neglect of nutrition in medical education, the public considers physicians to be among the most trusted sources, but if doctors don’t know what they’re talking about, they could actually be contributing to diet-related diseases. To stem the surging tide of chronic illness in the United States, physicians need to become part of the solution. But we don’t have to wait for that to happen. No longer do patients have to be patient.

Doctors no longer hold a professional monopoly on health information. There’s been a democratization of knowledge, and so until the system changes, we have to take personal responsibility for our own health and for our family’s health. We can’t wait until society catches up with the science, because it’s a matter of life and death.

In 2015, Dr. Kim Allan Williams became President of the American College of Cardiology. He was asked why he follows his own advice to eat a plant-based diet. “I don’t mind dying,” Dr. Williams replied. “I just don’t want it to be my fault.”

Thank you.

If you missed last year’s talk, I have it on DVD. And the year before that and the year before that, as well as 25 other DVDs. All proceeds from the sale of all of my books, DVDs, and speaking engagements all go to charity, and speaking of which: mark your calendars, December 8th of this year, my new book is coming out: How Not to Die.

December 8th—I’m so excited about it. It’s not only a compilation of my life’s work, with all the science and thousands of citations putting it all together, but a practical guide. I go through my daily dozen checklist of all the things I try to fit in my own daily diet. How many greens we should eat, how many beans we should eat, how much sleep, how much exercise. I’ve been working on it for over a year, and can’t wait for everyone read it.

And in the meanwhile, all my work is available free, on NutritionFacts.org.

Thanks again.

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

Please consider volunteering to help out on the site.

Recorded live at the University of Pittsburgh on July 11, 2015 thanks to NAVS and Aaron Wissner. Images thanks to Stanford Research into the Impact of Tobacco Advertising; Centers for Disease Control and Prevention; Steven Jackson, Leon Keller, and DES Daughter via Flickr; 18percentgrey, Rostislav Sedláček, and Anna Liebiedieva via 123rf; Nmajik, Gajda-13, and Brian Arthur via Wikimedia Commons; and OpenPics and Bambo via Pixabay.

Good evening.

For those of you unfamiliar with my work, every year I read through every issue of every English-language nutrition journal in the world so you don’t have to. Every year, my talks are brand new, because every year the science is brand new.

I then compile all the most interesting, the most groundbreaking, the most practical findings to create new videos and articles, every day, for my nonprofit site, NutritionFacts.org.

Everything on the website is free. There are no ads, no corporate sponsorships; it’s strictly noncommercial, not selling anything. I just put it up as a public service, as a labor of love. There are new videos and articles every day on the latest in evidence-based nutrition.

In my 2012 year-in-review, I explored the role a healthy diet may play in preventing, arresting, and reversing our deadliest diseases. In 2013, I covered our most common conditions. And, in 2014, I went through our leading causes of disability. This year, I thought I’d address some of our most dreaded diseases, and cancer tops the list.

The #1 cancer killer in the United States, of both men and women, is lung cancer. But, if you look at the rates of lung cancer around the world, they vary by a factor of ten. If there were nothing we could do to prevent lung cancer, if it just happened at random, you’d assume that the rates everywhere would be about the same. But, since there’s such a huge variation in rates, you assume there’s some contributing cause. Indeed, we now know smoking is responsible for 90% of lung cancer cases. So, if we don’t want to die of the #1 cancer killer, by just not smoking, we can throw 90% of our risk out the window.

Colorectal cancer is our second leading cause of cancer death, for which there’s an even bigger spread. So, it appears colon cancer doesn’t just happen; something makes it happen. Well, if our lungs can get filled with carcinogens from smoke, maybe our colons are getting filled with carcinogens from food. Why do African Americans get more colon cancer than native Africans? Why study Africans? Because colon cancer is extremely rare in native African populations; like more than 50 times lower rates than Americans, white or black.

We used to think it was all the fiber they were eating, however, the modern African diet is highly processed, low in fiber, and yet there has been no dramatic increase in colon cancer. And we’re not just talking low fiber intake, we’re talking United States of America-low, down around half the recommended daily allowance. Yet colon disease still remains rare in Africa; still 50 times less colon cancer.

Maybe it’s because they’re thinner and exercise more? No, they’re not, and no, they don’t. If anything, their physical activity levels may now be even lower. So if they’re sedentary like us, eating mostly refined carbs, few whole plant foods, little fiber—like us, why do they have 50 times less colon cancer? Well, there is one big difference. The diet of both African-Americans and Caucasian-Americans is rich in meat, whereas the native Africans’ diet is so low in meat and saturated fat they have total cholesterol levels averaging 139, compared to over 200 in the U.S.

So yes, they don’t get a lot of fiber anymore, but they continue to minimize meat and animal fat consumption, supporting evidence that perhaps the most powerful determinants of colon cancer risk are the levels of meat and animal fat intake. So, why do Americans get more colon cancer than Africans? Maybe, the rarity of colon cancer in Africans is associated with low animal product consumption.

But why? Did you ever see that take-off of the industry slogan, “Beef: It’s What’s For Dinner” – “Beef, It’s What’s Rotting in Your Colon”? I saw this on a shirt once with some friends, and I was such the party pooper—no pun intended, explaining to everyone that meat is fully digested in the small intestine, and never makes it down into the colon. It’s no fun hanging out with biology geeks —but, it turns out, I was wrong!

It turns out, up to 12 grams of protein a day can escape digestion, and when it reaches the colon, it can be turned into toxic substances, like ammonia. This degradation of undigested protein in the colon is called putrefaction; so, a little meat can actually end up putrefying in our colon. The problem is that some of the by-products of this putrefaction process can be toxic.

The same thing happens with other animal proteins. If you eat egg whites, for example, some of that can putrefy, too. But, there’s protein in plants as well. The difference is that animal proteins tend to have more sulfur-containing amino acids like methionine (which is found most concentrated in fish and chicken, and then eggs, less in beef and dairy, and much less in plant foods), which can be turned into hydrogen sulfide in our colon.  Hydrogen sulfide is the rotten egg gas that, over and above its objectionable odor, can produce changes in the colon that increase cancer risk.

Now, there is a divergence of opinion as to whether it’s the animal fat, cholesterol, or animal protein that is most responsible for the increased cancer risk, as all three have been shown to have carcinogenic properties. But, it may not really matter which component is worse, as a diet rich in one is usually rich in the others.

The protein does more than just putrefy, though. Animal protein consumption causes an increase in blood levels of a cancer-promoting growth hormone called IGF-1. But, remove meat, egg whites, and dairy proteins from our diet, and our bloodstream can suppress cancer cell growth about eight times better. An effect so powerful that Dr. Ornish and colleagues appeared able to reverse the progression of prostate cancer without chemo, surgery, or radiation; just a plant-based diet and other healthy lifestyle changes.

The link between animal protein and IGF-1 may help explain why those eating low-carb diets tend to die sooner, but not just any low-carb diet; specifically, those based on animal sources, whereas vegetable-based low-carb diets are associated with a lower risk of death. But low-carb diets are high in animal fat as well as animal protein, so how do we know it wasn’t the saturated fat and cholesterol that were killing people off, and it had nothing to do with the animal protein?

What we would need is a study that just follows a few thousand people and their protein intake for 20 years or so, and sees who lives longest, who gets cancer, and who doesn’t? But, there’s never been a study like that…until now.         

6,000 men and women over age 50, from across the U.S, were followed for 18 years, and those under age 65 with high protein intake had a 75% increase in overall mortality and a fourfold increase in the risk of dying from cancer. But, not all proteins.  Specifically, animal proteins. These associations were either abolished or attenuated if the proteins were plant-derived. This all makes sense, given the higher IGF-1 levels in those eating excess protein. Eating animal protein increases IGF-1 levels, which increases cancer risk.

The sponsoring university sent out a press release with a memorable opening line: “That chicken wing you’re eating could be as deadly as a cigarette,” explaining that eating a diet rich in animal protein during middle age makes you four times more likely to die of cancer than someone with a low-protein diet—a mortality risk factor comparable to smoking. And when they say low-protein diet, what they actually mean is just getting the recommended amount of protein.

Almost everyone is going to have a cancer cell or pre-cancerous cell in them at some point. The question is: does it progress? That may depend on what we eat. See, most malignant tumors are covered in IGF-1 receptors, but if there’s less IGF-1 around, they may not be able to progress.

And, it wasn’t just more deaths from cancer. Middle-aged people who eat lots of proteins from animal sources were found to be more susceptible to early death in general. Crucially, the same did not apply to plant proteins like beans, and it wasn’t the fat, but the animal protein, that appeared to be the culprit. 

What was the response to the revelation that diets high in meat, eggs, and dairy could be as harmful to health as smoking? One nutrition scientist replied that it was wrong, and potentially dangerous. Not the discovery that animal protein might be killing people, but the way they were telling people about it; it could damage the effectiveness of important public health messages. A smoker might think: “Why bother quitting smoking if my cheese and ham sandwich is just as bad for me?”

This reminds me of a famous Philip Morris cigarette ad that tried to downplay the risks by saying, “You think secondhand smoke is bad, increasing the risk of lung cancer 19%. Drinking one to two glasses of milk every day may be three times as bad—62% higher risk of lung cancer. Or, doubling the risk by frequently cooking with oil, or tripling your risk of heart disease by eating non-vegetarian, or multiplying your risk sixfold by eating lots of meat and dairy.” So, they conclude, let’s keep some perspective; the risk of lung cancer from secondhand smoke may be well below the risk reported for other everyday activities.

That’s like saying, “Don’t worry about getting stabbed, because getting shot is much worse.” Uh, how about neither? Two risks don’t make a right.

The heme in the ham may also play a role. Heme iron is the form of iron found in blood and muscle, and may promote cancer by catalyzing the formation of carcinogenic compounds within our bodies. Cancer has been described as a ferrotoxic disease: a disease, in part, of iron toxicity.

Iron is a double-edged sword. Iron deficiency causes anemia; however, excessive iron may increase cancer risk, presumably by acting as a pro-oxidant, generating free radicals that may play a role in a number of dreaded diseases like stroke. But, only the heme iron, the blood and muscle iron, not the nonheme iron that predominates in plants. Same with heart disease—only the heme iron, and same with diabetes—only the heme iron, and same with cancer.

In fact, you can actually tell how much meat someone is eating by looking at their tumors. To characterize the mechanisms underlying meat-related lung cancer development, they asked lung cancer patients how much meat they ate and examined the gene expression patterns in their tumors, and identified a signature pattern of heme-related gene expression. Although they just looked at lung cancer, they expect these meat-related gene expression changes may occur in other cancers as well.

The safest form of iron, then, is non-heme iron, found naturally in abundance in whole grains, beans, split peas, chickpeas, lentils, dark green leafy vegetables, dried fruits, nuts, and seeds. How much money can be made on beans, though? So, the food industry came up with a blood-based crispbread made out of rye, and cattle and pig blood, one of the most concentrated sources of heme iron—about two-thirds more than chicken blood. If blood-based crackers don’t sound appetizing, there’s always cow-blood cookies and blood-filled biscuits. The filling “ends up a dark-colored, chocolate flavored paste with a very pleasant taste.” Dark-colored because spray-dried pig blood can have a darkening effect on the food product’s color. But the worry is not the color or taste; it’s the heme iron, which, because of its potential cancer risk, is not considered safe to add to foods intended for the general population.

This reminds me of nitrosamines, a class of potent carcinogens found in cigarette smoke. They are considered so toxic that carcinogens of this strength in any other consumer product designed for human consumption would be banned immediately. If that were the case, they’d have to ban meat.

One hot dog has as many nitrosamines and nitrosamides as five cigarettes. And these carcinogens are also found in fresh, unprocessed meat as well: beef, chicken, and pork. But practice Meatless Mondays and you could wake up Tuesday morning with nearly all of these carcinogens washed out of your system.

So, toxic nitrosamines should be banned immediately, but are still allowed for sale in cigarettes and meat because the carcinogens are found there naturally, just like the heme iron. Not safe enough to expose the general population to, but allowed for sale at the deli counter.

The irony is that the iron and the protein are what the industry boasts about—those are supposed to be the redeeming qualities of meat: protein and iron, but, sourced from animal foods, they may do more harm than good. And that’s not to mention all the other stuff: the saturated fat, industrial pollutants, and hormones, which may play a role in our third leading cancer killer, breast cancer.

Steroid hormones are unavoidable in food of animal origin, but cow milk may be of particular concern. The hormones naturally found in even organic cow’s milk may have played a role in the studies that found a relationship between milk and other dairy products and human illnesses, such as teenagers’ acne; prostate, breast, ovarian, and uterine cancers; many chronic diseases that are common in Western societies; as well as male reproductive disorders.  Other dangers of high hormone levels in food range from increased risk of early puberty to endometrial cancer in older women, but they are particularly dangerous in the case of vulnerable populations, such as young children and pregnant women.  To this critical population, even a small hormonal intake could lead to major changes in the metabolism.

Look, dairy milk evolved to put a few hundred pounds onto a calf within the first few months of life. But the consequences of lifetime human exposure to the growth factors in milk have not been well studied. We know milk consumption increases IGF-1, which is linked to cancer, and we’re milking cows while they’re pregnant, resulting in particularly high levels of hormones.

Although dairy products are an important source of hormones, other products of animal origin must be considered as well. This may help explain why women can cut their breast cancer risk not just by being normal weight and limiting alcohol, but also by eating mostly foods of plant origin. To help differentiate the effects of diet from other lifestyle behaviors—like smoking and drinking—on overall cancer incidence, Adventists were compared to Baptists. Both discourage alcohol and tobacco, but the Adventists go further, encouraging a reduction of meat. In general, the Adventists had less cancer than the Baptists, and within Adventist populations, the vegetarians did even better, and those eating the most plants did the best.

All edible tissues of animal origin contain estrogen. This may explain why women avoiding all animal products have a twinning rate which is one-fifth that of vegetarians and omnivores. It appears that vegan women have five times fewer twins, presumed to be because they’re not exposed to all these hormones. Why is that a good thing? Because twin pregnancies are risky pregnancies, both for the mom and the babies, who may be ten times more likely to die at birth. To avoid these complications, women attempting conception may want to consider avoiding milk and other dairy products.

And this isn’t even talking about the synthetic hormones that are fed, injected, or implanted into farm animals. In 1979, an epidemic of breast enlargement was noted in Italian children. Poultry or veal were suspected, given that estrogens may be fed to farm animals to accelerate their weight gain. After this episode, Europe banned the use of anabolic growth promoters in agriculture and has banned the importation of American meat ever since, because we continue to inject animals with drugs like Zeranol, sold as Ralgro Magnum.

You drip Zeranol-containing blood from implanted cattle onto normal human breast cells in a Petri dish, and you can transform them into breast cancer cells within 21 days. But people are not Petri dishes.

Because these anabolic growth promoters in meat production are by far the most potent hormones found in human food, we should really be testing people, especially children, before and after eating this meat. Until then, we have no idea what kind of threat they may pose, though the fact that Zeranol is as potent as DES should concern us. DES is another synthetic estrogen marketed to pregnant women—until 1971 when it was shown to cause cancer of the vagina in their daughters. But few know it was also used in meat.

In the absence of effective federal regulation, the meat industry uses hundreds of animal feed additives, with little or no concern about the carcinogenic and other toxic effects. Illustratively, after decades of misleading assurances of the safety of DES in the meat supply, the United States finally banned its use some 40 years after it was first shown to be cancer-causing. The meat industry then promptly switched to other potentially carcinogenic additives, such as Ralgro Magnum.

When girls started dying from vaginal cancer, DES-treated meat was subsequently banned in Europe. However, misleading assurances, including the deliberate suppression of residue data, managed to delay a US ban on DES in the meat supply for eight years.

Today, virtually the entire U.S. population consumes—without any warning, labeling, or information—unknown and unpredictable amounts of hormonal residues in meat products over a lifetime. If all hormonal and other carcinogenic feed additives aren’t banned immediately, the least we could do is label them along with hormone residue levels in all meat products, including dairy and eggs.    

Speaking of eggs, the next on the list of dreaded diseases is heart disease. Eggs are the #1 source of choline, which can be converted by gut bacteria into a toxin that increases the risk of stroke, heart attack, and death. Eggs are also the #1 source of cholesterol.

Why does it matter if we have lots of cholesterol circulating in our bloodstream? Cholesterol doesn’t just infiltrate our arteries and help form inflamed pockets of pus in our arterial walls, but may play an active role in the final fatal plaque rupture. Cholesterol crystals may actually pop the plaque. If you look at ruptured plaques from autopsies, they are filled with cholesterol crystals protruding out from the plaque. Cholesterol in the plaque may get so supersaturated that it reaches a point that it crystallizes, like rock candy. The growing crystals may then burst the plaque open.

Here’s a cholesterol crystal shooting out the top of a test tube, and when you look at the tips of the cholesterol crystals under a microscope, they are sharp jagged needles. They placed a thin membrane over the top of the test tube to see if the cholesterol needles would poke through, and indeed, the sharp tips of the cholesterol crystals cut through the membrane. So, they showed that as cholesterol crystallized, the peak volume can increase rapidly within minutes, and sharp-tipped crystals can cut through and tear membranes—suggesting that the crystallization of supersaturated cholesterol in atherosclerotic plaques can induce rupture.

And that’s what you see on autopsy. All patients who died of acute heart attacks had perforating cholesterol crystals, like this, sticking out of their plaques. But no crystals were found perforating the arteries of people who had severe atherosclerosis but died first of other, non-cardiac, causes. This can explain why dramatically lowering cholesterol levels with diet (and drugs if necessary) can reduce the risk of fatal heart attack, by pulling cholesterol out of the artery walls, decreasing the risk of crystallizing these cholesterol needles that may pop the plaques in your arteries.

High cholesterol can also cause what’s called nonalcoholic fatty liver disease, our next global chronic disease epidemic. Fatty deposits in the liver can trigger inflammation, and result in liver cancer, failure, and death.

And again, it may be these crystals, cholesterol crystals, triggering the progression of fatty liver into serious hepatitis. We’re talking dietary cholesterol, the cholesterol people eat in eggs and other animal products. A strong association was seen between cholesterol intake and hospitalization and death from cirrhosis and liver cancer. And beyond just the crystals, dietary cholesterol may oxidize and directly cause toxic and carcinogenic effects.

It was not appreciated until recently that the average cholesterol level in the United States, the so-called “normal” level, was actually abnormal, accelerating the blockages in our arteries and putting a large fraction of the normal population at risk. Having a normal cholesterol in a society where it’s normal to die of a heart attack is not necessarily a good thing. Normal cholesterol levels may be fatal cholesterol levels.

In respect to cholesterol lowering, moderation kills. Even if all Americans kept their total cholesterol below the recommended 200, millions would develop coronary artery disease. Strong evidence shows we need to keep our total cholesterol under 150 to stem the epidemic. What kind of evidence? Well, in many cultures, coronary disease is practically unheard of when total serum cholesterol levels are under 150. And here in the U.S., in the famous Framingham Heart Study, few of those with levels below 150 developed heart disease, and none died from it.

We cannot continue to have public and private organizations on the forefront of health leadership recommending to the public a dietary plan that guarantees that millions will perish from the very disease the guidelines are supposed to prevent. The reason given by health authorities to not tell people the truth, for not advocating what the science shows is best, was that it might frustrate the public, who may have difficulty getting their cholesterol levels that low.  But maybe the public’s greatest frustration would come from not being informed of the optimal diet for health. Heart disease can be reversed with a plant-based diet. The evidence justifies igniting a social movement—let the people lead, and eventually the government will follow.

Some criticize plant-based diets as extreme or draconian. You want extreme, though?  Check out the consequences of our present diet. Having a breastbone sawed in half for bypass surgery or a stroke that renders one a mute can be construed as extreme, or having a breast, prostate, colon, or rectum removed to treat cancer—that’s extreme. Eating a bean burrito is easy.

Instead of just bypassing the problem—literally— you can treat the cause, arrest and reverse heart disease, our #1 killer, with a whole food, plant-based diet.

Next on the list is arthritis, such as rheumatoid arthritis, a chronic systemic inflammatory disorder that causes progressive destruction of the joints. As many as 80% become disabled, and it may cut up to 18 years off one’s lifespan. There are drugs you can take, but unfortunately they’re often associated with severe side effects including blood loss, bone loss, immune suppression, and toxicity to the liver and eyes. There’s got to be a better way.

Well, populations that eat more meat do seem to have higher rates of rheumatoid arthritis, and there have been some dramatic case reports of rheumatoid arthritis attacks triggered by the consumption of animal foods. These attacks started six to ten hours after ingestion of animal protein and lasted a few days, but they stopped when the patients stopped ingesting animal products. The researchers suggest that immune complexes formed by the body attacking animal proteins may promote autoimmune reactions in the joints themselves. And indeed, those with rheumatoid arthritis have striking elevations in antibodies to foods like fish, pork, egg whites, dairy proteins, and even some cereals. But it could also possibly be a pro-inflammatory property of meat fats or free radicals from the iron accumulating in the joints, or other mechanisms. But case reports and country-by-country analyses can be used only to raise questions. To prove cause-and-effect, you need an interventional study to put it to the test.

And here we go: a 13-month-long randomized controlled trial of plant-based diets for rheumatoid arthritis.  Patients were put on a vegan diet for three and a half months, and then switched to an egg-free vegetarian diet for the remainder of the study. Compared to the control group, who didn’t change their diet, the plant-based group had a significant improvement in morning stiffness within the first month, cutting the number of hours they suffered from joint stiffness in half. A drop in pain. A drop in disability. They reported subjectively feeling better, significant improvement in their grip strength, fewer tender joints, less tenderness per joint, and less swelling. They also had a drop in inflammatory markers in the blood: sed rate, C-reactive protein, and white count; highly significant and clinically relevant findings.

What about osteoarthritis? Osteoarthritis is the most frequent cause of physical disability among older adults, affecting more than 20 million Americans, with 20% of us affected in the coming decades, and becoming more and more widespread among younger people.

Osteoarthritis is characterized by loss of cartilage in the joint. We used to think it was just mechanical wear and tear, but it is now generally accepted as an active joint disease with a prominent inflammatory component. If the loss of cartilage is caused by inflammation, maybe if we put people on an anti-inflammatory diet, it could help; like with rheumatoid arthritis. Using optimal nutrition and exercise as the first-line intervention in the management of chronic osteoarthritis could well constitute the best medical practice.

Where’s the best science on what optimal nutrition might look like? The China Study is a prime example, showing the serious health consequences of high consumption of pro-inflammatory foods—meat, dairy, fat, and junk—and low consumption of anti-inflammatory plant foods—whole grains, vegetables, fruits, beans, split peas, chickpeas, and lentils. The unnatural Western diet contributes to low-grade systemic inflammation, oxidative stress, tissue damage, and irritation, placing the immune system in an overactive state, a common denominator of conditions such as arthritis.

Next on the list are stroke and high blood pressure, which go together, since high blood pressure is the #1 risk factor for stroke. The PREDIMED study found that a Mediterranean diet with nuts could cut stroke risk nearly in half, though they were still having strokes. Half as many strokes, but it was still a diet that promoted strokes and heart attacks.

That’s what Dr. Ornish noted when he wrote in: “There was no significant reduction in the rates of heart attack, death from cardiovascular causes, or death from any cause,” just that stroke benefit. But hey, that’s something. A Mediterranean diet is certainly better than what most people are consuming, but even better may be a diet based on whole plant foods, shown to actually reverse heart disease, not contribute to it. That may be true, the authors of the study replied, but the major problem with Ornish’s diet is that it doesn’t taste good, and so, hardly anyone sticks to it.

But it’s not true. Ornish got extraordinary adherence in his studies with no difference in any of the acceptability measures; same enjoyment compared to their regular diet. They even got success in barbecue country, rural North Carolina. See, stricter diets may meet greater acceptance among patients than more modest diets because they may work better. Greater adherence means greater disease reversal.

But you don’t have to be facing certain death. Even those who are young and healthy with no health problems had no problem sticking to a plant-based diet. In fact, it worked a little too well. This was a crossover study where they asked people to eat plant-based for a few months and then switch back to their baseline diet to note the contrast, but people felt so good eating healthy some refused to go back to their regular diet, which kind of messes up the study. They were losing weight with no calorie counting or portion control, they had more energy, their periods got better, better digestion, better sleep—many were like no way, we’re not going back.

But if doctors just presume people won’t eat this way, it may end up being a self-fulfilling prophecy. Just like smoking doctors are less likely to tell their patients to stop smoking, and couch potato docs are less likely to counsel exercise or things like more fruits and vegetables, we need to role model healthy behavior. This greatly enhances our credibility and effectiveness. Gone are the days of traditional authority when the fat physician, dropping cigarette ash down his gravy-stained vest, could credibly prescribe a change in behavior.

One reason why plant-based diets could save so many millions is because the #1 killer risk factor in the world is high blood pressure, laying to waste nine million people every year. And in the United States, killing off more than a thousand people a day; 400,000 Americans dead every year.

High blood pressure affects nearly 78 million Americans—that’s one in three of us, and as we age, our pressures get higher and higher, such that by age 60, it strikes more than half. If it affects most of us when we get older, maybe it’s less a disease and more just a natural, inevitable consequence of aging? No. We’ve known for nearly a century that high blood pressure need not occur. Researchers measured the blood pressure of a thousand people in rural Kenya who ate a diet centered around whole plant foods. Whole grains, beans, vegetables, fruit, and dark green leafy vegetables. Up until age 40, the blood pressures of rural Africans were about the same as Europeans and Americans, down around 120 over 80, but as Westerners age, their pressures creep up such that by age 60 the average person is hypertensive, exceeding 140 over 90. But what about those eating plant-based? Their pressures improved with age; not only did they not develop hypertension, their blood pressures actually got better.

The whole 140 over 90 cut-off is arbitrary. Just like studies show that the lower the cholesterol the better; there’s really no safe level above about 150. Blood pressure studies also support a “lower the better” approach to blood pressure reduction. Even people starting out with blood pressure under 120 over 80 appear to benefit from blood pressure reduction. So, the ideal blood pressure, the no-benefit-from-reducing-it-further blood pressure, is actually 110 over 70. But is it possible to get blood pressures down to 110 over 70? It’s not just possible; it’s normal for those eating healthy enough diets.

Over two years at a rural Kenyan hospital, 1,800 patients were admitted. How many cases of high blood pressure did they find? Zero. Wow, so they must have had low rates of heart disease. No, they had no rates of heart disease. Not low risk, no risk. Not a single case of arteriosclerosis, our #1 killer, was found.

Rural China too; about 110 over 70 their entire lives. Africa and China have vastly different diets, but they share the common theme that they are plant-based day-to-day, with meat eaten only on special occasions. Why do we think it’s the plant-based nature of their diets that was so protective?

Because in the Western world, as the American Heart Association has pointed out, the only folks really getting down that low are strict vegetarians, coming in at about 110 over 65. So, does the American Heart Association recommend a strict vegetarian diet? No, they recommend the DASH diet.

The DASH diet has been described as a lactovegetarian diet, but it’s not. It emphasizes fruits and vegetables and low-fat dairy, but just a reduction in meat. Why not vegetarian? We’ve known for decades that food of animal origin was highly significantly associated with blood pressure. In fact, you can take vegetarians and give them meat and you can watch their blood pressures go up.

So, when the DASH diet was created, were they just not aware of this landmark research, done by Harvard’s Frank Sacks? No, they were aware. The Chair of the Design Committee who came up with the DASH diet was Frank Sacks. In fact, the DASH diet was explicitly designed with the #1 goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet containing enough animal products to make it palatable to the general public. In fact, Sacks found that the more dairy the lactovegetarians ate, the higher their blood pressures went; but they had to make the diet acceptable.

A recent meta-analysis showed that vegetarian diets were good, but strictly plant-based diets may be better. Vegetarian diets in general confer protection against cardiovascular disease, some cancers and death, but completely plant-based diets seem to offer additional protection for obesity, hypertension, type 2 diabetes, and heart disease mortality. Based on a study of 89,000 Californians, those eating meat-free diets appeared to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free had 75% lower risk.

If, however, you’re already eating a whole foods plant-based diet, and you’re still not hitting 110 over 70, there are a few plants recently found to offer additional protection. A randomized placebo-controlled trial showing that a cup of hibiscus tea with each meal significantly lowers blood pressure. In fact, tested head-to-head against a leading blood-pressure drug, Captopril, two cups of strong hibiscus tea every morning were as effective as the drug.

Another randomized placebo-controlled trial found that a few tablespoons a day of ground flaxseeds induced one of the most potent antihypertensive effects ever achieved by a dietary intervention—two to three times more powerful than instituting an endurance exercise program (though, of course, there’s no reason you can’t do both).

Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? And the answer is both, though raw may work better. Kiwifruit didn’t seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with this study showing that raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy! They know the Big Pharma trick of choosing the right control group.

Next on the dreaded list is diabetes and vision loss, which go together, since diabetes is the leading cause of preventable middle-aged blindness. Even with intensive diabetes treatment—at least three insulin injections a day with the best modern technology, like implantable insulin pumps—the best we can offer is usually just a slowing down of the progression of the disease. So, we can slow down your blindness, but a half-century ago, Kempner at Duke proved you could reverse it with an ultra-strict plant-based diet of mostly rice and fruit. 44 consecutive patients with diabetic retinopathy, and in 30% of the cases, their eyes improved. From like this, to this. That’s not supposed to happen. Diabetic retinopathy had been considered a sign of irreversible damage. What does this mean in real life? Going from being unable to even read headlines to normal vision.

How do we treat diabetic retinopathy these days? With steroids and other drugs injected straight into the eyeball. And if that doesn’t work, there’s always pan-retinal laser photocoagulation, in which laser burns are placed over nearly the entire retina. Surgeons literally burn out the back of your eyeball. Why would they do that? The theory is that by killing off most of the retina, the little pieces you leave behind may get more of the remaining blood flow.

When I see this, along with Kempner’s work, I can’t help but feel like history has been reversed. Like, can you believe 50 years ago the best we had was this barbaric burn-out-your-socket surgery, but thank goodness we’ve since learned that through dietary means alone, we can sometimes reverse the blindness. Instead of learning, medicine seems to have forgotten.

The most efficient way to avoid diabetic complications is to eliminate the diabetes in the first place, and this is often feasible with a healthy enough diet.

A plant-based diet beat out the conventional American Diabetes Association diet in a head-to-head randomized controlled clinical trial, without restricting portions; no calorie or carb counting. A review of all such studies found that those following plant-based diets experience better improvements compared to those following diets that include animal products—but this is nothing new.

The successful treatment of type 2 diabetes with a plant-based diet was demonstrated back in the 1930s, showing that a diet centered around vegetables, fruits, whole grains, and beans was more effective in controlling diabetes than any other diet.

Randomized controlled trial: after five years, no big change in the control group, but in the plant-based group, insulin needs were cut in half, and a quarter ended up off of insulin altogether. Now, this was a low-calorie diet, though; maybe their diabetes just got better because they lost weight?

To tease that out, what we would need is a study where they switch people to a healthy diet, but force them to eat so much food that they’d actually maintain their weight. Then, we could see if a plant-based diet had benefits independent of all the weight loss. We’d have to wait 44 years, but here it is. Subjects were weighed every day, and if they started losing weight, they were made to eat more food. In fact, so much food some of the participants had trouble eating it all, but they eventually adapted; so, there were no significant alterations in body weight despite restricting meat, dairy, eggs, and junk.

So, with zero weight loss, did a plant-based diet still help? Here are the before-and-after insulin requirements of the 20 people they put on the diet. This is the number of units of insulin they had to inject themselves with before and after going on the plant-based diet. Overall insulin requirements were cut about 60%, and half were able to get off insulin altogether, despite no change in weight. How many years did this take? Was it five years like the other study? No, 16 days.

So, we’re talking diabetics who’ve had diabetes as long as 20 years, injecting 20 units of insulin a day and then, as few as 13 days later, they’re off insulin altogether, thanks to less than two weeks on a plant-based diet. Diabetes for 20 years, then off all insulin in less than 2 weeks. Here’s patient 15: 32 units of insulin on the control diet and then 18 days later on none. Lower blood sugars on 32 units less insulin; that’s the power of plants.

And as a bonus, their cholesterol dropped like a rock—in 16 days to under 150.  Just like moderate changes in diet usually result in only modest reductions in cholesterol,  asking people with diabetes to make moderate changes often achieves equally moderate results.  Which is one possible reason why most end up on drugs, injections, or both.

Everything in moderation may be a truer statement than people realize. Moderate changes in diet can leave one with moderate blindness, moderate kidney failure, and moderate amputations—maybe just a few toes. Moderation in all things is not necessarily a good thing.

The more we as physicians ask from our patients, the more we are likely to get. The old adage “shoot for the moon” seems to apply. It may be more effective than limiting patients to small steps that may sound more manageable but are not sufficient to actually stop the disease.

The only thing better than reversing diabetes is to not get it in the first place. That study that purported to show that diets high in meat, eggs, and dairy could be as harmful to health as smoking supposedly suggested that people under 65 who eat lots of meat, eggs, and dairy are four times as likely to die from cancer or diabetes. But if you look at the actual study, you’ll see that’s not true. Those eating a lot of animal protein didn’t have just four times more risk of dying from diabetes, they had 73 times higher risk of dying from diabetes.

As one eats more and more plant-based, there appears to be a stepwise drop in the rate of diabetes down to a 78% lower prevalence among those eating strictly plant-based. Protection building incrementally as one moved from eating meat daily, to less than daily, to just fish, to no meat, and then, to no eggs and dairy either. A similar pattern was found for the leading cause of vision loss among the elderly—cataracts. This suggests that it’s not all or nothing; any steps we can make towards eating healthier may accrue benefits.

But why? Why is total meat consumption associated with higher risk for diabetes, and especially processed meat, particularly poultry?

Well, there’s a whole list of potential culprits in meat. Yes, it may be the animal protein, but maybe it’s the animal fat; maybe it’s the cholesterol; maybe it’s the iron leading to free radical formation, which could lead to chronic inflammation. Advanced glycation end products (AGEs) are another problem. They promote oxidative stress and inflammation, and food analyses show that the highest levels of these so-called glycotoxins are found in meat. Here are the 15 most glycotoxin contaminated food sources: chicken, pork, pork, chicken, chicken, beef, chicken, chicken, beef, chicken, turkey, chicken, fish, beef, and… McNuggets—I don’t know if you can call those chicken.

Though other foods from animal sources can also harbor these pro-oxidant chemicals.  In this study, they fed diabetics foods packed with glycotoxins, like chicken, fish, and eggs, and their inflammatory markers shot up, like tumor necrosis factor and C-reactive protein. Thus, in diabetics, dietary AGEs promote inflammatory mediators, leading to tissue injury. The good news, though, is that restricting these kinds of foods may suppress these inflammatory effects. So these glycotoxins may be a missing link between the increased consumption of animal fat and meats and the subsequent development of type 2 diabetes in the first place, as well as Alzheimer’s disease, the final disease on our dreaded list.

Dietary AGEs appear to be important risk factors for Alzheimer’s disease as well. If you measure the urine levels of glycotoxins flowing through the bodies of older adults, those with the highest levels went on to suffer the greatest cognitive decline over the subsequent nine years, as well as the greatest brain shrinkage (it’s called cerebral atrophy), all helping to explain why those who eat the most meat may have triple the risk of getting dementia compared to long-time vegetarians. The bottom line is that the same diet that may help prevent the other dreaded diseases—cancer, heart attack, arthritis, stroke, high blood pressure, diabetes, and vision loss—may also help prevent brain loss and Alzheimer’s as well.

One disease that’s not on the list is ALS, or Lou Gehrig’s disease, a dreaded disease that strikes healthy, middle-aged people seemingly at random, and holds little hope for treatment and survival. Although mental capabilities stay intact, ALS paralyzes people, often from the outside in, and most patients die within three years when they can no longer breathe or swallow. At any given time, an estimated 30,000 Americans are fighting for their lives. We each have about a 1 in 400 chance of developing this dreaded disease. And it appears to be on the rise around the world. What causes it?

Well, there’s a neurotoxin produced by blue-green algae in our rivers, lakes, and oceans that ends up in seafood, which is currently a strong contender as the cause of, or at least a major contributor to, ALS and maybe Alzheimer’s and Parkinson’s as well. Researchers in Miami found this BMAA neurotoxin in the brains of Floridians who died from sporadic Alzheimer’s disease and ALS; significant levels in 49 out of 50 samples from Alzheimer’s and ALS patients. The same thing was found up in the Pacific Northwest and in the brains of those dying from Parkinson’s disease. You can also apparently pick up more of this neurotoxin in the hair of live ALS patients compared to controls.

So, is BMAA present in Florida seafood? Yes, in both freshwater fish and shellfish, like oysters and bass, and out in the bay. And not just in Florida – on up the Eastern seaboard, and out into the Midwest. This could explain ALS clusters around lakes in New Hampshire, or fish in Wisconsin, or blue crabs from the Chesapeake, or seafood eaters in France, or in Finland’s Lakeland district, or around the Baltic Sea, building up particularly in fish, mussels, and oysters.

There is a general consensus that these harmful algal blooms are increasing worldwide thanks in part to industrialized agriculture, which may increase exposure to this neurotoxin, leading to a possible increased incidence of these horrible neurodegenerative diseases. With substantial and ever growing evidence that BMAA does play a role in the onset and progression of neurodegenerative diseases, the most important question is “What mode of activity does BMAA exert?” What? No, it’s not! The most important question is “How do we reduce our exposure?”

We know that the presence of BMAA in aquatic food chains could be a significant human health hazard. So, until more is known, it may be prudent to limit exposure of BMAA in the human diet.

There are neurotoxins in the dairy supply too, which may explain the link between milk consumption and Parkinson’s. High levels of organochlorine pesticide residues are found in milk and in the brains of Parkinson’s patients, and other pollutants, like tetrahydroisoquinoline, which is what scientists actually use to try to induce the disease in primates found in the milk supply, particularly cheese.  So, maybe the dairy industry should require toxin screenings of milk.

You could always just not drink it, but then what would happen to your bones? That’s a marketing ploy; if you look at the science, milk does not protect against hip fracture risk, whether drinking milk during your adult years, or drinking milk during your teen years. If anything, milk consumption was associated with a borderline increase in fracture risk in men. This suggests a partial explanation for the longstanding enigma that hip fracture rates are highest in populations with the greatest milk consumption.

This enigma irked a Swedish research team, puzzled because studies again and again had shown a tendency for higher risk of fracture with higher milk consumption. Well, there is a rare birth defect called galactosemia, where babies are born without the enzymes needed to detoxify the galactose found in milk. So they end up with higher levels of galactose in their blood, which can cause bone loss. So maybe, the Swedish researchers figured, even in normal people who can detoxify the stuff, it might not be good for the bones to be drinking it every day. And galactose doesn’t just hurt the bones; that’s what scientists use to cause premature aging in lab animals. They slip them a little galactose, and can shorten their lifespan, cause oxidative stress, inflammation, and brain degeneration—just with the equivalent of like one to two glasses of milk’s worth of galactose a day. We’re not rats, though—but given the high amount of galactose in milk, recommendations to increase milk intake for prevention of fractures could be a conceivable contradiction; so, they decided to put it to the test, looking at milk intake and mortality, as well as fracture risk, to test their theory.

A hundred thousand men and women followed for up to 20 years, and milk-drinking women had higher rates of death, more heart disease, and significantly more cancer for each daily glass of milk. Three glasses a day was associated with nearly twice the risk of death. And they had significantly more bone and hip fractures too. More milk, more fractures.

Milk-drinking men also had a higher rate of death, but for some reason you never see any of this in any of the milk ads.

OK, so where does that leave us? What are the common threads? If you look at four of the major dietary quality scoring systems, which have all been associated with extending lifespan and lowering heart disease and cancer mortality, they all share only four things in common: more fruit, more vegetables, more whole grains, and more nuts and beans. They are all built on a common core of diets rich in plant foods, whereas opposite food patterns, rich in animal foods and poor in plant-based foods (in other words, the Western diet), are associated with higher risks. So, we need to optimize the food environment to support whole grains, vegetables, fruit, and plant-based sources of protein.

Taking the diet quality indexes to their logical conclusion, the most plant-based diet would be the most healthy diet. But again, it doesn’t have to be all or nothing. We now have evidence that simple advice to increase the consumption of plant-derived foods with reductions in the consumption of foods from animal sources confers a survival advantage.

And boy do we need it. In terms of life expectancy, the U.S. is down around 27th or 28th out of the 34 leading free-market democracies. The people of Slovenia live a year longer than citizens of the United States. Why? Most deaths in the United States are preventable and related to nutrition. According to the most rigorous analysis of risk factors ever published, the #1 cause of death in the U.S., and the #1 cause of disability, is our diet, which has bumped tobacco smoking to #2. Smoking now kills only about a half a million Americans every year, but diet now kills hundreds of thousands more.

Let me end with a thought experiment. Imagine yourself a smoker in the 1950s. The average per capita cigarette consumption was about 4,000 cigarettes a year. Think about that. In the 1950s, the average American smoked a half a pack a day.

The media was telling you to smoke and famous athletes agreed. Even Santa Claus cared enough about your throat to want you to smoke. I mean, you want “to keep fit”, and “stay slender”, so you make sure to smoke and eat hot dogs to keep trim, and lots of sugar to stay slim and trim, a lot less fattening than that apple, I mean sheesh. “Though apples do connote goodness and freshness”, reads one internal tobacco industry memo, which brings up many possibilities for making youth-oriented cigarettes. Shameless!

In addition to staying fit and slender and soothing your throat, “for digestion’s sake”, you smoke. I mean, “No curative power is claimed for Phillip Morris— but, an ounce of prevention is worth a pound of cure.” So, better safe than sorry, and smoke.

Like eating, smoking was a family affair. “Gee, Mommy, you sure enjoy your Marlboro.” “You’re darn tootin’.”  “Just one question, Mom, can you afford not to smoke Marlboros?” Your kids were giving you cigarettes in the 50s; even your dog was giving you cigarettes.

“Blow in her face, and she’ll follow you anywhere.” “No woman ever says no.” After all, they’re “so round, so firm, so fully packed!”

After all, popular, handsome John Wayne smoked them—until he got lung cancer and died.

Even the paleo folks were smoking, and so were the doctors.

This is not to say there wasn’t controversy within the medical profession. Yes, some doctors smoked Camels, but other physicians preferred Luckies; so, there was some disagreement. Eminent doctors, on high and impartial medical authority, call for Phillip Morris. Even the specialists could not agree which cigarette was better for your throat; so, best to stick to the science, and more scientists smoke this brand.

This should not be rocket science—but even the rocket scientists had their favorite: “For the man who thinks for himself.”

What was the government saying? Smoke Luckies. I mean who wouldn’t want to give their throat a vacation. Not a single case of throat irritation. How could your nose and throat be adversely affected— when cigarettes are “just as pure as the water you drink.”

And if you do get irritated, no problem; your doctor can write you a prescription for cigarettes. This is an ad from the Journal of the American Medical Association. After all, “Don’t smoke is advice hard for patients” to swallow. Reminds me of the recent survey of doctors that found the #1 reason doctors don’t prescribe heart-healthy diets today was their perception that patients fear being deprived of all the junk they’re eating. After all, Philip Morris reminded us, we want to keep our patients happy, and “to make a radical change in habit…may do harm.” You’re a doctor; you don’t want to harm your patients.

The tobacco industry gave medical journals big money to run ads like these. Not a problem, though, Phillip Morris claims come from “completely reliable sources” based on studies conducted by recognized authorities published in leading medical journals. Even kindly offering to send free packs of cigarettes to doctors so they can test them out themselves. So, join us at the next AMA convention.

What did the American Medical Association have to say for itself? Like most other medical journals, they accepted tobacco ads. They have yet to see an autopsy with a single lesion that had a Marlboro label on it. So, when mainstream medicine is saying that smoking may on balance be beneficial, when the American Medical Association is saying that, where could you turn back then if you just wanted the facts? What’s the new data advanced by science? She was “too tired for fun, and then she smoked a Camel.”

Babe Ruth spoke of “proof positive” medical science, that is when he still could speak, before he died of throat cancer.

Now, some of the science did leak out, causing a dip from about 11 cigarettes a day per person down to 10, but those who got scared could always choose “the cigarette that takes the fear out of smoking,” or even better, choose the cigarette that “gives you the greatest health protection.”

Now, if by some miracle, there were a SmokingFacts.org website back then that could deliver the science directly to the people, bypassing commercially corruptible institutional filters, you would have become aware of studies like this: an Adventist study in California in 1958 that showed that nonsmokers may have at least 90% less lung cancer. But this wasn’t the first.

When famed surgeon Michael DeBakey was asked why his studies published back in the 30s linking smoking and lung cancer were ignored, he had to remind people about what it was like back then. We were a smoking society; it was in the movies; medical meetings were one “heavy haze of smoke.”  It’s like the debates over cigarettes and lung cancer in Congress taking place in smoke-filled rooms. Makes me wonder what’s served at the Dietary Guidelines Committee meeting breakfast buffets to this day.

A famous statistician by the name of Ronald Fisher railed against what he called propaganda to convince the public that cigarette smoking was dangerous.

Fisher made invaluable contributions to the field of statistics, but his analysis of lung cancer and smoking was flawed by an unwillingness to examine the entire body of data available. His smokescreen may have been because he was a paid consultant to the tobacco industry, but also because he was himself a smoker. Part of his resistance to seeing the association may have been rooted in his own fondness for smoking, which makes me wonder about some of the foods nutrition researchers may be fond of to this day.

It always strikes me as ironic when vegetarian researchers come forward and list their diet as a potential conflict of interest, whereas not once in the 70,000 articles on meat in the medical literature have I ever seen a researcher disclose their non-vegetarian habits, because it’s normal. Just like smoking was normal.

So, back to our thought experiment. If you’re a smoker in the 50’s in the know, what do you do? With access to the science, you realize that the best available balance of evidence suggests that your smoking habit is probably not good for you. So, do you change your smoking habits or do you wait? If you wait until your physician tells you, between puffs, to quit, you could have cancer by then. If you wait until the powers that be officially recognize it, like the Surgeon General did in the subsequent decade, you could be dead by then.

It took 25 years for the Surgeon General’s report to come out. It took more than 7,000 studies and the deaths of countless smokers before the first Surgeon General’s report against smoking was finally released in the 1960’s. You’d think maybe after the first 6,000 studies, maybe they could have given people a little heads up or something? It was a powerful industry. One wonders how many people are currently suffering needlessly from dietary diseases. Maybe we should have stopped smoking after the 700th study like this.

With so much money and personal habit at stake, there will always be dissenters. But given the seriousness of these diseases and the sum total of evidence, we shouldn’t wait to put preventive measures in place.

As a smoker in the 50s, on one hand, you had all of society, the government, and the medical profession itself telling you to smoke. And, on the other hand, the science (if you were lucky enough to know about studies like this).

Now, fast forward 55 years. There’s a new Adventist study out of California, the Adventist Health Study 2, warning America about the risks of something else they may be putting in their mouth. And it’s not just one study; according to the latest review, the total sum of evidence suggests that mortality from all causes put together, and many of our dreaded diseases—ischemic heart disease, and circulatory and cerebrovascular diseases like stroke—were significantly lower in those eating meat-free diets, in addition to less cancer and diabetes.

So, instead of going along with America’s smoking habits in the 50s, imagine you or someone you know going along with America’s eating habits today. What do you do? With access to the science, you realize that the best available balance of evidence suggests that your eating habits are probably not good for you. So, do you change your eating habits or do you wait? If you wait until your physician tells you, between bites, to change your diet, it may be too late. In fact, even after the Surgeon General’s report, the medical community still dragged their feet. The AMA actually went on record withholding endorsement of the Surgeon General’s report. Could that have been because they had just been handed ten million dollars from the tobacco industry?

We know why the AMA may have been sucking up to the tobacco industry, but why weren’t individual doctors speaking out? There were a few gallant souls ahead of their time writing in, as there are today, standing up against industries killing millions; but why not more? Maybe it’s because the majority of physicians themselves smoked cigarettes, just like the majority of physicians today eat foods that contribute to our epidemic of dietary disease. What was the AMA’s rallying cry back then? “Everything in moderation.” Sound familiar? “Extensive scientific studies have proved that smoking in moderation is OK.”

Today, the food industry uses the same tobacco industry tactics: supplying misinformation and twisting the science.

The same scientists-for-hire paid to downplay the risks of secondhand smoke and toxic chemicals are the same hired by the National Confectioners Association to downplay the risks of candy, and the same hired by the meat industry to downplay the risks of meat.

Consumption of animal products and processed foods cause at least 14 million deaths around the world each year. 14 million deaths. 14 million people dead every year. This is not a failure of individual willpower, says the Director-General of the World Health Organization. This is a failure of political will to take on big business, which is a formidable opposition. Few governments are willing to prioritize health over big business. As we learned from experience with the tobacco industry, a powerful corporation can sell the public just about anything.

If there’s one thing we’ve learned from the tobacco experience, wrote one district judge, it’s how powerful profits can be a motivator, even at the cost of millions of lives and unspeakable suffering.

It may have taken 25 years for the Surgeon General’s report to come out, and longer still for mainstream medicine to get on board, but now there are no longer ads encouraging people to “inhale to your heart’s content!” Now, there are ads from the CDC fighting back.

Food-wise, there was “meat…for health defense,” or “nourishing bacon,” or “doctors prescribe… meat”, or soda for that matter. “Trix are habit-forming, thank heavens!”

Now, just like there were those in the 30s, 40s, and 50s on the vanguard trying to save lives, today there are those turning ads about what you can do with pork butt to what the pork can do to your butt:  The Physicians Committee for Responsible Medicine’s “Meat is the new tobacco” campaign. As Dr. Barnard tried to get across in an editorial published in the American Medical Association Journal of Ethics, plant-based diets can now be considered the nutritional equivalent of quitting smoking.

How many more people have to die, though, before the CDC encourages people not to wait for open heart surgery to eat healthy, as well? How long’s that going to take, though?

Just like we don’t have to wait until our doctor stops smoking to quit ourselves, we don’t have to wait until our doctor takes a nutrition class or cleans up their own diet before choosing to eat healthier. It’s not your doctor’s fault, writes a group of prominent physicians. There is a severe deficiency of nutrition education at all levels of medical training. We were just never taught it.

We know a whole food plant-based diet has been proven to reverse our #1 killer, and protect against type 2 diabetes and cancer. So how has this knowledge affected medical education? It hasn’t. Despite the neglect of nutrition in medical education, the public considers physicians to be among the most trusted sources, but if doctors don’t know what they’re talking about, they could actually be contributing to diet-related diseases. To stem the surging tide of chronic illness in the United States, physicians need to become part of the solution. But we don’t have to wait for that to happen. No longer do patients have to be patient.

Doctors no longer hold a professional monopoly on health information. There’s been a democratization of knowledge, and so until the system changes, we have to take personal responsibility for our own health and for our family’s health. We can’t wait until society catches up with the science, because it’s a matter of life and death.

In 2015, Dr. Kim Allan Williams became President of the American College of Cardiology. He was asked why he follows his own advice to eat a plant-based diet. “I don’t mind dying,” Dr. Williams replied. “I just don’t want it to be my fault.”

Thank you.

If you missed last year’s talk, I have it on DVD. And the year before that and the year before that, as well as 25 other DVDs. All proceeds from the sale of all of my books, DVDs, and speaking engagements all go to charity, and speaking of which: mark your calendars, December 8th of this year, my new book is coming out: How Not to Die.

December 8th—I’m so excited about it. It’s not only a compilation of my life’s work, with all the science and thousands of citations putting it all together, but a practical guide. I go through my daily dozen checklist of all the things I try to fit in my own daily diet. How many greens we should eat, how many beans we should eat, how much sleep, how much exercise. I’ve been working on it for over a year, and can’t wait for everyone read it.

And in the meanwhile, all my work is available free, on NutritionFacts.org.

Thanks again.

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

Please consider volunteering to help out on the site.

Recorded live at the University of Pittsburgh on July 11, 2015 thanks to NAVS and Aaron Wissner. Images thanks to Stanford Research into the Impact of Tobacco Advertising; Centers for Disease Control and Prevention; Steven Jackson, Leon Keller, and DES Daughter via Flickr; 18percentgrey, Rostislav Sedláček, and Anna Liebiedieva via 123rf; Nmajik, Gajda-13, and Brian Arthur via Wikimedia Commons; and OpenPics and Bambo via Pixabay.

Doctor's Note

I’m honored to bring you Food as Medicine, my annual talks on foods for dreaded diseases from back in 2015, which is still relevant today.

Every year I scour the world’s scholarly literature on clinical nutrition, pulling together what I find to be the most interesting, practical, and groundbreaking science on how to best feed ourselves and our families. I start with the thousands of papers published annually on nutrition and, thanks to a crack team of volunteers (and staff!), I’m able to whittle those. They are then downloaded, categorized, read, analyzed, and churned into the few hundred short videos. This allows me to post videos and articles every day, year-round, to NutritionFacts.org. This certainly makes the site unique. There’s no other science-based source for free daily updates on the latest discoveries in evidence-based nutrition. 

For more on dreaded diseases see:

Check out my other talks here:

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

The original video aired on August 3rd 2015.

174 responses to “Flashback Friday: Food as Medicine: Preventing & Treating the Most Dreaded Diseases with Diet

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. WOW.. this information was powerful to read, Dr. Gregor. Probably the best of what you’ve put out so far! I’d just read an article from a different health source encouraging people to eat MOSTLY plant based, but with SOME dairy and non red meat. So I was feeling confused about what to do! The science you present says otherwise. Thank you.

    1. Debi,

      Take your time learning this. Dr. Greger has a lot of videos and a lot of studies.

      If you look at the doctors who reverse diseases, they all are pro-vegan but most say that it is okay to go up to 5% of the calories from animal products.

      Over 5% of your calories from animal products raise IGF-1 and cancer tumors start growing. Under 5% of calories from animal products stalls that growth.

      If you start there, you can relax and enjoy the process.

      The Adventist males did much better vegan. The Adventist women, the pescetarians may have done slightly better but the vegans were eating a lot of processed foods and bread which are high in sodium.

      If you go vegan, you need to supplement B-12, possibly D, and keep your sodium low. Watch Dr. Greger’s stroke series for information about that. There are still videos to go on that topic, but that is one of the most important series if you do go vegan.

      As far as dairy goes, Finland has areas where they ended up with extremely high deaths from high-fat dairy and extremely high Alzheimer’s. They were dropping dead in their 50’s. They lowered the fat in the dairy and things improved. So, if you choose to add in dairy, make it the lowest fat possible.

      1. Debi,

        I don’t believe there is even one study where adding animal products extended life.

        The debate you will find on this site would be whether adding fish twice a week is beneficial and that probably depends on how toxic the fish is.

        1. Dr. Greger has some powerful information on dairy.

          For instance, In the population study “Milk Intake and Risk of Mortality and Fractures in Women and Men,” researchers following more than 100,000 men and women in Sweden for about 20 years found significantly higher rates of bone and hip fractures, heart disease, cancer, and premature death in general for women who drank more milk. Three glasses a day was associated with nearly twice the risk of dying early.

          1. 105 year old Japanese and longevity expert Dr. Shigeaki Hinohara says he drank a small amount of milk with olive every day for breakfast
            for smooth arteries and smooth skin. For dinner, some fish, rice and vegetables, and 2 times a week 4 ounces of lean meat.
            He didn’t eat any food that was junk or unhealthy. Of course he had a lot of other health advice for living a long life.
            It is hard to fool people for over a century.

              1. ‘Extra virgin olive oil may have more of a neutral effect, compared to butter, which exerted a noxious effect that lasted for up to six hours—basically right up to our next meal. In the largest prospective study ever to assess the relationship between olive oil consumption and cardiac events, like heart attacks, there was a suggestion that virgin olive oil may be better than regular olive oil, but neither were found to significantly reduce heart attack rates after controlling for healthy dietary behaviors, like vegetable intake, which tends to go hand-in-hand with olive oil intake.’
                https://nutritionfacts.org/video/olive-oil-and-artery-function/

                it’s probably better to stick with the rice and vegetables instead.

                There are plenty of examples of centenarians living to a ripe old age despite bad habits like smoking. They don’t prove smoking is healthy or promotes longevity any more than your Japanese example proves that consuming olive oil does.

                1. The 105 year old Japanese doctor knows what he is talking about.
                  If he took your advice and just sticks with consuming more of the rice and vegetables and reduces the milk, fish and meat,
                  he knows there is a very slight possibility he would consume more arsenic form the rice and micro plastics and toxins and impurities
                  that are in the water that grow the vegetables.
                  Dr. Hinohara also knows the 8 ounces of lean meat he consumes per week has no Vitamin C and no fiber,
                  but the oranges he eats does have Vitamin C and some fiber.
                  He solves these problems by consuming a wide variety of foods like they teach in Japan.

                  The exceptional Oleocanthrol in EVOO does not exist in the daily dozen, the monthly dozen or any other food anywhere.

                  1. You are clearly brilliant Yerky but have you ever considered that eating actual olives might be superior to consuming a nutritionally limited extract (oil) manufactured from those olives? The marketing abilities of the olive oil industry are surpassed perhaps only by those of the coconut oil industry. Although, to be fair, the meat and dairy industries are no slouches either.

                    As for microplastics, I am pretty certain that they are more highly concentrated in animals higher up the food chain than they are in plants. After all. plants aren’t the only things that need water to grow and survive.

                    I would think that eating several servings of fish a week might be beneficial but most Asians are lactose intolerant and mammalian meat consumption is associated with increased risk of death.

                    I have read somewhere that North American 7th Day Adventists are the longest lived population in the world. Among them, male ‘vegans’ have the lowest relative mortality risk. That fact is a lot more important to me than the opinions of some dead Japanese doctor..

                    1. For that matter, have you considered that the population famous for producing the largest numbers of centenarians – Okinawans eating their traditional diet – consumed no olive oil (or olives) whatsoever.

                      And somebody who lived longer than your Japanese doctor attributed her longevity to bourbon and Cheetohs.
                      https://www.goodhousekeeping.com/life/g5114/secrets-to-a-long-life/?slide=1

                      Preferring the opinions of some randomly chosen centenarian to the findings of nutritional science doesn’t sound particularly wise to me but each to their own.

                    2. Someday you might thank that 105 year old doctor because that seemingly silly non whole food item – extra virgin olive oil has super high levels of Hydroxytyrosol, Oleuropein and Oleocanthal. The whole olives are also good but they are in a brine so there is a lot of salt so one can’t over do it with that either.
                      The balsamic vinegar I use every day on a salad is also a non whole food, does that mean it has no value and is a waste to even use it?
                      These things listed are only meant to be used sparingly.

            1. >>> 105 year old Japanese and longevity expert Dr. Shigeaki Hinohara says he drank a small amount of milk with olive every day for breakfast for smooth arteries and smooth skin.

              This is what you call anecdotal evidence. Exactly how did milk and olive smooth his arteries? What’s the mechanism? That part sounds rather fanciful to me. 105 year old medical advice. Lol.

            2. I have a few patients in their 90’s that smoke, drink, and eat lots of meat and dairy. This does not mean that if you eat this way, and smoke, you will live into the 90s. These things increase the RISK of premature death. They do not kill everyone at a young age. Do you feel lucky? I don’t, so I’m careful what I eat and I don’t smoke.

              1. Ben,

                Actually I do feel lucky. Because I know what Sphingomyelin, Prostacyclin and Oleocanthal are and what they do.

                I do not feel so lucky in that I bought some velcro for $8.00. That velcro was a rip off… if you know what I mean.

      2. Deb,

        You wrote: ” Under 5% of calories from animal products stalls that growth.”

        Could you please post any studies you might have on the 5% number?

        All I have are the 1-4% numbers on the traditional Okinawan diet.

        Types of animal products?

        Thank you,

        Vivamus

  2. I had watched the twin mice and aging study video yesterday and the amino acids and mTOR was discussed half-way through.

    https://www.youtube.com/watch?v=QRt7LjqJ45k

    I understand the other mechanisms but I wonder what Dr. Greger’s opinion is on NMN?

    I did take some 3 years ago when I was trying to recover from my brain problems.

    I don’t like spending money on supplements but it is one of the ones that I still have a question mark waiting for Dr. Greger’s aging book.

    1. Deb,

      Just watched the url you posted: https://www.youtube.com/watch?v=QRt7LjqJ45k

      Most interesting.
      I am skeptical. But interested.

      Of the six “things we can do” – the Okinawans seem to excel in two:

      (1) Eat Less. Caloric Restriction.

      (2) Eat Less Protein. (9% by calories).

      As far as I know – and I will keep my eyes out for this – they do not do any of the extreme exercise or go for being hot or cold.

      Perhaps calorie restriction and protein restriction (both sufficient for life – but no more) are sufficient in themselves.

      Most interesting –

      Vivamus

      ———————————–

      The protagonist observed one such birth – a period of grief followed by disinterment of a body, to which life returns, “an old man with a long life before him”. What follows is life growing younger – “the sloughing of wisdom and responsibility, the plunge into a period of lovemaking and breathless excitement, the carefree years before the end” – and ultimately, the return to the mother – “And we grow new and forget and blindly seek a mother”.

      The Man Who Never Grew Young
      Fritz Leiber
      1947

      1. V,
        I think maybe Dr. Ess mentioned that the Okinawans were not exercising that much. They did have strong social connections. I am writing in past tense because the Okinawans were invaded with fast food culture decades ago. But this too shows the importance of good diet. If I remember correctly, Dr. Greger has done a video pointing out that, “It’s the food.” Dr. Greger is also big on exercise and the many pillars that influence good health. I would think, if you had to rely on just a few of the pillars, you would want to darn tootin’ make sure that good nutrition is in place.

        1. Dan, yes, but let’s not forget that Dr Esselstyn himself is a former gold medalist in rowing. If memory serves, there is a scene in Forks over Knives with a current-day Dr Esselstyn cycling along the country roads by his farm and looking pretty racey in his cycling clothing. Not a casual exerciser. Same with his son, Rip, who was/is a competitive triathelete.

          Was Dr Esselstyn does say is that it’s his personal belief that people have a limited capacity for change (and were so out of shape) , and that he wanted people to focus on food first.

          Also, Dr Greger included 90 min of exercise on his Daily Dozen, not for the good of his health, but ours. And that’s on top of staying active in the day. Exercise, sleep, food, meditation – all works together.

          1. Barb,
            My exercising is paying off. I do lots of stretching, in the mornings, on the abandoned bridge. Then I run three lengths of it, sometimes breaking into a slow run on the third try. Sometimes I continue back into my neighborhood, running a bit further each time. Then I run up a hill three times. I was inspired by a Runner’s World article claiming some people with neuromuscular / joint disability may have better health if they can safely run. Most of the anecdotal messages one hears are along the lines, “If you are older, don’t run,” or, “It’s time to start walking.” Running can be mood inhancing. My life is better for making the effort.

            1. Dan, you are doing so great. We just have to keep showing up ! The effort does pay off… I have found it to be true throughout my lifetime. The bbc and other sites have featured articles about running and keeping joints strong. And you don’t have to run fast, nor far, to reap the benefits.

              When I got my bike this past spring, I felt so hopeless on the first rides. My balance was shakey, I was nervous, and I felt too weak to go anywhere. 10 weeks later, and my confidence has gotten a boost, I have lost 7 lbs, and put on a surprising amount of muscle. I will keep up with it :)

              1. Barb,

                Have you tried toe clips?

                If you bicycle without them, you are largely using your leg muscles of extension – all the pressure is as you straighten out the leg – primarily your quadriceps – the muscles on the front of your thigh – and your legs become unbalanced.

                All front of thigh muscle development. No back of thigh muscle development.

                With toe clips – you are also using your muscles of flexion – primarily your hamstrings – on the upswing – the muscles on the back of your thigh – and you balance everything out.

                Plus you can generate ~40% more energy. Great for climbing hills – or just zoomin’ along – or going further without fatigue.

                Balances everything out.

                Tight toe-clips or those built into shoes may be accident prone. Appropriate to road racers. Unbalanced – falls.

                Loose toe clips – your feet slip out instantly without thinking – practice first – in my experience, anyway, they are very safe. Appropriate to the casual bicyclist.

                You have to think your way into using them the first time – but after that, they become second nature.

                Happy cycling!

                Vivamus

            2. Dan, That’s great! IMO, running up hills is far more effective overall and much less punishing on the joints than long, slow runs. It is more anaerobic too than slow runs (it is also, aerobic, of course) and so builds more muscle. Leg muscles around the knee joints protect the joints. Lose muscle and of course joints suffer because they have no protection. Climbing lots of stairs is also known to be effective. Also, short speed ups like you are doing are right on target.

              1. GG,
                Thanks. Building muscle strength does help. Hill running is easier on the knees. Walking and running helps my stability. Stretching alows me feel better, function better and do a bit of running.

        2. I’d always thought that the Okinawans on a traditional diet did little or no formal exercise but spent a lot of time gardening/growing produce on their smallholdings?

  3. Back when rBGH milk was first being pushed on the American people I was working with Pure Food Campaign to educate people against it. Recombinant bovine groth hormone not only forces cows to lactate longer raising udder infections and pus in the milk they produce. rBGH also raised IGF-1 in the milk produced by these animals. The FDA approval of rBGH completely ignored the IGF-1 issue.

    1. jazzBass,

      It brought tears to my eyes.

      Last night, I watched a true story movie and the college-aged woman died of cancer and all I could think was “She didn’t read, ‘How Not to Die.'”

      She said, if one person’s life is changed because of my death it will be worth it. How many more lives would have been affected if she had learned how to live?

        1. No, it was a true story.

          A woman fell in love, got cancer, thought she got healed from cancer, went on her honeymoon, had to fly back because she was sick from cancer. Died. Her husband is a musician and he heard his wife’s heart that she wanted people to benefit from her suffering. He became a very big Christian musician after she died and committed himself to make sure that her story was told.

          My father has a fever and just went to seek medical care. I am praying.

          If he has COVID, she might have COVID and she is a stroke survivor who can’t stand up on her own and I might be going in.

          If I do, I will post something because if I get COVID, you will already know if I stop commenting but I will want to give a big, “I love you” to everybody.

          Yes, those are big jumps in logic.

          My father, who doesn’t take COVID seriously, has a fever and perhaps flu symptoms.

          My brother who has all sorts of comorbidities is exposed from taking him to the doctor and so is my coworker.

          I will be doing my nasal saline irrigation tonight but this isn’t the first time I have had the gap of time between someone having symptoms and facing my mortality.

    1. Dr. Greger corrects people when they call him a vegan doctor or a Plant-Based doctor. He is an “evidence-based” doctor. His positions change with the evidence.

      As of right now, I listen to videos by him every single day, and, from that, I do believe that he does believe that vegan has an advantage but if there were some magically non-toxic fish, he is someone who could switch sides.

      1. Wouldn’t we all? I love meat dairy fish, OMG gimme some Stilton! Its just the way. You can make amazing foods that aren’t animal based and that’s good.

      2. Deb,
        I saw where Queen Elizabeth eats lots of fish. My thought is that the fish probably does not come from a farm pond. Maybe fish from a fast moving river near a remote mountain range.

    2. Sure. You will find no statement that eating some animal foods is better than none. But below a certain ill defined but quite small amount there are no studies conclusively showing some is worse or better than none. In fact most of the Blue Zone populations eat some animal products. But that also shows little either way. It’s a gray zone in terms of nutrition but not in terms of the costs in animal suffering and environmental damage.

      1. 言語学者 (gengo-gakusha)’s wrote: “In fact most of the Blue Zone populations eat some animal products.”

        Yup.

        Reality check:

        Of the five longest lived population groups – Okinawa (Japan); Sardinia (Italy); Nicoya (Costa Rica); Icaria (Greece); the Seventh-day Adventists in Loma Linda, Californian – not one of these groups is exclusively Vegan.

        They average 4-5 servings of animal flesh a month. As to which animals – I will leave that as an exercise for the reader.

        The answer is probably is not what you think.

        If you are in this for your health – Veganism may not be your best choice.

        From what I can see – Veganism does seem to work for many in the short term.

        Your body has reserves.

        But quite a few Vegans report finding it lacking over time, and switch out.

        YMMV.

        Best regards –

        Vivamus

        ————————-

        Give a man a fire and he’s warm for a day, but set fire to him and he’s warm for the rest of his life.

        Pratchett

        1. Whole food plant based (WFPB) diets are what Greger promotes. Not vegan’ or ‘vegetarian’ diets. The usual processed food ‘vegan’ diets and ‘vegetarian’ diets (often high in dairy) are probably little if any better than standard omnivore diets.

          Having said that, in the 7th Day Adventist mortality study, male ‘vegans’ had the lowest relative mortality risk of all dietary groups;
          https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1710093

          The key difference there I suspect is that Adventists have a religious obligation to eat only the most ‘healthful’ foods (core belief 22). And a healthful Adventist ‘vegan’ diet is probably a lot closer to what Greger recommends than the diet of the EPIC Oxford ‘vegans’ …… or any other random group of Western ‘vegans’ for that matter.

          1. Dan C,

            Because the result is – they end up being the longest lived peoples on the planet.

            If you want to live a long life – following the example of the longest lived peoples on the planet is obviously a pretty good place to start.

            A whole lot more useful than breathlessly following the latest daily up-to-the-minute constantly changing untested claims of many competing nutrition scientists. Then adding moral theory on top of the unsettled science.

            Just be patient – science and moral theory will catch up to the reality of the traditionally longest lived cultures – and coalesce with it – eventually.

            Perhaps in a hundred years or so.

            In the meantime – I will go with what is known to work. Not what I want to work – not with extrapolations and logical projections and theory – but with what actually does work.

            And that is not the latest nutrition study.

            It is the work on multiple traditionally long lived cultures.

            Reality. Patience. Open mind. Time.

            Dan C.

            Best regards –

            Vivamus

          2. Without supplements, they might benefit from eg B12, zinc, iron etc from occasional meat consum ption. It’s hard to know for sure.

            In the 7th Day Adventist study, male occasional meat eaters did significantly better than males who ate meat frequently. Male ‘vegans’ did best of all but it’s possible that health conscious North American Adventists supplemented with B12 etc.

              1. GG

                Yes, true.

                Such things are hard to find where I live and, by and large, i prefer whole foods to products anyway (although I do eat whole meal bread everyday). B12 fortified foods are probably widely available in North America though.

        2. V,

          >>> If you are in this for your health – Veganism may not be your best choice.

          Quite possible, at least where fatty fish are concerned. Other animal products – meat, dairy (at least unfermented dairy), and eggs seem unwise to me. The main issue, other than the unclarity in terms of how much is too much, is the fact that factory farmed animal food and even fish from the oceans are quite contaminated in various ways, so whatever the benefits, it should be weighed against the risks.

          >>> From what I can see – Veganism does seem to work for many in the short term.

          Many vegans, and likely most of the failed ones, do not know how to design a proper vegan diet or realize they might need some supplements, especially B12. At 73, I’ve been doing fine (no meat for over 50 yrs, successively ditched poultry, eggs and finally fish about 10 yrs ago). No diagnosed chronic diseases, no meds, excellent blood work. But I am very careful about my diet and do take some supplements.

        1. DC, Well, of course they are most likely not taking supplements, so without animal products B12 would be a major problem. But more generally speaking I don’t see the need but do take supplements.

          1. I am on a 100% WFP diet for ethical reasons. I mention this because but I realize that there is no science showing a 100% WFP diet is optimal and also realize that such a diet requires supplementation.

            Traditional cultures do not take supplements. Their eating patterns are heavily intertwined into their daily lives (how many shepherds do you hang out with?). Anyone following the science knows there is no sound argument that any individual will be better off eliminating all animal products.
            Dr. Furhman, for one, has explicitly said that a 100% whole plant diet is not man’s natural diet but — and this is the key point — in today’s world, the claim is that one is better off eating as few animal products as possible and supplementing as necessary (basically, B12 and DHA). It’s a matter of perceived risks vs benefits. How many people outside of these (semi-)isolated communities are going to eat grass-fed sheep or pigs, or have access to uncontaminated fish. I have Japanese relatives living in Japan who have given up eating fish because of the possible contamination. The effects of these changes (factory farming and all of its ills and overfishing of contaminated oceans) will take a long time to become apparent: animal food eating in the modern world is not equivalent to what traditional cultures have done or are doing.

            It is not sensible to compare the animal-food eating of a traditional culture living in isolation like the Sardinians with that of people eating factory farmed animals and contaminated fish.

            1. Not to mention that the Sards in fact carry a genetic marker M26 linked to extreme longevity.
              https://www.bluezones.com/exploration/sardinia-italy/

              Cf.
              https://www.technologyreview.com/2010/07/01/202188/genes-for-extreme-longevity/

              “Most centenarians possess a subset of the 150 variants, and the researchers found that their genetic profiles cluster into 19 different genetic signatures. The longest survivors, who live a median age of 108, have the highest number of longevity variants, says Sebastiani. “And some of the signatures correlate with the latest age of onset of age-related diseases, such as dementia or cardiovascular disease.”

              “To have about 150 genes involved in exceptional longevity is really very few,” says Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine, in New York, who was not involved in the study. “I think it’s within our power to understand their mechanisms and to start to develop drugs against aging.”

              I have no doubt that diet and general lifestyle an have a very significant effect on how long and how well someone lives. But that does not mean the longest lived do not reach those enviable ages in relatively good health just because of their lifestyles. For all one knows the large amounts of goat’s milk the Sards drink (26% of calories) is a negative factor but not enough to keep them as a group from reaching their full genetic age potential.

              BZs are suggestive and I think one can profit from understanding their lifestyles but one can also easily over interpret the findings.

              1. 言語学者 (gengo-gakusha),

                All good points.

                Theory can go either way – that is when you do the experiments.

                The experiment of going all-plant is not yet completed for you. May it always prove successful.

                It ended poorly for me – after many years – and I had given it my best shot – with a lot of nutrition knowledge.

                For the most part – with lapses – Whole Foods Plant Based, low salt, low sugar low fat – variety and moderation, legumes, whole grains, vegetables, fruit, nuts, seeds, avocado, olive oil, B12, Vitamin D.

                Organic as appropriate: https://www.ewg.org/foodnews/dirty-dozen.php

                Organic lawn and garden and housing products.

                But I just kinda ran out of gas . . .

                I wish you the best with your efforts.

                As to pollution and animal products – I share your concern and I do my best to keep the pollution to a minimum.

                Since reading Rachel Carson’s Silent Spring – lo, many years ago.

                Seafood lowest on the food chain I can get – from the coldest and least polluted waters I can get.

                But I also consider: Grandfather was a cotton / cattle farmer. Uncle farmed peanuts and hogs. Likely lotsa pesticides – from lead arsenate to the more modern materials. Probably got in the farm well-water.

                Yet – Grandfather died age 95. Dementia and pneumonia. Kids live into their late 80s (cancers) and 90s (dementia) – Mother still kickin’ at 96.

                Uncle made it to 92. Standard American Diet. His kids seem to be doing fine.

                I am most careful in regard to environmental issues. But I think it may be best not to let Perfection be the enemy of Good.

                YMMV.

                —————————————————-

                In regards to the genetic component of longevity to which you refer – from time to time I review the matter in regards to my own family.

                I originally thought that our family’s longevity was a get-out-of-jail free card – but on closer examination, it is just potential, not a guarantee.

                Death trends by age (with exceptions):

                60s – obesity. Indulgent lifestyle. Cancer – they go quickly. Fewer of us.

                70s – smoking, alcohol, Standard American Diet, sedentary lifestyle. Multiple health issues. Eleven different medications. It’s a bit of a race between their many ailments as to which delivers the coup de grâce. Fewer of us.

                80s – non-smokers, much more responsible in regards to taking care of themselves. Better Standard American Diet – you know the drill, salads and olive oil, baked chicken and fish instead of beef, no pizza or ice cream, that sort of thing. It’s a race between cardiovascular disease and cancer – with their stents and their cardiovascular medications on board to ward off their heart attacks, cancer seems to win – but slowly. More of us.

                90s – this crew is clearly physically smaller, skinny as a rail (blowin’ in the wind) – excellent diets, physical activity (farmers – cotton/cattle and peanuts/hogs), dancer; walkers) Also some relatively inactive: housewives. No known cardiovascular issues. Start losing memory in their early 90’s – I have been wondering if B12 may be an issue, but – I forget – what was I saying? Oh, yes – with 90-year olds, who’s to say? Usually deceased by mid-90s – one made it at least to 104 before I lost track. Particularly nice people – loving and loved – this seems to be a distinguishing characteristic – I think this may be a neglected socio-biological component to long life. More of us.

                I mention the above because many people who have no interest in adoption of healthy behaviors for long life refuse to do so because they know that their shorter life is “hereditary.” But when they get desperate and finally decide to go the WFPB route – their labs clear up like they never have before, they lose weight, they gain optimism – and the light bulb goes off that, hey, they can do this, too.

                Gentlemen will tell me that they don’t want to live to grow old – and they make a nasty facial expression. Always the same nasty expression of distaste. I then tell them that my Uncle died at 92 – at his girlfriend’s house. They tend to perk up.

                There was a lot of elbow-diggin’ – and smirks – and laughter at my Uncle’s funeral. Prewar US Navy – he was in on the search for Amelia Earhart. The original search. The Navy took part. Bunked with James Michener as Michener was writing what would become “Tales of the South Pacific” – “he was always writing in notebooks.” Lotsa good stories. Laughter. Did the church groundskeeping gratis – and did it well. Volunteer driving for meals-on-wheels into his 90s. Liked to help people. Well liked. Well loved.

                We used to think that family history was the basic key to human longevity. Then the estimates – from the separated twin experiences – put heredity at 50% of the puzzle. Then estimates went to one third. The latest guestimate I have seen put it in the teens.

                Ornish has really carried the ball on this. He has a particularly effective phrase and presentations: “Your genes are not your fate.”

                Maybe our family is not so special genetically. Maybe we just have good examples of what can be accomplished that give the rest of us a target to shoot for.

                I dunno.

                Our family does tend to celebrate and revere our elderly. Not to a traditional Shinto level, it is true – you may have us on that one, I do not know. Family reunions used to be packed – but the generation we were going to see has largely died off, and interest has waned with current generations.

                The Great Depression / WW II generation may not have had better lives, but they had much, much better stories! They lived lives that later generations did not – later generations stories are largely interchangeable with one another by comparison.

                Perhaps Jimmy Buffet is right (song written by John Sebastian): “You do it for the stories you can tell.”
                https://www.youtube.com/watch?v=liP3XqBX-0g

                The “niceness” component of our longest lived is notable.

                I was noticing one day that the cruelest people I have encountered – generally males in positions of authority who go out of their way to use that authority to hurt others – I do my best to steer clear – it is best to not even soothe the wounded, or one will be targeted, oneself – these unkind people have a tendency to die in their 50s and 60s. Unpleasantly. Most unpleasantly. Pancreatic cancer. Prostate cancer. And that people are happy to see them go.

                So – they do bring happiness to others in the end. But one feels bad about feeling good. So they get your there, too.

                Contrasting this with the loved comedians, who tend to last forever. Bob Hope – 100 years. George Burns – 100 years. They brought laughter and pleasure to generations. I wonder if the happiness that they brought to others somehow kept them alive so long.

                Looking around over the years, I find that the recent song “Only the Good Die Young” is not in tune with my experience at all. In fact – on first hearing, it sounded like an Army recruitment propaganda pitch like the “do you want to live forever?” contempt for life shown in WW II movies as the Marines stormed the beaches. Maybe recruiting for Afghanistan? In the antibiotic age, in my experience, this phrase seems inverted.

                Looking at all of this, as I became more interested in longevity – in addition to diet and exercise, I began to look at who I was – and I decided that an attitude change might just be in order. A little less authoritarian. Less demanding. More Golden Rule. Kinder. More generous.

                Easy enough to do as you get older. If you get older. Mellowing.

                Since that time – the concept of cellular aptosis has arisen. Programmed cell death. That our cells are preprogrammed, and that when defective, they may be triggered to automagically self-destruct for the good of the rest of the body.

                I wonder if that applies to humans and society, as well. Some degree of self-destruct built into people in regards to being a clearly toxic human being. Set off inside them. In nasty places. Conversely – some sort of built-in survival / repair mechanism for the good and the helpful and the fun and the kind.

                Perhaps that is one of many reasons that the ladies outlive their men. We hear of the stress of caretaking – but there may be biological benefits to helping others, as well.

                Not 100%, certainly. And it may be all my imagination – people look for reasons even in the senseless tragedies of life. There are certainly plenty of counter-examples – one can just look at the evening paper – no need to name names.

                But – it feels true. Over the decades. More than not.

                I can’t wait for Dr. Greger to give us an experimental double blind study on it.

                言語学者 (gengo-gakusha).

                All the best –

                Vivamus

                1. Vivamus,

                  You talk about potential and there are younger people doing SAD and getting sick younger.

                  There was food scarcity from the end of the 1800’s through WWII and rationing happened for years after WWII ended.

                  Real refrigeration wasn’t around until after then.

                  The people in their 90’s very likely spent most of their youth in calorie restriction with limited animal products. Probably not eating cows.

                  If you look at the history and the Depression, rationing for the war years, lack of refrigeration, lack of processed foods, I don’t believe that almost any of the 90 + year olds eat anything like they did for most of their lives.

                  Not did they have television, not computers, etc.

                  There weren’t roads or reliable cars for a long time. That affected things.

                  I did look it up and if you start with the pandemics in the 1800’s and food shortage then, then WW1 and the pandemic of 1918, and food shortage following that and the Depression, rationing for WWII lasted for so long.

                  My great grandmother was in food shortage into her 70’s and then ate SAD but she didn’t shift as much as the ones raised in the 1960’s and after.

              2. My understanding is that Sardinians have more or less the same life expectancy as other Italians.

                it’s just that one particular geographical region in Sardinia has a high rate of centenarians. People have suggested that this is due to genetic and/or environmental reasons. It’s not clear to me though whether the diet in that region is any different to the diet elsewhere in Sardinia.

                https://www.demographic-research.org/volumes/vol14/13/14-13.pdf

    3. Jump to minute 55 – “it doesn’t have to be all or nothing”. Increase your fruits, vegetable, whole grains, beans and nuts as far as you are can. Minimize animal products, and don’t sweat whether you are 100% plant-based or just close to it.

      1. Thanks @Cary I was asking about Dr. G’s recommendations but you have a good intent for sure.

        @Viv, I may not fit into the vegan label really, since being WFPB based can also mean you only eat plants and doesn’t mean necessarily that you qualify for vegan description, since vegans eat chips and doughnuts and I do nut. :)

        I believe at its core your post was suggesting the concept of “everything in moderation”, as in go ahead and eat just a little meat, it cant really hurt you, and so did the long living Okinowans. And in fact be careful as you might keel over eventually if you do go -all veggies.

        But in watching this vid, I saw a section which is similar in sentiment, regarding Big Tobacco suggesting a little bit of this similarly carcinogenic thing , cigarette smoke, is ok also – “comparatively”.

        Are you suggesting that there is a study of Okinowans et al, of that time, who did not eat meat, AND showing they died earlier than their meat-is-a-sometimes-thing friends?

        I wonder, isn’t it more probable that they ate more veggies and those yummy potatoes than most cultures, and that is the reason they survived so long? So, it would not be what they ate sometimes, but what they ate most of the time. Now this may go to your point of “go ahead and eat a little bit it wont hurt you”, and while its possible one could eat some meat fish etc, and probably have a long life, if other factors could be controlled I suppose, but its not eating the animal that necessarily made them live long is it? I’m not sure one can scientifically make that case, but I do ask in sincerity.

        I believe Ive read that you mention some shortcomings and deficiency in the all veggie diet WFPB (with no animals), like zinc iron dha, b12 and D I think, but in my recent research, inspired by your posts actually, (trust but verify) which I felt are at odds with the messaging here, I have found that all of these things can come from the pant world – albeit with a few fortifications, but still plant based, and there isn’t anything lacking in this all veggie plan, pointing to the need to supplement b12 with a mollusk vs. yeast or fortified soy milk for instance. Truth is they are all three, supplements, per se.

        If one says, “but that’s what they did, so it must have made them live longer than if they only ate veggies”, then couldn’t they even have hit themselves in the head 4 times a week as well? Isn’t the science itself pointing to the veggies with these long life cultures? (the meat is the outlier regarding the causal benefit here no?)

        I believe, the then future humans (us), now with the benefit of proper factual data showing animal protein itself is in fact, carcinogenic, and that it acts as to amplify the cancer receptors, would suggest: “eat your veggies, but do skip the meat and self flagellation.”, right?

        Lastly, am I wrong in my memory that Dr Greger has, more than a few times, shown studies proving that even a little bit of animal product wreaks havoc on the endothelial system, and that it causes damage, until you reverse it by eating veggies? One can bite his nails and they will grow back, but why not just….. not bite them, no? Should we smoke for 5 years and quit for 10 because it shows repairative* benefit when you quit?

        Is it really ok to go ahead and ingest carcinogenic foods, on purpose? (One hotdog is like how many cigarettes?)

        * ( i made this word up I believe)

        1. Hi jazzBass.
          Yes, I seem to remember Dr Greger saying, maybe in a Q&A video (and I’m paraphrasing here):
          One of the questions I’m most often asked is: Is it OK for me to eat a little animal product?
          To which I reply: yes, if you don’t mind a little cancer.

        2. jazzBass,

          A lot of time has been wasted out there on discussions as to whether or not humans are carnivores, herbivores or omnivores.

          People can come up with all sorts of anatomic and physiological arguments on any side of this question. Each side can think that it is right and that anyone who disagrees with it is wrong. And have all sorts of snide remarks prepared to demolish the points of the other side.

          High School Debate Club Strategies 101. Designed not to further truth, but to win arguments.

          Hey – I get it.

          I think that all of those arguments miss the essential point.

          Humans are not essentially carnivores, herbivores or omnivores at all.

          Human beings are nutritional opportunists.

          They will eat whatever you put in front of them.

          Contrast, say, Koalas or Pandas.

          Koalas eat eukalyptus. And you haven’t seen them spread all over the earth to places without eukalyptus.

          Pandas eat bamboo shoots. You haven’t seen them spread all over the earth to places without bamboo.

          But humans will eat anything you put in front of them. Which is why we have spread all over the planet.

          If humans spread to the Arctic Circle – they will be meat eaters, ’cause there is just not a whole of plant calories available up there.

          Equator? Lotsa plant foods available all the year round.

          Coasts? Fish for the taking.

          More Northern temperate zones – grasses may handle the weather better than many other food crops – cattle and dairy may dominate.

          And remember – the grains are grasses, too.

          The question for the person interested in longevity becomes – not what is most moral, the Arctic animal-eater or the Equator plant-eater. But who is healthiest and lives the longest?

          Hey – we have an almost infinite number of long term experiments run out there – as many completed long term large population experiments as there are human cultures.

          We don’t really need to run 20 year experimental double blind studies enrolling thousands of people to get the facts.

          Just look around. The facts are all around us.

          Turns out – the Arctic meat eaters have all sorts of interesting health burdens. That doesn’t seem a very healthy way to go.

          The Standard American Diet? Just look around you. Need I say more?

          Populations living it the tropics, well – you are also talking about all sorts of parasites and vector borne diseases (malaria, trypanosomiasis, etc.) that complicate nutritional health studies. There is just too much confounding data to puzzle out the nutritional elements.

          If you are health inclined – a good way to figure things out is to look at which cultures are the longest lived – and imitate them as much as possible.

          Careful about using YOUR logic to fiddle with the “details” – because you really do not know which details are vital, and which are not.

          And no modern day nutrition guru can tell you. Because science always lags reality.

          Dr. Greger has his biases – they appear to me to run toward the Vegan side of things. All the science he presents always supports his Vegan style. Fair enough.

          You have your biases.

          I have my biases.

          My major bias in this regard is that I have a strong survival drive and I would like to live as long in as good a health as possible. And I seek to take my own biased blinders off and proceed with the evidence wherever it takes me.

          And – despite what Dr. Greger may say – I do not see the arc of evidence as supporting the exclusively Vegan option as the longest lived option.

          That is not what the longest lived traditional populations actually do.

          It is not what the longest lived relatives do.

          It is not what the longest lived people I encounter do.

          It simply does not survive my simple clear everyday reality checks.

          Steve Jobs had his reality distortion field. See where it got him.

          Dr. Greger has considerable charisma.

          You follow your leader. That’s fine by me. No problem.

          I am content to follow my best judgement.

          All the best –

          Vivamus

          ————————————————-

          I saw a man pursuing the horizon;
          Round and round they sped.
          I was disturbed at this;
          I accosted the man.
          “It is futile,” I said,
          “You can never —”

          “You lie,” he cried,
          And ran on.

          Stephen Crane
          1895

          1. Sure thing Viv, but my questions were not rhetorical actually, and i did mean them, even as I jested a bit.

            When you said “Hey I get it”, I don’t think that’s the case, but as you said it is fine for me as well. I simply used an extreme example to further a point, not to “win”, but hey you must have felt something like that at that moment, there, so I apologize.

            I will say though, that you might not agree with it, however that is exclusive of the fact that MY logic is sound.

            For me, its not a waste of time to ask you what you know about the model you are advocating, because its never a waste of time to learn something. I hope we all can share this viewpoint.

            There are a few simple facts I know regarding your model which lead me to ask the questions, nothing more:

            1. Meat causes cancer.
            2. Okinawans may not have lived longer because of the meat.
            3. Its likely they drank a boatload of green tea, which makes you live longer.
            4. Thousands of variables will have lead to our discovery of some factors which appear to have caused the outcomes.

            I do respect that your observations alone, which you appear to single out as evidence regarding old people, “I just ran outta gas”, “My uncle died at his girlfriends house”, “Just look around. The facts are all around us.”, has given you personal and unique insight and a drive to mirror the model you see from, your perspective, in the goal of living a long life.

            I was only asking for evidence if there was any to be had. I liked the breakdown you gave of human opportunism, but again I say this also translates to information we are fed. (Not to mention that we now just deliver food across the planet so theoretically we can live anywhere and eat as we wish, or hopefully how we learn what is best for us, with history as our backdrop, and new info as our rudder, longevity as our goal.)

            Like really, how do you feel that you know it was the inclusion of meat that made them live longer – enough to make you have some every now and then, when we do have the availability they didn’t, of B12 etc…? I want to do the same because I am argentinian and I cannot tell you how much I love meat. :)

            It may read as a snarky challenge, but I assure you it is sincere. I enjoy learning what makes people do what they do, think what they think.
            But more importantly, in this case, I want to know: Did you exercise more or less then, as you do now, and when you switched out back to some animal protein, what did you eat, and how much of it? AND did you notice a big difference and did how long did that take?

            Truly, I don’t fault you at all for “picking a team” through personal research and observation, and then going with it, and I hope you are right and live longer than even the ideals you’ve chosen. I sincerely mean that, and of course, I also seem to have “picked a team” as it appears we all have here – including the sometimes biased and always human, Dr. G.

            It is his penchant for evidence that does make me trust him though, and I suspect we are all here for this same reason – a bit of trust, curiosity (I hope we aren’t planted) and agreement on the benefits of WFPB, which apparently is the basis of Dr. G’s life and message.

            I don’t worship him like a cult of personality and have found a few human flaws in him. I’m still here for the bigger picture, and an interest in the truth, and a wonderment that how we perceive it changes, while at the same time it doesn’t.

            What I mean is, it isn’t history that teaches by observation, though it will always inform, but rather the timelessness of our collective consciousness itself. Okinawans were also part of this continuum, not separate from it. They lived long as hell. Others may live longer in the future. Maybe they wont eat any animal. And for debate 101 purposes then, just ruminate on some things like Capernicus’s theory of the solar systems order etc… You will find people at that time had similar views based on observation which did in fact turn out false.

            But hey, I get it. (just kidding)

            For my part in making my points to you earlier, its just that you have suggested lots of info, advice, at times lengthy, but always a pleasure to read and well-intentioned, and so much if it is evidenced based, that I couldn’t have thought other than that you could have had other evidence beyond the knowledge that these centenarians did include some meat in their diets. I simply thought you had evidence other than observation on this topic as well.

            I should read the study, admittedly I have not. I’m spoiled here since, as he says, Dr. G reads thousands of studies: “So that YOU don’t have to!” C’mon man you gotta love this guy!

            Ok, so mylogic goes to this:
            There are other habits, situations, and paradigms of your ideal health and longevity models which you are just not mirroring due to the innate restrictions placed upon you by virtue of geography, paradigm differences, cultural difference (I assume), environmental differences, historical differences, social differences, etc. (yada yada)

            Its sound logic and I don’t mind saying, its not “101 college debate” material. (hopefully more like youthful grade school banter where even as children we know we don’t know, but we may not show it.)

            AND I don’t mind saying that I do hope your chosen path keeps you around here and everywhere for a long time, and that you will have a playmate at 95! (we promise not to tell your espoused)

            PS: But dude: “Coasts? Fish for the taking.”…. hoping that was a joke? (we are in a serious fish depletion problem)

            1. jazzBass,

              Quick break.

              I read your post this morning – been thinkin’ . . .

              There’s a lot of meat on dem bones.

              I plan to get back to you this evening when we’ll have time to chew the fat.

              See ya later –

              Vivamus

              1. Tired.

                12-hour shift. N95s. Goggles. Break for hydration – then get dressed (again) and back to the races.

                Home, finally – watermelon for rehydration. No dinner hunger. Head in hands. Wiped. Slow motion.

                Numb.

                A little altered state of consciousness without resorting to any mind-altering materials –

                jazzBass,

                An Argentinian Vegan? Omigosh!

                Are you high or an I?

                You based in Argentina or the U.S?

                Your reception in Argentina amongst different demographics?

                Eating out?

                ———————————————–

                As to any interaction concerns – I like to assume that everyone posting to this site is well-intentioned.

                I write as I would talk if someone were here. Body language and intonations and other social cues are lost. Not everything comes across as intended.

                Known issue with Internet communication. Best to assume good intent on everyone’s part – assume the best – avoid taking offense – and plow straight on ahead.

                Don’t worry about it.

                ——————————

                Thoughts.

                Sleep.

                Not yet.

                Called Brother. Keeping his kids home this fall. Older people in the household. Chinese American community – they know the drill. Chronic effects of the Novel Coronavirus remain unknown – if significant, we will only learn over time. Murphy’s Law. I suggested that it it time for a dog for the family – they remain in quarantine, the kids need a buddy. We talked of favorite dogs from the past – interestingly enough, all were males. More personality – active attitude of being someone you would like to go bar-hopping with. The bitches were more boring, stay-at-home types – there and loving, but personalities were not that distinct from one another – they meld together in our minds over time. The males stand out in memory – each to their own. The older child – still young – is male. A male dog it is.

                None may be available. If not – hares are boon household companions. House trainable and very active and very social.

                Zeus used to perch on my shoulder as I studied late into the night.

                We will see.

                Now we can sleep.

                Not yet –

                Called another of the crew.

                All is quiet in the Coronavirus front.

                Locally they have largely stopped testing. No kits. Republican-controlled state – the numbers will look much better without testing for the November election.

                We’re thinking of moving to California where it’s safe. ;-)

                His son is in California – called in yesterday – he is fine.

                Everything is local.

                And – we keep an eye on what is happening in the local hospitals.

                It helps to have the inside track.

                —————————–

                Next A.M.

                Let’s look at your post.

                Questions asked reveal the questioner – a basic principle of Intelligence work.

                You questions reveal someone who is trying to get at the truth.

                But also – they very much reveal someone who has learned just enough to get himself into trouble.

                It is not time to correct the error of your ways. You are adult – you will push back against such knowledge.

                It is how adults are built.

                Instead – we will try to give you additional knowledge – so you can make the needed corrections on your own.

                Please assume that everything below is intended in the spirit of giving you knowledge that you can use – not in the spirit of winning a debate.

                ————————

                We will take the example of the original Star Trek. If you know the show, you will understand the examples viscerally. If you do not know the show, I will explain as we go along.

                Mr. Spock (Leonard Nimoy) is the Science Officer of the show. Half alien – Stranger in a Strange Land. He represents pure logic without emotion. He was a magnet for adolescent asocial science nerds to identify with. Socially awkward in human society, but he found his place. And he was always right – outside of social matters. He was them.

                “Bones” – “Doc” – (DeForest Kelley) is the show’s physician. More emotional style. But he keeps the crew patched up.

                OK.

                Let’s look at biological systems logically – as Mr. Spock would do.

                You write:

                “1. Meat causes cancer.” Your logic in this and prior posts suggests that we therefore should not eat meat. But that you are open to proof that you will accept otherwise.

                OK. Reasonable extrapolation. Makes sense. Understood. Following similar logic –

                Oxidation causes cancer. So we should eliminate oxygen.

                And the patient dies.

                Salt contributes to high blood pressure. High blood pressure is associated with death. We should eliminate salt.

                And the patient dies.

                Eating too much causes obesity. Obesity leads to early death. We should eliminate eating.

                And the patient dies.

                We could go on all day.

                The logician who takes logic and extrapolates – excellent logic, step by step – to human systems – kills the human.

                That is why Mr. Spock confined his logic to science – 2 + 2 = 4 – where science works.

                But kept his hands off medicine – where 2+2 becomes infinitely complicated – completely.

                ————————————

                Another example that will be close to your heart.

                As I understand it – and we are in your territory, now – the decibel scale is logrythmic.

                “A perceived doubling of sound level is generally said to be 10dB. A doubling of power is 3dB, a doubling of distance from the source is 6dB”

                Feel free help me correct my errors – I am no expert in this. But the general concept I am trying to get across should be clear.

                A doubling of perceived volume, apparently, involves an increase in sound pressure – in energy – times ten or so (my math may be off – it may be 3-4 times instead of ten times – but the principle is there).

                A quadrupling of perceived sound level involves an increase in sound pressure of 10 X 10 = 100 (or so).

                So – logically – it must take the musician ten times (or so) more energy to double this sound output. And 100 times (or so) the energy to quadruple his sound output.

                Applying science to your musicianship, I have just proven that it takes you 100 times (or so) more energy to produce a note at forte than it does to play a note at a piano level.

                If you disagree with me – you are disputing science.

                You are wrong.

                I’ve got the math to prove it!

                Hold on, you say.

                It does not take me 100 x more energy (or so) to play loudly that it does to play softly. Your science is bunk.

                Or – much more importantly – you are applying the science incorrectly.

                When you do the Reality Check with science – and the Reality Check is the important thing in science – not the logic or the theory or the extrapolation or the proof – it is the Reality Check that is much more important than the scientific thesis – you see that the science is often correct in itself, but that it has been applied incorrectly.

                Delving deeper, you see that biologic systems expend considerable baseline metabolic activity, even at rest. And that just the act of being completely still in a stressed position actually requires considerable energy – you are holding extensor and flexor muscles in tension with each other to maintain a still position. And such tension requires energy.

                So – when you strum – or bow or thump (I do not know string bass terminology) that string a little harder, you are not strumming that string from zero muscle energy to 100 – you are really going from, say 90 baseline to 100.

                So you are not actually expending 100 times more energy at all.

                —————————-

                Classic demonstration of the concept I am trying to get across.

                There was an old saw that mathematical modeling had proven that the bumblebee cannot fly.

                Conclusion – nobody better tell the bumblebee.

                Reality – the science was obviously wrong. This is the classic illustration of reality overruling flawed science.

                The Reality Check always trumps theory.

                Always.

                The it is “back to the drawing board.” And science tries again.

                Those who pursue theory over reality, however – always run into trouble.

                —————————–

                Conclusions:

                (1) Logical extrapolations of taking recognizable risks to zero have a marked repeated record of failure in biological systems.

                If you are going to go this route – the burden of proof is ALWAYS ON YOU.

                And you will find that you are facing an uphill climb.

                Biological systems are extraordinarily complex systems that are always balancing acts. Remove any part of the system and you risk throwing the whole system out of balance.

                Ecologists see this all the time.

                You might find a population that is inclined to agree with you – even though they may not be right – and let yourself be carried away with the logic of the crowd.

                Humans are social creatures. Conformity is always comforting. And reassuring.

                But an Argentinian who is considering the choice on whether or not to eat meat – is no stranger to nonconformity.

                And to working out things for himself.

                Simple going from red team to competing blue team may not be the best choice.

                There are times when it is wisest to remain independent.

                And take the best from wherever you may find it.

                (2) Reality Checks are the heart and soul of science.

                If you go with theory and extrapolation over reality – you will reap what you sow.

                jazzBass.

                All the best –

                Vivamus

  4. Incredible lecture. I dozed off once but was still listening. I will read the transcript to take in more. I remember the pervasivness of smoking in the teaching profession. My parents were smoking teachers. Dad died of lung cancer, He quit years before getting the disease because his cardiologist gave him the heads up. Mom quit after a major stroke took away the addiction. She regained speech and movement though.

    1. Dan C,

      Thanks for sharing. Sorry that you had to go through those health things with your family.

      I laughed that you “dozed off once but was still listening” it reminds me of a lifetime of parties where some specific people in my family would eat and then sit on an easy chair and nod off and then say, “Nope, I am still listening.”

      I used to have to take allergy pills and would do that in class. Head bobs.

        1. Dan C.,

          Yes, there is so much practical information in there.

          I have watched those videos several times and I still get so much out of them.

    2. I read the transcript and was able to soak up more. Dr. Greger is definitely saying that a WFPB (vegan even) diet will cut the mortality rate by a thousand a day in the U.S. He is saying food is the #1 killer and likens the fight for better nutrition to the long fight of curtailing the all powerful tobacco industry. WFPB is so powerful it can reverse heart disease, cancers and diabetes, the latter sometimes in only 14 days. Think of taking an insulin kit, throwing it up in the air and blasting it with a 12 guage shotgun. Then maybe saying, “Astalavista baby!” Okay, I’m being dramatic here. Or, maybe, in Dr. Greger’s words, (paraphrase) “Would you rather have a bean burrito or have your chest sawed open?”

  5. These “Annual Summary” videos are very helpful. These are the ones I recommend to friends and family members who haven’t yet “got the word” on the WFPB way of eating. Most of the regular short weekly videos require some background and context, but these are what I would call stand-alone videos.

  6. My friend, who thinks COVID is fake and who pre-shot me down now has 3 relatives with it.

    One in the ICU with brain problems.

    And I am so upset with my fathers doctor. I just brought dinner over there and my father was sitting wrapped in a blanket with a pale for throwing up and I asked what the doctor said and the doctor decided that his fever was only elevated by a few degrees so he decided not to test for COVID.

    GI symptoms can be related to COVID, too, Is my logic, but my father and his doctor don’t think it would be COVID.

    The doctor sent him home and said he would probably feel better in about a week and to come back if he didn’t.

    I am the only one who is concerned because I believe that he has about 10 symptoms that could be COVID and if he has the flu he could have given Tamiflu or anything.

    I fight with doctors every single time

    I am going home and will be gargling and doing nasal rinses and using PEMF and infrared and high ph water and my Wabi baby and I will start up with the zinc and NAC and Vitamin C and D and broccoli sprouts and turmeric and ginger and will eat low fat and he will do nothing at all.

    How am I related to that man?

    I will be do frustrated if my whole family and all of my workers get COvID just from driving my father.

    1. Deb,

      You wrote: “My friend, who thinks COVID is fake and who pre-shot me down now has 3 relatives with it.”

      Yup.

      I have been seeing that all over the place.

      Not a problem.

      You save which friends and family you can. At no risk to yourself.

      The rest are self-triaging and are no longer of concern.

      You do what you can.

      You cannot do more.

      ———————————–

      “One in the ICU with brain problems.”

      Earlier report from the ICU – huge percent with neurological issues.

      No survivors are discharged home – they are all being discharged to nursing homes.

      You do NOT want to expose yourself to this disease.

      ———————————–

      “And I am so upset with my fathers doctor. I just brought dinner over there and my father was sitting wrapped in a blanket with a pale for throwing up and I asked what the doctor said and the doctor decided that his fever was only elevated by a few degrees so he decided not to test for COVID.

      GI symptoms can be related to COVID, too, Is my logic, but my father and his doctor don’t think it would be COVID.

      The doctor sent him home and said he would probably feel better in about a week and to come back if he didn’t.

      I am the only one who is concerned because I believe that he has about 10 symptoms that could be COVID and if he has the flu he could have given Tamiflu or anything.”

      I had best stay out of this.

      If your father is unhappy with his care, he can seek out a second opinion.

      —————————————————-

      “I fight with doctors every single time”

      That is a fight you can never, ever win.

      The doctors are the gatekeepers.

      Better handled with honey than with vinegar.

      Try vinegar – you don’t stand a chance.

      ——————————————————

      “I will be do frustrated if my whole family and all of my workers get COvID just from driving my father.”

      Protect yourself first.

      Nothin’ you can do about those who will not.

      Except avoid exposure to them.

      Deb.

      Careful –

      Vivamus

    2. Deb sorry to hear, but jeez, where the hell do you live with all these people you personally know getting covid. You’ve mentioned a few times times actually this sort of scenario of close associates getting this thing.

      Not the case here or in my travels to and from new York, but yes there have been a few, but they werent fraught with panic, and all recovered with no further issues, as 90+% do.

      Even with the recent spikes, the percentage of people with covid vs, the population is so low in all states, I think I just have to know where you are because we should all try to avoid it, and maybe you should get out of there. I just spent a month in New York and happy people everywhere, though biz is slower due to earlier closings and social distancing etc.. but bustling farmers markets, and subways riding along etc… DC not much different, but yes less active, but I guess I don’t see the people who are staying self quarantined.

      I do however personally know lots of people that haven’t seen the light of day since March, preferring to stay home until…not sure what really..

      I hope your associates and family don’t suffer, or get it bad, or at all. I hesitate to wish for the flu for them as an alternative, but I guess in this case its appropriate if there are some mirrored symptoms.

      This thing is of course real, but I am certain that its worse for some mentally than physically, and older folks who live alone are likely the ones worse off as its hard to turn to anyone.

      1. jazzBass,

        You just spent a month in NY? I have been watching NY videos on YouTube where people walk all over the place with nobody around.

        It has been fun to watch. Surreal almost.

        Some of them have done whole walking tours everywhere in NY even the bad areas and nobody was there either.

        Seems like some of the foot traffic is starting to come back but one of the men started listing the groups of people who aren’t coming into NY, tourists from other countries, tourists from the USA, many of the businesses are still working online. Many people moved to their other housing and many people moved. There are over 13,000 apartments listed in NY. We have been having so many people from NY come and buy houses and lake houses that my cousin sold his house. One open house and he had so many offers way above what he was asking. There are lake wars because the people from NY have come in and are sectioning up the water and doing all sorts of behaviors that the locals find offensive.

        1. Deb, yes scared folks are leaving in droves, but honestly there are so many millions staying they wont be missed. Likewise while many affluent areas are playing it conservatively in terms of empty streets, just go uptown at 3am and see for yourself whats happening.

          I cant speak for lakefront properties, and Gatsby etiquette but again, that’s a game for the more well to do, who usually protect and bolster their health better, if not while also overdoing things.

          I know or heard of plenty of people who left their apartments and even their furniture and got the hell out too, but again, they have this financial luxury to do so.

          All that said, here in DC all homes go above asking generally, and that’s the way it is for so many areas in the country, simply depending on the time of economic season and, again, fear.

          I am sure you aren’t in some sort of covid hotspot. Your dad will be fine Im sure. Good thoughts to you both.

          1. jazz Bass,

            No we aren’t having the same rates as Some states but there have been spikes and like I said, my friend poo poo.d the statistical chances of getting and dying from COVID and 3 of her relatives got it even though the rates are low where they live.

            We just had another nursing home outbreak and sports community outbreak in the state so it is still a pandemic.

            There are still over 1000 people dying of it every day in the USA.

    3. Deb,
      Hope your dad gets to feeling better. He is fortunate to have a concerned daughter. I read your writing that your dad and his doctor don’t thing the GI stuff is related to COVID. Also that the doctor sent your dad home unless things change. If your dad is not COVID, he may be safer at home.

  7. The doctor didn’t tell him to self-isolate and my father plans on going grocery shopping tomorrow and has a whole list of plans.

    He has already exposed my whole family by how he handled today.

    I consider that doctor negligent.

    A man comes with a fever and GI problems and nausea in the middle of the pandemic and he isn’t going to test him.

    1. I am no expert but, from what I know, your father’s doctor’s response seems reasonable and appropriate in the circumstances you described …. although perhaps self-isolation would be prudent advice for all seniors at this time.

      1. Tom,

        Express your logic with more words.

        I am trying to understand.

        My logic is that flu-like symptoms and a fever and chills alone would make me want him to be tested and self-isolated.

        Explain why the doctor didn’t test him.

        I respect your opinions.

        I just can’t figure out any logic in that direction.

        Maybe because we had so many COVID cases that up until now the drill has been if you have these symptoms, get tested and self-isolate for 2 weeks.

        Did I miss a change in protocol?

        1. I wonder if it seems more reasonable to you because you aren’t in the USA with our almost 180,000 deaths. The third leading cause of death this year in the USA is COVID.

        2. Deb , those seem also as flu symptoms. Its the trouble breathing and tightness in chest that’s a sign leading to testing I believe. Anyone can request the test, they don’t need some sort of permission…

            1. Well, around here you can go to Walgreens or CVS, but yes a doctor usually will prescribe it. In absence of this opportunity one might do well to take their health in their own hands.

              Doctors are the 3rd leading cause of death, before Covid,

              SO I prescribe the following:

              1. Call any other doctor, perhaps your dad has others beyond his GP.
              2. Tell the doc that yoir dad has difficulty breathing, Fever, and pain in his chest, and a history of asthma.
              3. Ask directly: Doctor will you prescribe the test please? He really needs it. We need to know in order to get in front of this, hes 73 etc…
              4. You can say the regular GP is away on vacation or something or got covid even , who cares.

              I’d be surprised if they refuse you then. Even as heartless as they can sometimes become.

              (True story: Once in Boston I went to emergency. I never go unless I think I am dying. SO I told them I was sent there form down the hall by urology. peeing blood fever the whole thing…All true, as I had just had a test down the hall and they asked me to pee in a cup and it was nothing but blood. So they said, go immediately to emergency… At emergency, they said “have a seat”. I figured it would be a few minutes. There were others there but I was freaking dying. SO, after asking a few nurses how long this might be in my obviously fading voice, I resolved finally to stop a busy nurse walking by and asked for a cup of ice. I could barely get the words out. She obliged, and then she handed it to me. As she started to walk away, I said “wait, take my temperature.” I began now chewing ice in front of her. She took my temperature and it was 104. Her eyes grew enormous and she said oh my god! Yes there was a guy next to me bleeding, but I was dying, i was so sure and I think she did too in that moment. She picked up immediately that my high temperature was in spite of chewing ice in the same mouth.
              Deb, we have to take these matters and our health into our own hands because nobody, especially most doctors, gives a shit, until they do. Nobody sees until they do.)

        3. Well, covid-19 testing is expensive, unreliable and might take five days to get a result.

          In the meantime, your father has relatively mild symptoms that could indicate anything from low level food poisoning to a cold. They don’t sound serious enough to even indicate a flu – most people who say they have the flu, probably just have a heavy cold. In any case, from your account, your father did not have any respiratory symptoms whatsoever.

          Why not reserve covid-19 testing for those with serious symptoms that could develop into serious illness and for those individuals who have come into contact with people who had diagnosed covid-19? You might find the CDC’s guidance on testing to be helpful
          https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html

          And also this
          https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

        4. Here, if you come down with any symptoms, there is a number you can call that will help advise you…. they will tell you if or when to go to hospital etc. My doctors told me to call them if I feel ill, but to NOT go to doctor’s office, and do NOT go to the hospital unless told to. They won’t test here either…. just say to stay home, do get relatives to shop etc and drop it off at the door. zero contact with anyone for 10 days. Even if doctors think it’s the flu, instructions are the same.

          1. Thanks, Barb and Tom,

            He is still not eating today. Still nauseous. Still has a low-grade fever. It has been 2 days where he was too weak to drive, so I am on food duty for his wife.

            He looks like someone who has the flu. 48-hours so far.

            There isn’t anything to do unless he gets worse, so it is just feeding his wife and checking in on him.

            He said that he feels seriously lousy and I know that for sure because he would go to the grocery store with the flu if he could didn’t feel too weak to stand up.

            1. I think I am worried because he is such a social person and such an active person. To see my father who plays an hour of tennis every morning and then walks a few miles and then swims and plays golf barely be able to get up off of the couch is so different from who he has been.

              Him saying that he was too weak to drive to the doctor is not him.

              Even being in Florida when there were 10,000 cases per day, nothing could stop him from going out to restaurants, etc. I know that he was just with a large elderly community of very active snow birders. Meaning they have enough money to have houses in two states and live divided between the two. My mind wants him to get tested and warn the snow birders.

              I guess I don’t understand how every college student in America is getting tested but an eldery male who is in the age and gender that is most likely to die has to wait and see what happens.

              1. The thing about the males in my family is that when my brother had his kidney removed, the very next day he did 40 laps around the hospital floor and he would have done 80 laps if he hadn’t had visitors trying to catch up with him, but he would bring them back to the room and have them sit down while he stood and talked for hours.

                And they all are so stubborn that they would never ever ever not do things.

            2. Deb, I would feel so much better if you were not the person ‘on duty’. I am sorry your family is feeling poorly, and I agree with your view of the situation. I believe my doctor would come to my house and do the test herself or send me to emerg if I had the symptoms your father has. The complaints of weakness are worrisome. Frankly, I would assume it IS covid and act accordingly. Better safe than sorry.
              There were instructions at federal websites on how to care for sick family members. bbc had pages on that topic too. hope everyone is wearing masks, and sick peeps are isolating themselves in the house as much as possible.
              So important for you to get rest Deb. Please take good care. Groceries can be delivered.

      2. Tom,

        I went to my state pages and they said that the minute you have any symptoms or if you know you were exposed to anyone to go get tested and not to wait.

        They list a lot of symptoms that my father has. And say to contact your primary care doctor.

        My father felt so sick that he wanted to go to a doctor but his doctor didn’t read the state guidelines.

        1. I read the most fabulous thing today. The FDA has approved convalescent plasma.

          https://www.cnn.com/2020/08/23/health/covid-19-convalescent-plasma-eua-white-house/index.html

          My father is still in the same room with the same “lousy” answer to “How are you feeling?” but I was praying because I want convalescent plasma and the drug from Israel to come forward and one did.

          My friend’s relative who is in the ICU will be able to get convalescent plasma now! I am so grateful.

        2. I am confused.

          Your state guidelines said that you should consult your primary care physician. You did.

          As far as I can make out, it is then up to the PCP’s professional judgement Given your father’s symptoms could indicate any one of a large range of conditions, and there was no sign of respiratory distress. IMO, it’s hard to argue with her/his judgement call.

    2. Sounds negligent to me, Deb.

      But then I live 35 minutes outside of NYC and survived the original covid tsunami, and have been self isolating for months.

      1. >>> The doctor didn’t tell him to self-isolate

        That’s the part I think is misguided if not negligent. Anyone who possibly has covid should be in isolation. I would be pissed as hell if he were walking around me. Saying it sounds like the flu or some more benign viral infection just does not cut it with me. The symptoms overlap.

        The main problem with testing in the US is turn around time (thank your government). If a person has covid, they are very likely to exhibit clear symptoms before the test results are available. Unfortunately many wait too long for treatment, so keeping an eye on him is essential. Once a person has significant breathing problems, it can be too late.

        Good luck, Deb.

        1. Thanks, Gengo,

          I agree with you. Testing is so that you know to protect everybody else.

          You still can’t go to the hospital until you are really bad.

          I watched my father who goes to the gym every week not be able to lift his own body.

          But I just am concerned because over the past 2 days so many people were exposed to him and it might be the flu but, boy, this is a pandemic.

  8. Deb,

    Rootin’ for ya!

    A friend’s son works in the restaurant business in Chicago. Lots of fellow workers at meager pay levels – different immigration statuses (I don’t ask). Ten of them live in one house.

    The Novel Coronavirus swept through the house and apparently got them all.

    The interesting thing is – everybody had different symptoms – fever, no fever, cough, no cough, H/A, no H/A, whatever, no whatever – or no Sx. at all. Different severities all over the place.

    Only one got knocked down HARD and had to be hospitalized.

    The Novel Coronavirus seems to be a great imitator – of anything and everything. And a hider, as well.

    The tests are inaccurate.

    A wee bit difficult for anyone to Dx.

    I.e. – even if you get a test, can you believe the result?

    ‘Tis a puzzlement.

    ——————————————–

    Considering the common Novel Coronavirus Sx. of “Brain Fog” – previously neurally intact people can handle a few lost mental watts – but I am concerned for you – you report already dealing with neural issues for which you must compensate. I am concerned as to whether you can muster the necessary reserves if needed. I would be saddened to see you get pushed over the edge.

    I would feel a lot better about you going into hibernation mode.

    Yesterday.

    Protect yourself – that is all you can do –

    Vivamus

    1. Vivamus,

      Thank you for your sweet words.

      You are telling the truth of the great imitator.

      I have thought that so many times.

      My father had a lot of doctors visits last week For him and for his wife.

      What I am going to say is that he called my cell phone first but it was charging on my desk at work and somehow it was when I wasn’t near it.

      Him calling me first means that he wanted to be tested.

      I am so upset by that doctor.

      I reviewed the symptom pages and they showed a man wrapped in a blanket shivering just like my father looked.

      I was almost upset enough that I wanted to say. ”Is this the doctor who missed your wife’s stroke for a week even though she had a common stroke symptom?”

      I knew it would have hurt them and it wouldn’t cause them to get tested.

      Vivamus,

      I worry about the same thing. My brain is so vulnerable that I have been so careful.

      I am genuinely not even sure what to do because my whole family is as stubborn as I am in opposite directions.

      He is not going to listen to me and my whole family, including me, have now been exposed.

      Not sure how many droplets come when people are vomiting into pails but I know that I have to make decisions and I will be there for my family.

      But my father plans on going grocery shopping tomorrow and someplace else over the weekend. He will be a super spreader.

      Stupid doctor not having him tested.

  9. “Stupid doctor not having him tested.”

    Careful.

    Odds are – Doctor is not stupid at all.

    Whenever I talk to someone in health care – it turns out they are actually pretty darned smart.

    And thinkin’.

    Even the ancillary personnel.

    Doctor is probably following protocols.

    Locally – we do not have enough tests. Tests are being rationed to specific protocols.

    This makes no sense – a lot is political, over the heads of the people in direct patient care.

    Doctors locally have been overruled by the test givers who are enforcing the rationing.

    That sort of madness.

    What can you do?

    Avoid exposure.

    That is all you can do.

    Deb.

    Batten down the hatches –

    Vivamus

    1. I have met so many stupid doctors, ill informed and careerists. They kill patients every day. Sad but true.

      Plenty of smart ones yes, but odds are truly unknown and it could just as easily be true if one dares utter a disparaging word against such a holy profession.

      1. jazzBass,

        Technically, you are right about the death by doctors.

        And yet, they are still probably much smarter than I am so I will have to pause and think about how to define intelligence.

        There are so many kinds of intelligence that I am already just willing to raise a white flag and say, I can’t use that standard.

  10. Thank you for this wonderful speech and documentation of the large impact on a healthy Nutrition by eating and whole food plant based.
    Thanks for sharing your knowledge with every one around the world. My husband and I are feeling so much better by adapting the diet. We are in our fifties, so we still hope our elderly, daughters and grandchild will follow suit.

        1. Where did you get the idea that “elderly” means over 80?

          I like your definition but unfortunately it is not standard.Traditionally it was defined to be “over 65”. More recently various groups or individuals have argued it should be moved up to 70 or 75.

          As a healthy 73 yr old I detest the term as it suggests a person is a dotard. But then I also refused to let my grandchildren call me “granddad”. I am also happy to have push up and running contests with them.

          1. ROFL , Yes Gengo, when someone refers to “seniors” I look around the room to see who they might be talking to. Can’t be me ! lol People were laughing when I first got my bike last spring, but they aren’t laughing any more…. I get an hour’s ride in before breakfast while my dogs are still sleeping and I haven’t missed a day yet.

            1. Barb,

              That is so inspiring!

              Good for you!!!!

              I might look at bikes after I pay off my generator.

              I always loved walking with my dog and I loved walking at the gym.

              Walking without my dog, I keep wanting to extend my arm.

              So wrong.

          2. It always used to be that being ‘old’ or ‘elderly’ was defined as being 65 or over while the ‘old old’ were 85 and over. Many Western countries now are trying to increase the age at which one is defined as old or elderly though … but this seems primarily driven by a desire to reduce age pension expenditure and other government payments.

            Personally, I’ve been called a lot worse than ‘elderly’ so that’s not an issue for me. I’m also grateful to still be here and consider being called ‘elderly’ to be a small price to pay.

            You may be interested to know that the International Day of Older Persons is 1 October and apparently we are already in the international Decade of Healthy Ageing (2020-2030). Being a grumpy old f*rt though, I will content myself with pointing out 2020-2030 is a period of 11 years and is not actually a decade.

            What’s that old joke? Young men think old men are foold but old men know that young men are fools.

            1. Tom,
              I am 60 and now considered a senior citizen, which comes with some price breaks and arthritis. I’m doing the head game on advanced aging. One of my thoughts is that I should try out some retirement while I can still enjoy it and before I contract something like COVID 19, cancer or any number of ailments that come with the territory.

              1. Ah, OK. Here in the Philippines you are also officially a senior if you are 60 or over.

                My reasoning was much the same as yours is on this whole issue and I ended up retiring as soon as I could afford to …… a bit short of my 63rd birthday. Something had stuck with me when I joined the UK Civil Service in 1974. One of the pension scheme documents I saw then, reported that half of people died within two years of retiring. That always left me with an inclination to leave employment early Of course, those people would all have been born before WW1 but still ……

  11. Hi!

    I’ve read on the “contact-us” page that I should post a question at some video and decided to post at the last one thinking that maybe I wouldn’t get any attention to the older ones. I’m really sorry if I’ve did something wrong.

    I recently read that Xylitol can help with protecting the teeths against tooth decay and that it also helps with remineralization. Apparently, one should take daily about 6-10g of Xylitol (not at once, but spreaded through the day).

    Do you know more about this?

    I also read that the fact of chewing a gum is itself helping with preventing tooth decay.

    I’ve started to get some caries and I think it could be from the popcorn I’ve been eating daily (50g two times, since about a month or more) as they got stuck into teeths and I left them like that (swishing water after eating them didn’t help much to get rid of all the leftovers). I’ve also been eating kinda a lot of sugar (especially in the form of homemade jam) in the last months when I was getting depressed and was overeating it though.

    Right now I’m considering to:
    1) Use Xylitol (in the form of crystals as an homemade mouthwasher / rinser —swishing for 5-10 mins after eating and then spitting out — or chewing gums, but the gums seems to be quite expensive and can’t really get one vegan and with no aspartam or other things unless ordering online).
    2) Switch to a toothpaste with xylitol and baking soda (I’m looking at the Colgate’s Smile For Good Whitening; I have no memory of having white teeths ever and never tried baking soda).
    3) Switch from the cheap and healthy popcorn to something else to fill 300 calories as I’m trying to bulk, either in the form of snack or just eat more whole wheat pasta or something else.
    4) Properly wash my teeths and don’t rush. I’ve been doing the opposite my whole life.

    Basically what I’m trying to do is to prevent getting any further caries and revert the current ones if possible. I know that I had caries like 1-2 years ago too and at some point they were gone.

    However, it seems that the upper right molar is kinda black and I wasn’t aware of it. I guess I can’t do anything about it at home, but going to dentist right now isn’t possible due money (and most likely neither anytime soon). I think I’ve been to dentist only 1-3 times in my life lol, when I was a kid. My parents doesn’t care about health at all.

    So yeah, this is why I’d like to know if xylitol can actually help with this. There seem to be many websites who claims that it does, including chewing gum companies, but it’s like I have doubts about it.

    This is my first post on this website ever, even though I’ve checked it countless times. With this occasion, I also want to thank you Dr. Greger and everyone else for the amazing work you’re doing!

    1. I forgot to mention, but I’ve also been using Apple Cider Vinegar daily (15ml at lunch) for about a month I think (previously used Balsamic Vinegar for about the same amount of time).

        1. Deb,

          Thank you so much for your reply!

          I’ll check them out. I believe I’ve checked the second one already, but will check again.

    2. NinNin56,
      Welcome to the site. I might suggest not consuming acids from refined sugar and vinegar. Think alkaline. Swishing your teeth with water after an acid meal could be a good thing. Dr. G. advises not brushing your teeth right after an acid meal—because acid softens teeth. I use Colgate Total and floss daily. You’ve just read health advice from a retired house painter with only two brain cells left :-)

      1. Dan C,
        Thank you a lot for your reply!

        Yeah, I’ll definitely stay away from vinegar. As for refined suguars, I’ve been staying away from it since 13th July 2020 and continue to do so (looking into getting that 1 year+ sugar free streak again).

        I’m glad I’ve never brushed my teeths after meals. I’ve only swished some water after meals sometimes, but from now on I’ll do it always.

        I think I’ve never tried that Colgate Total (I always used any paste bought by parents and never cared about it). I’ve just got that Colgate Smile For Good Whitening few hours ago and will start using it from tonight. I really hope things will get better if possible.

        Right now I’ve got some teeth/molar pain (sorry, but I don’t know the teeths in mother tongue, let alone English lol), but what seems to be weird to me is that the upper right molar which is kinda black on the bottom isn’t hurting, but actually the teeth next to it it’s hurting me.

        I just had dinner which consisted of 150g whole wheat pasta, 150g frozen green peas, 100g frozen broccoli, 100g frozen yellow beans, a carrot, 115g raw green cabbage, two small red peppers and 15g hemp seeds. I’ve noticed the pain after I’ve finished to eat…

        Could (too?) ripe bananas be a problem too? I’m using one in oatmeal (putting it on the heat near the end) and one after lunch or popcorn snack which I used to eat. It’s kinda hot nowadays and they get ripe way faster before I finish them. Perhaps I should just freeze before they get too ripe…

        Regarding your last sentence, I’m not sure what you meant. It was about Xylitol? So it doesn’t help with teeths?

        Once again, thank you so much!

        1. Dan C,

          I’m really sorry. I think I just got it now that you meant the last sentence about yourself after reading further comments…

      2. Dan,

        I just found out that I love you. You are a retired painter with two brain cells left and I only have 5% functioning in a few areas of my brain.

        Plus, I had my house painted by a painter who really is like a sweet Madhatter. Very sweet and protective, like the Bliind Side guy, but genuinely damaged brain.

        When I went home the first night after he Kilzed all of the windows were open and the house had been airing out for 8 hours or more but my eyes burnt so bad that I couldn’t even stay and I cried. He was killing his brain cells and probably shortening his life for me.

        1. Laughing.

          I know that the English language uses love to mean just about anything at all.

          Painting my house opened my eyes up to someone who had laid down his life for everyone and I know that he had such brain damage that people would make fun of him.

          I will never take that profession for granted. Nor any physical labor.

          When I fell mentally down to the bottom, it was the laborers who walked me through.

          Not even kidding.

          They are still the ones who are protective of me.

          I am the one from the Prodigal son parable and the Christians stepped over me and the laborers are still serving me.

        2. Deb,
          It’s good to be loved. NOVA is showing a program on domesticated dogs now. It includes their ancestor, the wolf. The domesticated dogs are friendlier and thought to have more oxytocin genes. I love my dog dearly. A thought of mine is that maybe people might benefit with more oxitocin, the natural genetic kind. A few people do have the oxitocin gene alignment. They love everyone in the whole world. Yeah, this could be a not so good thing.

          After decades of painting I’m surprised I still have a brain. I switched to water based paint years ago and dreaded the occassional reqest for oil based cabinet painting. I came to a conclusion that it should be illegal to open a container of high VOC paint inside an occupied space. I noticed that painters do pretty good compared to other occupations. At least painters are exercising. A really toxic profession is sitting at a desk. Painters who smoke though wind up not being able to pull air through a respirator—so, they don’t wear them :-0

    3. NinNin56,

      Your thoughts 1-4 are probably excellent options for improved dental health. I would highly recommend that you consider a low cost or no cost dental clinic regarding the tooth your describing as black is very concerning. Dental health is going to reflect on your total health and is not to be taken lightly.

      In terms of the Colgate product the idea is great except…. for the fluoride content. https://www.colgate.com/en-gb/products/toothpaste/colgate-smile-for-good-whitening-toothpaste. Which of course is still a controversial issue, but clearly helps with enamel considerations.

      The xylitol idea is sound based on its effect which is preventing demineralization by the bacterial inhibition, which then keeps the pH from dropping into a range that adversely affect the enamel. As a note when used as a gum or mints, you stimulate saliva, bringing salivary minerals in contact with the teeth, accelerating remineralization.

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

      1. drkadish,

        Thank you so much for your reply!

        To be honest, I don’t know much about dental health and I would’ve never thought that it reflects on the total health.

        I’ll try to find the cheapest dental clinic and see if I can do it. I know that there’s some clinics which gives free consultation, but I’m afraid that’s just some talking or planning and they won’t actually check my teeth. I think I’ll call to be sure if my assumption is correct. I’m not afraid of dentist or anything like that, but it’s the costs that I can’t really afford currently (I have some money saved, butI’m studying a programming language to try to get a job in that area). I also think that they might make their best to take as much money as possible from me or that I might experience some problem(s) after they’d “fix” my teeth problem which maybe I wouldn’t have experienced otherwise (well, I’m worrying about many things in general though).

        I read about fluoride before and I was aware that this toothpaste has it. The thing is, like pretty much with everything, there’s people (and studies?) that says that fluoride is good and fluoride is bad. At this point, I no longer know what to believe into and it’s like I have to choose a side and believe in it. Currently I don’t know what to believe in regarding fluoride, but considering that I got some teeth problems, I’ll continue using toothpaste with fluoride. Maybe I’ll stop using one with fluoride after I get rid of my teeth problems and see how it goes.

        The reason I chose this toothpaste was mainly because it doesn’t have many ingredients (and the ones it has aren’t bad from what I read, except possibly fluoride), it’s vegan, has Xylitol and baking soda which I’ve never tried before and it’s accesible (I can get it from a close supermarket and don’t have to order online and pay shipping fee too or go far away to buy).

        I’m glad to hear your opinion about Xylitol. Have you tried it too before? Hmm, I think I’ll consider using Xylitol crystals and also Xylitol gums (I’m looking at the Xlear Spry brand but the way, which is vegan and the best I could find here, online), so that I’ll spend much less on Xylitol gums as it would be too expensive for me to use only gums since 1 gum seem to have either 0.72g or 1g Xylitol and I read that the recommended daily dose is 6-10g. The cheapest way is with Xylitol crystals, but as you’ve said, the gum is better.

        I don’t know what helped or if it’s just temporary, but since I woke up today and as of typing right now, I got no more teeth pain at all. It wasn’t a very strong pain, but it seems to be kinda gone now and I didn’t notice any pain at all after breakfast (oatmeal + banana + walnuts + frozen raspberries and strawberries) compared to previous day when I did. I’ll see how it will go the whole day. I’m washing teeth slower, more (I think it takes me about 5 mins now or so versus maybe 30s – 1m or less previously lol) and better, rinsing mouth with water and then mixing 2g Xylitol with a bit of water and then swishing it 5-10 mins after every meal and stopped eating popcorn.

        PS: I’m almost 25 years old.

  12. Off topic:
    I signed up for online Netflix recently. Years ago I got Netflix DVD’s in the mailbox. I thought it would all be online by now. I thought wrong. To get educational DVD’s I will need to order them to my mailbox. By “educational,” I mean Dr. Greger’s presentations, NOVA, Nature, PBS, History and so on. I assume Netflix is the way to go.
    I live rural and have a hotspot router for my laptop. I have antenna TV but my TV is Smart. Scuttlebutt is that free WiFi may go rural in some months. If so, that may save me $160 / month. That’s a big savings for someone semi-retired.

    1. Dan C,

      My coworker still does Netflix DVD’s and he also streams.

      I can’t afford wifi yet and nobody will understand that. I don’t have cable or internet nor a landline.

      I have been spending my money trying to get my ducks in a row.

      I just pulled the trigger on my generator and I am still researching the best way to go off-grid.

      Inwardly, I have such a strong sense that I need to prepare these things now, before health issues or inflation or recession or both.

      My coworker keeps saying, “You can afford Netflix” but I can’t even afford the time to do Netflix because I already am just trying to learn all of the nutrition and food shopping and look at recipes and learn about how to get rid of utilities and every other thing.

      I haven’t missed anything since I cut the cable.

      Between YouTube videos and this site, I already have my hands full.

      I strongly feel like more of my friends are going to go homeless and it is important that it not be all of us.

      I watched the latest episode of America’s Got Talent and there was a man who had a stroke and lost his ability to work and he ended up recovering from his stroke as a homeless person. I am contacting that organization about WFPB.

      https://www.youtube.com/watch?v=Pf8SPfrJrYs&t=61s

      People who are poor cannot recover from medical things the same way.

      Another man I watched had been homeless from losing his job from health problems, and got a job, but ended up in the hospital again and lost his job again.

      It is daunting to get back from homelessness and so many older people get there with their first stroke or heart attack.

      1. Deb,
        So you do not have Internet. With the power outage you still posted to this site, which means maybe that you posted via your phone. But you were doing that anyway? If so, I find that to be amazing.

        1. Yes, I was using a cell phone and a generator running several hours of the day. I can’t read things all that well on my cell phone but it still works.

          I wasn’t watching the videos so that I could not go over my data plan. Transcripts are very appreciated even if I missed a few words here or there.

        2. Dan,

          This was the ONLY site I could get to most days. I was so happy that I start and end here so that I wasn’t stuck on Lowes looking at generators all day long.

  13. Dear Dr Greger and team.
    I don’t know where else to post this, but I have recently been hospitalized for gallstones, and of course I look to Nutritionfacts.org to get details on anything to do with diet. I cannot find information on the gallbladder, gallstones, and very little on the liver. I am seriously looking for answers, and wondered if you knew about the liver cleanse or detox? Or had any other information I could use. I really want to avoid surgery, I am vegan and have normal weight. Can you find any research for me?
    I have all your books!
    Much love
    Keep up the brilliant work you do
    E. A. Knappert

    1. Lizzy,

      Boy, you are the third person who has said a sentence like that this week but you are the first vegan to say it.

      Meat eaters get them twice as often because cholesterol is one of the culprits.

      Question #1

      Are you juicing or doing smoothies meaning are you eating enough fiber or are you processing your foods so that the fiber is removed?

      https://www.vegetariantimes.com/health-and-nutrition/avoiding-gallstones-might-be-easier-than-you-think

      https://www.pcrm.org/good-nutrition/nutrition-information/lowering-cholesterol-with-a-plant-based-diet#:~:text=Plants%20are%20also%20rich%20in,good%20sources%20of%20soluble%20fiber.

      Question # 2 which is a list of questions but I don’t feel like counting them

      How about fats and oils? Refined grains? Do you cook with oil? Any fried foods? Processed vegans foods? Look at the fats and try to go low fat.

      https://www.healthline.com/health/gallbladder-diet

      Question #3

      Are you on birth control or hormonal replacement therapy?

      Question #4

      Are you diabetic with uncontrolled sugar? And if so, sugar intake can also cause NonAlcoholic Fatty Liver issues and palm oil and alcohol can cause the alcohol version.

      Question #5

      Do you drink any soda?

      I will put this link where it is linked to gallbladder issues

      https://www.nbcnews.com/health/health-news/sodas-linked-gallbladder-cancer-n608716

      Question #6

      Do you smoke?

      https://www.hopkinsmedicine.org/health/conditions-and-diseases/smoking-and-the-digestive-system#:~:text=Smoking%20increases%20the%20risk%20for,stomach%2C%20pancreas%2C%20and%20colon.

      Question #7

      Do you drink enough water?

      https://www.medicalwesthospital.org/the-dangers-of-dehydration.php#:~:text=Gallstones%2D%20Similarly%20to%20blood%20vessels,in%20the%20formation%20of%20gallstones.

      Dr. Greger has one video on the FFA’s and insulin resistance being lower by avoiding animal products there is a doctor on YouTube whose name…. begins with an L…. I think…. it is on the tip of my tongue, but he has the fructose cause of the NonAlcoholic Fatty Liver and they both can cause it and Mic The Vegan has a version where he talks particularly about Palm oil which is big in the Vegan community and that is NOT good.

      1. I should have added that I am not a doctor, I am a person whose friend called bawling at 1:30 in the morning with symptoms of Lyme Disease and Gallbladder problems and she does turn out to have both.

  14. One of Dr Gregor’s messages is that doctors should “say it as it is” and not sugar coat the truth to make it more palatable for people. In other-words give people the best available science and let them make the decision. That is why I am highly disappointed that Doctor Gregor did not follow his own advice in the following interview: https://www.youtube.com/watch?v=97HiavAClUk . Rich Roll asked many times in the interview what we needed to do to prevent a pandemic and to protect ourselves from a pandemic. The actual answer that should have been given by Doctor Gregor without “sugar coating” Everybody should stop eating animal products i.e meat, dairy, fish, eggs and convenience foods and convert to a whole food plant based diet. This would largely prevent animal viruses making the jump to humans and also reduce the risk of people dying from a virus by reducing obesity, hypertension, cardiovascular disease and diabetes.

    Instead Dr Gregor suggested first such things as pigs having hay, animals for food having “social distancing”, people wearing masks, ventilation in rooms, eating meat substitutes etc, etc etc with only a very brief passing mention of whole food plant based diet. The advice for people following a wholefood plant based diet was the last thing mentioned on the list of Dr Gregor’s recommendations – and stated only in cursory passing manner – like it wasn’t that important.

    The message should have been clearly articulated without the pussy footing around the point. I suggest Dr Gregor follow his own advice and tell people the best available facts without the sugar coating, side-stepping that he did in the above interview with Rich Roll. Give people first and foremost the best advice based on the science and keep it at that. No more sidestepping and placating as Dr Gregor did in the above interview – People need to convert to whole food plant based diet. Period.

    1. Dr JB,

      His Rich Roll interviews are some of my very favorite.

      That being said, as someone who comes from a family where everybody HATED vegan and vegetables, many, many, many people really do need to not feel pressured.

      I am one of them. I came here announcing that I would not give up dairy and would not go vegan and he was so charming and entertaining that he got someone with zero health interest to camp out here for heading toward 3 years. I never ate one bite of anything for health issues until I came here and I am not a young person.

  15. I also posted this in the blog: Unrelated to above, I heard an carnivore diet advocate (Dr. Paul Saladino) who noted that Hong Kong has the highest longevity and highest meat consumption in the world, which I found shocking. Wondering if Dr. Greger could address this seeming paradox in a podcast.

    1. giguy,

      I read a statistician talking about it and he said that the real answer is that they have the absolute lowest child mortality of any nation and not having infants die skews the final answer considerably.

    2. I am going to add in:

      You have to look at smoking, air pollution, toxins in the environment, RoundUp, accidents, murders, suicides, genetics, sodium, obesity, etc.

      A few things I noticed.

      For instance, few people smoke and smoking is not allowed in public areas indoors and many outdoor areas. Never smoked was 98% females and 96% males

      Drinking is very expensive in Hong Kong and fewer than 10% of the people drink.

      Hong Kong has about 50 fatal car accidents per year. Well over half of the people in Hong Kong don’t drive.

      They don’t have “death by doctor” on their list, versus in the USA it is pretty high.

      Suicide is very low and murder is low, people aren’t allowed to own guns unless they are law enforcement.

      They have the lowest murder rate in the world

      Their prison system is dropping every year and most of their prisoners are from other countries – people who overstayed visas or worked as prostitutes were the sample list.

      The elderly people are generally taken care of by their children versus being put in nursing homes.

      It is interesting reading about them as a city.

      I wish I knew a really good math person who could adjust for all of that and then look at diet.

      1. Medical care is FREE for everyone in Hong Kong

        https://www.internations.org/go/moving-to-hong-kong/healthcare#:~:text=There%20are%20no%20financial%20contributions,but%20also%20non%2Dpermanent%20residents.

        And it is VERY tech-oriented.

        https://www.healthcareitnews.com/news/evolution-health-it-hong-kong%E2%80%99s-hospital-authority

        One of the things that I LOVED reading is that they have AI robots do the diagnosing most of the time and if those get stumped, the person can get a video chat with a doctor who can tell them if they are having a stroke or a heart attack. Most of it is done at home. That has to save so much money.

        I was reading that there is a trend that people can recover at home from COVID in the USA and the doctors and nurses will do that video process and it saves 1/3 of the cost. I have been researching it because if I find out in a day or two that my father has COVID, his wife not being able to walk on her own may make him not want to go.

        They can even do ICU care at home with computers monitoring.

        1. The concept that Hong Kong already knows that their algorithm is accurate 80% of the time for common illnesses, they can make another algorithm to deal with the ones that trick them soon. People can get 24/7 virtual medical appointments. That is excellent.

          Doctors not having to step in until things are more serious seems like it would decrease medical error.

      2. I also saw that Hong Kong had a big push for flu and pneumonia vaccines changing rates from less than 3% vaccinated during the period 2000–2002 increasing to more than 50% in 2004–2006

        They estimated that it resulted in a 30% reduction in complications after influenza infections and a 40% reduction of influenza-like illnesses, and 50% reduction in laboratory-confirmed influenza infections, specifically during influenza epidemics

        https://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-019-3735-7#:~:text=Since%20October%202009%2C%20a%20subsidy,%2F13%20season%20%5B13%5D.

    3. That’s probably true about HK and current meat eating levels. It’s a bit like saying the Okinawans (now) eat lots of pork and other fatty foods. It’s all perfectly true but it’s also misleading.

      HK has become very wealthy with China’s economic boom of recent decades and more people are eating rich people’s diets. HKers also benefit from extensive government health, housing and other social welfare services inherited from the time of British administration.

      However, it takes perhaps 50 years of eating the Standard American Diet before the adverse health effects start showing up with a vengeance. What were older people in HK (or Okinawa) eating for most of their lives? It probably wasn’t a meat heavy diet. There’s a lengthy lag effect with diets and the true effects of HK’s shift to a meat heavy diet probably won’t be seen for decades to come.

      What happens in places where heavy meat consumption is of long-standing though? This study below tells us

      ‘Background: High red meat consumption is associated with a shorter survival and higher risk of cardiovascular disease (CVD), cancer, and all-cause mortality. Fruit and vegetable (FV) consumption is associated with a longer survival and lower mortality risk. Whether high FV consumption can counterbalance the negative impact of high red meat consumption is unknown………………………………
      Conclusion: High intakes of red meat were associated with a higher risk of all-cause and CVD mortality. The increased risks were consistently observed in participants with low, medium, and high FV consumption.’
      https://academic.oup.com/ajcn/article/104/4/1137/4557128

  16. Also, doing the whole diet may not tell the whole picture.

    Meaning that it doesn’t mean that what we have been studying is wrong. For instance, with lung cancer in Hong Kong: In studies in Hong Kong, a diet with higher intakes of fresh fruits, vegetables, and fish seems to ameliorate the risk of lung cancer. Just like Dr. Greger said in this video.

    So the fact that it can look like they get the benefits without having to eat the vegetables isn’t the truth. Yes, not smoking is even better, and they do that.

  17. It would take a skillful analysis because, for instance, Hong Kong has started seeing an increase in strokes in younger people. Plus, their rates of each disease has to be put in context to see whether they are squandering any genetic advantage. For instance, in stroke they have double the rate compared to mainland Chinese and Japanese women. They eat too much salt, for sure and their hemorrhagic stroke levels tell on them.

    There are paragraphs describing the disturbing trends in the young people and THAT shouldn’t be happening if they are going in the right direction by eating more meat. Seems like there might be a smoking gun someplace. Some clever minded doctor could probably turn it into a good webinar.

    https://www.researchgate.net/publication/49662057_Trends_in_Stroke_Incidence_in_Hong_Kong_Differ_by_Stroke_Subtype

  18. It seems like you would have to look at the rate of stroke and heart attack and diabetes and obesity for people under 65 in Hong Kong versus their elderly population.

    Diabetes was easy: They said that they found an increase in the incidence of Type 2 Diabetes in youth and young adults in Hong Kong and stabilization in older adults. Plus, the incidence of Type 1 Diabetes continued to climb in youth but remained constant in adults.

    So, so far, increasing meat made the old people live forever and is increasing strokes, and diabetes.

    Oops, cancer is increasing in Hong Kong, too.

    https://www.scmp.com/news/hong-kong/health-environment/article/3035624/number-new-cancer-cases-rises-10-year-high-hong

    https://www.cancer-fund.org/en/blog/cancer-rates-in-hong-kong-continue-to-rise-as-global-cases-hit-a-high-of-14-million/

    And it is strikingly worse in the young people

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2364319/

    The rise in relative risk was seemingly linear in successive birth cohorts, showing a 2–3-fold difference when comparing women born in the 1960’s with those born around 1900. They suggested that direct and indirect consequences of westernization may have been responsible for most of the increase in breast cancer incidence.

    Same thing with colorectal cancer.

    Well, I can’t solve this whole thing tonight, but I did my sample fight for the WFPB logic as modeled by Dr. Greger in the first video I watched of his.

  19. If you can find any age-period-cohort modeling charts, I would be so happy.

    The 2–3-fold difference in breast cancer when comparing women born in the 1960’s with those born around 1900 sounds like my family.

    Now, I have a name for it. “Age-period-cohort modeling” the explanation why all of the women born around 1900 lived into their nineties and so did the ones born in the 1920’s and 1930’s, but from the mid 1950’s and even more in the 1960’s they started losing the longevity but didn’t know it because there were so many 90-year olds and the young people didn’t die until around 50.

  20. Since the old people have already faced every cge range it might be possible to show the difference between when the elderly first developed each disease to predict the lowered mortality.

Leave a Reply

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

Pin It on Pinterest

Share This