Four Nuts Once a Month

Four Nuts Once a Month
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A single serving of Brazil nuts may bring cholesterol levels down faster than statin drugs and keep them down even a month after that single ingestion.

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This is one of the craziest articles I saw all year. A single consumption of high amounts of Brazil nuts improves the cholesterol levels of healthy volunteers. OK, that’s interesting. They gave 10 men and women a single meal containing zero, one, four, or 8 Brazil nuts, and found that the ingestion of just that single serving almost immediately improved cholesterol levels. LDL, so-called “bad” cholesterol levels in the blood were significantly lower starting just nine hours after the ingestion of nuts, and by no insignificant amount, nearly 20 points within a day. Even drugs don’t work that fast. It takes statins like four days to have a significant effect. But that’s not even the crazy part. They went back and measured their cholesterol five days later, and then 30 days later. Now keep in mind they weren’t eating Brazil nuts this whole time. They had just that single serving of Brazil nuts a month before and their cholesterol was still down 30 days later. It went down and stayed down, after eating just four nuts… That’s nuts!

And no, the study was not funded by the Brazil nut industry.

Interestingly, four nuts actually seemed to work faster than the 8 nuts to lower bad cholesterol and boost good cholesterol. These results suggest that eating just four nuts might be enough to improve the levels of LDL-c and HDL-c for up to 30 days, and maybe longer—they didn’t even test past 30.

Now normally, when a study comes out in the medical literature showing some too-good-to-be-true result like this you want to wait to see the results replicated before you change your clinical practice, before you recommend something to your patients, particularly when the study is done on only 10 people, and especially when the findings are literally just too incredible to be believed. But when the intervention is cheap, easy, harmless, and healthy—eating four Brazil nuts a month—then in my opinion, the burden of proof is kind of reversed. I think the reasonable default position is to do it until proven otherwise, so now every month I eat four Brazil nuts. In conclusion, a single serving is sufficient, without producing liver and kidney toxicity. I should hope not, but what they’re referring to is the high selenium content of Brazil nuts, so high that four eaten every day may actually bump us up against the tolerable daily limit for selenium, but not something we have to worry about it we’re just eating four once a month.

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.

Images thanks to Allison J-B via Flickr.

This is one of the craziest articles I saw all year. A single consumption of high amounts of Brazil nuts improves the cholesterol levels of healthy volunteers. OK, that’s interesting. They gave 10 men and women a single meal containing zero, one, four, or 8 Brazil nuts, and found that the ingestion of just that single serving almost immediately improved cholesterol levels. LDL, so-called “bad” cholesterol levels in the blood were significantly lower starting just nine hours after the ingestion of nuts, and by no insignificant amount, nearly 20 points within a day. Even drugs don’t work that fast. It takes statins like four days to have a significant effect. But that’s not even the crazy part. They went back and measured their cholesterol five days later, and then 30 days later. Now keep in mind they weren’t eating Brazil nuts this whole time. They had just that single serving of Brazil nuts a month before and their cholesterol was still down 30 days later. It went down and stayed down, after eating just four nuts… That’s nuts!

And no, the study was not funded by the Brazil nut industry.

Interestingly, four nuts actually seemed to work faster than the 8 nuts to lower bad cholesterol and boost good cholesterol. These results suggest that eating just four nuts might be enough to improve the levels of LDL-c and HDL-c for up to 30 days, and maybe longer—they didn’t even test past 30.

Now normally, when a study comes out in the medical literature showing some too-good-to-be-true result like this you want to wait to see the results replicated before you change your clinical practice, before you recommend something to your patients, particularly when the study is done on only 10 people, and especially when the findings are literally just too incredible to be believed. But when the intervention is cheap, easy, harmless, and healthy—eating four Brazil nuts a month—then in my opinion, the burden of proof is kind of reversed. I think the reasonable default position is to do it until proven otherwise, so now every month I eat four Brazil nuts. In conclusion, a single serving is sufficient, without producing liver and kidney toxicity. I should hope not, but what they’re referring to is the high selenium content of Brazil nuts, so high that four eaten every day may actually bump us up against the tolerable daily limit for selenium, but not something we have to worry about it we’re just eating four once a month.

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.

Images thanks to Allison J-B via Flickr.

Doctor's Note

I’d be curious to hear if anyone experiences similar results. Even if the study was just a fluke, Nuts May Help Prevent Death by improving the function of our arteries (Walnuts and Artery Function) and fighting cancer (Which Nut Fights Cancer?) and inflammation (Fighting Inflammation in a Nut Shell).

Even eating nuts every day does not appear to result in expected weight gain (Nuts and Obesity: The Weight of Evidence), so enjoy!

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

208 responses to “Four Nuts Once a Month

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  1. “four nuts actually seemed to work faster than the 8 nuts”

    That red flag (dose-response) as to the validity of the effect is at least as large as the 30-day duration.




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    1. I agree. Also, the researchers were all Brazilian – maybe they weren’t funded directly by the nut industry, but maybe their Universities funded the work through a foundation supported by the government, who also wants to promote the industry. Also, the LDL levels were pretty low to start with. This brings up the concern, as always: What was the background diet of these eaters? Was the low LDL a result of Lipitor, other meds, a good diet, or what? The food industries have a nasty way of stacking the trial to get the results they desire. For those eating a whole foods, low fat, vegan diet, this sort of food chemistry manipulation is unneeded and maybe harmful. In my view, this is the dark side of diet manipulation. Let’s get back to eating a whole foods, low fat (less than 15% of calories), balanced diet of grains, vegetables, fruits, and legumes. Some daily ground flax seeds with a B12 cap is a good idea, and an english walnut now and then makes a nice treat. See Jeff Novick’s video titled “From Nuts to Oil” if you want to learn about fats in your diet.




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      1. It doesn’t seem difficult to remain below 15% calories from fat while eating MORE THAN one walnut per day (assuming no or minimal fat from other sources). Seems that Dr Greger recommends two handfuls of nuts. Also, I understand below 25% from fat to be considered low-fat. No?




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        1. Depends on what you want to mean by “low-fat.” Proponents of low-fat plant-based diets generally mean less than 20%, and often less than 15% when other aspects of the pattern are typical.

          I’ve heard McDougall estimate his diet recommendations to result in 7% energy from fat, and given his general stance on fat, I’d anticipate his bias to underestimate the amount if anything. It seems Greger regards a handful of nuts as an ounce: http://nutritionfacts.org/questions/what-is-the-definition-of-a-handful-of-nuts/ . 2 oz walnuts is 333 calories and 90% fat: http://ndb.nal.usda.gov/ndb/foods/show/3720?fg=&man=&lfacet=&format=&count=&max=25&offset=&sort=&qlookup=walnuts .

          So, to be 25% fat or less, a 2000 calorie diet with 2oz walnuts would have to be no more than 10% fat in the non-nut portion. I’d say that it’s not necessarily easy to be less than 25% fat with two handfuls of nuts. It would seem to impose some serious restrictions on the greediness of your handfuls and the composition of the non-nut portion of your diet.




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          1. Such debates somehow remind me of the medieval Scholastics absurd quibble on the dogmas of the Catholic Church. The 11th Commandment: You must not eat more than 15% calories from fat. ;D




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            1. Just one happy Catholic grateful for quibbles that lead to TRUTH! May these quibbles here do the same and can we stay on topic and be tolerant of Christians please? Many thanks




              3
              1. Huh? Why should any Christian or even Catholic feel offended by what I wrote? Does your understanding of Catholicism exclude any kind of irony towards the history and doctrine of the Catholic Church? If so, you have a more fundamentalist attitude towards Catholicism than the Pope himself. I am tolerant of any religion but not of fundementalists incapable of irony.




                6
                1. Come on Timar, you clearly tried to hijack the conversation with a jab at Catholicism, and Charity called you on it. You said the discussion reminds you of some black legend of Catholic history, the absurd quibbling of dogma. But while your comment contributes nothing to the issue of nutrition and rather simultaneously vilifies Catholicism and reasonable debate, what does this remind people of?

                  If they were like you and felt themselves familiar with the history of religion, your comment may remind people of the protestant propaganda tactic to vilify Catholicism for the use of reason, citing Martin Luther who referred to reason as “the devil’s greatest whore.” Are we to surmise that because your vilification of reason and catholic dogma reminds some people of a protestant propaganda tactic, that you are really not reasonable at all and rather spreading protestant propaganda here? I don’t think most people would surmise that, because most people are far more willing to give benefit of the doubt and far less likely to jump to some obscure religious similarity. Regardless, the connection to previous protestant religious history to discredit your comment is no less legitimate than your attempted connection to previous Catholic religious history to discredit the comments of others.

                  I can’t speak for what your comment really reminds other people of, but since you based your entire comment on what the discussion reminds you of, I will do the same. What your contribution to the discussion reminds me of is Bill Maher’s blatant jabs at religion, thinking people are so stupid that they don’t see what he’s doing, so that when fellow Atheist S.E. Cupp called Maher out for attacking religion, he did the same thing you’re doing. He tried to innocently pretend, despite clear evidence to the contrary, that he didn’t attack religion, so why would anyone be offended?

                  I hate to break it to you, Timar, but Theist or Atheist people are not that stupid, to simply leave off a discussion because you have authoritatively deemed it with the scary “just like Catholic dogma” label and as they walk away from the discussion they will be too naive to realize you took a jab at religion in the process. Charity for one proved this point, and while I’ve long since stopped wasting my time with disingenuous comments like yours, and most people understandably ignore them so as not to feed the troll, I have to add my voice to stand up to this type of hit and run on religion in general and Catholicism specifically, not just because it is riddled with errors and attempts to manipulate perception on the issue of religion but because it is too often used to detract from and discourage legitimate and healthy debate on a host of unrelated but significant issues like nutrition.

                  This issue had nothing to do with religion until you drew some tortuous parallel to Catholic history almost as if you were obsessed to somehow see in anything that annoys you some precedent and twisted root in Catholicism; for you to write off previous, reasoned debate that led to the development of dogma as ‘absurd quibbling’ reveals almost as much about your anti-Catholic bigotry as it does about the pseudo-historical worldview upon which it is based.

                  Perhaps you would prefer dogma did not develop along the lines of reasoned debate? How should it have developed then, by people like yourself stepping in and saying “no more debate, it’s all just quibbling, just do as I say!” This is characteristic of trolls that try to hijack discussions or debates about science, medicine, or nutrition and somehow try to discourage or vilify a position (or in your case vilify the very process of people from various perspectives engaging in reasoned debate) as if it ‘reminded them’ of some black legend of the evil or ignorant or absurd or ironic or (insert stereotypical anti Catholic talking point here) Catholic Church.

                  Like Charity said, reasoned debate is a good way to come to the truth whether in religious dogma or in secular matters, most reasonable people can appreciate that. Sadly, there are those trolls that discourage reasoned debate as it if were nothing but “absurd quibbling” because they have nothing reasonable to contribute and to cover for this lacking, they vilify the process of debate by playing the religion card.

                  Look again at this issue and the comments. You are the only one that brought religion into this, and likely due to the hope that your hit and run would go unchallenged or if it was challenged, confident in the false security that you would be able to enlighten and educate everyone on the evil, ignorant, absurd, or ironic Catholic Church. When people can’t get others to listen to their feeble arguments in appropriate forums that are devoted to the issue of religion where they are quickly disillusioned of their stereotypes and their fallacious premises, it is all too common to try to inappropriately misdirect conversations anywhere they can, even in a discussion about nutrition.

                  If upon seeing a reasoned debate about nutrition, you immediately see it as a religious thing and thus a bad thing, and can’t stop yourself from drawing some belabored parallel to religion, and can not control the obsessive urge to spew that out in a comment … the problem isn’t with debate, the problem isn’t with religion, the problem is that you have been indoctrinated to read a vilified caricature of religion into anything that displeases or annoys you. The problem is you’ve been further conditioned to act out in accordance with this obsessively twisted distortion of history, religion, and now infecting nutrition by leaving comments such as yours. You have become, while attempting to appear reasonable and knowledgeable via the inclusion of references to Scholasticism, someone who has proven yourself grossly misinformed and not only unreasonable but with your discouraging of reasoned debate, rather anti-reasonable. For someone who claims to grasp irony, you are rather ironically ignorant.




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                2. Timar, your comment, “medieval scholastics absurd quibble on the dogmas”, merits the observation– quite aside from thomas — you have made a sweeping generalization about the scholastic method which, itself, is absurd. The comment shows little but a second-hand, anecdotal acquaintance with the method, itself. The scholastics were guilty of exploring the power of reason to reveal the nature of God, but not of defining God by reason, alone– a fundamental distinction with a profound difference.




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      2. Brazilian researchers studying ‘Brazil nuts’?
        Hmmm… I maybe cannot SAY that there’s an ‘implied’ COI or background bias, but somehow, the green flag hasn’t appeared yet.

        Ecological benefits, to be sure. What thereapeutic intervention(s) does or might this protocol displace?




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        1. The researchers are not really doing much for the Brazil nut industry, and Brazil nut consumption in general, with this study, when the indications are a very meager intake will do the job.




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      3. I would try this, but would eat more than four nuts a month! My cholesterol is genetic, and I don’t think four nuts a month would do it! Doctor has me back on a statin (generic Lipitor, first time taking it!), because it had climbed again–but I don’t intend to take it for long. Back to flax seeds, B12, and coconut and other oils, and now brazil nuts. I am a vegetarian/vegan and have to be mindful to get all the nutrients I need, which is kind of difficult. I have also began to stop eating processed grains again; that affects me and my weight! Thank you for this!




        0
        1. You may be interested in the work of Ornish, Esselstyn, and McDougall who have shown consistent success in improving cholesterol levels and overall cardiovascular health with dietary intervention. Their diet consists of no oils of any kind, limited nut consumption, and lots of carbohydrate in the form of whole grains, beans, and tubers. McDougall and Esselstyn prescribe a vegan protocol, while Ornish allows limited animal foods in the form of low fat dairy and egg whites. The books Prevent & Reverse Heart Disease by Esselstyn and The Starch Solution by McDougall are good places to start. For concerns about micronutrient intake, cronometer.com is also a very useful tool.




          1
        2. You may also benefit from Drs Abram Hoffer and Andrew Saul’s work. It’s called ‘NIACIN: The Real Story’. A good deal of the book talks of wonderful results from Niacin (Vitamin B3) for a variety of ills but particularly cholesterol problems.




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          1. I’m also interested in Niacin, but haven’t seen any comments from Dr. Gregor on it, despite putting some questions on his site.




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        3. If you buy in bulk, you can limit the purchase to only 4 that way you are not tempted to eat more. If it helps lower your cholesterol great if not, it’s just a little treat eaten once a month.




          1
        4. I used to think my high cholesterol was genetic. Turns out we don’t inherit high cholesterol, we inherit our bad diet. Doing Dr. McDougall’s program (there are many lectures of him going over the science on YouTube and his books), my cholesterol is now normal and don’t need statins. Whole Food, plant based, no oil, sugar or salt. I am also gluten free. If you add exercise and meditation you might live to be a very old person in very good health off of all meds. Still plenty of yummy things to eat. Your genes are not your destiny, you lifestyle habits are. Good luck. You’ve got this.




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        5. Barry Bonds claimed that he grew so big by eating flax seeds. Be careful. Even your head will grow, as his did, if you eat too many. I have always eaten them, too, but, somehow, I never got very muscular.




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      4. Ummm, Doctor Dave, let’s put this into even better perspective. You’re claiming that there should be red flags because a Brazilian university published a study stating the possible benefits of eating four nuts (which happen to be called “Brazil nuts” in English) over a thirty-day period.

        Why would any sane government, food producer, or especially a university with its reputation on the line choose to “manipulate” or ” stack” the numbers in their research in order to get people to eat four nuts a month? This would do very little in terms of sales. Why not stack it to say four a day? Besides, for many, this would drastically decrease their consumption of Brazil nuts.

        Just a thought, Doctor Dave.




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      5. Please state more precisely in which way eating four(!) brazil nuts(!!) a month(!!!) is to be considered as “food chemistry manipulation”!? I’d be very interested in your explanation.

        It is preposterous to suggest that some sort of “brazil nut lobby” is behind this study. Brazil nuts come from wild collections in the rainforest, mostly by indigenous people, for whom brazil nuts are an important income they derive from the intact forests. Sadly, those poeple have the least political influence in Brazil. As we all know, the are vastly more powerful interests in the clearance of these forests for short-term profit from wood and soy plantations which drive the goverment’s politics.




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        1. You’re right to be suspicious of everything and everyone but Brazil nuts are not the only food that lowers cholesterol. You can obtain satisfactory results eating avocado and steel-cut oats. And make sure you don’t eat scrambled eggs, ever! Their cholesterol oxidises in the frying process leading to raised levels of LDL.




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          1. Is a four-egg omelet o.k? Sometimes I do that, and I feel pretty good.
            Also, who can afford avocados anymore? I used to try an eat one every day, but now, only Rockefeller can afford them. I can’t.




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      1. dose response is one factor that lends credibility to a cause-effect relationship..if the dose goes up, and the effect goes up, and if the does goes down the effect goes down, it indicates cause and effect. In this case, the dose goes up, but the effect goes down. 4 nuts was better than 8. This means that less of the chemical in the nuts made a larger effect than more of it. It’s fishy, or a ‘red-flag’, meaning tends to decrease credibility of cause and effect.




        3
        1. I remember seeing in one of the videos that the absorption of animal proteins are nearly unrestricted by the intestinal lining compared to plant proteins. Would it be possible then that nutrition would also be limited if certain nutrients were at their tolerable limit for the body? Or maybe the boost in consumption from 4 to 8 nuts caused absorption to slow with quantity due to longer digestion time as well? Just throwing in some thoughts that I had while watching the video.




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        2. I don’t see how it rules out an ideal amount of 4. What of the body responds to the high selenium levels from 8 nuts and does something to halt all absorption? Eating too much of a lot of good things causes bad reactions.




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        3. Could well be similar to that “U” shaped curve on Vitamin D benefits. There is a sweet spot in the mid range; both more and less than that lead to increased disease risk.




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  2. What about for vegans who already have low cholesterol levels, both HDL and LDL. And in vegans who have levels considered
    to be too low? Could ingestion of nuts actually go in the other direction, as is being implicated in causation for driving cholesterol levels too low in vegans? As well as hindering a vegan’s ability to raise up their “too low” cholesterol levels? And what exactly is it in brazil nuts
    that allows this drop? Are other nuts capable of causing the same reduction in cholesterol as the brazil nuts?




    0
      1. In the low 100’s, total cholesterol. Seems to be going even lower. Yes, there is debate on what is too low – not sure
        who to trust on this, but there is science implicating too low cholesterol as causation for depression, suicide.
        Maybe this is a non-issue, and that I should be happy to be vegan. I’d really like to know a plant-based
        doctor’s view of what exactly is considered “too low”?

        Risks of Low Cholesterol

        What happens when cholesterol is too low? According to the Mayo Clinic, low levels of LDL cholesterol may increase your risk of cancer, depression, anxiety, and preterm birth and low birth weight. A study published in the Netherlands showed that middle-aged men with low cholesterol were more likely to experience severe depression, while an earlier study at the Duke University Medical Center showed that young women with levels below 160 mg were more likely to have depression and anxiety than women with normal or high cholesterol.

        Recent studies from Germany linked low cholesterol with increased risk of agression, impulsivity, depression, and suicide. Other research shows that extra low levels can increase risk of Parkinson’s disease, stroke caused by bleeding in the brain, infertility and decreased libido, osteoporosis, hyperthyroidism, chronic indigestion, and nutrient deficiencies of fat-soluble vitamins.

        Sources
        “Cholesterol Facts,” Centers for Disease Control and Prevention, http://www.cdc.gov/cholesterol/facts.htm.

        “What is Cholesterol? What Causes High Cholesterol?” Medical News Today, May 29, 2009, http://www.medicalnewstoday.com/articles/9152.php.

        Mayo Clinic Staff, “Cholesterol levels: What numbers should you aim for?,” Mayo Clinic, September 21, 2012, http://www.mayoclinic.com/health/cholesterol-levels/CL00001.

        Schatz IJ, et al., “Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study,” Lancet, 2001 Aug 4;358(9279): 351-5, http://www.ncbi.nlm.nih.gov/pubmed/11502313.

        “Cholesterol Levels and Deaths: A Bit of a Shocker,” University of Medicine and Dentistry of New Jersey, August 2002, http://njms2.umdnj.edu/hwmedweb/archives/CholMortality_archive.htm.

        Krumholz HM, et al., “Lack of association between cholesterol and coronary heart disease mortality and morbidity and all-cause mortality in persons older than 70 years,” JAMA 1994 Nov 2;272(17): 1335-40, http://www.ncbi.nlm.nih.gov/pubmed/7772105.

        Forette B, et al., “Cholesterol as risk factor for mortality in elderly women,” Lancet, 1989 Apr 22;1(8643): 868-70, http://www.ncbi.nlm.nih.gov/pubmed/2564950.

        Weverline-Rinjsburger AW, et al., “Total cholesterol and risk of mortality in the oldest old,” Lancet, 1997 Oct 18;350(9085):1119-23, http://www.ncbi.nlm.nih.gov/pubmed/9343498?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=3.

        Ulmer H, et al., “Why Even is Not Adam: prospective follow-up in 149650 women and men of cholesterol and other risk factors related to cardiovascular and all-cause mortality,” J Womens Health (Larchmt), 2004 Jan-Feb; 13(1):41-53, http://www.ncbi.nlm.nih.gov/pubmed/15006277?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=10.

        “Cholesterol: Can it Go Too Low?”, Dr. Weil, March 14, 2002, http://www.drweil.com/drw/u/id/QAA43423.




        0
        1. The newest way to look at cholesterol is not as high or low, it’s to look at the whole diet.

          Regardless of whether or not your cholesterol is high or low, people who eat a whole food, low fat, plant based diet have the lowest risk of heart attack, stroke, vascular disease, etc.

          Those that eat a high fat, high animal food diet that is low in fruits, vegetables, legumes and grains have the highest rates of vascular disease (eg. Coronary Artery disease, vascular disease, heart Attack, Stroke, Back Pain etc.)
          So it’s not how high your cholesterol is it’s how clean is your diet.

          Are you eating a varied whole food, low fat plant based diet? If you are then you have no reason to worry. The body is meant to heal and function at an optimal level and will not inherently kill itself unless directed to do so by a chronic inflammatory diet.

          I have never seen, nor has Dr. McDougall (my mentor) anyone following this type of lifestyle that has had any detrimental effects from “too low” a cholesterol.
          I hope this helps




          2
          1. Wow, thanks so much! This helps. I am wondering what you consider low-fat. One could eat 2 avocados a day
            and this only accounts for 42 percent of the RDA for saturated fat, and is 98 percent of the RDA for total fat.
            It seems to me that there are vegans who, by the end of the day, only take in about 20 percent or, even less, of the RDA for total fat intake. Is ‘this’ low intake healthy, safe, adequate? Thank you for any insight on this.




            0
            1. When I say low fat I mean about 10-20% of your calories come from fat. I don’t follow the RDA for anything. They are too behind the times as far as I am concerned. My patients that eat a varied, whole food, low fat, plant based diet and take Vitamin B12 (250mcg daily) and Vitamin D if they don’t get enough sun have all done very well not following any RDA.

              Regarding fat: For me, I might eat a quarter of an avocado once every 1-2 weeks. I have about 5-6 walnuts per day and usually a handful of peanuts (why, cause I like them). Rarely do I use any oil and if I do it is a little Olive Oil.

              The best way to track your fat intake is to take the time and enter all your food into the program Chronometer. This will give you your daily Carbohydrate, fat and protein intake. When I did this I found I was following an 80-10-10 diet (80% Carbohydrate-mostly complex, 10% protein and 10% fat).
              Again I hope this helps.




              1
          2. Possible that like blood sugar level, “too low” is attainable but only with drugs that reduce it (cholesterol or blood sugar)




            0
        2. I guess that’s why those rice-eating, aggressive/impulsive Chinese soldiers with super-low TC #s (see: The China Study) rushed across the border to kick our meat-eating, fat-clogged vessel butts over in Korea. They were obviously just depressed about us repelling their aggressive/impulsive, rice-eating neighbors.
          Makes me wonder what the average total cholesterol number is for typical North Koreans nowadays? Maybe that’s why they make so much trouble?




          0
        3. Are these studies referring to omnivores who would be expected to naturally have higher cholesterol levels? For them lower levels may indicate a pathological state. Whereas a person on a purely plant-based diet would be expected to naturally and healthfully have lower cholesterol levels.




          0
    1. I don’t think brazil nuts or any whole plant food would have a negative effect to your body’s system in any regard (unless you overdid them as some people have been known to even overdo water). Our bodies are very intelligent in design, give them what they need and they know exactly what to do. They’re designed to work with plants however, and when animal products are introduced, that’s when things get messed up.




      0
  3. Also interesting: the 10 subjects had a *baseline* total cholesterol mean ± SD of (6 men; 4 women) of 145 ± 4.8; 143 ± 6.7, and LDL-C of 87.7 ± 9.8; 84.5 ± 6.5. LDL-C after 30 days was in the 60s.




    0
  4. I have been eating 1 brazil nut each day as part of a WFPB diet for over a year now to get my selenium intake for the day. Do you think this is a harmful amount and I should go to 4 nuts a month? If not harmful would it be more beneficial to go to 4 nuts once a month rather than a daily brazil nut? I do make a very small amount of raw non roasted/salted nuts and seeds a part of my daily diet (walnuts, pecans, almonds, peanuts, hazelnuts, cashews, pistachio, sunflower seeds, and pumpkin seeds) but they don’t add up to more than a handful.




    1
    1. I was using Brazil nuts to top off my daily selenium but I noticed that eating more spinach and sweet potatoes worked instead of the Brazil nut. Not sure which of those two did it… but checking CRON-o-meter now… it was the spinach.




      0
      1. Tobias: Thanks for this tip! I hadn’t known that about spinach beforehand. Since I haven’t been too diligent about the Brazil nuts, I appreciate knowing that I have some other options too.




        0
          1. @tobias_brown:disqus @disqus_EXJURIXKLQ:disqus and Armando, I had done research on selenium in Brazil nuts so I posted above about the great variation of selenium in Brazil nuts, there’s a link to the more complete article.




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    2. I’d vote for one a week, to even out the selenium. It’s a trace mineral which the body will hoard up, so probably don’t need a daily dose just to ensure you have some. But, more interestingly, what is YOUR LDL cholesterol number like? It should be very very low if this actually works. Please post if you can….the LDL number?




      1
      1. Haven’t had it checked for about 6 months or so but during my last annual check up my doctor did mention it was quite low. I didn’t ask for the numbers though. I should have in retrospect. I’m up in Canada so I understand the numbering system for LDL cholesterol is different than the U.S. He was a bit concerned about my very low HDL level and was recommending fish oil but I wasn’t too concerned about that since people like Caldwell Esselstyn have remarked in the past that this is not an issue among relatively healthy people and has pointed to the very low HDL levels observed among the Tarahumara Indians to illustrate his point. Will be sure to ask for my numbers during my next exam and will post it here at that time. Thanks for the feedback all. I’m thinking I will maintain my daily routine so long as I’m not having an issue with my weight which I am not. Very interesting discussion.




        1
    3. a brazil nut a day should be more than fine. I know of a lot of people who do that (some even two or three) including myself (I eat one or two if they’re very small) to ensure selenium needs for the day. I haven’t had any problems nor heard of anyone having any problems. Since it’s a whole plant food, I doubt there’d be any issues unless maybe you did something crazy like 7 a day or something. Also, some brazil nuts are lower in selenium compared to others. I like Sunfood’s brazil nuts since they’re high in selenium. Now Foods has only a 70 %DV of selenium in a serving of their brazil nuts (which is probably about 3).




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  5. Brazil, where this study was conducted, has low soil selenium 1. In another country with low soil selenium, Finland, low plasma selenium has been associated with more than doubling of cardiovascular risk 2. While much credit for the 61% reduction in cardiac mortality in Finland since the 70s has been attributed to their reducing dietary fat content from 38% of energy to 34%, and saturated fat from 21 to 16% 3, they also started enriching fertilizer with selenium in ’85. A plausible mechanism for the benefit of adequate selenium is the Se containing enzyme GPx4, which helps metabolize oxidized LDL4.




    1
    1. Hi @disqus_PhKM1GHehI:disqus Very interesting, I think you will be interested in my post above with a link.
      PS: Did you write the above or paste it from a study. If the latter could you tell me where you pasted this from please? I would like the whole article. Thanks.




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      1. No, all my comments on NutritionFacts collect my own thoughts, and I try to link to the relevant sources (in this case, the highlighted numbers are links to the abstracts or full papers).




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        1. Exactly, I completely agree. If the above is what you wrote yourself, it seems very publication-worthy to me, even at least on a blog. Do you publish any of that somewhere @disqus_PhKM1GHehI:disqus ? If so drop me the link.
          As for the variations in selenium content of Brazil nuts, if single intakes of high amounts selenium are safe, and if selenium buffers somehow and averages in the body, then that would confirm the safety of selenium intake through Brazil nuts. But the variations need to be a studied in a real life context, i.e. sampling a wide range of brands. A study mapping Brazil nuts production could give a good idea what proportion of Brazil nuts in the world are high-selenium based on what is known of soil selenium.




          1
    2. Note that GPx4 is saturated only with an daily intake of ~100 mcg, roughly twice the RDA. The avarage US intake is about 100 mcg, but much of that comes from animal foods derived from animals eating feed supplemented with selenium[1].

      Vegans are therefore well adviced to supplement selenium – preferably in an all-natural and very tasty form. According a a study from New Zealand, two brazil nuts a day, providing 53 mcg of selenium (the actually measured the selenium content of the nuts used in the study as it can vary considerably between nuts from different regions) increased plasma selenium levels to the same extend as 100 mcg of selenomethionine. Remarkably the increase in in whole blood GPx was more than twice as high in the brazil nut group compared to selenomethionine.[2]

      Interestingly, selenium toxicity does not seem to occur even in Amazonian tribes eating large amounts of brazil nuts as a dietary staple and having plasma levels of selenium usually associated with symptoms of selenosis.[3] Another intruiging example where inherent safety of whole foods compared to isolated compounds challenges our reductionistic approach to nutrition.

      Last but not least, by eating brazil nuts you are actually helping to protect the Amazonian rain forest! That’s right – brazil nuts are hardly cultivatable and almost all of the world’s supply is from wild harvesting by native poeple. Hence the demand for brazil provides a much needed economic incentive to protect the rainforest.[4]

      1. http://lpi.oregonstate.edu/infocenter/minerals/selenium/
      2. http://www.ncbi.nlm.nih.gov/pubmed/18258628
      3. http://www.ncbi.nlm.nih.gov/pubmed/21856002
      4. http://www.treehugger.com/green-food/eating-brazil-nuts-protects-the-amazon-rainforest-literally.html




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      1. It’s believed highly bioavailable, though unless selenium “enriched” with fortified fertilizer, total levels are much lower than in the typical Brazil nut.

        See: Fairweather-Tait, S. J., Collings, R., & Hurst, R. (2010). Selenium bioavailability: current knowledge and future research requirements. The American journal of clinical nutrition, 91(5), 1484S-1491S.

        Mustard, onion and garlic absorb selenium from soils well enough that they’ve been investigated for bioremediation of selenium contaminated industrial sites.




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        1. @azdonald:disqus, @julotjulott:disqus See my post above with the link, the article I posted discusses the safety aspects and selenium doses in Brazil nuts.




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  6. If you have a question for Dr. Greger please post it as a comment under any video or blog post and check back often to see if Dr. Greger includes it in his “Ask the Doctor” column. Thank you Dr. G. Today there is news about a blood filter to remove bacteria and viruses using “a modified version of the protein mannose-binding lectin (MBL).” http://post.jagran.com/artificial-spleen-cleans-up-blood-infections-1410798344
    If this is a naturally occurring protein, as some sources say, what in the diet promotes production of that protein in our bodies?




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  7. I coached a pastor losing 164 pounds with a nutrition plan having 1 pound of walnuts a week. The start was difficult but he is a pastor and the body is the temple of the soul 380 Lb is too much,No ?. I told him “if you lose weight all the church will lose. ” He had pathological blood tests with high cholesterol. The answer to my prescription was “and I will lose weight with walnuts?”, answer YES, and you have German blood? answer YES,and do not come back if you are not following the nutrition plan. He lost 164 lb in 18 months with some additional 6 months of weekly discussion before to start , about barbecue and the scriptures and the other religions to end by eating organic vegetables , tree nuts and meet only for special events. he did not gain more than few pounds, and the people in the church shrunk.




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  8. I just weighed four of my small Trader Joes Brazil Nuts and got a total weight of only 7 grams. So I would have to eat 12 of these nuts to get the 20 grams in the study. I know it says online that the typical Brazil nut weighs 5 grams, but apparently it is not always the case.
    Also, I am skeptical of this study because they had the subjects avoid Selenium containing foods. Someone wrote that some of these people may have been Selenium deficient. So the Selenium could have been more beneficial to them. I know this doesn’t mean much but I eat Brazil nuts all of the time and my Cholesterol isn’t so great.




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  9. I eat TWO a day…almost every day…along with my low-sodium V-8…it’s my afternoon snack at work…yes, I’ve read that 2 a day is the limit for the selenium…and there are days when I forget to bring my Brazil nuts home from work…etc etc. so it’s NOTalways exactly 2 a day but I do enjoy them. Had my “health assessment” at work to day (voluntary health screening) and the technician sat back in her chair and said “I RARELY EVER see such great numbers! Are you an athlete?” I said “nope, I do walk every day but I eat all plant-based whole foods and those with high antioxidants.” THANK YOU Michael Greger for helping me to TWEAK my diet to include so much good stuff! The numbers: total Cholesterol 150. HDL=95. BMI=20. Non-fasting glucose=79, Blood Pressure=120/60.




    1
    1. Just wanted to let you know, Val, that it turns out that V-8 is not vegan. The “natural flavor” is actually animal products: meat, dairy, etc. Food Babe uncovered this.




      2
        1. That is good to know! I have a big problem with having low sodium and low blood sugar. Whenever I am feeling a little dizzy I reach for my “V-8 medicine.” It has plenty of sodium and plenty of sugar. I carry it around with me in my first-aid kit.




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  10. I eat two Brazilian nuts a day. I have high cholesterol levels and over the last ten years the nuts have not lowered my levels. However, I’m wandering if I’m getting to much selenium.




    0
      1. I did not mean to imply my concern was entirely within the confines of brazil nut consumption, which is already limited. Dr Gregor has been recommending 2 handfuls of nuts a day!




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        1. I have read (don’t recall exactly where) that a ‘handful of nuts’ is not a cupped handful, but an amount over which one can CLOSE one’s fingers. Big difference there. Of course, brazil nuts are pretty big. I haven’t tried how many brazil nuts I can enclose. :-)




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    1. I think that edict primarily applies when one is trying to reverse heart disease. Otherwise, I thought I saw a presentation of his where he stated limited nut consumption was okay for healthy people. Oils, I’m not so sure of…




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      1. But all of us who grew up on the standard American diet do have bad arteries. I’m not officially at risk for debilitating cardiovascular issues but I sure do want to clean up my arteries and reduce inflammation. The question is whether nuts improve cardiovascular health or impair it. It’s one or the other, with improvement being the claim on this site, and impairment by others. We want to know which. Every study cited here would suggest no reason to shy away from handfuls of nuts a day. I sure hope that remains the consensus after more controlled experiments.




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        1. There is probably no black and white answer to the question as you have set it up. Nuts contain inflammatory omega-6 fats and cholesterol raising saturated fats. They also have cholesterol lowering phytosterols, and are an excellent source of magnesium.

          There are competing factors at play, and the end result may depend on the amount consumed, as well as the initial health status and quality of diet for each individual. Someone with a relatively unhealthy diet may see a significant benefit from the phytosterols if their cholesterol intake/production was high to begin with. If their diet is of poor quality, the amount of magnesium and fiber introduced by a handful or two of nuts may be a dramatic increase relative to their previous intake. Whereas someone already eating a low fat plant based diet may not see any significant health improvement from introducing nuts into the diet if their cholesterol levels and micronutrient intake are already optimal.

          However, even if we don’t have demonstrated and dramatic benefits for WFPB eaters, they are still allowed by every low fat plant based doc/rd: Barnard, McDougall, Esselstyn, Novick. If a small amount of nuts a) won’t hurt you (both in the eyes of the professionals; and if your own cholesterol readings, weight maintenance, etc confirm this), b) provides a unique source of certain micronutrients, and c) improves dietary enjoyment and satisfaction for many people, then I personally don’t see much room for controversy or debate.

          When Dr. Esselstyn talks about people with heart disease, he means those clinically diagnosed or undergoing treatment for it. Even 10 year olds have arteries with fatty streaks these days, but I can’t imagine anyone recommending zero nuts or avocado for children. We have to draw the line somewhere.

          On nuts and avocado, in Dr. Esselstyn’s own words:
          “As nuts are a rich source of saturated fats, my preference is no nuts for heart disease patients. That also eliminates peanuts and peanut butter even though peanuts are officially a legume. For those with established heart disease to add more saturated fat that is in nuts is inappropriate. For people with no heart disease who want to eat nuts and avocado and are able to achieve a cholesterol of 150 and LDL of 80 or under without cholesterol lowering drugs, some nuts and avocado are acceptable.”




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          1. I think Dr. Esselstyn is dead-wrong on this issue. His rejection of nuts as part of a heart-healthy diet is quite revealing regarding his true intention, which seems the relentless promotion a consistent no-fat Esselstyn-brand dietary idelogy rather than an objective evaluation of the actual scientific evidence which is overwhelmingly in favor of nut consumption. His “argument” against nut consumption is moot as it unduly favors dogma and speculation over epirical evidence. Besides the fact that most nuts actually contain very little SFAs, it is long obsolete thinking to pigeonhole all SFAs as equally harmful. We know, for example, that different SFAs have very different metabolic effects, short- and medium-chain FAs (2-12:0, which are usually subsummized under SFAs) are benign if not health-promoting, whereas long-chain SFAs differ in their atherogenicity (16:0 > 14:0 >> 18:0). Moreover, the metabolic impact dietary FAs depends on their stereoposition on a triglyceride molecule. Long chain SFAs on a sn2-position are much better absorbed and thus more atherogenic than those on sn1 or sn3 position. Most plant-based SFAs, however, are found in those position whether animals based SFAs are found primarily in the sn2 position. Moreover, nuts contain large amounts of phytosterols which more than offsett any adverse effects on cholesterol levels due to their moderate content of SFAs. There are plenty of human trials showing decreased LDL and increased HDL levels from nut consumption. And, since 2013, there is even a large-scale and long-term interventional study (PREDIMED) showing a significantly reduced risk of heart deaease from nut consumption. In summary, nuts are a prime example for the validity of Colin Campbell’s criticism of a dominant reductionist approach in nutrition. There are many factors affecting the metabolic and health impact of a whole food and there is always the possibility that some of them have so far eluded the analytic, reductionist method which is always prone to the “know-all bias”.




            1
            1. Timar writes, “I think Dr. Esselstyn is dead-wrong on this issue. His rejection of nuts
              as part of a heart-healthy diet is quite revealing regarding his true
              intention, which seems the relentless promotion a consistent no-fat
              Esselstyn-brand dietary ideology rather than an objective evaluation of
              the actual scientific evidence which is overwhelmingly in favor of nut
              consumption.”
              Esselstyn does not advocate a no-fat diet; he advocates one that is ~10% of total calories as fat, which epidemiological as well as carefully controlled human studies have shown has an excellent record in lowering heart-disease risk factors. For some people with heart disease, aggressive steps must be taken, including reducing saturated fat as much as possible, which involves eliminating even nuts from the diet. Ornish has made this point persuasively, as has Pritikin.

              Calling these innovators “dogmatic,” “know-it-all” or “reductionistic” does not alter the validity of their ideas or the well-documented success of their diets.




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    2. Esselstyn does not argue against consumption of nuts or avocados. He seems to be worried about people overeating them, and so sometimes makes statements that appear to be against nuts. However when asked explicitly, he advocates for 1 ounce or less per day. This could be a small handful of nuts or a quarter of an avocado.




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  11. I LOVE that nuts don’t increase weight gain! So awesome! What about the high omega-6 content though? Seems like it needs to be balanced out with omega-3 from flax as suggested here: http://m.imgur.com/a/9RY3l

    Does the important omega-6 to omega-3 ratio somehow not apply when indulging on nuts? I’ve never heard any warning on any of the nut videos. Whole food plants do seem to often be an exception to the animal-source rules, but is that the case with nuts and the omega-6 to 3 ratio?




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  12. I love the emphasis on nuts and healthy oils. But can we overdo it? I just realized I probably get 25-30 grams of daily saturated fats from Brazil and other nuts, olive/canola oils, flax, chia, and cocoa, which is more than my omnivore friends. Is that unwise for ideal cardiovascular and coronary health? Based on earlier videos, should we all be striving to stay under about 10 grams a day?




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    1. Two things most people warn against that Dr. Greger doesn’t seem to have any concern for: eating too much fruit, and eating too many nuts. The fact that they’re whole foods make that idea sound wonderful, and I’d like to believe they’re just fine to indulge in, along with still getting plenty of greens, whole grains, beans, and other veggies. Dr. Greger seems to not discourage as much fruit and nuts as a person likes. This issue is what I’m most curious about currently. Especially because of the omega-6 to omega-3 issue he has used to promote eating 2 tablespoons of flax a day. It would seem we might need more though. I’m trying to figure it out. Should I really need five+ tablespoons of flax to balance out a cup of almonds? According to the amounts needed to keep a 4:1 ratio of omega-6 to omega-3, that would be the case. Still haven’t gotten a compelling response as to why not.




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  13. Selenium content in Brazil nuts varies greatly (from almost 0 to at least 20 times the RDI)
    http://www.youcefbanouni.com/1004/selenium-content-in-brazil-nuts-varies-greatly/
    Most people eat them even daily with no obvious adverse side effects. But given that some Brazil nuts can be exceptionally high in selenium (see link), far beyond recommendations, it is fair to raise the question of safety, shall one come across a batch, or brand with the highest selenium concentrations.
    Looking forward to a post on selenium Dr. Greger :)




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  14. Doc, with the rise of the raw till 4 diet and a high carb vegan lifestyle (fully raw) I see guru’s advocating eating 3000+ calories a day for sustainability. While as an active man I have no issues with eating these levels of nutrition daily, I am concerned about the lack of scientific facts or at least opinions from someone like yourself helping the lay person decide what is right.

    I feel a video on this would be a great help and if you weren’t willing to put one on your own site would you consider to doing an interview with me so I can get this information to the many 100’s of thousands who I feel really need this answer addressing. I am sure you are aware of the Freelee and Durianrider brand of veganism and there is a very good raw vegan I enjoy watching called “bite size vegan”. Both of these groups tend to eat high calorie diets, my main concern isn’t the calories although it does worry me and I have questions about how the pancreas copes with the levels of natural sugars consumed. My main area of concern is the sheer volume of food albeit good clean vegan food on our internal organs. Things like the Stomach distending or the valve releasing stomach acid and undigested food into our intestines. Along with all manner of aging affects caused by overworking any system.

    As a healthy vibrant vegan who has no cancer or heart disease and is sold on the eating a clean plant based diet for both self and the planet. The last remaining question lies in the details of how best to go about it in a way that is optimum for my body.




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  15. Note that there is another study derived from the same trial not mentioned in Dr. Gregers video, showing a significant and equally long-term improvement in inflammatory parameters from the high doses (20 and 50 g) of brazil nuts.[1]

    Exiting as these results are, a major problem with this trial is – besides the small size and absence of a placebo arm (it should be possible to administer ground and homogenized brazil nuts in some hidden form, which also would provide a way to ensure a well-defined, consistent intake of selenium from the nuts) – the lack of a baseline assessment of the participants’ selenium status. I hope that those weaknesses will soon be adressed in a larger, methodically more rigorous trial.

    1. http://www.ncbi.nlm.nih.gov/pubmed/24607303




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  16. Would you expect the same positive effect by eating one Brazil nut each week instead of eating 4 per month (ignoring the slight difference in counting weeks as opposed to months)? This ought to pretty much negate any fears from getting too much selenium or fat in a single day.




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  17. I’m vegan and jumped into it too quickly. I wasn’t getting enough iodine and selenium and developed hypothyroidism. However, any other soruces of selenium? I’m tracking my food and am having a hard time getting enough. Also, do you recommend taking a multivitamin? I don’t see the point, only the micronutrients I am lacking.
    Also, is soy bad for you?




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    1. Hello Derreck, please see here for information on iodine.
      http://nutritionfacts.org/video/avoiding-iodine-deficiency-2/

      Whole grains, such as brown rice has quite a bit of selenium. Adding 1 Brazil nuts provides 137% of your DV, so that would also cover it.

      Here is Dr. Greger’s info on dietary vitamins.
      http://nutritionfacts.org/video/are-multivitamins-good-for-you/
      http://nutritionfacts.org/video/should-we-take-a-multivitamin/
      http://nutritionfacts.org/video/multivitamin-supplements-and-breast-cancer/

      Soy is great for you, please see here.
      http://nutritionfacts.org/video/soy-breast-cancer-3/
      http://nutritionfacts.org/video/breast-cancer-survival-and-soy/
      and more
      http://nutritionfacts.org/?s=soy




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  18. Dr. Greger! I need help for my best friend!!! She has a cholesterol reading over 300. The crazy thing is we played sports in h.s., she’s been a serious runner since college and a vegetarian since she was 16. She does yoga everyday, has a weight and cardio routine and still walks or jogs several times a week. She is a diet and exercise icon! She does eat eggs and cheese now and then. She is trying a diet related approach to her problem without success to date. Oatmeal with raisins, local honey and cinnamon to start the day. Has a kale smoothie with walnuts and flax seeds and who knows what else. She’s also taking red yeast (?) That her doc recommended. What more can she possibly do? I checked the cholesterol links here but confused. Please help!




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  19. Is fluoridation bad?
    Also is intermittent fasting bad? Since I’m not getting as much nutrients when fasting do I need to take a multivitamin? I’m vegan.




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    1. First you must decide on your goal. Then decide on the way to get there. From a general health standpoint, fasting once or twice per year has demonstrable benefits. You should NEVER take supplements or medications while fasting.




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    1. Sounds okay to me, unless your doctor has different thoughts regarding your thyroid status. In fact, 1 Brazil nut per day is suggested. Oh, just to note, iodine has impacts on thyroid function and iodine recommendations are in the link I added.

      And one more note: If taking other medications it’s crucial we all talk to our doctors before dramatically altering our diets or taking (omitting) supplements.




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  20. I discontinued simvastatin May 29th 2014 because I was having muscle weakness and leg cramps.
    On August 29, 2014 my cholesterol was 206, triglycerides 65, hDL-cholesterol 61, LDL 132,

    On January 20, 2015 I started taking one Brazil nut a week. I also take a handful or two of walnuts and almonds a day but I have been doing this since 2013 when I went on a high-protein low-carb hydrate diet.
    On January 20, 2015 I was seeing a different doctor and my cholesterol was 177, Triglycerides 80, HDL 59, LDL 102.
    I’m not due to have my cholesterol checked again until July




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  21. I read a Yahoo news item that stated that brazil nuts were the food that contained the highest amount of radium. What do you think?




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    1. Never heard of such thing! Have not seen any research on Brazil nuts and radium. A quick search and one article popped-up. I’ll retrieve at and take a look, as I am curious, but until there is a definitive study showing Brazil nuts have negative implications they remain a perfectly healthful food and good source of selenium.




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      1. I am glad that dr. G. speaks of 4 Brazil nuts per month. The ‘dark side’ of these nuts is their high methionine content, while a very moderate intake of this useful amino acid seems to starve cancer (see elsewhere on this blog). See also Josh Mitteldorf’s blog about methionine intake moderation. A WFPB diet seems the very best start for longevity, but not with daily Brazil nuts….




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      2. I am glad that dr. G. speaks of 4 Brazil nuts per month. The ‘dark side’ of these nuts is their high methionine content, while a very moderate intake of this useful amino acid seems to starve cancer (see elsewhere on this blog). See also Josh Mitteldorf’s blog about methionine intake moderation. A WFPB diet seems the very best start for longevity, but not with daily Brazil nuts….




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  22. Had my blood test done yesterday and a bit disappointed with my cholesterol levels. My triglyceride was 89.4 (I think that is good). My LDL is 105.7(I think that is good) Total Cholesterol is 151.2 (also ok I think) BUT my HDL was only 40.5 (I think that is bad/way to low). I’ve been all plant based for 2 years with lots of greens and raw fruit and veggies, nut and seeds. I walk over 90 minutes every day and I’m not at all over weight (5 foot 6 and 120 pounds). Before going all plant based I was vegetarian. I really thought my HDL would be great




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    1. I HIGHLY recommend eating more beans if you aren’t already. Low sodium of course. Oh and I believe chia seeds are great for raising HDL too.




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  23. hello doc … as brazil nut has highest percentage of seliinum…. can one nut in two days help hep c infected guys for their liver




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  24. Can this be true? Un-soaked nuts cause constipation?

    “Wonder why those seeds, (including almonds, sunflower, spelt, oats, pecans,
    sesame, wheat etc.) in your cupboard don’t turn into plants, or get moldy?

    Well, nature is amazing, and has given nuts and seeds a special enzyme
    that inhibits their growth until it has all the things it needs to grow (sunlight, water, soil etc.).

    When we eat raw nuts, we also eat the enzyme inhibitors that prevent the seed from sprouting.
    This takes a toll on our digestion, since they will prevent our own enzymes
    from breaking down the food in our digestive tracts, inhibiting absorption of
    vitamins and minerals. Simply by soaking nuts in a water (8+ hours according
    to several sources), the nuts release these harmful enzymes, and at the same time
    their nutritional value skyrockets “




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    1. Hi, m. For more information on this I’d recommend Brenda Davis’s book “Becoming Raw”. She did a guest post about paleo diets, too. I have not heard about un-soaked buts causing constipation. Soaking nuts can be helpful but I do not think it’s necessary.




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  25. Were they controlling for all the other things in someone’s diet? It would seem to me that “eating 8 nuts” includes “eating 4 nuts” so it’s a little confusing. So if I ate 4 nuts, plus something else that had a similar nutritional profile, then what?




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  26. Initially, only four nuts (20g estimated) monthly seemed to have an earlier and greater effect than eight nuts (“50g”).

    Yet, at the end of a 30-day period, the 50g dose values for decreased LDL and increased HDL matched or exceeded the 20g dose. At 30 days, the values plot suggests the 50g dose with equal or superior results, particularly in raising HDL.

    BTW, since when does twice 20g equal 50g? At an estimated weight of 5g per brazil nut, 50g means 10 nuts, not eight.

    A link to the actual study– http://www.hindawi.com/journals/jnme/2013/653185/




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    1. Nice to see the actual paper… 10 subjects.. they do conclude that further investigation is needed to validate the results. Dr Greger says ‘normally, when a study comes out in the medical literature showing some
      too-good-to-be-true result like this you want to wait to see the results
      replicated before you change your clinical practice, before you
      recommend something to your patients, particularly when the study is
      done on only 10 people, and especially when the findings are literally
      just too incredible to be believed. But when the intervention is cheap,
      easy, harmless, and healthy—eating four Brazil nuts a month—then in my
      opinion, the burden of proof is kind of reversed’…..the researchers want to investigate more but the article suggests following this as biblical truth…what if 4 or 10 or 100 was ‘best’? what if it worked different for men/women? what about children? what level is toxic? there is SO much more to investigate before you start giving people a number to follow or worry people sick because they are eating 10 not 4 etc.




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  27. Just read about it in your new book. What about eating 1 brazil nut per day? does that help with cholesterol? or does it have to be 4 at once, once a month? Thanks!




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  28. I am a very healthy eating vegan, that has just discovered that I have high LDL. How can this happen if I don’t eat anything with LDL? I was told that it is then a genetic thing. So should i worry about having high LDL if it is not from my diet? I already eat plenty of nuts and HDL foods. It is scary to have that LDL so high, when we all say how dangerous it is. My blood pressuure is low about 90/60. What do you recommend?




    0
      1. Thank you Thea. I do have “low thyroid” levels, but not low-enough to diagnosed hypothyroid. So maybe that is related. In the article it does say “but if folks are practicing healthy eating and managing body weight and
        still find their LDL is not coming down they should definitely consider a
        statin”. Since my high LDL doesn’t seem to be affecting my health, I will not consider taking statins.




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  29. Dr. I know nuts and seeds are very beneficial but I am confused about the form in which they are eaten. Since the fats/ oils in nuts & seeds are highly unstable especially seeds like flax would you recommend raw unroasted whenever possible? Even nuts and even worse nut and seed oils (sunflower, safflower, cottonseed, peanut, sesame seed, canola) that claim to be raw or not are in the grocery store are not refrigerated and are exposed to fluorescent light all day long. Nut butters sound even more dangerous to me as their rancidity must be awful, not only are they roasted to expose their oils to heat but they are also ground up to leak even more of the oils and expose them to oxygen then made to sit on the shelf for long periods of time, they could at least put them in darker containers. To be rancid fats sound like a BIG culprit in heart disease as much of the arterial build up is said to be from polyunsaturated fats that are rancid and are exposed to body heat on top of all the processing they underwent before hand. I love butters, nuts and seeds but I can’t feel but think that almost everything nut based I see unless sprouted is potentially rancid and will do more harm than good. Any wisdom with links to studies would be appreciated, also these oils form nuts and seeds once exposed to so much oxidation from processing potentially turn into trans fats do they not? You yourself acknowledge the serious consequences of such fats. Poor processing of nuts are starting to sound more and more like the fish oil scheme, fats made for cold climates LCFA (polyunsaturated) to stay liquid in cold bodied (hence no rancidity in THEIR bodies) animals and protection/ food for plants, where exactly do we fit into the equation.




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  30. Also could you comment on the daily intake of nuts compared to rotating as continually eating the same nut/ seed protein everyday could potentially build an intolerance/ immune response. As peanut I believe has done because of the excessive intake.




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  31. Just curious: There were studies about a decade ago that linked the size of LDL molecules to heart disease and arteriosclerosis. The smallest molecules of LDL were the culprits, but the study pointed to the fact that these tiny molecules were linked to simple sugars, not fats. The implications here are that low-fat diets do not necessarily decrease risk for heart disease and arteriosclerosis. Is there any new data on this?




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  32. My experience with Brazil nuts. I read his article about Brazil nuts just five days before I was due to take a blood test. On Thursday night I went and got a bag of Brazil nuts. ON Thursday and Friday I ate several of these nuts, although I had never eaten them before. They seemed so bland and oily. On Monday I took the test. For years my total level hovers around 200 and LDL at 130. The results from this test were 180 for total Cholesterol and 110 for LDL. Just one case, I admit. But for me a remarkable effect. I am sold on Brazil nuts, eating one a day now.




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  33. I’m following dr. Esselstyns no oil and no nuts lifestyle to reverse CVD. Would you still recommend Brazil nuts to lower cholesterol! This is almost a life or death issue since nuts (omega 6’s) damage the endothelium & Brazil
    Nuts are quite high. Dr. Gregor, can you possibly discuss this with Dr. Esselstyn because right now I have to be in Crestor to get my LDL & TC lowered and I would love to be able to eat a plant food instead to do the same trick without side effects! Thank you!!




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    1. Hi Robin! Dr. Greger recommends 1 serving of nuts/seeds per day as a part of his Daily Dozen. 1 serving is equal to 1/4 cup nuts/seeds or 2 tablespoons of all-natural nut/seed butter.

      In addition, here’s some info from Dr. Esselstyn that you might be interested in: “As nuts are a rich source of saturated fats, my preference is no nuts for heart disease patients. That also eliminates peanuts and peanut butter even though peanuts are officially a legume. For those with established heart disease to add more saturated fat that is in nuts is inappropriate. For people with no heart disease who want to eat nuts and avocado and are able to achieve a cholesterol of 150 and LDL of 80 or under without cholesterol lowering drugs, some nuts and avocado are acceptable. Chestnuts are the one nut, very low in fat, it is ok to eat.” Dr Esselstyn’s FAQ

      I would suggest taking information from both sides and make a decision that you feel is best for your health. There might be a minor difference between the two in terms of nut consumption, however both Dr. Greger and Dr. Esselstyn are leading pioneers in the lifestyle medicine – both strongly promoting the power of a whole-food, plant-based diet!

      Last tip – are you able to be physically active? Exercise, paired with a whole-food/plant-based/high-fiber diet can really help in lowering cholesterol levels. Hope this helps!




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  34. I had 4 Brazil nuts a couple of days before my latest blood work. My cholesterol total had been historically 199, but the latest result was 149! Sold!




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  35. I started on the 4 Brazil nuts 3 months ago along with a friend, Marie. Now Marie eats very little meat due to a health problems that make it difficult to digest animal protein. She eats lots of veggies and salads, yet, she has been battling high cholesterol as a “gift” from her family tree. Marie went to her doctor 2 months after starting the 4 Brazil nuts a month program. The doctor looked at her test results and was blown away. He told her: “I don’t know what you are doing, but you need to keep doing it!” Marie’s cholesterol dropped a whopping 20 points.

    As for me, I am looking forward to my annual visit with my cardiologist in December. I can’t wait to see what the Brazil nuts will do for the different components of my cholesterol which entails high LDL & Triglycerides and low HDL – the unholy trifecta. I’ll check back and let y’all know.




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    1. No*, it’s fine, even dr G recommends 1 brazil nuts daily for northern europeans (http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/).
      1 brazil nut has 68-91mcg Selenium, the daily requirement for selenium is 55mcg, tolerable upper limit is 400mcg. (figures from https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/ )

      * of course, my assumption is you don’t have other major Selenium sources in your diet.




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    1. Below is a fact sheet from the NIH on selenium, which is super abundant in the brazil nut. There is research in the hemodialysis population using 1 Brazil nut/day to target inflammation, but this population is at higher risk of deficiency and inflammation. If you look at the daily requirement for selenium it is 55mcg/day. Tolerable upper limit is 400mcg. 1 brazil nut is 544mcg. So you would only need to consume 3/month to meet the daily recommendation (not taking into consideration absorption)… If you consumed 22/month… you would be pushing the tolerable upper limit.

      All that aside.. In Dr. Greger’s daily dozen recommendations, he recommends 1 serving of nuts/day. I would recommend a variety as every nut seems to have it’s own distinct nutrition features.




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    1. That’s a question, the good point is nowadays we can find answers (or at least some clues) for our concerns on the internet. I googled this exact question of yours (What happens if you get too much selenium?) and the first result was this page, and there’s a paragraph “Can selenium be harmful?”, which lists some potential problems with high Se intake: Garlic breath, Nausea, Diarrhea, Skin rashes, Irritability, Metallic taste in the mouth, Brittle hair or nails, Loss of hair or nails, Discolored teeth, Nervous system problems, or even breathing, tremors, kidney failure, heart attacks, and heart failure.




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    2. WATCH THE METHIONINE INTAKE, TOO
      Marianna, Dr. Greger already cautions about eating even one Brazil nut daily, since it may “bump up against the maximum daily intake” for selenium.

      There is already much to read on excessive selenium, but you also should avoid excessive methionine. Brazil nuts have more methionine than any other plant source, so it might be wise to read both Dr. Greger’s articles on methionine and tumor development–

      Starving Cancer with Methionine Restriction–
      https://nutritionfacts.org/video/starving-cancer-with-methionine-restriction/ As with any therapy, even “Brazil Nut Therapy”, excessive intake of the therapeutic agent can wreak havoc, with opposite of the intended effect.

      A Low Methionine Diet May Starve Cancer Cells–
      https://nutritionfacts.org/2014/07/08/a-low-methionine-diet-may-help-starve-cancer-cells/ — he speaks of methionine as an element to be reduced, in order to “starve” tumors in formation, or already present.




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  36. Recently I thought I might be not getting much in selenium, and perhaps soil levels greatly vary and perhaps it was one of the minerals higher long ago. Looking into works on selenium, it is highly variable, even with brazil nuts. Cruciferous and mushrooms are also mentioned as sources, though now. Allium possibly can be high though from the variation in soil, as is also true with brazil nuts, perhaps some blood test is possible?

    From Selenium in Food and Health:

    … (Barclay et al., 1995). None of these nuts approached the levels of 0.85 to 6.86, with a mean of 2.54 µg/g found in the same study in Brazil nuts. Brazil nuts have been reported to be the richest natural source of dietary selenium. In the US nuts purchased in supermarkets averaged 36 ± 50 µg/g, with the extraordinarily high level of 512 µg in an individual nut. However, not all Brazil nuts contain such high levels, and concentrations, even in batches of nuts from the same source, can be highly variable. The nuts are produced by Bertholletia excelsa, a large tree that grows in the tropical rainforest of the Amazon basin in South America. Concentrations of selenium in the nuts depend on how effectively the element is taken up by the roots from the soil. This is dependent on the maturity of the root system and the variety of the tree, as well as on the concentration and the chemical form of the selenium in the soil, soil pH, and other factors (Reilly, 1999).

    Members of the Allium family, which includes garlic (A. sativum) and onion (A. cepa), and contain a variety of sulfur compounds which are responsible for their distinctive odors and flavors, are also able to accumulate significant amounts of selenium, especially if grown on selenium-rich soil. While levels of 0.03 to 0.25 µg selenium/g have been reported in garlic grown on normal soil, this was increased to 68 µg/g when the soil was enriched in selenium.




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    1. Preferably, you should eat them raw.
      Please see dr G remark “I no longer recommend toasting nuts” from this article.

      You should avoid roasting nuts because of these AGE (Advanced glycation end-product) that appear in brasil nuts when roasting (to be specific for your question; but generally, AGE levels can increase in different foods based on how they are cooked). To read more about AGE, see nutritionfacts page or wikipedia. You can see different AGE levels for different foods here, and here, and here. (I didn’t find roasted brasil nuts in these links, but you can take a look just to compare different AGE levels in different foods, based on different cooking methods).




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  37. As Dr. Greger indicates, the duration of the brazil nut study was one month. We have no evidence of what happens after 30 days, although that seems of great importance in defining any “brazil nut effect”.

    There could be such an effect, and begs further research. After all, diet modification is a powerful tool in promoting good health– also known as the whole foods, plant-based diet. Within that dietary model, researchers may have found in the brazil nut a phytonutrient complex precisely focused on reducing serum cholesterol. The question now, why not study the phenomenon further, both to replicate and to define it more extensively?

    My own dietary question is more specific– if researchers focused on serving size of 0,1,4 and 8 nuts in a single meal, what effect would steady administration of one nut weekly have on serum cholesterol levels?




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  38. I can report that I ate exactly four Brazil nuts a month for the six months between my blood tests, and my LDL dropped 21 points. My diet was mostly plant-based and did not change during the six months. I definitely intend to continue this “research.” Thanks for the tip!




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    1. Recently, I came across Dr. Greger’s cautionary note about excessive methionine– https://nutritionfacts.org/video/starving-cancer-with-methionine-restriction/ As with any therapy, even “Brazil Nut Therapy”, excessive intake of the therapeutic agent can wreak havoc, with opposite of the intended effect.

      Methionine is a critical element in tumor development and spread throughout the body. Since Brazil nuts happen to be the most concentrated plant source of methionine by a wide margin, even four nuts monthly may affect tumor development risk significantly.

      While reduction of serum cholesterol by up to 17 points by eating only four Brazil nuts monthly may seem beneficial, it may also promote metastasis of existing tumor(s).

      In the Greger article linked above, and in this article– https://nutritionfacts.org/2014/07/08/a-low-methionine-diet-may-help-starve-cancer-cells/ — he speaks of methionine as an element to be reduced, in order to “starve” tumors in formation, or already present.




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  39. A similar study is underway here in Norway. We have already had 25 of a total of 50 participants completed the study, which is a non blinded randomized controlled trial extending for 14 days for each participant. We use only one dose of Brazil nuts (50g) and the control group receives an isocaloric amount of coconut (46g). Results are expected to be published latest May 2018.




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  40. 4 brazil nuts were part of my last meal before a recent fasting blood test which could very well be the best results i’ve ever gotten: total cholesterol=154, LDLc=89, HDLc=50. While i got lower total & LDLc numbers from a 20%-fat diet a couple years ago, this is the best total/HDL ratio i’ve seen for me at 3.08, and those are pretty good numbers overall for a 35%-40% fat diet which seems more fun.




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    1. I’m Joan-NurseEducator a volunteer with NutritionFacts.org
      I’m Jone-NurseEducator and one of the moderators on this site. Glad to know you’re getting good cholesterol numbers. but I’m concerned if you really are consuming 35-40% fat, Fidel. That can have harmful effects leading to problems down the road, even if you’ body managed to keep the cholesterol in check. Remember people often start with low cholesterol but as we get older, our bodies often develop problems based on accumulation of cholesterol in arteries, so why not avoid future problems? Remember, cholesterol isn’t the only parameter to consider, especially if you are eating animal protein- IGF-1, risk for cancer, diabetes to mention a few. Please look these videos then decide if that 35-40% diet is right for you.
      https://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/
      https://nutritionfacts.org/video/trans-fat-saturated-fat-and-cholesterol-tolerable-upper-intake-of-zero/




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  41. Hi

    I live in Germany. There seems to be quite a few discussions about mould or Aflatoxine in Brazil nuts which makes them poisonous. I assume this is only when stored incorrectly? Could you please clarify? I’m trying to have an accurate reply ready for my mother as she is worried about it. What you gotta do ey. How would you store them to avoid the mould buildup and how can you tell when they are mouldy? Looking forward to hearing from you. Thanks in advance.




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  42. Felice–
    Your mother is correct to be concerned, especially since improperly stored rye grain was once a constant public health hazard in middle Europe. In California, Pistachio nuts once were almost wiped out by mold until improved inspection, drying and storage procedures were put into place. The threat is everywhere, but the agricultural industry and government has taken action to protect continued sales– for what that is worth in reassurance.

    Selenium and Aflatoxin Levels in Raw Brazil Nuts from the Amazon–
    http://pubs.acs.org/doi/abs/10.1021/jf072434k

    Selenium and aflatoxin levels in raw Brazil nuts from the Amazon basin–
    https://www.ncbi.nlm.nih.gov/pubmed/18052094

    Comparison of aflatoxin content of Brazil nut kernels with that of the shell–
    https://www.food.gov.uk/science/research/chemical-safety-research/fs241008Nov 22, 2010

    Science Direct– Aflatoxin production by Aspergillus flavus in Brazil nuts–
    http://www.sciencedirect.com/science/article/pii/S0022474X04000608

    SciELO– Brazil nuts: determination of natural elements and aflatoxin–
    http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0044-59672012000100018

    You also might find useful information by emailing one or several Brazilian government agencies in regard to your concerns about Brazil nut production and measures used to prevent mold with stored Brazil nuts.

    For my part, I have stopped using Brazil nuts, not because I am concerned about mold, but because the nuts are the most concentrated plant source of methionine, a promoter of tumor growth. Dr. Greger has written two articles about using methionine restriction to “starve” cancer tumors (see linked references to these articles, in the other posts below).




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  43. Hi there! I’m currently in a discussion with my non-vegan friend about chloesterol. He would like to know, what are the dietary precursors for the body making chloesterol? I’d love to know too! Thank you so much!




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  44. Hi there,
    I follow Dr Gregers optimum nutrition reccomendations and have hit a snag when it comes to selenium. He reccomends eating a brazil nut however I have a nut allergy so he reccomends supplementing selenium but does not state what type? I couldnt find anything further in the reccomendations or the website. Would you kindly be able to advise and/or make it available on the site?
    Kind regards
    Oliver




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  45. Hi Lentil Lifter V,

    I am a volunteer for Dr. Greger. Thanks so much for your question.

    Fortunately, despite your nut allergy, you do not need to supplement with selenium. Selenium is found in many foods, including mushrooms, beans, seeds, and vegetables. Most people do not eat Brazil nuts on a regular basis, and we do not see selenium deficiency issues very often. I wouldn’t worry–just eat a good variety of whole, plant foods.

    I hope this helps to answer your question!




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  46. Why is it that despite following an oil free plant based vegan diet and eating 4 Brazil nuts a month along with daily exercises A persons HDL can drop (along with LDL) ? Any other suggestions to raise HDL?

    Thanks




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    1. HCMalcomson: I am not an expert on the topic of HDL, but some of my favorite NutritionFacts forum members and some experts have had a thing or two to say on the matter. BOTTOM LINE: I synthesize the information below to mean we do not need to worry about HDL levels or HDL falling in the context of a whole plant food based diet, when LDL goes down or is already at a healthy level.
      .
      In other words, if you have high/unsafe cholesterol levels (total and LDL) overall, then also having high HDL can be protective (especially if you got that high HDL through exercise or some other healthy behavior rather than diet). But in the face of healthy LDL levels, the HDL level doesn’t seem to matter. I may be wrong about this, but see what you think.
      ************************************
      .
      First, check out the following article from heart health expert Dean Ornish. He does a great job of explaining the role of HDL and when we need to worry about it’s levels vs when we do not. http://www.huffingtonpost.com/dr-dean-ornish/cholesterol-the-good-the-_b_870655.html “A low HDL in the context of a healthy low-fat diet has a very different prognostic significance than a low HDL in someone eating a high-fat, high-cholesterol diet.”
      .
      Two of our more knowledgable forum particpants, Gatherer and Darryl, have put together for us some of the strongest evidence–a list of good studies. Gatherer wrote (from comment http://nutritionfacts.org/video/how-do-we-know-that-cholesterol-causes-heart-disease/#comment-3098014284 ) :
      .
      “”Don’t put too much stock in HDL levels. Here is a news release
      “Raising ‘good’ cholesterol doesn’t protect against heart disease after all, study finds” https://www.statnews.com/2016/10/31/hdl-cholesterol/
      that provides an overview of the study
      “High-Density Lipoprotein Cholesterol and Cause-Specific Mortality in Individuals Without Previous Cardiovascular Conditions”
      http://www.onlinejacc.org/content/68/19/2073 LDL and non-HDL cholesterol appear to be better indicators of health status than HDL.”
      .
      Darryl wrote (from comment: http://nutritionfacts.org/video/how-do-we-know-that-cholesterol-causes-heart-disease/#comment-3098365137 )
      .
      “Meta-analysis of 108 randomized controlled trials effecting HDL levels (statins, fibrates, resins, niacin, n-3 fats, ACAT inhibitors, ABCA1 inthibitors, CETP inhibitors, PPAR activators, diets, bariatric surgery): No effect. (http://www.bmj.com/content/338/bmj.b92.full ) Subsequent AIM-HIGH niacin trial No effect. (http://www.nejm.org/doi/full/10.1056/NEJMoa1107579#t=abstract ) ABCA1 gene loss of function No effect (http://archneur.jamanetwork.com/article.aspx?articleid=182020 ), LCAT gene single nucleotide polymorphisms (SNPs) lowering HDL: No effect. (http://press.endocrine.org/doi/full/10.1210/jc.2011-1846 ), composite HDL effect from 20 SNPs No effect (http://www.sciencedirect.com/science/article/pii/S0140673612603122 ), 19 SNPs affecting HDL from a genome wide association study (which don’t simultaneously affect LDL) No effect. (http://eprints.gla.ac.uk/91036/1/91036.pdf )
      .
      … One reason that HDL appeared protective in epidemiology may be that a number of lifestyle factors (like exercise, or moderate alcohol intake) both increase HDL and reduce cardiovascular risk by independent mechanisms. Or perhaps only a subfraction of HDL is active, one which isn’t increased by either clinical interventions or genetic variants affecting aggregate HDL levels. It seems likely that that most dietary interventions that increase HDL would not offer the benefits calculated from a reduced LDL/HDL ratio, particularly when they also increase LDL.”
      .
      .
      WHICH MATTERS MORE, LOW LDL OR HIGH HDL?
      Moderator Rami found some great information for us. Here is what he shared with us some time ago:
      “Low LDL matters far more than raised HDL. 108 randomized trials involving nearly 300k participants at risk of cardiovascular events. HDL levels found to play no significant role in determine risk. Primary goal remains to lower LDL.
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645847/
      Genetic studies of high HDL, high LDL, and low LDL. High genetically raised HDL not protective, while high LDL is damaging. Low LDL is protective
      http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960312-2/fulltext
      http://www.ncbi.nlm.nih.gov/books/NBK174884/
      http://www.sciencedirect.com/science/article/pii/S0735109712047730
      http://www.nejm.org/doi/full/10.1056/NEJMoa054013#t=articleTop
      In this animal model study, atherosclerotic lesion growth regressed in a low LDL environment, but did not with high HDL.
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098380/
      Quote from the comment: http://nutritionfacts.org/2016/03/22/the-effects-of-dietary-cholesterol-on-blood-cholesterol/#comment-2630127562
      .
      .
      WHAT ABOUT TRYING TO INCREASE HDL?
      There are healthy ways to increase HDL (such as through exercise) and unhealthy ways to increase HDL (such as through eating saturated fat–see explanation from Ornish above). Exercise is a great idea for a bazillion reasons and may be helpful in a heart protective way if someone is having trouble getting to healthy cholesterol levels. However, in general, increasing HDL does not “…reduce the risk of coronary heart disease events, coronary heart disease deaths, or total deaths.”
      .
      .
      WHAT ABOUT FALLING HDL?
      When some people switch to a WFPB diet, both their LDL and their HDL goes down. Do people need to worry about HDL going down? I thought that Dominic (a participant on this site) had a really great post on this topic. Here’s a quote I find compelling: “In populations where CAD is just about nonexistent, people have both low LDL and HDL levels. These populations follow diets that are higher in whole plant foods and lower in fat and saturated fat than the typical western diet. Studies have shown that it does not appear that low HDL levels provide any vascular risk in individuals who attain very low concentrations of LDL – through diet alone or on extensive statin therapy.3,4.” To see the full post: http://nutritionfacts.org/video/paleo-diets-may-negate-benefits-of-exercise/#comment-1849535796 This post also includes a guideline (not sure where it came from) on how to better judge your cholesterol numbers rather than worrying about HDL levels by themselves.
      .
      Dr. McDougall also has an article on the topic in one of his older newsletter articles: https://www.drmcdougall.com/misc/2003nl/sep/030900pugoodcholesterolworsens.htm The article includes these quotes:
      .
      “Worldwide (comparing people who eat different diets) those who have the lowest HDL levels (like people in rural Japan, China, and Africa) have the lowest rate of heart disease…”
      and
      “HDL cholesterol is a risk factor – not a disease. No one dies of low HDL – they die of rotten arteries.”
      and
      “When you adopt the McDougall Program, you will watch your total cholesterol fall dramatically. As it does, both LDL and HDL levels will drop, as well. And as they do, so too will your risk of heart disease. And your health will improve dramatically. Unfortunately, because HDL doesn’t go up with a healthy diet some unenlightened physicians – acting like puppets for the pharmaceutical industry – give their patients a totally undeserved hard time.”
      .
      I hope this information is helpful in allowing you to judge your own situation.




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    2. This is not something you should worry about if your total cholesterol is low. According to this cohort study on a plant-based diet for metabolic syndrome:

      “When people move towards a low-fat, plant-based diet, HDL levels decrease while other indicators of cardiovascular risk improve. This observation raises questions regarding the value of using HDL levels as a predictor of cardiovascular risk in populations who do not consume a typical western diet. As HDL is part of the assemblage of risk factors that constitute MetS, classifying individuals with MetS may not be appropriate in clinical practice or research when applying lifestyle interventions that promote a plant-based eating pattern.”

      This makes sense because the purpose of HDL is to “carry our the garbage,” so to speak. If there is no “garbage” (AKA bad cholesterol) to carry out (because your LDL cholesterol levels are already very low due to eating a plant-based diet), you don’t need as much HDL. Therefore, the recommended HDL levels do not really apply to individuals on a plant-based diet who have low LDL and total cholesterol.

      Dr. Jamie Koonce (Moderator)




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  47. I was wondering whether someone could please help me with this query. Do nuts need to be pre-soaked to remove phytic acid? I have read they do but not come across anything in Dr Greger’s book or this website. Any advice would be helpful. Thank you.




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  48. Uzma,

    Need to address the phytic acid is a big question. First consider that the amount of phytate present can vary up to 20x in the same product…. complicate this with the prep and indeed it does pose a question. You can reduce the phytate significantly by using any of the three methods referred to at:https://www.healthline.com/nutrition/phytic-acid-101#section5

    Soaking: Cereals and legumes are often soaked in water overnight to reduce their phytate content (1, 4).
    Sprouting: The sprouting of seeds, grains and legumes, also known as germination, causes phytate degradation (5, 6).
    Fermentation: Organic acids, formed during fermentation, promote phytate breakdown. Lactic acid fermentation is the preferred method, a good example of which is the making of sourdough (7, 8).

    You might also find Dr. Greger’s vidoe on enhancement of nutrieitn intake and phytates at: https://nutritionfacts.org/video/new-mineral-absorption-enhancers-found/ of interest.

    In general the WFBP consensus seems to be, not to focus on the phytate level, but rather the combination of nutrient concentration available in the diet and use the easy to apply onions and/or garlic in your meals should you want increased absorption.

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




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  49. Tried this. Ate four the month before, and then 4, two days before my blood test. HDL 53! In 25 years, my HDL has never tested above 42! LDL was 14 points lower than last time, but the HDL is what got me excited!




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  50. Does this mean that I can stop taking vegan omega 3’s and just take my four brazil nuts? This definitely would be cheaper than buying supplements.




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    1. Hello Cam,
      Thank you for your question. I am a family doctor with a private practice in lifestyle medicine and also a volunteer moderator for this website. This video is about a (very small) study showing that eating four Brazil nuts per month lowers LDL (“bad”) cholesterol, and raises HDL (“good”) cholesterol. The reason Dr. Greger recommends a vegan source of DHA/EPA has more to do with preventing dementia and preserving brain function. See this video:
      https://nutritionfacts.org/video/should-vegans-take-dha-to-preserve-brain-function/

      If you don’t have high cholesterol, you do not need to eat Brazil nuts. Dr. G, and all of us who advocate eating a whole foods plant based diet, only recommends a very few supplements. Eating a healthy diet will take care of most of your nutritional needs. And remember that selling supplements is a multi-billion dollar industry, and you should not believe most of the claims you hear about supplements. Here is a link to Dr. G.’s short list of supplements you should consider: https://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

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




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