How to Counter the Inflammation of Aging

How to Counter the Inflammation of Aging
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What can we eat to combat “inflamm-aging,” the chronic low-grade inflammation that accompanies the aging process?


One of the most recognized consequences of aging is a decline in immune function, illustrated by vulnerability to dying from the flu and poor response to vaccinations. But, about 20 years ago, a paper was published showing that the immune cells of 80-year olds produced significantly more pro-inflammatory signals, suggesting the worst of both worlds, a decline in the part of the immune system that fights specific infections, and an aggravation of nonspecific overreactions that can lead to inflammation. This has since been formalized in a concept referred to as “inflamm-aging,” a chronic low-grade inflammation we now know is typical of aging, which may be responsible for the decline and the onset of disease in the elderly.

 So, what can we do about it? Inflammaging appears to be a major consequence of growing old. Can it be prevented or cured? The key to successful aging and longevity may be to decrease chronic inflammation without compromising an acute response when exposed to pathogens. How are we going to do that? Nutrition. What we eat is probably the most powerful and pliable tool that we have to attain a chronic and systemic modulation of the aging process.

 In the first systematic review of the associations between dietary patterns and biomarkers of inflammation ever published, the dietary patterns associated with inflammation were almost all meat-based or so-called “Western” diet patterns, while vegetable and fruit-based or “healthy” patterns tended to be inversely associated, meaning more plant-based, less inflammation.

The reason why meat is associated with inflammation may be because of both the animal protein and the animal fat. In the  first interventional study that separately evaluated the effects of vegetable and animal protein on inflammatory status as it relates to obesity and metabolic syndrome when you’re trying to lose weight, what they found was that a higher intake of animal origin protein—specifically meat—is associated with higher plasma levels of inflammatory markers in obese adults.

The reason obesity is associated with increased risk of many cancers may be because of obesity-associated inflammation. Obesity-driven inflammation may stimulate prostaglandin-mediated estrogen biosynthesis in breast tissues. The inflammation may activate the enzyme that allows breast tumors to make their own estrogen via this inflammatory compound called prostaglandin. If you measure the level of prostaglandins in women’s urine, it correlates with breast cancer risk. And how do you get high levels of this inflammatory compound?  Smoking, a high-saturated fat diet, and obesity. Why does eating saturated fat lead to prostaglandin production? Because prostaglandins are made from arachidonic acid, and arachidonic acid is a major ingredient in animal fats. Animal fats contain arachidonic acid, and arachidonic acid is what our body uses to produce inflammatory compounds, like prostaglandins, with. Inflammatory compounds can then go on to stimulate breast cancer growth, and may also play a role in colon cancer, lung cancer, and head and neck cancer as well.

 In contrast, whole plant foods have anti-inflammatory effects, though some plants are better than others. The folks made to eat five-a-day of high antioxidant fruits and vegetables, like berries and greens, had a significantly better impact on reducing systemic inflammation and liver dysfunction compared to five-a-day of the more common low antioxidant fruits and veggies, like bananas and lettuce.

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 Sara Fasullo via Flickr.

One of the most recognized consequences of aging is a decline in immune function, illustrated by vulnerability to dying from the flu and poor response to vaccinations. But, about 20 years ago, a paper was published showing that the immune cells of 80-year olds produced significantly more pro-inflammatory signals, suggesting the worst of both worlds, a decline in the part of the immune system that fights specific infections, and an aggravation of nonspecific overreactions that can lead to inflammation. This has since been formalized in a concept referred to as “inflamm-aging,” a chronic low-grade inflammation we now know is typical of aging, which may be responsible for the decline and the onset of disease in the elderly.

 So, what can we do about it? Inflammaging appears to be a major consequence of growing old. Can it be prevented or cured? The key to successful aging and longevity may be to decrease chronic inflammation without compromising an acute response when exposed to pathogens. How are we going to do that? Nutrition. What we eat is probably the most powerful and pliable tool that we have to attain a chronic and systemic modulation of the aging process.

 In the first systematic review of the associations between dietary patterns and biomarkers of inflammation ever published, the dietary patterns associated with inflammation were almost all meat-based or so-called “Western” diet patterns, while vegetable and fruit-based or “healthy” patterns tended to be inversely associated, meaning more plant-based, less inflammation.

The reason why meat is associated with inflammation may be because of both the animal protein and the animal fat. In the  first interventional study that separately evaluated the effects of vegetable and animal protein on inflammatory status as it relates to obesity and metabolic syndrome when you’re trying to lose weight, what they found was that a higher intake of animal origin protein—specifically meat—is associated with higher plasma levels of inflammatory markers in obese adults.

The reason obesity is associated with increased risk of many cancers may be because of obesity-associated inflammation. Obesity-driven inflammation may stimulate prostaglandin-mediated estrogen biosynthesis in breast tissues. The inflammation may activate the enzyme that allows breast tumors to make their own estrogen via this inflammatory compound called prostaglandin. If you measure the level of prostaglandins in women’s urine, it correlates with breast cancer risk. And how do you get high levels of this inflammatory compound?  Smoking, a high-saturated fat diet, and obesity. Why does eating saturated fat lead to prostaglandin production? Because prostaglandins are made from arachidonic acid, and arachidonic acid is a major ingredient in animal fats. Animal fats contain arachidonic acid, and arachidonic acid is what our body uses to produce inflammatory compounds, like prostaglandins, with. Inflammatory compounds can then go on to stimulate breast cancer growth, and may also play a role in colon cancer, lung cancer, and head and neck cancer as well.

 In contrast, whole plant foods have anti-inflammatory effects, though some plants are better than others. The folks made to eat five-a-day of high antioxidant fruits and vegetables, like berries and greens, had a significantly better impact on reducing systemic inflammation and liver dysfunction compared to five-a-day of the more common low antioxidant fruits and veggies, like bananas and lettuce.

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 Sara Fasullo via Flickr.

187 responses to “How to Counter the Inflammation of Aging

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  1. I’ve been reading a lot about a ketogenic (high fat/low carb) diet lately because I want to understand. There are people out there getting 70%+ of calories from fat, and they say they feel great. They say that once their body adjusts they feel virtually no fatigue, no food cravings, and unparalleled mental clarity. They also seem to have good bloodwork, i.e. higher HDL/lower (bad) LDL and a huge reduction in body fat.

    Now, I don’t buy that eating this way is healthy, but I would really like to understand the paradox. If saturated animal fat, for example, taxes the body so greatly, why would anyone report feeling great eating so much fat? Why would traditional markers of disease get better? I am not sure that weight loss alone explains the improvements in light of the diet.

    Am I going to wake up one day ten years from now and realize all the ketogenic diet people have dropped dead from heart disease, strokes, and cancer, or am I going to wake up 30 years from now and realize they are healthy as the day they started their diet and I was the fool for not being more open minded? I suspect the question really is this binary. Such an extreme diet is bound to be either super unhealthy or, by some freak of nature – as the ketogenic diet people would like to believe – the opposite.

    1. How long do these people feel great on a ketogenic diet? I’ve read of many folks through online blogs initially feeling great on low fat or ketogenic diets and then it all falls apart. Adrenal fatigue, reduced metabolism, hypothyroid, low energy kick in and it takes years to recover.

      1. The people I’m referring to have been on a ketogenic diet longer than a year. I realize their experience is highly anecdotal, but then there are the physical results – bloodwork and body fat. I am not going to give up eating a whole food plant-based vegan diet based on the reported experience of a few, but I think there may be things here that need to be elucidated.

        1. Are you indicating that you are tired, crave food and don’t think clearly on a WFPB diet? I am confused because I have never felt better. Maybe you need to tweak some things?

          1. I think you can take my post at face value. I offered my own dietary choice not because I am unhappy with it but because I didn’t want people to interpret my questions about the ketogenic diet as promotion of it. I’m looking for information, not to perpetuate diet wars.

            I guess maybe that backfired a bit.

            1. Hi UCBAlum-I didn’t take it that way. I thought you really were feeling bad on a WFPB diet and were considering a change. I found a later post from you interesting on the distance runner who eats this way. I can’t even imagine it. I have a hard enough time digesting a banana on long runs. I wonder what the persons time was as compared to Scott Jurek–who dominated in ultra distinct running for years.

        2. There are ketogenic diets, where fat comprises upwards of 90% of calories, that do offer a net health benefit to children with intractable, inoperable epilepsy, and perhaps in late-stage metastatic cancer. And then there are the high-protein, high-fat diets that many less qualified individuals are calling ketogenic. Ketosis is a starvation response, one doesn’t get there with moderation.

          Children on true ketogenic diets, besides an unpalatable diet of mostly vegetable oil, experience worse blood lipids (link), gastrointestinal disturbances, inflammation, protein & mineral starvation (link), and bone loss (link).

          Any high-protein diet will increase satiety (likely via hypothalamic mTOR, a regulator responsible for pro-aging effects generally) and reduce intake, and weight loss towards the normal (in the pre refined food world) range of 20-25 BMI can offer benefits that temporarily outweigh adverse effects. However, weight loss cannot go on forever, so its important to look at longer term outcomes of lower-carb diets in individuals just maintaining weight: more cardiovascular disease (link) and more death (link).

          Anecdotally, I’ve encountered a few people who developed prediabetic insulin resistance after extended “ketogenic-lite” diets. This is what we might expect from animal studies, where ketogenic diets cause insulin resistance (link), glucose intolerance (link), liver pathologies, inflammation (link), and pancreatic β-cell loss (link). That’s the etiology of type 2 diabetes. Another study found that adding just 10% carbs to a ketogenic diet raised insulin resistance to a maximal level (link). I fear a lot of keto diet advocates are tickling the dragon of diabetes, and a good reason some of them are constantly checking their blood glucose.

          1. Darryl,

            I would appreciate your thoughts on specific amino acids that you think warrant supplementation for some vegans.
            And are there some amino acids that have red-flags, as far as caution in taking in supplemental form?

            Thank you.

            1. No amino acid supplement is a “natural” product. Glycine is produced via chemical synthesis and the other, chiral amino acids are commercially produced via fermentation with mutant microbes selected for overproduction.

              So long as vegans consume enough lysine in their regular diet, its likely they’re meeting all generally recognized amino acid requirements. Jack Norris’s VeganHealth discusses this. 2-3 servings of beans or nuts will go far to correct this in healthy people. Diets comprised mostly of refined grains, of refined calories like alcohol and sugar, or prescribed diets that are especially low in overall protein will be lysine deficient. Dr. Kempner’s original white rice diet, for example, has only about half of the lysine requirement. This may contribute to his diet’s effectiveness: our cells respond to amino acid shortages by expressing FGF21 (a href=””>12), a protein starvation signal with potential benefits in cardiometabolic diseases (13)

              Methionine, histidine, tyrosine, glutamic acid (aka glutamate), and cysteine are toxic when consumed well in excess of requirements (14).

              Glycine is not generally recognized as an essential amino acid but it might be semi-essential (15, 16), and elevated urinary 5-L-oxoproline is evidence of deficiency in vegetarians and others consuming a diet low in collagen (17, 18). Rather than load this reply down with more citations, I’ll direct you to a post where I collected them elsewhere. In human studies, supplemental glycine improves sleep quality, while in cell and animal studies, glycine has broad cytoprotective, anti-inflammatory, tumor-retarding, and anti-glycation effects. It may be the anti-methionine, and the National Intitute of Aging’s Interventions Testing Program is looking at very high dose glycine (8% of calories) in cohort 10. So it may be in the news next year. Glycine is about as sweet as glucose (80% as sweet as table sugar), and I take a heaping teaspoon (5-10 g) in my evening hibiscus tea.

              1. This really helps. I was considering supplementing with creatine. It seems that there a bunch of vegans that supplement with this because they claim to have failed to thrive on a vegan diet.

                I was not aware of glycine but your words suggest that it might be worth considering supplementation.

                  1. I read over all the links. Yes, I does seem to me that there are compelling reasons and data
                    to consider creatine use in vegans. I have seen some warnings out there on creatine dangers,
                    but nothing that convinces me that creatine supplements are that harmful. Who knows.

              2. What about COLLAGEN supplementation?
                Dr. Greger does not recommend supplements (except B12 and D)
                and he’s against animal sourced supplements –
                but isn’t all collagen from animal sources?
                Should we consume Collagen protein? It’s all the rage these days – including Bulletproof brand.

              3. Glycine can be obtained from plant foods too. Plant-based sources include beans; vegetables like spinach, kale, cauliflower, cabbage and pumpkin; plus fruits like banana and kiwi.

              4. I disagree. Creatine might only synthesized up to 1 gram a day when we need 2. Read more about my post here:
                And carnitine might be a problem for a lot of vegans too:

                Funny thing is, I mentioned you in my post about creatine ;) At the moment I am looking into beta-alanine (carnosine), taurine and a few other amino acids. But I am pretty sure the average vegan who aims to get enough lysine does NOT get proper creatine and carnitine in their diet.

                This is the study Jack Norris is reffering to:

        3. Names of these ultra-fit endurance athletes, links to their athletic performances and blood test results after a year+ on a high fat, low carb diet? If you’re referring to that Paleo Blueprint dope, he was an athlete years ago and excelled on the normai high carb, low fat diet that all endurance athletes follow. He decided to go paleo after he retired from competition, based on his ‘research’, mostly nonsense from Weston A. Price and the ‘ancestral health’ advocates.

            1. I should add that I know a number of people, including myself, who studied Price’s work. After two years of eating pastured beef, chicken, wild salmon and raw milk from pastured cows, along with lots of veggies and fermented foods, I developed an aggressive breast cancer. It has not been detectable a year earlier. That’s when I adopted a vegan diet, and I’m more convinced than ever that all that animal protein stimulated the cancer growth. Many of the women I know who still embrace the paleo diet, or a more moderate one including some grains and beans, are overweight and don’t look all that healthy to me.

              Also, I knew two women who had breast cancer and adopted a ketogenic diet. The last I heard from one of them, about a yer ago, the cancer had metastasized to her brain a second time and the other died. Don’t people realize that the body will still make sugar, even from protein? And the cancer will gobble it up.

              1. So sorry to hear that, Rebecca. Are you still undergoing treatment, or is it in remission? Your and your acquaintances experiences speak to the danger of the ‘ancestral health’ misinformation put out by Weston A. Price et al. And unlike UCBAlum’s questionable anecdotes of super endurance athletes thriving on keto diets, your anecdotes are in line with the science. The strong causal relationaship was enough to get the WHO to finally concede and list red and processed meats as known carcinogens.

                Unfortunately, a lot of (obviously misinformed) doctors have taken to prescribing keto diets to patients in advanced stages of cancer. As Dr. McDougall’s presentation on Steve Jobs’ cancer revealed, his condition significantly deterirated after he relented to his doctor’s advice to start consuming meat after decades on a vegan diet.

                1. Poop Patrol (!), I’m doing just fine these days. I’ve been in remission three years and feel my diet will keep me there.

                  Interestingly, today this video came to my inbox: I forget the woman’s name, but she is an expert in what paleolithic people actually ate and she totally debunks the high fat, meat-centric diet hype. Even today any hunter knows that wild game is very low in fat. Perhaps one exception is opossum. I hear they’re very greasy, but I’ve never put one on my plate!

                  1. However, neither was any of the diverse real paleo diets totally vegan. And many populations, depending upon where they lived, and the season, ate a lot of animal foods, and others a lot of plant foods. I watched the video. We are back to mostly fresh whole food eating. And personally I believe, most of that should come from plants but people do not have to be vegan.

        4. I have been wondering too ever since Dr. Mark Hyman’s Fat Summit. One scientist whose been on a ketogenic diet for about 10 years or something like that Dr. Dominic D’Agostino, who has a PhD in physiology and neurology and does grant supported research on ketogenic diets and disease e.g. epilepsy.

          However, although the brain can use ketones for energy instead of glucose, it is clearly not the default since it takes time for the brain to adjust to the new energy source, which makes me skeptical unless one has a specific disease that might be treated like epilepsy (and some claim cancer, as cancer cells thrive on glucose).

          It would be great if Dr. Greger could address this issue.

          1. Interesting parallels between dogs which seem to perk up when given coconut oil or MCT oils at around 7-8 yrs and humans who seem to undergo a similar mental/physiological slowdown in their 50-60s. Maybe glucose metabolism in the brain gets bunged-up in later years…

            A heaping tsp of coconut oil has seemed to perk up my dog…and he still gets lots of carbs in his dry dog food.

        5. I am currently reading about the Sir Shackleton expedition to the South pole in 1915. The party met with disaster and were forced to continue back to safety, taking months. They all survived , but were forced to live on seals and penguins when they ran out of starch. The first thing they gorged on was starches when back to civilization. Sir Shackleton realized how inadequate their diet was when they ran out of flour and other starches, leaving them with little energy to pull the sledges. These people were clearly not functioning well on this ketogenic diet. Fascinating book,”Endurance: An Epic of Polar Adventure” by F.A. Worsley

      2. Hi Julie, I recently watched an interesting BBC show called Sugar Vs: Fat. Two identical twin doctors went on a 30 day experiment to see which is worse – the typical American high sugar diet, or the typical British high Fat diet. Although we cannot get any science from case studies, I enjoyed the way the story followed the two brothers, and helped to explain some of the scientific findings. Most interesting – both brothers lost weight during their 30 day extreme low fat and extreme low carb journeys – but the extreme low carb brother lost weight from muscle loss. Ketogenesis, of course, metabolizes muscle to make glucose, very inefficient for the body. Following the brother’s journey are a few interviews with researchers who are doing animal experiments with high sugar and high fat diets, and THAT is really interesting! Let me know what you think.

        1. The statement that “Ketogenesis, of course, metabolizes muscle to make glucose,” is incorrect. I assume, by muscle, you mean the cannibalization of amino acids from protein to synthesize glucose. That is called gluconeogenesis, which does occur in the initial response to running out of glucose, especially to feed the brain. Ketogenesis is a longer term response to running out of glucose to feed the brain whereby the body metabolizes fat to make something called ketone bodies that the brain can survive on in the absence of glucose.

          1. Right, Dr. Dominic D’Agostino, who has a PhD in physiology and neurology and does research on ketogenic diets and disease. addresses this and other issues in various places (search youtube). As I mentioned in another response, he has been on a ketogenic diet for many years (I think 10). He also keeps close track of many health indicators and seems to be perfectly healthy. What makes me skeptical of the diet is that, as he admits, glucose is the primary/default mechanism for supply the brain with energy. He makes a big deal out of the fact that burning fat requires no insulin, but I still don’t get why relying mostly on burning ketones would be superior to the default mechanism provided by evolution, at least in an otherwise generally healthy person.

            I’m a vegan and am not about to change from my die but still his exeprience and claims makes me wonder.

        2. Thanks Lisa, that must have been an interesting program! It doesn’t surprise me that the low carb twin lost more muscle, had a rise in fasting blood glucose, felt “thick headed” and had less energy for exercise.

      3. How about this? Eat to get a lot of balanced fiber and the macros sort themselves out. Just saved you a bunch of reading and try/ fail.

    2. The placebo effect is a very real phenomenon. They want to believe they are feeling better so they do. This is only short lived. I don’t see long term adopters because they really do start feeling crappy. Also the only patients I have EVER stop and/or reverse their chronic diseases are whole food plant based eaters.
      If I compared those on high fat meat diets to plant based diets by chemistry panels of their blood the plant eater always have lower inflammatory markers, lower cholesterol and triglycerides and lower blood sugars.

      1. Thanks Hemo D Doc. The placebo effect is the first thing that occured to me. Reporting on lipid panels is probematic to say the least. Many paleo fad gurus will insist that high cholesterol is only unhealthy if you worry about it. So for them a total cholesterol level of 300 might be something they claim is fine. Your experience therefore is informative and authoritative and what one would expect.

        Also given that a ketogenic diet is a state of carbohydrate deprivation it would be very hard for energy levels to increase. So again, back to the placebo efffect.

        1. Is 145 cholesterol good because someone falsely believe it’s good? How about triglycerides of 81? A 35 pound weight loss? 20% body fat down to 8%?

          These are results someone who has eaten a ketogenic diet for over a year has posted on the Internet. He is an athlete. Some professional endurance athletes are doing ketogenic diets and winning endurance races, like the Western States 100.

          Now, assuming these results are real, I would like to find an explanation. I don’t think the placebo effect does it.

          Maybe these results are not real. That is a possibility, but I’m not going to dismiss them outright. I’d rather try to understand what’s going on there.

          Again – I am not promoting a ketogenic diet. I have a hard time imagining it’s healthy. However, what i have said above are facts, or appear to be. If these results are real, as they appear to be, I think it would be good to understand.

          1. Hi UCBAlum – it is always interesting when people report such amazing results from going on a high saturated fat diet! Many clients that I see are advised by traditional health care providers to “cut carbs” and just eat protein. It can be challenging to overlook the long tern affects of a high saturated fat diet (which are well documented) in favor of a short term gain.
            Dr Greger discusses the main side effect of a high fat diet in his series that talks about insulin resistance. This may be a much better marker of what happens to people over a longer period of time when they are eating the majority of their calories from high saturated fat animal foods. Let me know what you think!

            1. Thank you. So in the study the participants were fed a high fat diet for two days. What I am gathering is that those on a “ketogenic” high fat diet like the ones I refer to take a while to adapt – say a month or so. During the adaptation their cholesterol, triglycerides, etc look horrible. However, after the adaptation happens things appear to change for the better. Blood glucose may drop dramatically on a high fat diet, in time, and insulin may drop so low it becomes undetectable. For example, I’ve seen people report anywhere between 50 and 70 mg/dl fasting glucose and insulin less than 2 (I forget the units). If I understand right, their blood sugar stays low because both carbs and protein in the diet are low, and thus, no need for a lot of insulin.

              Now, am I convinced this is healthy? No. I don’t know what’s happening to arteries, muscle cells, the pancreas and liver, etc. with such a high fat intake. But it seems clear something is happening. But because I don’t know what’s happening I can’t predict the effects in the long-run. For example, if someone with such great insulin & blood glucose numbers on a ketogenic diet start eating more carbs – even the healthiest of carbs – would they find that they had developed diabetes because they damaged themselves with their diet? Or, would they find that their insulin sensitivity had improved? I have no idea. I don’t think a study testing the result of a 2-day high fat diet addresses that…even if the results point in a certain direction. It seems that something happens on a long-term high fat diet that includes some (though very few) healthy vegetables and fruits – in other words, a diet that does not produce nutritional deficiencies from lack of fruits & vegetables.

              1. You are right, two day studies are not very revealing! Nor are case studies of those who are adapting a ketogenic approach. We haven’t seen any long term studies (I believe) of outcomes from a multi year adoption of a ketogenic diet. You raise a great point with your comment “a diet that does not produce nutritional deficiencies from lack of fruits and vegetables.” Do you know what that threshold is? Are we in the “5 a day” land with nutritional adequacy?

                1. I would guess that 9 a day is too much for them. What they seem to do is keep carbs below 50 grams a day, or thereabouts. They may eat salads topped with low carb veggies, broccoli with lots of butter…etc….and they do eat fruit. They just keep the total daily carbs low. I think they probably avoid overt deficiencies this way but to answer your question – I think they are far from optimal on some or many nutrients. This is why in my mind the question about HFLC becomes “X, in the absence of overt nutritional deficiency…”

                  1. Remember most of these people are spending a small fortune on supplements and special “bone broths” to not land in nutritional deficiency land. It is difficult to find any paleo website not pushing supplements, so a diet like that, its very hard to take at all seriously.
                    I understand your frustration about it, how foolproof are these results you see though? Most of the posts I’ve seen just say their bloodwork is fantastic, actual results are very rare, and since they’ve already discounted all the markers we know that are bad to actually be good, they say bad results are fine.

                    How a diet can pretend to be all about paleo living one moment, make really bad excuses to avoid carbs at every turn, then turn around and sell bottles of pills like that is somehow natural is beyond me. Actually what is beyond me is how the believers can’t see it.

              2. I truly believe it is carcinogenic and cancer rates will be much higher among those who eat this way, not to mention heart problems. Do a search of Dr. Atkins and see what he looked like in his later years (hint: huge) and while we’re on the subject, he died of slipping on ice but he had heart problems at the time. Look at Dr McDougall, Dr. Greger, and other plant-based doctors and see how they look.

                1. Yes, I can’t disagree about carcinogenicity. The Atkins diet though is also high in protein, and this is different from HFLC in one important way: protein raises insulin, and the positive effects I am hearing about in people eating HFLC could be explained by a reduction of insulin. These people are eating 75% of their calories in fat, and sometimes even more.

                  1. My n=1. I ate HFLC for a good 15 years. I thought I had to, to lose weight. It was a constant struggle. I would say that I averaged 70-80% fat because I can’t bring myself to eat lean meat. Yuck. I ate salmon and ribeyes or chuck eyes and averaged less than 25 g of non-starchy carbs a day. My cholesterol slowly climbed to 300-325 and I became hypothyroid. My fasting blood sugars have always been good, although they were creeping up, too, to mid 80s. But when my PP was 150 2 hours after a ribeye, I started looking at other options. I started the McDougall program in september and have lost 20 lbs. my PP BS is now normal, when I eat a meal of starches! I’m amazed and I’ll never go back to low carb. My cholesterol in november was 225, so coming down. I have so much more energy now. I’m just sorry it took me so long to figure it out.

                    1. Thank you. Very interesting. Is your fasting BS also normal now? Did you have good cholesterol numbers initially on your HFLC diet? Your experience counters that of others I’ve heard, but you were on the diet much, much longer, and the long-term effects are the issue here as far as I’m concerned. Yes it’s n=1 but that’s where it starts, so thanks for sharing.

                    2. After a year on a ketogenic diet my cholesterol skyrocketed from 190 to 298. A CT scan of my heart revealed a moderate amount of calcium. Subsequently, after 3 months on a healthy low fat, high carb vegan diet my total cholesterol plummeted to 128 and my LDL to 72. Another data point for you. (Oh, and I’m not contributing to violence pain and suffering we inflict upon defenseless non-humans – what a thought!)

                    3. Yes, my FBS is usually in the 70s. If not, low 80s. My cholesterol was 140 with LDL at 70 in my early 30s. My doc said I would never die, lol. It started rising after starting LC. My experience tells me it’s the fat that causes insulin resistance, not carbs. So counter-intuitive! There are a few docs out there saying just that. Fortunately, I finally heard them. My weight loss has slowed some but my body is changing, losing inches. I am at my lowest weight in probably 10 years. Also, I had all kinds of gut distress, since my teens, and that has all resolved. I hadn’t eaten bananas in probably 30 years because even a little bite made me feel like someone had kicked me in the stomach. I can eat them with no problem now. It sounds silly but that is such a joy! I enjoy them so much. I think our micro biome plays a bigger role in this than most people think, and I think removing carbs is a serious detriment to that balance.

              3. When I was being treated for cancer with insulin potentiation chemotherapy, the blood sugar reaching 45-50 caused dimming of the visual field, and a bit of dizziness or weakness. That was what they considered the therapeutic moment, when the cancer’s insulin receptors were wide open looking for sugar. The nurse would quickly give a 10% dose of chemo, followed by the only sweets we ate, which were always sweetened with fruits like dates, to bring the blood sugar back to a healthy range. Thus the tumor gobbled up most of the drugs, so side effects were minimized, or even absent.

                This makes me think that a consistent blood sugar as low as 50 couldn’t possibly be healthy. Are there any doctors out there who have observed anybody with such low blood sugar readings, and how healthy they were?

          2. I applaud your open mindedness. I have been on high protein diets years ago . There was the Canadian Air Force Diet and I forget all the names over the years long before Adkins and Paleo came along. I lost fat. Not so much weight. Obviously since my size changed but the scale did not, I decided it must be my body composition changed. I think the fat turned to muscle. But that kind of diet is not sustainable. The body cries out for fruits and vegetables. And then the fat comes rushing back with a vengeance. The making and using of cholesterol is a very complicated bodily function. Cholesterol is needed by the body for many reasons. If you don’t eat any, your body will make it all from scratch. For myself, a mysterious (to me and the average guy) thing happens when I quit eating it – my cholesterol goes up. This has happened to me a few times in my life so that I am comfortable saying it always does. The chemistry involved in cholesterol synthesis is extremely complicated. I don’t think the scientists have it all figured out yet but they are working on it. But for myself, I would rather eat what I consider a healthy, sustainable diet and have higher cholesterol than eat a carcinogenic, unhealthy one. You may think I am an exception, but I see it happen more frequently than you might believe to people following a very low fat plant based diet.

            1. Good for your eating healthy. And yes the cholesterol system is a complex system and one that we are understanding better everyday.

              Regarding your cholesterol levels going up after eating healthy there are a few mechanisms by which this can happen. First, though, see my post to UCBAlum above regarding cholesterol levels.

              How can your cholesterol be high when eating plant based but low on a KetoGenic diet. Remember you are an exception to the rule. The rule is ~95% (and probably higher) of people will have lower cholesterols levels when they stop eating meat and switch to a whole food plant based diet.

              You however may have:
              1. You have a body (genetic code) that makes a lot of cholesterol when you are not eating any from another source (exogenously).
              2. You have a strong cholesterol negative feedback loop.
              3. Your body rapidly metabolizes exogenous cholesterol and gets it out of your body faster than others.

              Bottom line, and what you have expressed, is that you will always be healthier and lower your chronic disease risk when eating a whole food plant based diet. Keep up the good work.

          3. While we are all human, we must also realize we are in many ways biologically individuals. Perhaps diets that emphasize animal fats and proteins are healthy for some. However, not too many people have followed those diets for long periods, so it will be interesting to see if they tend to develop insulin resistance.

          4. I think that person may have won the genetic lottery and inherited a set of genes with mutations that predisposed him/her to excellent metabolism for burning fat and becoming better at keto adaption than the average person.

            Your mileage may vary as they say. WFPB diet is most likely better suited for the average person.

          5. Maybe those are correct number maybe they aren’t. The only way to know is to dissect their daily diet.

            That said the way that the bodies cholesterol monitoring system works is by negative feedback. When you eat excess cholesterol your body reduces production of its own cholesterol. In some persons they could have an excessive negative feedback mechanism excessively reducing their cholesterol manufacturing. Also they may be rapid metabolizers of their cholesterol.
            Cholesterol synthesis, maintenance and excretion is an interesting but complex system.
            One thing I do know though is that it doesn’t matter how low your cholesterol is if you eat a crappy, high saturated fat, trans fat and cholesterol laden diet! Eating a crappy diet means you can still have heart attacks and strokes no matter what your cholesterol levels!

            I had a patient that I posted the numbers on this site (when that was allowed) which showed the cholesterol levels of that patient who had a total cholesterol of ~125mg/dL. (Which is very low by any measurement standard) and I showed the carotid duplex scan of the ruptured plaque that caused his stroke!

            That is also one of the reasons the medical research is moving away from total cholesterol and looking at other factors because it is a very complex system. In fact the most sensitive indicator we have at this time for risk of MI and stroke is the Apolipoprotein B (ApoB)/apolipoprotein A-I (ApoA1) ratio and apolipoprotein B. Long-term predictors of myocardial infarction in initially healthy middle-aged men–a 13-year follow-up.
            This isn’t used very much in mainstream medicine because new testing and treatments are hard to get infiltrated into routine medicine.
            Also even though his total cholesterol is low it has been shown that when you eat a poor diet such as the Atkins, Paleo or any other KetoGenic diet that the HDL (High density lipoprotein) is dysfunctional. You do not want dysfunctional HDL because this is the reverse transport of cholesterol molecules from your tissues to your liver for degradation and excretion. So a dysfunctional HDL can kill you instead of protect you.
            Interestinglly the reason the HDL become dysfunctional is because of the oxidation of the Apo A1 molecule. An abundant dysfunctional apolipoprotein A1 in human atheroma

            Bottom line, eat a whole food plant based which stops the above oxidation process and protects you from heart attacks, strokes, alzheimers and all the chronic diseases.
            If the people want to promote their unhealthy diets and try to persuade you to change just remember no matter what their cholesterol levels are if they eat anything other than a whole food plant based diet they are turning on their genetic code (yes at your DNA level) and expressing the genes that promote morbidity and mortality. Don’t be fooled!

          1. That’s it!! That’s the reason I went (back) to Dr. McDougall’s way of eating. It is sustainable for the rest of my life and I learned my lessons the hard way and will not be going off it again.

        2. I think our ketogenic ability is what allows humans to live in extreme climates, like the arctic, and through extreme times when little plant food is available but they can still find some animal life and insects. But if we truly started life, all those eons ago, in tropical regions, why would ketosis be anything close to normal? To me ketosis is an amazing adaptation, but not one to pursue as a way of life.

      2. There HAS been a study of long term plant based eaters blood panels. The Adventist Study, where calorie restricters were compared to animal protein restriction, had some amazing findings. Dr G’s series on Why Do We Age? is a great reminder of the consequences of inflammation, as related to animal protein consumption. You can find my favorite one in the series, Caloric Restriction Vs. Animal Protein Restriction here: Let me know what you think!

      3. I’m not sure you are correct about the chemistry panels. I might be a freak of nature but my cholesterol goes UP when I eat low fat plant based. No way do I know how to explain this, other than a very unsophisticated reply that my body was scared into making more because of the loss of it coming in. It over reacted. That said, I would rather have all the other benefits of this way of eating than have perfect cholesterol. And besides, my cholesterol depends on the eye of the beholder whether it is good or bad, but for sure the total is higher.

    3. When I found out I had prostate cancer – I tried a few diets to see if I could get my psa down…

      Ketogenic diet…no change in psa level.
      Not eating for 13 days (fasting so only water…and even that tasted revolting)…no change in psa level.
      6 weeks of whole food plant based diet…psa came down from 10.5 to 7.

      Plant based whole food diet with the supplements Dr Greger recommends is the best for me, you, the animals and the planet.

      1. I just finished 14-day long fasting. 14-day fast was a good experience, a lot of my health started to resolve but only started, and I want this good process to continue.

        Based on this experience I can pretty safely state that 14 days is too short. You need a much much longer duration like… six weeks (which was the case for whole plant diet). But this is impossible to do with fasting… however… there is this thing called intermittent fasting and it has been shown to decrease IGF-1 levels by 50%. I don’t remember the number exactly but surely the decrease is huge.

        If you fast for 1 day (600 calories) and eat for 1 day (2000 calories) actually you fast for 40 hours then eat for only 8 hours. 40 hours – this is where the body’s response to fasting kicks in.

        This is only one of the patterns for intermittent fasting – so called 1/1. There are other like 5/2.

        And I just wonder which one would be the best. 1/1 seems to have the highest ratio of fasting to non-fasting time so it seems to be the best but is it?

        Of course I am on the whole plant diet plus gluten free too.

        1. Hi Mick – I did some research on IF a few years ago as interest seemed to circulate. Interestingly, there is only one published study which was done by a company that sells protein powder recommended for the IF. The study was small, and the length of the study was short.
          In nearly ALL studies of dietary interventions (“diets”) weight loss across types of diets is quite similar, quite small (when comparing 6-12 months duration) and diet attrition is quite high.
          Again, the “best” diet is the one we can be with for the long haul, which has positive consequences for ourselves, other living beings, and the planet!

          1. Joel Fuhrman, M.D. wrote a book on fasting “Fasting and Eating For Health” which references a number of research papers. Also, True North Health Center in Santa Rosa, CA is a fasting center with a complete set of medical physicians and other professional clinicians that has excellent results with complete safety. You can also Youtube Valter Longo, Ph.D., Director of the Center for Aging at University of California, Davis who has spent his career researching and publishing on fasting. Dr. Long is working with both True North as well as Harvard univeristy on researching fasting because of the incredible informatin they are accumulating. In fact, Oncologist are now using fasting in conjunction with chemotherapy because of the benefits of fasting on the body when chemo therapy is administered. Dr. Long has the most interseting informatin on this information.

        2. I did the 5:2 diet as well, – on a Monday and Tuesday I only ate 600 calories.
          The 5:2 diet is a great way of losing weight but my conclusion was that eating lots (and I mean lots!) of fantastically nutritious food is the best way to repair your body’s mechanisms and keep your cells as healthy as possible.
          I now eat more than I ever used to, never put on weight, and friends and relatives say I look healthier than I have in years.
          My only frustration is that I didn’t know all this 30 years ago!
          Dr Greger is a legend.

          1. Well, I am trying to track down the benefits that fasting (IF fasting especially) may provide me beside the plant-based diet does provide me already. I wish someone could discuss this, maybe even dr Greger himself in one of the videos.

            The problem with fasting is more or less like this: when people start fasting they were usually on a “western” diet. No wonder they loose weight and have all the test results (like cholesterol) improved. The exactly same thing happens when you start a plant-based diet.

            And this is what happened to me when I started a plant-based diet – my weight dropped from 233 to 186 pounds. Then I reached plateau and now when I fasted my weight dropped to 180. That’s only 6-pound drop for a 14-day fast. I want my weight to drop even more because I can still see a lot of fat around my belly and elsewhere. I am tall but extremely slim (when I was actually slim) so I need to be this slim again.

            Fasting stopped inflammation in my joints which plant-based diet couldn’t stop. But I am still on the verge of rheumatoid arthritis.

            Fasting has one advantage over plant-based diet – it causes certain hormonal changes that are beneficial (less inflammation etc).

            Otherwise these two look quite similar – they both change gut flora composition to the one that is beneficial for rheumatoid arthritis (if one is allergic to a certain gut bacteria). They both decrease amount of body fat and thus leptin and leptin is one of the stimulants in rheumatoid arthritis. Probably there are even more similarities but I don’t remember now.

            The point and the question is: will IF allow me to loose some more weight and reap the possible benefits? I certainly would like that…

            1. Mick, I think the easiest way to do IF is everyday fasting for 16 to 18 hours. If you eat dinner at 6 pm and brunch at 10 am you give your body time to rest from processing food and become more adapted to burning fat. I’ve been eating this way for a couple of years and really love it and feel great! Sorry I have no lab values or anything but I keep my BMI of 19 without any effort at all (other than working at eating healthy whole foods). I think after adapting to IF your body will be better at fat metabolism and feel cleaner. The beauty of IF is it has benefits of fasting without the negatives (slow metabolism, stressed body etc).

              Also best to work into IF slowly. Always fast for the number of hours that feel comfortable to you, then gradually increase the fasting window until you can go 16 hours without food. Never be uncomfortable; as soon as you are quite hungry always eat.

            2. Simplest way of losing weight is chop out 1 meal a day.
              It avoids any pointless calorie counting…
              I won’t eat breakfast and then I eat my breakfast at lunch time – simple.
              If you eat a plant based whole food diet – you will be the weight you should be – then just forget it.

            3. I think fasting can be very powerful. For example, it (600 kcalories per day) has been reported in one study to, in effect, reverse Type 2 diabetes within 7 days.

              However, such diets should only be followed under strict medical supervision, In the US, the TrueNorth Health Center has a plant based diet approach and a good reputation for effective use of (water) fasting. It has a number of free resources that may be worth checking out………………….

              1. Thanks for this link. Quite interesting or rather organized in a new way, especially this one:

                This basically says that I can start with one fasting day per week and throw more days in, as needed, up to 3-4 days a week which at this moment would be equivalent to 1/1 IF.

                And that flexibility is a great idea!

                I can adjust IF pattern to my work schedule (which by itself is sick and probably one of the main reasons why I have so many health issues). Also because of the work schedule I’d probably be unable to go with throwing out one meal a day. Besides this strategy is too similar too caloric restriction which does not induce the same effects as IF.
                So I’d rather go with IF for now.

            4. Mick, I think there’s enough evidence out there on the benefits of IF for you to at least give it a try and see how your body reacts. Also for weight loss around the middle and reduced joint inflammation try avoiding wheat and gluten; it’s worked as a real miracle for some. Again, give gluten-free a try for a few weeks and see how your body reacts.

          1. Agreed but OMG – 382 days…

            The problem was not with fasting per se, it was with me fainting all the time… and I needed to get to work finally… it was an unsupervised fast so this got me a little scared… otherwise I could go on at least for another two weeks and that was the plan… I already planned for another long fast when I found out about IF…

            I also wonder how it is possible for some people to feel energetic during fast – most confess that they are rather bed-bound.

            1. I think the answer is probably that the adaptation where the body relies on fat for the majority of energy as opposed to glucose takes time. I’m no expert but from what I gather, people four weeks in to fasting (or a ketogenic diet) feel better than those two weeks in. That’s not to say everyone ends up feeling better in time on a fast. I don’t know enough about it. And yes, 382 days is extreme but shows what is possible…though I’m guessing that’s at or near the edge, and only for those with enough of a reserve to survive it.

              1. From that paper:

                There have been reports of five fatalities coinciding with the treatment of obesity by total starvation

                So it’s better to be careful.

                1. Just what I was going to say. Plus it does nothing to teach a healthier way of eating than what got them that way in the first place.

            2. Why are you in such a hurry to lose the weight? A plateau isn’t anything to worry about depending on how long it lasts but even a month isn’t enough to cause you to change your plan. I recommend just staying the course on a low fat starch & plant based diet, making sure to avoid all oil. If you don’t start losing again by a month, then I would start wondering about your hormones like thyroid. Fasting isn’t sustainable and might cause your metabolism to lower due to thinking you are starving making it even more difficult to lose weight.

              1. So, here’s the answer – you asked for it, although I have a feeling that we are drifting away from the nutrition a little…

                Maybe it’s a little naive (though not entirely) but I hope losing weight will solve my problems with inflammation and other problems that follow (I am on the verge of full-blown rheumatoid arthritis caused by food allergies (wheat, meat, garlic among others) which seems to have been partially stopped just a week ago by fasting, there are also other problems too and because none of them is fully developed I don’t really have alarming parameters so doctors usually ignore my complaints).

                The problem is that I am trying to fight all of this for the last 13 years and (1) I’m sick of it, (2) I don’t want to miss another opportunities in my life. Enough is enough.

                So what else is left for me to do? Only to intensify my efforts. To find what the gist of the therapy is and use it as aggresively as I can.

                And I think plant-based diet and IF is just it.

                As for avoiding the oil – that would be a problem. Flax oil is almost the only thing that helps decrease inflammation. After fasting however I am almost able to avoid it entirely.

                1. You can eat ground flax seed and still avoid oil. Avoiding all oil is crucial for success according to drs. mcdougall, essylstein, campbell and others.

        1. Thank you Lisa.
          The only frustration is that I was 53 years old before discovering Dr Greger and so had 53 years of “western diet damage” which as you know is appalling.

          1. Yes, it can be so frustrating to feel we are late to the party! But reversals in markers can be dramatic, profound, and lasting. Just because western medicine can prolong our lives it cannot improve our quality of life as we age! We can do that ourselves through plant based diet, managing our stress, and engaging in moderate, regular activity!

          2. I was 48, now 49 and lighter and feeling much better. Benefits were so obvious so quickly, that I find it strange that this hasn’t “caught on” before. I’m WFPB mostly, and it’s great.

      2. I believe you are right on target.
        You may not be aware that Dr. Dean Ornish performed research on WFPB diet and prostrate cancer reversal. He took a group of men whose prostate cancer was measurable but not sufficiently aggressive enough to warrant aggressive treatment. These are men whose clinical presentation was sufficient to “watch and wait” to see what happens with their particular cancer. Dr. Ornish took these men and put them on a WFPB diet to see if their PSA would change. Sure enough, it did and it went down. I don’t have a link for you, but I suspect you can find some of his research somewhere or read his books. He also has a clinic that you can contact in California to find out more information.
        What a great little experiment you did. Thank you for sharing that with us!!

        1. Hi there – yes, I was aware of the Dean Ornish research. I don’t understand why this isn’t common knowledge. Everyone with a raised psa level should be given the option of the plant based diet route – I’m not sure how many would give it a go as people are so set in their ways and so blinkered. The “I love my steak” brigade are addicted to bad food and get very emotional when you suggest an alternative – even when it can literally save their life. The ignorance of GPs in the UK about diet is quite incredible and theres an awful long way to go to put it right. On the positive side, there are businesses realising there is money to be made from plant based food and drink so the change will arrive eventually. For me – finding Dr Greger was the best thing that ever happened to me (health wise) – I eat more than I have ever eaten, I’m the same weight as when I was in my 20’s (I’m now 56) – my diet is more varied and I love what I eat. Dr Greger is an angel and if he was in the UK, he would/should be knighted! Arise Sir Dr Greger!:-)

          1. Iain,

            I’m sure Dr. Greger would much appreciate your comments. And my hats off to you for your changes in diet and results…..nice work.

            You will be seeing a plethora of “fake” meat products coming to your selves shortly. They look and taste the same but……drum roll….are made with plant products. It’s a revolution that might be indeed slow in coming but….it’s rolling forward with more steam than most think. If this is what it takes to convert the taste buds of the “I love steak” crowd I’m all for it !

            Again, great work on your diet and keep letting other know that indeed prostate health is connected to your diet.

            Dr. Alan Kadish moderator for Dr. Greger

      1. Lol. Well, given what we know I would certainly not bet against a whole food plant-based vegan diet. However, having said that, it is not inevitable that only one diet leads to good health and longevity. It might make intuitive sense, but people tend to think in binary terms generally, and this is particularly true when it comes to diet. Something is happening when people eat high fat/low carb for a long time, and if this is unhealthy, the traditional tests we use to measure health (triglycerides, cholesterol, blood glucose, body fat) don’t seem to be picking that up.

        1. I’m wondering as Dr G’s video suggests that looking at inflammation markers would be an indicator? It would be interesting to see lab results for CRP and other markers of inflammation. We are likely moving past the stage of viewing health through the traditional tests of TCHOL, LDL/HDL & FBG.

          1. Yes, this is along the lines of what I’m interested in knowing too. The study below showed a statistically insignificant rise in CRP on a high fat/low carb diet, so I interpret that as no change in the absence of more data – and also a need for more data. I would like to know if such a high fat diet is atherogenic despite the good test results, and I can’t tease that out.


        2. You are right that something is happening. And I wholeheartedly agree that traditional tests are not what we should be going by. But if you want to see what eating high fat/low carb looks like after a long time go search Dr. Atkins and see his photos. His family wants to hide the fact that he had heart disease but he did.

          1. I don’t think there is any research on the long-term health effects of a HFLC, nutrient sufficient diet where participants ate 70%+ fat and under 50 grams of carbohydrates. There is research on “high fat” intake, but they are different in many ways, and the results are so different from what is being posted by many people eating HFLC that it seems something unknown is happening. The meta-study conclusion you posted in reply to my initial comment said this same thing.

    4. There is a nice saying that there are no paradoxes in science but just temporary lack of understanding :) I’m pretty sure people can experience certain positive effects from “ketogenic diet” (which in fact is merely low carb as Darryl said above). It is to our benefit to understand what are mechanisms. IMHO a lot of effects you listed are quite achievable via strict control of blood sugar – be it from meat-heavy diet or purely WFPB the choice is ours. Personally I get notably inflamed (face skin quality etc.) from too much carbs of mere rolled oatmeal or brown rice. I also get brain foggy – and Ive seen studies showing that there is a dramatic increase in brain inflammation and circulating amyloid beta when blood sugar is high. In the light of neurodegenrative epidemics it is may prove very dangerous not to pay attention to this data. It’s not all WFPB, IMHO, it has to be low glycemic version of WFPB (remember those Okinawans and their sweet purple potatoes?:). Too much sugar in the system is inflammatory. Flavonoids will negate some amount of inflammation (say when eating high glycemic dark skinned grapes) but i woudnt count on guaranteed negative net effect at all. Another interesting version why grains are not very well tolerated by some people is that their gut flora is just not well suited – too much food for patogenic overgrowth or something like that, so they feel better on “low reactive” food such as nuts, broccoli or meats/fats.
      As a bonus my personal favorite antiinflammatory protocol: lots of green tea and (not overly – al dente) steamed cabbage in huge quantities – in a few hours I feel like I was born again :) I also get same effect on the next day after having omega-3 rich fish which I do too once in a while. And it is important to note that I never felt same effect from flax oil with dramatic change the very first time I tried fish after long abstinence. Hard to beat EPA I figure… :)

      1. “a lot of effects you listed are quite achievable via strict control of blood sugar”

        I gravitate toward this as a potential mechanism too. People who adapt to HFLC seem to settle in to very low insulin and blood glucose. You’re right about the mechanisms – when we figure those out we will know much more.

    5. I found this on the website “ChrisBeatCancer” referencing a paper from Dr Nicholas Gonzalez:

      I had spent a couple hours listening to Dr Mercola and an obviously very bright scientist recommend the ketogenic diet, which spurred me to dig deeper. I’m siding with Gonzalez based on something I learned from Dr Greger. . . Can you back it up with real science (not theory) and real people this worked on? Dr Gonzalez could with his own patients. Dr Mercola and his brainy scientist were impressive but it lacked the case study proof or medical research proof I require.

    6. UCBAlum: It’s a fair question. I appreciate your post and the discussion that has followed. Here’s my own 2 cents: We know from observation and studies that the most successful populations on the planet are plant-based. These long-lived, healthy populations eat small quantities of animal products, but only very small quantities. The vast majority of the diet is minimally processed whole plant foods.

      I am not aware of a single, significant, *successful* (Inuit do not count due to their health problems–and plus, they avoid ketosis anyway) human population that takes in 70%+ of calories from fat over their lifetimes. So, the people promoting this ketogenic diet are saying that they have a diet hack. They have found a way to eat that is not “natural”, but that they claim works. ie, That they found another way, in addition to WFPB eating, that is healthy if not short term, then long term.

      My feeling about that diet hack is that while I think it may be possible they are correct in some way, I don’t believe our current body of evidence supports the assertion that a ketogenic diet is healthy short or long term for the majority of the population. (Ie, not counting the sick kids that Darryl mentioned.)

      So, how to account for the *apparent* success you are reading about? I think it is a combination of all of the answers you have been getting. ie, everything from placebo effect, people not truly being on a ketogenic diet (just thinking or reporting they are), some of the worst effects (like cancer) not having kicked in yet, etc. Also I came up with this one: consider that some people are able to eat eggs and bacon almost every day of their lives and still live to be over 100. But those people are the exception, not the rule. Some of those stories you are seeing may also be from “exception people.” It’s all just anecdotes. We don’t know how many people have tried a ketogenic diet and failed to thrive. We know there are lots of those failed ketosis people out there. So, the impression you get from reading certain websites may not accurately reflect reality.

      On the topic of the placebo effect: I think of the ketogenic diet as the extreme version of Atkins/paleo/blood type/wheat belly type of diets. I think of the ketogenic diet as being on the “far right” side of a range/scale. Way over on the far left side, is an extreme version of a WFPB diet: fruitarians. And from what I have seen, neither the science nor my personal observation supports an all or mostly all fruit diet as being all that healthy. But I guess that if you went on a fruitarian site, it would look and feel very much like the ketosis sites you are looking at in terms of testimonials. Despite being as opposite ends of the scale, I see a fair number of parallels between fruitarians and ketogenics.

      So here’s my point: I met someone once who had been eating a fruitarian diet for a long time. (I don’t know exactly how long.) She looked frail and way too thin to me. She moved very slowly/delicately. But she reported having high energy. She felt like very low energy to me. I felt like she was experiencing the placebo effect when it comes to “energy” and her diet. And that she was likely to experience long term negative effects like loss of muscle mass. I think there is every reason to believe that this self-fooling could be happening to a significant percentage of the ketosis people too. One or two athletes does not tell us enough. Especially since hard exercise can make up for bad living, at least for a while. Just a thought.

      1. All good thoughts.

        ” ketogenic diet…a diet hack”

        That is where my mind takes me. It may not even be possible to eat this way “in nature”. Only with modern technology is it even possible, so if by chance it turns out healthy, it is by some freak of nature that we aren’t yet aware of. Is this possible? Sure. Is it likely? I wouldn’t bet my life savings on it. There is something happening at least for some people eating HFLC, and I think we’ll be better off when we learn what that is.

        1. As far as I know, the key thing happening for people eating low carb is increased mortality

          Of course, even with smokers, you find some living to healthy old age. So the existence of some healthy HFLC dieters neither surprises nor proves such diets are healthy. Survivorship bias probably plays a role here – people who don’t do well on such diets usually don’t or can’t recount their experiences (Jimmy Moore might be an exception!).

          This effect is perhaps clearer in experimental studies with genetically similar lab animals where some of the subjects on a high fat diet did not become obese or experience premature mortality. These are perhaps the equivalent of the long term human HFLC dieters singing its praises. But the fact remains that there was a high level of obesity in the HFLC test subjects and also much greater mortality than was seen in the control (low fat) diet subjects:
          “C57BL/6J mice were fed with a HF diet (60% kcal/fat) or control diets (15% kcal/fat) for 27 months. One-half of the mice on the HF diet developed obesity (diet-induced obese (DIO) mice), whereas the remaining mice were diet resistant (DR). At 8 months of age, both DIO and DR groups had increased hyperglycemic response during a glucose tolerance test, which was normalized in 16-month-old mice. At this latter time point, all groups presented similar performance in cognitive tests (Morris water maze and inhibitory avoidance). The survival curves of the HF and control diet groups started to diverge at 15 months of age and, after 27 months, the survival rate of mice in the DIO and DR groups was 40%, whereas in the control diet group it was 75%.”
          Source: “High saturated fat and low carbohydrate diet decreases lifespan independent of body weight in mice”

    7. Great question @U@UCBAlum:disqus – did this get answered in any real sincere and ‘normal’ manner, or was it just defensive nonsense? This is a KEY question and I wish normal people would just say “hey, look, this is why their tests are coming back so good – this is why they feel that way” because I’m reading the same stuff. A LOT of science based / data driven people in Silicon Valley are on these ketogenic diets – are they ‘wrong’? I too am curious.

      1. Michael are there any research articles that support the high fat diet? I have studied and worked in health and fitness for many years and I can tell you that most of the fads you see like the high fat ketogenic diet start in gyms.

      2. Hi Michael,
        You might find this interesting–regarding endurance athletes. From Exercise and Sport Sciences Reviews Issue: Volume 43(3), July 2015, p 153–162 (I couldn’t link actual article but if you have access to journals here is info)
        “The earliest is the study by Phinney et al. (28), which looked at the effect of chronic ketosis on performance in endurance athletes. They reported that 4 wk of ketogenic nutrition did not have any negative effects on the aerobic performance of endurance cyclists. A very recent study by Zajac and coworkers (42) reported a significant increase in VO2max and improvement in the lactate threshold in off-road cyclists after a KD. The authors explained their findings as being caused by reductions in body mass and fat mass and/or a greater oxygen uptake necessary to obtain the same energy yield as on a mixed diet because of increased fat oxidation or by enhanced sympathetic activation even though the maximal workload and the workload at the lactate threshold were both reduced significantly on the KD.”

      3. Defensive nonsense? Back to bashing Vegans again Mr. Gains? Why do you keep coming back to start trouble again with low fat Vegans on a site that expressly denounces low carb fad diets? Plenty of unhealthy 300+ cholesterol fat addicts over at Jimmy Moore’s site who embrace the low carb fad nonsense. Those poor souls on high fat diets ‘want’ a diet that lets them eat all the unhealthy fat and meat they want. Of coarse people ‘want’ to believe low carb is healthy. It’s not. Lets leave the meat and fat BS diets to those sites.

      4. Some smokers lived into their 80’s so smoking must be healthy? Give each diet a FAIR trial and see how you feel. Your life and all. But do NOT make sweeping statements about something that is patently BS…SHOW us the science!

        1. Sweeping statements? This is the type of response that kills this debate. Mine is a sincere question. Funny how defensive people are – even re questions. Reflexive, non curious, totally not open responses – not even answering the question or making sweeping statements like “so not all smokers die young ” which is a common, trite and tired response. I’m simply asking questions as are people over at the rich roll podcast. You realize there’s other data driven science which holds your iron clad views in question no!? Your response reminds me of the church sign that says “education takes us further from God”.

    8. From Ketgenic Diet and Sport: A Possible Marriage

      I thought you might find this interesting. You might be able to find article but in case you can’t I copied their conclusion.

      “The use of KD in sports is still a twilight zone… “the middle ground between light and shadow, between science and superstition.”
      There are some encouraging data that are suggestive of a useful role of KD in certain sports, and these include those with weight categories and aesthetic and endurance sports, but it is necessary that trainers, sports physicians, and dieticians are aware of strengths and limitations of this nutritional strategy.
      Many sports require weight control, and specific sports have very strict weight categories. All athletes are by definition competitive but also are in general very young and often under great pressure to perform. As we have discussed, necessity for rapid weight loss is a very common situation that occurs regularly in an athlete’s life, and the temptations are to try any means possible to lose a few kilograms in the weeks before a competition. It is an advantage to be just at the top of the weight range of the lower category rather than be at the lower end of a higher category. So to compete in a particular weight category brings advantages but, if incorrect rapid weight loss is used to get there, many of the advantages will be lost. Even worse, in the long-term, repeated inappropriate weight loss efforts can lead to long-term difficulties in maintaining the correct body weight (10,31). Many of the techniques used have been shown to be inappropriate for many reasons. These include “crash” diets with extreme energy restriction, dehydration attempts, and use of pharmaceuticals. The KD is fundamentally different from many other types of weight loss diets — it induces distinct physiological changes and exploits natural mechanisms that have evolved to cope with the historically normal situations of frequent short-term food shortages. The KD also is different from the more studied Ramadan fasting mainly because, during Ramadan, fasting subjects do not became ketotic (5,35). It should be emphasized again that the induced ketosis actually is defined as “physiological ketosis,” it is not a pathological situation such as observed in “diabetic ketosis.” It is a form of dietary pattern that has been subject to intense scrutiny especially across the decades since the popularization of the Atkins diet and, apart from its positive effects on weight loss, the short-term use of energy-sufficient KD has not been associated with any long-term health issues; the few symptoms such as fatigue and headaches disappear after a few days (22). Biochemical, physiological, and observational studies also provide good evidence that an actual KD (i.e., where adherence is checked) can lead to fat loss with little or no loss of muscle mass (13,25). Indeed, it is a common misconception that the KD intuitively is unsafe because it is a “high-protein, high–saturated fat” diet. This is not the case. The key feature is an energy sufficiency while with a very low carbohydrate intake, but this is compatible entirely with normal protein consumption and a rich nutrition providing full complements of micronutrients and essential macronutrients. Overall, the KD may well be one of the most intensely studied and characterized nutritional systems that exist for weight loss. It also is being used more frequently as a long-term therapy for several pathologies, including epilepsy, and others (20) and, moreover, is a traditional dietary pattern of Circumpolar populations. In view of these considerations and the fact that there will always be athletes who will want to do, or be pressured into doing, almost anything required that may give even a small advantage, at the very least protocols that are known to be damaging should be avoided in favor of methods that may be effective and unlikely to be harmful. The evidence reviewed here and elsewhere suggests that properly designed KD could be such a candidate.
      Regarding weight category sports, it should be remembered that:
      * rapid weight loss should, in principle, be avoided
      * long-term planning and gradual body weight reduction is recommended
      * if necessary, a KD may be a viable route but at least 2 wk is necessary to avoid any negative effects on performance
      Regarding aesthetic sports such as bodybuilding:
      * as noted previously, rapid weight loss should be avoided
      * it is very difficult, maybe impossible, to gain muscle mass during a KD
      * a KD may be used during the final days before a competition, bearing in mind that it causes a glycogen depletion (i.e., reducing muscle volume and vascularization)
      Regarding endurance sports, there are some interesting preliminary findings suggesting that the KD may be an instrument to improve fat metabolism and oxidation with improvements performance (Fig. 4).
      Finally, the various studies reviewed here demonstrate, in our opinion, that the use of KD in sports both deserves and requires more research, and we would invite researchers to explore the effects of KD in sports.”

      1. Interesting. This excerpt is consistent with the anecdotes I’ve seen. The possibilities of what is going on when someone eats HFLC are numerous, and maybe unique to individuals to some degree. The horrible reputation of Atkins-style diets notwithstanding, I think our understanding of nutrition may likely be advanced significantly by understanding what is happening on a HFLC diet…

        or it could just raise more questions than it answers like everything else we discover. I suspect though that it would be worth the effort.

        1. I don’t normally find what one or two or twenty people consider to be all that important. But personally (n=1) the more running I do the more carbs I crave. I crave things like potatoes and oatmeal. And this was as a meat/fat eater. With running we know the lighter you are the faster you run. That could be the advantage they are expressing.

          And one last thing. How do the times of the ultra marathoners eating high fat compare? Are they winning? Or just saying they feel great?

    9. I too have been concerned about this paradox – smart, serious people on both sides of the argument. I have a bit of a pet theory – completely scientifically unfounded, but I am not sure I have seen it elsewhere. My thinking is that high fat and high protein diets are particularly good for short-term virility – and in particular for strength and reproduction. Evolution-wise – this is all really our DNA wants, for us to fight-off threats, reproduce and be around until the baby can take care of itself, thus, (in a neolithic society) we really only need to live until about age 35 – who cares if we get inflammation or clogged arteries or dementia in the future? We won’t be around long enough for those to be a problem.
      However, these diets are very poor, as everything on this website suggests, for longevity – which is more highly valued in our modern society – because they slowly hurt us over a long period of time. This is important if you want to live into your 80s.

      For me this explains the paradox, if you want to build muscle and increase testosterone, find a mate, have children and beat up others, but not live super-long – the ketogenic diet is good in the short term. If you want to live to a ripe old healthy age, low fat, no animal product is better.

      Thus, both diets have their strengths and weaknesses depending on your aims.

      I would be interested in people’s reactions to this theory – but please be gentle.

    10. Thank you for the question. Remember there are lots of variations of the diet. The real fanatics are pure stupid because they don’t consume healthy meats and tend to not eat their veggies. The problem that I have with is that the studies hardly ever include grass fed meat, chick or eggs.
      Modified Ketogenic diets appear very interesting. I don’t think the like of Dr. Peter Attis can be all wrong. Check out his videos on You tube. While he advocates the diet, he lets everyone know we at eat different and one size does not fit all. There are ways to eat Keto while staying mostly Vegan (LOL). Eat lots of avocados, and some MC oil with a little butter. Peter and other recommend the LDL-P test. The size of the particulates are very important and not testing for that is at our peril.
      It would be interesting if Dr. G would look at the Keogenic diet with open eyes. I think the problems with science is the studies results are not always what you think. Their are always input variables not considered. But in the in end I prefer to play it safe and do the modified keto diet with occasional grass fed meats and fish. Maybe my life gets cut off by a few years but if I supplement with whole food natural vitamins (My My Kind) and super foods I am confident I make most of those years back. The issue is quality of life and then long life. I believe we can do it all and also enjoy some grass fed beef once in a while. Of course eating at Taco Bell every day will kill but moderation and the elimination of processed foods along with a 95% plant based diet will work.
      Question which is healthier strawberries sprayed with round up ? or Grass Fed Meat boiled in water with organic turmeric, pepper, onions, vegs etc… ? Nothing is ever what is seems.

      1. David X Singer: I would not consider Peter Attia to be a reputable source of information. You can read more about Peter Attia and his claims here:
        I just addressed the ketogenic diet for someone else. You can read about the short and long term health problems with a ketogenic diet in this comment:

    11. I’ve been eating keto for about a year and I’ve been pondering the same questions. I’m leaning towards evolution for the answer. Prior to farming keto is how our ancestors ate for millennia. Meat (including the fat), fish and eggs, veg and fruits in season, nuts, seeds and legumes are the foods our bodies have evolved to process. We would also have eaten maybe once a day if lucky, more likely every few days, so intermittent fasting is optimal too. What we’re best adapted to eat on an individual basis might depend on our genetics, where our ancestors lived and the primary food sources available then.

  2. Dr. Greger I really think you should have your own PBS special like Dr. Hyman and Dr. Fuhrman. You tell us so many interesting things. I bought your book. Thanks for the education.

  3. Just to clarify, prostaglandins are not evil molecules (actually a family of molecules) that we should avoid. They work like hormones, but only affect close-by tissues. Our bodies make them for a purpose. Plus, they generally come in pairs, working both sides of an issue. For example there are prostaglandins that promote inflammation (useful in repairing an injury) and some that reduce inflammation (which is how we want to be when we are not repairing an injury), some that are vasodilators and others that are vasoconstrictors. Most important for us is that a diet rich in plant-based foods (especially omega 3 fats) generally promotes a healthy balance of prostaglandins (less background inflammation and more vasodilatation) and diets rich in animal protein and fats do the opposite.

    1. This is an excellent point, Steve! Prostaglandins’ job is to stimulate healing through the inflammatory response. Inflammation is always necessary for repair/regeneration. Having a balance of prostaglandins in their complimentary pairs is very important. Like many things, if we are producing too many of the inflammatory prostaglandins through a mostly animal protein diet, this alone can overwhelm the homeostatic balance of the paired vasodilators and vasoconstrictors. I really like Dr G’s video on Osteoarthritis from last week which talks about the anti-inflammatory effects of plant based foods.

  4. Reversing inflammation, as well as virtually every cause of chronic disease is simple following WFPB starch centered lifestyle. I followed Dr McDougall’s MWL program for a year and achieved remarkable results. I dropped my HS-CRP score from 7.15 to 0.58 (a 92% drop in inflammation) in one year doing nothing more than eating proper foods and walking essentially. No need for medications, weird diets, heavy exercise, and trying to understand dozens of studies… just a simple wilingness to try it.

    My results:

    And how I did it. A personal, day by day, one year journal of everything I did and ate:

    1. Geos what a great testimonial! I love these. How are you doing now? You mention the slow reversal of vascular disease. Did you by chance ever so an angiogram? It’s been 4 years? Love this stuff!

      1. It’s been almost 3 years since I completed my one year study on myself and i’m doing great. I haven’t bothered with any more blood tests because physically I’m like 30 years younger and don’t even worry about health anymore. I just eat my food and try to get about 10K steps of walking a day. On the other hand, I’m still experimenting to see if I can achieve even more. I’m getting ready to start another one year study on myself to see what can be accomplished not with just food but also with a multifunctional/multifactorial, aggresive exercise program. I hope to show what can be achieved with proper diet and proper lifestyle factors even at my age.

        My CVD results can be seen in my testimonial thread, page 3, 8th post down or there abouts. I used Ultrasound. I will never get a cardio angiogram because I’m very allergic to contrast dyes.

        But really if anyone is simply looking at the blood markers, then your missing the real point. You need to look at the totality of the results. The “Big Picture” (ref: “Creator” – a great Peter O’Toole movie!). Individually, each marker tells but just a small snippet of the health story. Together they represent the totality of health that can be achieved.

        Health is NEVER about any one or two single markers or magical “super foods”. Health is SOLEY about the totality of diet and lifestyle over time. There is no importance in what you eat at any single meal or even in a week or two. Its about everything you eat over time. No one is just sick with one issue that can be magically corrected with one food as so many people on here seem to think and search for. No single study* will ever prove anything. Thats not how science works. And its not how your body works. Its not a static system where you can just change a single variable and find a simple solution to the issue. The body is a very dynamic system with thousands if not millions of functions going on all at the same time, constantly. Change one variable and you get alot of corresponding changes in a multitude of systems, which cause more changes in more systems along the way over time. You can’t control that, but your body can, it was made to do so. And all it requires from you, is to fuel/feed it properly and treat it properly in an appropriate environment.

        If you’ve been eating SAD for 2,3,4,5 decades or more, I guarentee, you are sick and have issues, no matter if you feel or look healthy or your doctor says your are. You aren’t anywhere near real health, let alone optimal health. All those issues you just naturally put off to “signs of aging” really aren’t. You simply can’t abuse your body for decades with improper fuel and expect it to function at anywhere near optimal levels.

        IMO, foods don’t cure anything. What food does is properly fuel your body so that its immune system and recuperability/healing functions can work at optimal levels to fix the issues you have to the extent its capable. Fuel your body properly and it will automatically do everything it can to keep itself in as perfect condition as it can.

        No, diet can’t cure everything because the body can’t cure everything, but fueled properly it can function at the highest levels possible to keep you healthy and with the adjunct of allopathic medicine, it can seemingly do miracles. And again, these points are only important in the bigger picture of time. Healing continues as long as your body is alive and fueled properly.

        My one wish by posting my results is simply to show that a multitude of problems can be easily and simply fixed by feeding your body properly. No need for singular “super foods”, expensive suppliments, “health” foods, weird diets, timing when you eat, moderation, or focus on any one macro/micro/phyto nutrient or even counting calories. Just eat a simple, cheap, easy diet of WFPB- starch centered – no SOS – minimally processed – low calorie dense foods and drink water when your thirsty. It really is that simple. All you have to do is try it for a few months.

        Sorry for my rambling thoughts and preaching to the choir…my writing skills are poor. But I hope you do get my message. JUST TRY IT…what have you got to lose? or better yet, think what you have to gain…

        * None of this is to disparage the work that Dr Greger provides. His work is an invaluable and exhaustive search for the scientific proof. I applaud him greatly for his efforts. I just wish that the people who read the studies he points out, treat them as the small nuggets of nutritional information that reductionist science is good for. But understand that its the big picture thats what is most important. Health won’t be found in any one of these studies. But taken as a whole and with great understanding, the totality of the information will take you down the proper path to optimal health. Thats what Dr Greger shows with his yearly review videos so clearly.

  5. This has me wondering – on the one had, it is reported that diets high in sat fat are correlated with inflammation, on the other, arachidonic acid in particular is implicated. So this begs the question – are other sat fats really so bad? Dr. Bland e.g. says palmitic acid is very bad, but stearic acid is fine.

    I’d like to see the discussion and analysis get beyond simply sat fats, and delve into the drawbacks or possible benefits of particular sat fats, equivalent to discussions on O3s: ALA, DHA, EPA, Oleic acid, etc.

      1. Many thanks for that link! I would encourage those interested to read it but for me the key take away on sat fat was that (1) palmitic and myristic fatty acids are definitely harmful, (2) although stearic and lauric fatty acids seem neutral, there is no evidence they are health promoting, and (3) everyone agrees sugar/refined carbs are worse than sat fat, and that trans fat is toxic.

        1. Thanks David. I didn’t see any statement that “sugar/refined carbs are worse than sat fat” there although Hu observed back in 2010 that
          “refined carbohydrates are likely to cause even greater metabolic damage than saturated fat in a predominantly sedentary and overweight population………..”

          although a more recent study in which he was involved found that “Replacing saturated fats with carbohydrates from refined starches/added sugars was not significantly associated with CHD risk (p > 0.10).” which seems to impliy merely that they are equally bad.

          1. I could be misremembering but I think I read that currently 90% of the “food” on grocery store shelves contain processed (GMO) corn and soy because they are so economical for industry. In combination with the fat and other crap they add to it, and the otherwise nutrient poor diet of most western populations, it’s a massacre. How do you wake people up when they don’t want to know though? It’s pretty frustrating seeing loved ones commit slow suicide.

    1. A discussion of specific fats, saturated or not, is fine as long as we don’t lose sight of the fact that the oils olive oil and coconut oil we eat are a mixture of different fats. When people focus on a single type of fat, be it the focus on the health effects of mono-saturated fats in olive oil or the lauric acid in coconut oil, it is easy to lose track of the fact that this fat doesn’t represent 100% of the given oil. So even if the given fat in question has some positive health benefits, that doesn’t mean the oil containing that fat promotes health. The negative effects of the other types of fat in the oil could, and from all I have seen does, make the net health impact from refined oils of every type negative.

      1. That’s a good point. I’m on the fence when it comes to extra virgin olive oil. I’d like to know why you think that is also a net negative (I know the general argument about whole foods containing all sorts of extra nutrients, but that does not convince me it cannot have a positive effect on health, but then I have no weight issues; in fact, my issue is how to gain weight on a vegan diet, not lose weight).

        1. Whether losing or gaining weight, a consistent goal should always be gaining health and losing disease. The best way to do that is to maximize the micronutrients, recognized or not, that we get each day to give our bodies the most resources possible to heal and maintain our health.So the biggest problem with refined oils and carbohydrates isn’t whether they are health promoting by themselves or not, but the fact that they don’t come cloaked in a protective blanket of micronutrients. Thus every calorie we get from the a refined food is a missed opportunity to increase our micronutrients and so definitively reduce our disease fighting capability. Refined carbs, proteins and oils are like friends who come over for dinner, but don’t stay to help wash the dishes.

          So if you are trying to gain weight the healthiest way would seem to me to be by simply eating more whole food until you get enough calories while maximizing your micronutrient load to deal with the extra stressors that come with exercise.

  6. Have you seen the recent reports where mice lived up to 35% longer by removing damaged cells? One of the outcomes was a reduction in inflammation. One of the hallmarks of aging seems to be an accumulation of damaged cells. The mechanisms that clear them out become less efficient as we age. So, could this be part of the reason for the decrease in inflammation from a WFPB diet? That it leads to fewer damaged cells, maybe by enhancing the efficiency of clearing them out?

    1. That’s interesting. How did they remove the damaged cells? If they can do it with diet, that would be something we really could use.

      1. Here is the article:

        The published paper is hidden behind a paywall, of course:

        They used transgenic mice with a gene that is targeted by a drug to remove the cells. So, the experiment wouldn’t work with people as-is. Still, there were no negative side effects that they observed.

        The main point is that the body already removes these cells, the mechanism just slows down as we age so the damaged cells start to accumulate in our organs. So, the proper diet could most certainly enhance this ‘cleaning out’ mechanism. And I’m sure over time maybe certain foods could be identified that enhance this process.

  7. Ok, so color me confused for a moment. WPFB-diet notwithstanding, humans need SOME omega-6s – I mean AA is derived from linoleic acid, and it is a key secondary lipid signaling molecule, etc. What’s the balance here? Is it only dietary AA that we should be concerned about?

    1. Linoleic acid is an essential fatty acid, so humans need to get it from food. But “essential” doesn’t mean ” a lot ” or “unlimited”. I think the American diet contains too much linoleic acid. All those so called vegetable oils have a lot of linoleic acid., meaning a lot of AA formed in the body. Until I immigrated to the US, the only oil I consumed was coconut oil. Those days coconut oil was hard to find here and was very expensive, so I started using vegetable oil. Then a few years ago, I switched back to coconut oil and joint pain I had developed over the years disappeared gradually. Of course, coconut oil could give me a heart attack. The best action, I suppose, is to give up all refined oils, not an easy thing to do.

      1. > All those so called vegetable oils have a lot of linoleic acid., meaning a lot of AA formed in the body

        Not true. No evidence of this. LA intake reduction or increase do not translate into lower or higher levels of AA. I have not seen any evidence that LA is pro-inflammatory.

        That’s not a free pass for refined oils, of course. Nuts and seeds are always the better option.

  8. Thank you for raising this question. I’m confused as well ; is it the ketogenic diet or plant based diet. I have shifted to a plant based diet, mixed with fish every so often, and i feel better compared to the time that i was also taking meat & animal fats. My children however cant be w/o meat and animal fats and takes very limited vegetables. They feel just as good. Only concern i have is they continue to be overweight. So really which one is the diet for a sustainable, long term healthy life.
    Dr. Greger what have been ur research findings?

    1. I have posted this elsewhere recently but it does no harm to repeat it. Low carb diets like your children’s deliver increased mortality

      And, of course, the 7th Day Adventist studies also show that meat eaters have worse mortality figures than vegetarians

  9. Hmm… pineapple belonging to the high antiinflammatory foods? How come?
    If so, does canned pineapple count too? Dr Greger has a video “Best Fruit Juice” and pineapple juice is comparable to apple juice which means not that good.
    It may be a completely different story with a whole fruit… it may be better than an apple.

  10. I read Dr. Gregor’s, How not to die book. I did not find much information about iron. As a vegetarian (almost vegan), one of my daily battles is how to get my body to get and absorb enough iron. I am also pregnant which makes my iron needs even higher. My bloodwork just came in and I have low iron. I have been religiously drinking spinach+fruit smoothie everyday. So the results are pretty disheartening. I will need to go back on my iron pill. Is there anyway people (specially women) who eat plant-based foods, keep up their iron levels naturally rather than resorting to pills?

    1. Hi tutu,
      There are great videos on iron in topics above. Also make sure you are always eating a high vitamin C food with every meal. That will help with absorption. That being said I tend to be low also-whether eating meat or not and I do need to supplement occasionally. Some of us just don’t absorb iron that well.

    2. There aren’t simply because the plant iron is bound to oxalates and not very bioavailable.
      Keep the egg yolks handy if don’t want to touch meat, at least until the pregnancy ends.
      Vitamin C is helping somewhat with the iron absorption but in the context of plant-based diet the effect is minimal.

  11. I drink a lot of homemade almond milk. Is it important to buy organic almonds? Do conventional ones contain a lot of pesticides? How about other kinds of nuts, like walnuts and cashews? Thanks.

  12. I’m doing a ketogenic diet with regards to lung cancer it entails eating vegan. I eat a pound of assorted cruciferous vegetables, I’ll add asparagus, green beans,mushrooms, garlic, onions, and others to this mix. Rarely does this exceed 175 calories. I also make an avocado and cashew mayonnaise dressing or olive oil and lemon. My protien s come from spurlina, nutritional yeast, flax seed, nut butters, (also a major source of fats) chocolate, temphuah, soy yogurts. Daily my protien is about 44-48 grams-less than 200 calories, the rest is plant based fats (only coconut and olive oil used for cooking) Most of the fats are consumed as a beverage (nutri-ninja). I use cauliflower with garbanzo flour to make bread like dishes. I intermediate fast the diet is caloric restricted no more than 1300 calories a day. Also berries, sweet potato, or beets are added ay times to the beverage. Supplements are beta 1-3d glucan, IP6-Gold, B12, C 4000-w/trace minerals, D 5000. The cancer has not metastasized, nor has it grown since the last imaging. I take it one day at a time. My oncologist is a little baffled

  13. On January 11, the Washington Post summarized an article from the January Issue of the American Journal of Clinical Nutrition. The discouraging conclusion of that article is that all cause mortality is the same for vegans as for meat eaters. I would sure like to have Dr. Greger’s opinion about the article.

    Paul N Appleby, Francesca L Crowe, Kathryn E Bradbury, Ruth C Travis, and Timothy J Key
    Mortality in vegetarians and comparable nonvegetarians in the United Kingdom
    Am J Clin Nutr 2016 103: 218-230;
    First published online December 9, 2015.

    Conclusions: United Kingdom–based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation

    1. Just as with non-vegetarians, there are junky vegetarian and vegan diets. What they need to compare are those who eat plant based WHOLE FOOD diets. As we all know, diet Coke and french fries are vegan.

    2. I took a look at this “Study”. And anyone else interested should do that as well. First off, this was a “pooled analysis of data from 2 prospective studies”. Two separately conducted studies that may or may not have been conducted well or in similar or exact ways. There were meat eaters, fish eaters, vegetarians and some vegan vegetarians represented. Of the “Vegetarian Group”, 2,222 of the 20,000 vegetarians were vegan. And as another post mentioned, vegan does not mean WFPB vegan. As it is, the vegan vegetarians in this particular study only represented 11% of the vegetarian group. Of that vegan vegetarian 11%, we don’t know if they were WFPB vegan vegetarians or something else.
      As we also know, many people who claim to be vegetarian consume no meat but do consume dairy, eggs. This delineation was not mentioned at all in this composite of data from 2 separately conducted study’s. These are just the first problems that I see with this study – I see others which I won’t go into further here.
      But this is an excellent example of “research” that is very poorly conducted and insufficiently discussed before coming to a “conclusion”.

  14. iI’d like to see my question answered by

    Doctor Michael Greger:
    my mother has been diagnosed with Alzheimer’s disease. Since then i’ve been learning about it. but i got some doubts:
    which is the most effective drug to treat such a disease in your opinion?

    Is it true that Foods highest in Glutamic acid can increase the release of glutamate in the brain so that it kills lots of neurons?

    Glutamic acid list (some nuts, oats and other cereals are there)

    Is it true , also, that Foods highest in Aspartic acid (aspartame) can speed up the release of glutamate in the brain so that it kills lots of neurons?

    Aspartic acid list (eggs, soy-based products are there)

    Glutamic acid and Aspartic acid-based foods should be averted at all since they increase the overall inflamation on the body?

    So it’d be better to avoid them in order to maintain the health of my mother with Alzheimer’s disease?

    Can you provide a complet list of foods that should be averted to developing neurological diseases, such as Alzheimer’s disease?

    I’m looking forward to receiving good news.

    1. Hi Clarkkent- I’m so sorry to hear about your mother’s Alzheimer’s diagnosis. I also have family with this disease, so I know how devastating it can be. You’ve likely checked out many of Dr. G’s videos on Alzheimer’s, but here is a link to the collection: And here is a nice infographic: http://wwwhttp// A WFPB diet is a good bet for someone with Alzheimer’s and there is good evidence that keeping up with regular exercise (as long as ok’d by their health care provider) can slow progression. I’m sure more videos and posts will be coming as this is (sadly) a hot topic right now.

    2. ClarkKent,

      I’m sorry about your mom’s diagnosis. Last night I was looking into the use of lithium orotate (not the prescribed form) for bipolar and I was interested to see that is also helps Alzheimer’s. Here’s a link to a 13 minute talk on the subject by a doctor.

      My personal experience is that aspartame, the artificial sweetener, should never have been allowed on the market. I went through a period of having seizures 20+ years ago, and finally figured out it was caused by that sweetener, which I didn’t use often, but had used each time I had a seizure. One of the seizures put me in a hospital where I didn’t wake up for 32 hours, so I’m talking serious seizures. This indicated it was crossing the blood brain barrier. There have been more complaints to the FDA about aspartame than any other single thing. It causes not only seizures, but MS or symptoms identical to MS, and many other brain problems. Since I learned of this connection I weaned myself off the seizure medication. I’ve been scrupulous about never ingesting any aspartame since then and I’ve never had another seizure.

  15. Is there anything I can do about ringing in my ears? It started just a couple weeks ago, and I can’t find anything to stop it. Thanks!

  16. What kind of meat was used?
    Pesticide-GMO laced, hormone laced, antibiotic laced meat? How’s that supposed to be good for anyone?
    And why is “our” government allowing that shit to even exist in the market?

  17. From my experience, doctors warn thyroid patients that they need animal protein and they should never attempt a vegan diet. I would like to go vegan but I don’t want to upset my hashimotos disease. After listening to your videos on how meat causes inflammation, I think the opposite. I think if I take a lot of anti-inflammitory foods such as ginger, turmeric etc… that I’ll be fine. Dr. Greger can you shed some light on this issue please?

  18. Dear Dr. Greger, May 26, 2016 was the beginning of severe
    vomiting, 2-3 day intervals. I was diagnosed(endoscopy) with h-pylori June
    2016. Was treated successfully with an array of antibiotics. More vomiting. Additional
    tests for other bacteria (c-diff et al.) were negative. Radiology of UGI was clear. I continue to
    vomit, 3-4 week intervals. No ulcer, no cancer. Am on BRAT diet. Am ravenous.
    Don’t have pain, don’t have GERD. Am I now suffering from inflammation of
    stomach, duodenum, esophagus lining? Upon medical advice, am taking Nexium 22mg
    2caps pre-lunch. Am desperate for some order! I would be most grateful for
    info, suggestions.

    1. I don’t know if this is helpful or not, but I got this information from Dr. Kim, the new Medical Director at Dr. John Mcdougall’s clinic. This info is from a talk he gave; you can view the whole thing here:
      But if you want to cut to the chase, go to minute 47 in the presentation where he discusses a woman named Gabrielle (I believe). She had severe 10 year ulcerative colitis and was helped by McDougall and True North. In the video she is shown eating a mish-mash of spinach, purple yam, zucchini squash, and white rice congee. You can find recipes for white rice congee on the web easily enough. I realize you may not have UC, but I wonder if this recipe might help with your GI disturbance and slow down the inflammation.
      Also, check out Dr. Esselstyne’s talk here:
      I bring this up because he suggest that to turn down the inflammation in the whole system to eat green leafy vegetables at every meal if you have an inflamed system. He suggest Swiss chard, kale, beets and beet greens, spinach, arugula.
      Hope this might be helpful. Good luck

      1. Thank you so much for your response, and for your suggestions– I do not suffer from UC, but I know someone who does and will forward the suggestion to her. I need information to learn as much as I can about inflammation of the stomach’s mucosal lining post h-pylori (excessive vomiting), and/or specific recommendations for abating and healing the inflammation by a professional, an MD or a clinical nutritionist. Thank you for taking the time.

    1. Lynn Erikson: I don’t know how fish compares to red meat. I can say that fish comes with a host of known health risks: animal protein, saturated fat, cholesterol, contaminants, and lack of fiber. None of this is good. Food is a package deal. What little good can be found in fish always comes with the bad too. I’d say it’s not worth it.

      Here are topic pages from NutritionFacts with overviews of some of these subjects.
      Animal Protein:
      IGF-1 (an issue with animal protein):
      Fish in general:
      Saturated Fat:
      You can look up additional information by exploring this site. Does this help?

  19. I am a 48 year old female suffering from Chronic Inflammation since at least 1998….. I still don’t know the cause so my CI remains untreated. I am a vegetarian. I did smoke cigarettes until 2011. For the last 20 years or longer both my CRP and sed. rates are higher than they should. My lifestyle in general is healthy, I exercise and I avoid stress. WHat am I doing wrong or not doing ? WHat could I change or give a try ? Intermitant fasting maybe ? I am by now a bit hopeless and helpless but knowing what CI means in the long run makes me want to find a way to lessen it. thanks

  20. This is a direct quote from Wikipedia:

    “The efficacy of Protandim in humans has been investigated in three double-blind, randomized, placebo-controlled clinical trials, which showed it to have no significant overall effect on SOD or oxidative stress levels.[6][7][8] In 2017, LifeVantage was issued a warning letter by the U.S. Food and Drug Administration (FDA) regarding illegal advertising claims on the company’s websites suggesting that Protandim can play a role in helping to cure various ailments, including cancer and diabetes.[9][10][11]”

  21. Has their been any studies on the effectiveness of supplementing with nicotinamide riboside or Niagen to boost longevity and are their natural ways that work the same. I realize the basic eat a plant based diet increases life expectancy already but was wondering since NAD+ from what I read decreases with age. I thought the Coenzyme Q10 being made in the blood from eating greens was a very interesting study since there are recommendations to supplement CoQ10 as we age.

  22. Thank you for your question. Although there is theoretical reasons for supplementing nicotinamide, supported by laboratory studies, I am not aware of any human studies that support its use. In fact most human studies supplementing isolated vitamins and minerals have had negative results emphasising that it is the diet as a whole that is important and not the individual ingredients. The only supplements required on a plant based diet are vitamin B12 and probably DHA/EPA (long chain omega 3 fatty acids) for brain health.
    You may find this video useful
    I would also recommend the book Whole: rethinking the science of nutrition by T Colin Campbell

  23. Pardon me for asking this in this section but is somewhat related to possible inflammation. Do flu vaccines cause aging and inflammation? Why are flu shots recommended for the elderly apart from the obvious – to send them to their graves faster?

  24. There is no grand conspiracy to wipe out the human race. I know some of the scientists that perform research into the efficacy of items such as flu vaccines. They are regular folks like us that work hard then go home and play with their kids like the rest of us and are seeking the truth to make the world a better place to live. The fact is that there are thousands of deaths every year due to the flu that could have been prevented with the vaccine, especially in the very young and very old. Sure, the vaccine does not work all the time, and yes, some people have a bad reaction to it and can even die, but when you weigh the thousands of deaths from the flu vs the handful of deaths to the vaccine, and the millions of flu illnesses that are prevented by the vaccine (and lives saved), you’ll see that the vaccine is net/net beneficial to humanity since more lives are saved than lost. Here is another example: 40,000 people die in the USA in auto accidents annually (1/2 of which are alcohol related). Automated cars would prevent all of these down to Zero/none. But lets say that failure of the automated cars results in the death of 5000 random people every year. Should we require a switch to automated cars? I say yes, since we would experience a net 35,000 lives saved, even though 5000 people would die that may not have without the automated cars. Just my opinion, and most other people’s as well. You are certainly welcome to come to any conclusion you prefer.

    Dr. Ben

    1. Thanks. Let me rephrase my question: AA is required for the metabolism, especially of the brain. Can our body generate the required amount from linolic acid as we age or do we have a situation as with DHA and EPA, which in theory can be metabolized from Omega-3 but in real life cannot, as we age?


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