How to Develop a Healthy Gut Ecosystem

How to Develop a Healthy Gut Ecosystem
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What we eat determines what kind of bacteria we foster the growth of in our gut, which can increase or decrease our risk of some of our leading killer diseases.

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

As I’ve explored before, whether you’re young or old, male or female, smoker or non-, high blood pressure, low blood pressure, high cholesterol or low, having high levels of a toxic compound called TMAO—trimethylamine oxide—in your bloodstream is associated with a significantly higher risk of having a heart attack, stroke, or dying over a three-year period. Where does TMAO come from? The choline in foods, like eggs, can be turned by gut bacteria into TMAO, which is then absorbed back into our system. And, the more eggs we eat, the higher the levels climb.

“Given the similarity in structure between…carnitine and choline,” the same group of Cleveland Clinic researchers wondered if carnitine found in red meat, energy drinks, and supplements might also lead to TMAO production. So, they put it to the test. If you feed someone a steak, their TMAO  levels shoot up. Now, this was someone who regularly ate meat. Those who eat strictly plant-based may start out with almost no TMAO in their system, presumably because they’re not eating any meat, eggs, or dairy. But, even if the vegan eats a sirloin, almost no TMAO is made. Why? Presumably, they don’t have steak-eating bacteria in their guts. No TMAO is produced if you don’t have TMAO-producing bacteria in your gut. If you don’t regularly eat meat, then you’re not fostering the growth of the meat-eating microbes that produce TMAO.

This suggests that “once we develop a plant-based [gut ecosystem], our bacteria will not [produce] TMAO,” even if we eat meat every once in a while. However, we still don’t know how rapidly gut bacteria shift after a shift in our diet. But, it does not appear to be all or nothing.

If you take men eating the Standard American Diet, and have them eat two sausage, egg, and cheese biscuits, before and after just five days of eating lots of high-fat meals like that, you can boost TMAO production even higher. So, it’s not just, do you have the bad bugs or not? You can apparently breed more of them, the more you feed them.

On the other hand, meat-free diets “have been demonstrated to have a profound influence on human metabolism.” You can analyze a urine sample, and tell what kind of diet people eat, based on measurements like how low the TMAO levels are in the urine of those eating egg-free vegetarian diets. You can even take the same people, and rotate them through three different diets, and you can tell who is who; who is on a high-meat, low-meat, or no-meat diet—in part, based on the different compounds churned out by the different gut flora, or different flora activity, after just about two weeks on the different diets. It’s possible that some of the beneficial effects of whole plant foods may be mediated by the effects they have on our gut bacteria. At the same time, the Standard American Diet may increase the relative abundance of undesirables that produce toxic compounds, including the cardiotoxicant TMAO.

Strictly plant-based diets “have gained acceptance as a dietary strategy” for preventing and managing disease. Perhaps, in part, because of their rather unique gut flora, less of the disease-causing bacteria, and more of the protective species. So, all along, we thought the reason those eating plant-based had lower heart disease rates was because they were eating less saturated fat and cholesterol. But, maybe, their lower TMAO levels may also be contributing to their benefits—thanks to their reduction of ingestion of carnitine and choline.

I talked about the egg industry response to the choline revelation. How has the carnitine supplement industry reacted? Well, the former VP of Advocare, a multilevel marketing company that sells carnitine supplements, like “Slam,” while getting slammed with lawsuits, finding them, for example, guilty of “false, misleading, or deceptive…practices,” forced to pay over a million dollars in response to the research implicating carnitine in TMAO production, he questioned whether there was a secret vegan conspiracy at the Cleveland Clinic. Restricting our intake of meat or carnitine supplements to prevent our gut bacteria from making TMAO, he argues, is like trying to prevent car accidents by restricting “the sale of fuel.”

Uh, okay, but there are benefits to transportation. We’re talking about TMAO, which may be fueling our epidemic of heart disease, the #1 killer of men and women in this country. As far as I’m concerned, the more we can cut the fuel for that, the better.

Please consider volunteering to help out on the site.

Image credit: MelSi via pixabay. Image has been modified.

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

As I’ve explored before, whether you’re young or old, male or female, smoker or non-, high blood pressure, low blood pressure, high cholesterol or low, having high levels of a toxic compound called TMAO—trimethylamine oxide—in your bloodstream is associated with a significantly higher risk of having a heart attack, stroke, or dying over a three-year period. Where does TMAO come from? The choline in foods, like eggs, can be turned by gut bacteria into TMAO, which is then absorbed back into our system. And, the more eggs we eat, the higher the levels climb.

“Given the similarity in structure between…carnitine and choline,” the same group of Cleveland Clinic researchers wondered if carnitine found in red meat, energy drinks, and supplements might also lead to TMAO production. So, they put it to the test. If you feed someone a steak, their TMAO  levels shoot up. Now, this was someone who regularly ate meat. Those who eat strictly plant-based may start out with almost no TMAO in their system, presumably because they’re not eating any meat, eggs, or dairy. But, even if the vegan eats a sirloin, almost no TMAO is made. Why? Presumably, they don’t have steak-eating bacteria in their guts. No TMAO is produced if you don’t have TMAO-producing bacteria in your gut. If you don’t regularly eat meat, then you’re not fostering the growth of the meat-eating microbes that produce TMAO.

This suggests that “once we develop a plant-based [gut ecosystem], our bacteria will not [produce] TMAO,” even if we eat meat every once in a while. However, we still don’t know how rapidly gut bacteria shift after a shift in our diet. But, it does not appear to be all or nothing.

If you take men eating the Standard American Diet, and have them eat two sausage, egg, and cheese biscuits, before and after just five days of eating lots of high-fat meals like that, you can boost TMAO production even higher. So, it’s not just, do you have the bad bugs or not? You can apparently breed more of them, the more you feed them.

On the other hand, meat-free diets “have been demonstrated to have a profound influence on human metabolism.” You can analyze a urine sample, and tell what kind of diet people eat, based on measurements like how low the TMAO levels are in the urine of those eating egg-free vegetarian diets. You can even take the same people, and rotate them through three different diets, and you can tell who is who; who is on a high-meat, low-meat, or no-meat diet—in part, based on the different compounds churned out by the different gut flora, or different flora activity, after just about two weeks on the different diets. It’s possible that some of the beneficial effects of whole plant foods may be mediated by the effects they have on our gut bacteria. At the same time, the Standard American Diet may increase the relative abundance of undesirables that produce toxic compounds, including the cardiotoxicant TMAO.

Strictly plant-based diets “have gained acceptance as a dietary strategy” for preventing and managing disease. Perhaps, in part, because of their rather unique gut flora, less of the disease-causing bacteria, and more of the protective species. So, all along, we thought the reason those eating plant-based had lower heart disease rates was because they were eating less saturated fat and cholesterol. But, maybe, their lower TMAO levels may also be contributing to their benefits—thanks to their reduction of ingestion of carnitine and choline.

I talked about the egg industry response to the choline revelation. How has the carnitine supplement industry reacted? Well, the former VP of Advocare, a multilevel marketing company that sells carnitine supplements, like “Slam,” while getting slammed with lawsuits, finding them, for example, guilty of “false, misleading, or deceptive…practices,” forced to pay over a million dollars in response to the research implicating carnitine in TMAO production, he questioned whether there was a secret vegan conspiracy at the Cleveland Clinic. Restricting our intake of meat or carnitine supplements to prevent our gut bacteria from making TMAO, he argues, is like trying to prevent car accidents by restricting “the sale of fuel.”

Uh, okay, but there are benefits to transportation. We’re talking about TMAO, which may be fueling our epidemic of heart disease, the #1 killer of men and women in this country. As far as I’m concerned, the more we can cut the fuel for that, the better.

Please consider volunteering to help out on the site.

Image credit: MelSi via pixabay. Image has been modified.

Doctor's Note

If that was the supplement industry’s response, how did the egg industry react? See my video Egg Industry Response to Choline & TMAO.

For more background on TMAO, see Carnitine, Choline, Cancer, & Cholesterol: The TMAO Connection, and then find out How to Reduce Your TMAO Levels.

Our gut flora are what we eat! Check out:

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

112 responses to “How to Develop a Healthy Gut Ecosystem

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  1. Hi, the video was very informative. I have a question, what about eating organic meat, organic eggs, and organic poultry? Would they still be unhealthy?




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    1. Ozzie Miller: This question is quite understandable and comes up all the time. Here is some information on the topic:
      .
      “b00mer”, a well respected poster on this site, once wrote the following words which helps put the issue into perspective: “……A grass fed cow will consume even more food than a grain fed cow due to the lower caloric density. Their food may not be genetically modified, but they are still part of the food chain, their food still contains environmental pollutants, and they are still concentrating them in their tissues.
      ……How people can think that the nutritional profile of an animal completely changes with its diet is beyond me. If I eat mostly kale, or mostly corn, sure an analysis of my tissues may lead to some detectable differences, but it’s still going to be human flesh. I still produce hormones, I still have dioxin, pcbs, flame retardants in my tissues, I still have saturated fat in my tissues, arachidonic acid, etc.”
      .
      The summary answer is that while these products may be *marginally* healthier, they are not significantly healthier. How do we know that? Because many of the reasons why these products are unhealthy would apply to the product regardless of its source. While an organic or wild or grass fed product may have less say saturated fat, they still have plenty of saturated fat–enough to matter. All of these animal products are still going to have saturated fat, cholesterol, animal protein, TMAO, contaminants, etc. All of these products are going to be lacking in fiber and vital phytonutrients, including precious few antioxidants. http://nutritionfacts.org/videos/antioxidant-power-of-plant-foods-versus-animal-foods/
      .
      The following NutritionFacts overviews gets you started on this topic and you will see that most if not all of these mechanisms apply to the product regardless of it’s source: http://nutritionfacts.org/topics/meat/ and http://nutritionfacts.org/topics/igf-1/ and http://nutritionfacts.org/topics/endotoxemia/ Here’s a quote from moderator Rami: “Looking at meat and dairy, they still contain trans fats which the recommended daily allowance is at 0 http://nutritionfacts.org/videos/good-great-bad-killer-fats/ Dairy blocks the phytonutrients of plant foods, http://nutritionfacts.org/videos/nutrient-blocking-effects-of-dairy/ Looking at chicken, its fat to protein ratio is abominable http://nutritionfacts.org/videos/does-eating-obesity-cause-obesity/ Fish protein itself shortens lifespan by 6 years by cutting down our telomeres http://nutritionfacts.org/videos/research-into-reversing-aging/ . … What do animal products have in common? They promote cancer due to raised IGF-1 levels, promote heart disease, autoimmune disease, dementia, etc. What can stop the progression and in most cases reverse these diseases? Plants, not meat. It seems clear based on all of the evidence that plant food, all around, is much healthier than meat, organic or not.”
      .
      NutritionFacts does have some videos that directly address your question. For example, here is a video on organic salmon: http://nutritionfacts.org/video/the-problem-with-organic-salmon/ Note that while organic was better, it’s still got plenty of contaminants. “The differences were really marginal…” Here is a video showing arsenic in organic chicken: http://nutritionfacts.org/videos/arsenic-in-chicken/
      .
      Looking outside of NutritionFacts for a minute, lets look at “wild” game, something paleo proponents make a big deal of. Participant donmatez once wrote, “Wild game also carry campylobacter, pathogenic E. coli, salmonella, etc. All the data available on pubmed. Example: Assessment of Shiga Toxin-Producing Escherichia coli Isolates from Wildlife Meat as Potential Pathogens for humans http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765146/ AND Highly Pathogenic Avian Influenza Virus among Wild Birds in Mongolia http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3439473/
      .
      For a smidgen of science on the issue of say grass fed beef, check out the following:
      >>> Tom Goff notes that In Uruguay for example where all beef comes from grass fed animals, the more beef eaten, the higher the rates of cancer. http://nutritionfacts.org/2016/09/08/eat-protect-kidney-cancer/#comment-2884319823
      >>> The difference in palmitic acid concentrations between grass fed and grain fed beef is not significant Table (SFA): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846864/table/T1/
      >>> Healthy Longevity pointed out some information from Plant Postive who noted that the nomadic Sinkiang in northern China who consumed diets rich in organic grass-fed animal foods experienced a 7 fold greater incidence of coronary artery disease than the Chinese living in Zhoushan Archipelago who consumed a diet much richer in plant based foods. These findings resemble even earlier observations from the 1920’s of the nomadic plainsmen in Dzungaria in northwest China and across the border in Kyrgyzstan who consumed enormous amounts of organic grass-fed animal foods and experienced severe vascular disease at young ages. https://www.youtube.com/watch?v=ioadYLEho8M
      >>>Darryl once wrote: “any of the constituents of animal foods of most concern are also present in organic, grass-fed, free-range, lovingly stroked animals too. Organic dairy milk will have high levels of leucine and microRNA-21 (http://www.biomedcentral.com/content/pdf/1475-2891-12-103.pdf ), for example. Its intrinsic to milk’s biological purpose.
      .
      What it comes down to is that “grass fed”/natural/fresh/organic/wild might be marginally (and I mean marginally) better, but that doesn’t make it healthy! It’s marginally better in the sense that a Snickers candy bar with peanuts is marginally better than a Milky Way candy bar that doesn’t have peanuts. Neither is really healthy for you.




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      1. Thea,
        Thank you so much for crafting such and in depth, superb response! Just what I needed to bring me up to speed on the issue of ‘grass fed beef’ and other animal products.




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        1. Indeed, Thea is amazing! I’m going to show this to a friend of mine who keeps insisting that organic, grass-fed beef & free range chicken & eggs is a part of a healthy diet.




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      2. Another point about wild game – all year round I see the deer eat GMO, non-organic corn, barley, alfalfa and whatever else the local farmer grows in our rural neighborhood. I’m sure we have plenty of neighbors who use weed killer on their lawns & gardens. There may be fewer toxins in a caribou from the Yukon, but the reality is that we have no idea what sort of toxins these animals eat.




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        1. WFPB Nancy: *Great* point about not knowing what wild animals eat. Humans have taken over so much of the planet, there really isn’t that much truly wild/no-contact-with-humans areas any more.

          Also, thank you very much for your nice feedback in the other comment. Today is a happy day for me.




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      3. Wow, great thorough response, Thea! I’m going to save this for when my meat-eating friends ask me about eating grass fed animals.




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        1. Thanks WFPB-Hal. :-) This question/claim comes up SO often on NutritionFacts. (Sometimes it’s a question like what happened here. Other times it’s a matter of someone claiming/asserting that if only study X had been on “organic” or “wild” etc animals, it would have had a completely different outcome. ) I wanted a good answer to satisfy myself and so started collecting info. Then one day I decided to put it all together to share with others. So happy to hear that people are getting something out of it.




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          1. Great idea to compile something like that for future use. (I’ll be glad when the up-vote capability is restored … I’m sure you would have received a bundle for your post!)




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      4. Thea,

        You are obviously well read. What would you say to someone who believes there has never been a 100% PBWF diet based culture in human history, and that one of the most powerful studies, the Adventist Health Study 2, found pescatorians have a lower overall hazard ratio, thereby conferring a longevity advantage for them over vegans.

        Further, there are various morbidities and medications that preclude people from taking high levels of dark green leafys (with elevated levels of vitamin K).

        Your consideration would be appreciated.




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        1. As a follow up to my previous post.

          https://www.ncbi.nlm.nih.gov/pubmed/23836264

          RESULTS:

          There were 2570 deaths among 73,308 participants during a mean follow-up time of 5.79 years. The mortality rate was 6.05 (95% CI, 5.82-6.29) deaths per 1000 person-years. The adjusted hazard ratio (HR) for all-cause mortality in all vegetarians combined vs nonvegetarians was 0.88 (95% CI, 0.80-0.97). The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in lacto-ovo-vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with nonvegetarians. Significant associations with vegetarian diets were detected for cardiovascular mortality, noncardiovascular noncancer mortality, renal mortality, and endocrine mortality. Associations in men were larger and more often significant than were those in women.




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        2. Bruce Gray: I’m not an expert in these matters, but I’m happy to share my thoughts. re: “What would you say to someone who believes there has never been a 100% PBWF diet based culture in human history…” I would say that that’s my understanding also (unless you count small populations of monks). I would also say that it is completely irrelevant. There are two factors affecting human food choices: food availability and culture. Humans don’t eat based on instinct or what is good for us. So, it’s not surprising that “monkey see, monkey do” ancestor primates ate some meat and the rare egg that they stumbled upon. Eating animals probably even provided survival benefit in times when it was hard to get food.

          The question before us today is: What is the diet which maximizes our changes of long term, healthy outcomes? What does the body of scientific evidence tell us? What does our biology tell us? What do the healthiest populations do? The answers to these questions are detailed on this website and all point to the same answer: a diet of whole plant foods.

          That doesn’t mean that some people can’t get away with small amounts of animal products, especially in the context of a life long whole food plant based diet. The traditional Okinawans were some of the longest lived, healthiest people on the planet and 4% of their calories came from animal products. Someone could argue that that 4% is important, but I think we have enough evidence to show that the people of Okinawa did well in spite of that 4%, not because of it. So, eating that say 3 to 5% may not be harmful to those people and to some people in our own society. However, if you life in a society like mine, then you live in a sick society where people have been eating extremely unhealthy diets for decades. We often hear stories on this site from people who did not solve their health problems until they went to a diet of 100% plant foods, most of which are whole plant foods. There is also some science presented on this site which backs up these anecdotes–ie, that the healthiest diet may very well be 100% plants, since we can get B12 in safe and cheap supplement form.

          As for the outcome of the Adventist study: I’m aware of that. I’ve seen a few explanations for the results, all of which make sense to me. You might consider that while it is a powerful study and contains much for us to learn, it is just one study. Understanding human nutrition is about understanding the body of scientific evidence, not a single study. I’ve also heard that the amount of fish eaten was very small. I’ve also heard that we have some reason to believe that the people who ate the little bit of fish were overall eating healthier diets. As you probably know, eating vegan diet is not necessarily healthy. Lots of people are ethical vegans first – meaning that the health aspect of the diet is not as important to them as being cruelty-free and saving the planet. Ethical vegans might be more likely to consume (vegan) oreos, potato chips and coke… You get the idea. It would not at all be surprising that ethical vegans did not do quite as well as some people who largely ate a diet of whole plant foods, but also had some fish. This could potentially explain the result of the Adventist study that you are talking about.

          The following statement that you wrote is interesting to me as I haven’t seen anyone concerned about this before: “Further, there are various morbidities and medications that preclude people from taking high levels of dark green leafys (with elevated levels of vitamin K).” I don’t know why this is relevant to the discussion. If I had a peanut allergy, I wouldn’t eat peanuts. That wouldn’t mean that peanuts are not generally a health food for most humans. If you have been following Dr. Greger’s, you know that dark leafys play a central role in a healthy diet. But those are not the only foods which play a central role in a healthy diet. If someone absolutely could not consume say kale, then surely the answer is to fill in the hole with other healthy foods (as opposed to filling the hole with unhealthy foods like animal products).

          Those are my thoughts…




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          1. Thank you for your great contributions to this site. I would like to contribute a note about people who say they can’t eat green leafy veggies because they have to avoid vitamin K. This is most likely due to their having to take warfarin, or Coumadin, a blood thinner. This drug works by affecting the blood clotting factor that is affected by vitamin K. While it is true that eating these healthy foods will counteract the effect of the drug, it’s not true that patients need to avoid the foods all together. Most green vegetables are significant sources of Vitamin K, and we would hate to tell our patients to omit them from what they eat. The key is that they eat a consistent amount of them. The doctor will use blood tests to adjust the dosage, so patients can get both the benefits of the medication regimen and the healthy food. Unfortunately, many patients are counseled not to eat anything with Vitamin K in it, and many use this as an excuse to just not eat their veggies.




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            1. Kay Lehman: Thanks for your nice words!

              Also, thanks a bunch for your interesting contribution. You educated me on this topic. While I know this was not your point, I had a funny thought when I read, “The key is that they eat a consistent amount of them.” I imagined a situation where a wife says to a husband, “I’m sorry dear, you absolutely have to eat your kale because you had that big salad just before you started taking the meds, remember?” ;-) I know that’s not what you meant, but I thought it was a funny thought.

              re: “Unfortunately, many patients are counseled not to eat anything with Vitamin K in it, …” Oh sigh. That type of misinformation is what we are trying to fix on this site. You did your part with your post. Thanks for clearing this up!




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        3. Hi i read somewhere that true Vegans, do sometimes sneak in animal proteins into their diets. Sometimes other variables in our environments also dispose us to diseases, its not only the animal protein factor. The air we breathe, the water we drink, the sprays that have been used in growing vegetables, the toxins all around and also people can be toxic to out bodies, mentally and emotionally. The list is endless. What I do know is that a healthy lifestyle contributes to longevity, and a happy life.




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      5. How do you get the amounts of fat soluble vitamins A, D and K in the amounts needed for optimal health eating a plant based diet? Most people are not good converters of beta carotene to vitamin A. Cows eating grass are. The Inuit in Alaska had no heart disease following their Traditional diet of mostly animals, the Masai in Africa eat mostly milk and blood from their cattle and have no heart disease. The raised TMAO in people who eat animal products is just an association. It doesn’t mean one causes the other. It’s like the old lipid hypothesis which has been debunked. As to the kefir issue, yes, kefir can be made non-dairy, but it has to have milk every few ferments to stay alive. It requires dairy. And only the dairy version has all the benefits of reducing biofilms and repopulating the gut. If a diet requires supplementation to be healthy, it can’t be a healthy diet.




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        1. Tami Berman: You are operating under a great number of falsehoods. For example, you wrote, “The Inuit in Alaska had no heart disease following their Traditional diet of mostly animals…” This is incorrect. Even ancient Inuit mummies (ie, before any modern contamination of the diet) showed signs of heart disease (and cancer). You can read about it for yourself. The following NutritionFacts video gives a great overview. And then you can click the Sources Cited button to read the studies if you want: http://nutritionfacts.org/video/omega-3s-and-the-eskimo-fish-tale/
          .
          The people who are telling you that the Inuit have no heart disease are lying to you. Following is a link to a website which does a great job of debunking that kind of misinformation. You can dive into learning about the Inuit and the Masai. You can learn more about Taubes verses Keys, etc. and how your statement “…the old lipid hypothesis which has been debunked.” is completely false. You can get the straight scoop, all with references that actually support the claims (unlike what you will get at the sites you have been reading). If you are interested, here is the website: http://www.plantpositive.com.

          You also wrote, “How do you get the amounts of fat soluble vitamins A, D and K in the amounts needed for optimal health eating a plant based diet?” Very easily! As a group, vegans are not deficient in those nutrients. If you are worried about nutrient deficiencies, best to start overhauling the omnivore diets: http://nutritionfacts.org/video/omnivore-vs-vegan-nutrient-deficiencies-2/

          Based on your general comments, I’m guessing that you are under the impression that humans need a lot more fat than we actually need. Consider that one of the longest lived, healthiest populations on the planet was the traditional Okinawans. They have so many people who get to 100 that they have a group party where the birthday girls and boys march down the street… Their diet was 85% carbs, 6% fat and 9% protein. About 4% of their calories came from animal products. http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/ I’m not saying you need to exactly imitate the Okinawans to be healthy. I’m trying to drive home the point that patterns of healthy eating involve lower amounts of fat and minimal (if any) animal products.

          That’s enough to get you started. If you want to learn what the body of scientific evidence says regarding human nutritional health, you are at the right place! I encourage you to stick around and learn more. If you absorb the information I linked to here and then want additional recommendations on what to tackle next, I’d be happy to point you in some helpful directions.




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          1. Since I am traveling in Mexico, adding in this example of the famous long-distance runners:

            “Staple crops of the Tarahumara are maize, beans, greens, squash, and tobacco. Chilli, potatoes, tomatoes, and sweet potatoes appear in Mexicanized regions. Corn is planted in February and March using oxen which are often loaned as not everyone owns one. Corn begins to flower in August; by November it is harvested and cooked or stored.[23] Common corn dishes are pinole, tortillas, esquiate, atole, tamales, and boiled and roasted ears.[24] Beans are one of the Tarahumaras’ essential protein-rich foods and are usually served fried after being boiled. Tamales and beans are a common food which the Tarahumara carry with them on travels. Wheat and fruits were introduced by missionaries and are a minor source of nutrition. The fruits grown by the Tarahumara include apples, apricots, figs, and oranges.” wikipedia

            The Tarahumaras also eat meat, but this constitutes less than 5% of their diet. Most of the meats that they consume are fish, chicken, and squirrels.[25] On ceremonial occasions, domesticated animals such as cows, sheep, and goats are killed and eaten. The Tarahumara practice persistence hunting of deer and wild turkeys by following them at a steady pace for one or two days until the animal drops from exhaustion.[26]

            In the award winning documentary GOSHEN Film (2015) the Tarahumara traditional diet is examined through interviews with Dr. William Connors clinical dietary research expert. Their traditional diet was found to be linked to their low incidence of diseases such as Type 2 Diabetes. However, the Tarahumaras’ health is transitioning in regions where processed goods have begun to replace their traditional staples.[citation needed]




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    2. Yes of course. Organic poultry for example is fed organic corn which has zero to no effect on how the body reacts to one over the other.




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    3. Ozzie, it’s my understanding that it doesn’t matter whether or not the meat and eggs are organic. TMAO is produced in the body either way. Also, the information Thea gave below looks very thorough. Thea, you are awesome!




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    4. You just got pwned!

      Sorry, I had to say it.

      Thea that was some awesome reply. I know you’ve copied and kept a lot of great replies /answers/posts from some of the very knowledgeable posters over the years and in all seriousness these would be amazing to read. I’m sure you have them in an organised manner with a document(s). You should make it a Google document for others to view. I’m a 100% serious :-)




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      1. Scott: I’m not ashamed to say, I had to look up “pwned.” :-) I found a great page that surprised me by estimating how far back the word may go. (https://www.lifewire.com/what-is-pwned-2483497 )

        I totally agree that we have had some really amazing participants on this site who have shared with us a wealth of information and helpful perspective. I’ve probably saved too much as it is hard to find what I want. I currently have over 2,500 separate e-mails in a special folder, each with a post on this site – or the rare post from myself such as the one above. So, honestly have nothing organized to share with the world.

        The NutritionFacts staff have been flirting with the idea of doing a Nutrition FAQ page where common questions are listed and answers from moderators or other people are given. If they do a feature like that, I could include some of my favorite pre-written answers and hopefully people could nominate posts for inclusion. We shall see what happens.




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        1. I learned a few things from that article to Thea, so thanks :-)

          Definitely a good idea to have a FAQ with contributions from some of our esteemed readers, just like what you’ve shared with us in this thread x




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        2. Hi Thea, We are probably not alone in having saved certain replies, comments, and explanations that we felt were exceptional. I have created many files and folders so that I can quickly retrieve information when an acquaintance asks a question. As a retired academic science librarian, I guess I couldn’t help myself. I also did this because the NF site, while it is well-indexed, can be overwhelming in the number of videos it returns in response to a search. I have copied the links to my favorite, most informative videos into a separate file document so it is easier for me to send them the “best” 3 or 4 videos on a topic. I do like the topical blog posts that compile the links to many videos; these are good starting points. Invariably, though, I try to go back and locate something that I know I saw here and find that it just didn’t get indexed under the terms one would commonly use to describe it. Part of this problem is that a single video title may sound uninteresting due to its topic, but often there is a gem of wisdom that is more widely applicable contained within.

          I admire and appreciate your readiness to help others navigate the site, find the answers they are seeking, and how you courteously respond to people with different viewpoints. You model how to listen, respectfully acknowledge what someone has said, and still remain firm in support of the science presented on this site. Brava!! Your volunteer contributions to NF.org are valuable to newcomers and longtime “choir” members alike. Carry on!




          1
          1. Sunshine99: Wow, such supportive feedback. Thank you!!

            re: “Part of this problem is that a single video title may sound uninteresting due to its topic, but often there is a gem of wisdom that is more widely applicable contained within.” I so resonate with that comment. There is only so much that can be said in a title and there is so much information packed into the videos. I often have a hard time finding the right video because the title and description does not match the particular subject/point in the video that I’m looking for. I don’t know the answer to this. I’m certainly not advocating for less information in a video! ;-) Anyway, it’s nice to know that I’m not alone and even an academic science librarian (cool) struggles with this.




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    5. Yes, it is not about environmental toxins, it is about meat and the gut flora that thrive on meat. They will produce TMAO without regard to what your cow was eating for lunch.




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    6. Hi, Ozzie Miller. The question of TMAO has nothing to do with whether or not animal products are organic. This is not an additive, or something given to animals. It is a substance produced in our intestines when we, with the help of our intestinal flora, digest animal products, which are rich in choline and carnitine. The more of these foods we eat, the more we feed the bacteria that produce TMAO, and the more they reproduce in our intestines. I hope that helps!




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    1. That’s good question. “Does the ingestion of preformed L-Carnitine cause a the same kind of spike in TMAO as does meat, dairy and eggs?”

      I would imagine that microbiome would have a field day when presented with preformed L-Carnitine.
      The following is an excerpt from a previous video on TMAO
      “Even if you eat vegan, though, you’re not necessarily out of the woods. If you regularly drink carnitine-containing energy drinks, or take carnitine supplements, or lecithin supplements, which contain choline, presumably you’d foster and maintain those same kinds of TMAO-producing bacteria in your gut, and increase your risk of heart disease and, perhaps, cancer.”
      From (Carnitine, Choline, Cancer, & Cholesterol: The TMAO Connection, http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/ )

      I would appear that L-Carnitine supplementation is not a good idea, and not necessary because it is a non-essential amino acid which your body produces:
      “The best food sources of carnitine are animal products, including meats and dairies, but vegans who strictly avoid these products generally do not get carnitine deficiency. Human liver and kidney make carnitine from lysine and methionine, two amino acids that you derive from protein intake. Other nutrients are required, including iron, and vitamins C, B-3 and B-6, according to Oregon State University. If you have normal liver and kidney functions and balanced nutrition, you most likely will not develop carnitine deficiency.”
      http://www.livestrong.com/article/420041-do-vegans-need-carnitine/




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      1. Doubtful that the precautions about carnitine apply to those over 65?

        http://www.drwhitaker.com/health-benefits-of-l-carnitine

        “Clinical trials of supplemental L-carnitine have yielded consistently positive results in terms of self-reported physical and mental fatigue, ability to exercise, and improvements in body composition—particularly when the study subjects are older and/or have documented carnitine deficiencies. Here’s an example.

        Italian researchers enrolled centenarians, who fatigued easily and had impaired strength and mobility, and gave them either 2 g of L-carnitine or placebo capsules daily. After six months, no significant changes were noted in the placebo group. Those who took L-carnitine, however, gained an average of 8.4 pounds of muscle mass and lost four pounds of fat. Mental and physical endurance improved, and they gained an average of four points on the 0–30 scale of the Mini-Mental State Examination, a common test of memory function.

        Now you can see why I’m so enthusiastic about the health benefits of L-carnitine. If 100-year-olds can have such remarkable turnarounds, just imagine what it could do if you started taking L-carnitine in your 60s or 70s, when carnitine concentrations begin to plummet?”




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  2. Simply … Thank you for your clear, fact based research and conclusions … you are the light at the end of the tunnel …. full steam ahead!




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  3. So that means soy is ruled out as well.

    Cause they are under the category of lethal high choline levels that breeds tmao bacterior .




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    1. hi Smith, as per this source, http://nutritiondata.self.com/foods-000144000000000000000-1w.html? only soy flour and soy protein isolates are mentioned in the top 500 food sources for choline. Both of these products are not regularly featured in a whole food plant based diet. The vast majority of other listings come from animal derived foods. From what I have seen, the doctors that espouse wfpb eating style recommend choosing traditional sources of soy such as tofu, tempeh, edamame, soy milk as opposed to products containing refined flours or isolates.




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      1. IF you read the studies about TMAO, lecithin from soy and other plant foods does not appear to raise the TMAO levels, while lecithin from eggs does. Not quite sure why this is so, but it appears to be correct.




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    2. Thanks for your comment.

      As far as my understating goes and according to one of the publications mentioned by Dr Greger in this video, the answer may be in the bacteria in our gut depending on whether we follow a plant based diet or the conventional omnivore diet and I quote:

      A postprandial increase in TMAO was not observed in a vegan subject, presumably as a result of the absence of selection for carnitine-metabolizing gut bacteria

      Hope this answer helps.




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        1. Hi, Benjamin Dowell. I am Christine, a NF volunteer nutrition moderator. With regard to choline supplements and TMAO, you might find this study interesting:
          http://circheartfailure.ahajournals.org/content/9/1/e002314
          The mice in the study were given choline supplements in their food, and it did increase TMAO levels. The issue is gut flora, however, and this depends on the diet usually consumed. On a whole-food, plant-based diet, the research suggests it is unlikely that the intestinal microbiome would be TMAO-producing. My question is this: why would you want to take choline bitartrate tablets? Dried shiitake mushrooms, soybeans, chickpeas, and peanuts are among the whole plant foods that provide choline. I would recommend eating them in lieu of taking a tablet. I hope that helps!




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  4. While eggs, beef, fish roe & other animal foods top the list of choline-rich foods, dried shiitake was moderately high at 202 mg/100-gram serving. For those of us eating plant-based, presumably with nice anti-inflammatory colonies of gut microbes thriving, should regular use of dried shiitake (a staple in Asian cuisines) be avoided?




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    1. Cathy: Choline is a vitamin. (Humans can make choline but not in sufficient amounts.) It’s not a good idea to try to completely eliminate choline from the diet.




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    1. It appears that LifeExtension.com is a large, highly profitable seller of supplements with a long record of problems with the FDA. I don’t think they have much credibility.




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      1. Lifeextension is one of the few organizations that attempts to shed some light on the machinations of the FDA? Yes they have problems with the FDA…as do many other Americans…who mostly don’t know it.




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    2. All I can say about carnitine is that it was helping me tremendously (with muscle pain and stamina). Until I got used to it and it helped me no longer (which was terribly disappointing). So my body wasn’t making it in appropriate amounts and no plant-based diet could help (or maybe I needed it in medicinal amounts?).

      If you feel that it helps you then you rather do not have a choice – you have to take it. But you have to remember that it’s a packaged deal and there may be side effects in the form of TMAO and raised cholesterol. If you need to take carnitine, the question is rather: should one take it intermittently in order to minimize the production of TMAO? How long the breaks should last?

      Recently I discovered that I have many deficiencies because of the plant-based diet. I started feeling very very weak about three months ago (but it was a recovery from a serious strep throat and it felt like I could never recover).
      A few days ago I started taking adenosylocobalamin (a form found only in meat) – and I immediately felt better. Moreover I am taking methylcobalamin – so what’s with that? Looks like you need a form that is found in meat.
      But it gets worse. I also started taking methylfolate (not folic acid) – and I immediately felt better. This methylfolate is also found in meat but also (green leafy) vegetables are rich in it…
      I suppose you can be carnitine deficient in the same way and no study will tell you what you should do because it’s about how you and particularly you feel.
      I am by no means supporter of meat as we all know what kind of shit it is but it’s just a warning based on my experience…




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      1. So with carnitine it’s all a matter of considering pros and cons in your particular situation – unfortunately dr Greger’s videos may give you impression that you are doomed when you take carnitine – well, only cons are highlighted here and particularly one con (TMAO production from carnitine) – because that’s what this video is about. And you should consider the whole picture which may be not easy because it may be not easy to weigh pros against cons when the data is scarce and contradictory. Often you have to guess what to do. In my case it was simple – carnitine helped me and that was it but in a case of ordinary supplementation I wouldn’t be so sure if I would recommend it (still it’s not to say that I wouldn’t, I simply don’t know).




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      2. Some of the posters on this forum are a bit limited in their breadth of comprehension? They are disciples? It’s always a good idea to have a variety of sources for information…as long as you don’t freeze and do nothing. Keep some perspective….




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    1. Hi Norman. Fourty percent of people with idiopathic ataxia (meaning doctors don’t know the cause) have gluten ataxia. Gluten ataxia is when the ingestion of gluten causes an autoimmune reaction to the cerebellum, the part of the brain responsible for balance. It’s a case of molecular mimicry where to the immune system, protein sequences in the cerebellum look a lot like gluten. In these cases a gluten-free diet will halt progression of the disease. A healthy gut is also important so yes, a good probiotic supplement would be part of the healing protocol along with a whole foods plant based diet with plenty of fiber to feed the health promoting gut bacteria. https://www.verywell.com/what-is-gluten-ataxia-562400 and http://jnnp.bmj.com/content/74/9/1221.full




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  5. The former VP of Advocare’s car/fuel analogy doesn’t even make sense. Here’s a better analogy: if you don’t put the right fuel in your car, IT WILL BREAK DOWN! Studies show that TMAO can cause your ‘vehicle’ to break down. However, if you put non-TMAO producing fuel (WFPB diet) into your ‘vehicle’, you can substantially lower the odds of vehicle break down. There, fixed it.




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  6. Gut bacteria don’t generate TMAO; they generate TMA (trimethylamine), which is converted to TMAO (trimethylamine oxide) in the liver.




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  7. Great news! and yes, we indeed are a covert group anti-meat eating militants armed with sharp carrots and smoothed cabbage projectiles trying to take over the world. Vegan conspiracy- geeze!!!




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  8. The less you worry about what you eat, but tune in with your inner being and choose your foods from the state of alignment, with clarity and guidance, the less disease will be attracted your way.
    Every worry and negative thought (bad feelings thoughts) will affect the microbiome adversely. So keep positive, enjoy and eat foods, which feel good to you and your healthy microbiome will proliferate. Foods can have their impact, but are minimal compare to the power of positive thinking and from a aligned position. If you believe meats are bad for you, it will be so. If you believe meats are good for you, it will be so.
    The right attitude has more power than any bite of right or wrong food.




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    1. I truly believe that the mind is far more powerful than we can currently scientifically prove. However, to suggest that no matter what food you eat will only affect you positively or negatively if you think it has a positive or negative health effect is quite frankly BS. The research as presented by Dr Greger proves your belief as wrong. Also, it’s an eloquent way for people to justify eating unhealthy foods, ESP animal flesh and animal secretions. Good luck. Peace




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    2. My sweet and positive mother-in-law died slowly and painfully of duodenal cancer. My equally serene grandfather, of congestive heart failure.
      Me, on the other hand, will face a violent end because I am so hornery someone will be provoked; disease: naaa.




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  9. Wow Thea! Just wow! That’s the best compilation of information. I’ve always somewhat worried when I see guys in my office making smoothies using Whey powder with added ‘nutrients’ choline and carnitine. They drink this stuff by the 20 oz every lunch, trying to ‘bulk up’ for their exercise program. You want to break in and say something but unfortunately it seems most people only listen when they’re facing a dire health issue. Today I just introduced a young guy from Tenn to hummus for the first time. I’m like, eat this with celery or an apple, orange or banana instead of chips for a snack. I’m trying to be a little WFPB sneaky!




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    1. TofuAnnie (love your user name): I so hear you. I meet people who know (sorta, kinda) that they are eating unhealthy, but do it anyway. I consider that sort of informed behavior foolish, but not a crime. What I consider upsetting is the number of people who are so sure they are eating healthy (because that’s what they are hearing from government and the media and their doctors) and yet are actually increasing disease risk. I’m sure those carnitine chugging men think they are engaging in best practices when it comes to nutrition. The situation is a terrible crime.

      Your story about sneaking in the humus and veggies: NICE! You go girl!!




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      1. It seems to me that everybody THINKS they are healthy until the first shoe drops: heart attack, cancer, stroke, or even just some bad numbers on their labs that result in a fistful of prescriptions. That’s the first reason most people don’t really pay attention to eating better, even though they know they could be doing better. That, and the confusion fostered by industry feeding on what Dr McDougall famously says, “People like hearing good news about their bad habits.”




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  10. Choline is a vitamin that is required for health. Adequate daily intake is 425mg for women and 550mg for men. Choline occurs naturally not only in meat and eggs, but also in vegetables. For example,100g of cauliflower contains 177mg of choline. I tallied up all of the choline from my (vegan) diet and discovered I only get about 200mg per day, and that is with eating plenty of high choline foods. I take a choline supplement (choline bitartrate 250mg) to make up the difference. If I am interpreting this video correctly, It is the type of gut bacteria produced by eating eggs and meat that turns TMA into TMAO. So, if I eat a vegan diet and don’t have those type of gut bacteria, I should be able to take a choline supplement without TMAO production. Is that correct?




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    1. Isolda: Dr. Greger has recommended the book, Becoming Vegan, for when people have questions about specific nutrients. The Express Edition of the book has this to say on page 118:
      .
      “Choline has hopped back and forth across the line between vitamin–and therefore essential–and nonvitamin. That’s because the body can produce sufficient choline unless a person’s diet is short on folate, vitamin B12, and the amino acid methoionine. … Women should get 425 mg choline per day, and men should get 500 mg. … There are plenty of good sources of choline. A few that are particularly rich are beans, broccoli, peas, quinoa, and soy foods.”
      .
      It seems to me that if someone is eating a healthy, the amount of choline in the food is not really an issue. I also thought you might find the list of choline-rich foods helpful. You said that you are eating lots of choline rich foods already, but I didn’t know if you were aware of that list.
      .
      I don’t know the answer to your specific question. However, Joe Caner did an awesome job of answering a similar question above. He wrote: The following is an excerpt from a previous video on TMAO
      “Even if you eat vegan, though, you’re not necessarily out of the woods. If you regularly drink carnitine-containing energy drinks, or take carnitine supplements, or lecithin supplements, which contain choline, presumably you’d foster and maintain those same kinds of TMAO-producing bacteria in your gut, and increase your risk of heart disease and, perhaps, cancer.”
      From (Carnitine, Choline, Cancer, & Cholesterol: The TMAO Connection, http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/ )




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    1. Thanks for your comment.

      Indeed kefir has been “associated with a range of health benefits such as cholesterol metabolism and angiotensin-converting enzyme (ACE) inhibition, antimicrobial activity, tumor suppression, increased speed of wound healing, and modulation of the immune system including the alleviation of allergy and asthma” (see here).

      However, kefir fermented beverage does not have to be dairy based and there are other vegetable milk alternatives that can be used (see here).

      Hope this answer helps.




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    2. Hi Zeba, et al,
      I give Nancy’s organic Kefir to my patients all the time, with awesome results (I’m a holistic critical care nurse). I’m also the crazy guy on the unit trying to get everyone to go whole foods/vegan, so I am a little conflicted about it. It doesn’t take much to ‘dose’ one with the pro-piotics (about 40ml or a shot glass). I give it to my patients on antibiotics twice a day because I believe the benefits in acute situations outweigh the long term risk of dairy (plus, we had to work to get the hospital to supply us with Kefir, and we’re grateful for the intervention). That said, there are some cool vegan alternatives I like Nancy’s stuff
      because I live in Oregon and they are an Oregon company, but they are also organic, so even though they use soy in their vegan alternatives, it doesn’t contain GMO (over 93% of soy grown in the US is GMO, organic is the only way to ensure you are getting non-GMO).




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  11. Question: Does this suggest that those who follow a plant-based diet and also take probiotic supplements would return the plant-based gut ecosystem to a more “meat digesting” and TMAO converting ecosystem?




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    1. Hey Winnie, I don’t believe that evidence suggests TMAO buildup occurs from probiotic use. A good question to ask is, if you’re eating plant-based, why would a probiotic be required? There are specific medical conditions for which probiotic supplements have been found helpful, but these are the same ones that plant-based diets have been found to effectively prevent or treat.




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  12. I find some of the industry responses to the data that paints these sellers of death and desease in an adverse light to be totally ridiculous and laughable.




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  13. I have been under the impression that most of the choline in eggs is in the yolk. Might it be reasonably safe, from the perspective of limiting TMAO. to eat egg whites?




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    1. David Schwartz: Every time NutritionFacts does a video that mentions eggs, people start asking about egg whites. That’s understandable given the emphasis that is often placed on eggs. However, NutritionFacts also has some information on egg whites. And I have compiled some information about the health impact of egg whites over time. While I understand your question is specifically about egg whites and TMAO, I thought you might be interested to know the information below.
      .
      *******************
      There are two problems with eggs, the yolk and the white. (To paraphrase Dr. Barnard.) Egg whites are likely a big problem health-wise, just like the yolks. It is true that egg whites do not have cholesterol. But egg whites are essentially all animal protein. Here’s what we know about animal protein in general and egg whites in particular:
      .
      Dr. Barnard links potential kidney problems to animal protein (though I don’t have the details on that). And Dr. Greger talks about the problems of animal protein in general in his annual summary video, “Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet” http://nutritionfacts.org/video/food-as-medicine
      .
      Here on NutritionFacts, you can get a great education on how animal protein is linked to the body’s over-production of a growth hormone called IGF-1. IGF-1 helps cancer to grow. To watch the series about IGF-1, click on the link below and then keep clicking the “next video” link on the button to the right until you get through the bodybuilding video. Then you will have seen the entire series.
      http://nutritionfacts.org/video/igf-1-as-one-stop-cancer-shop/
      .
      Here’s another great tidbit from NutritionFacts on another mechanism linking egg whites to cancer as well as increased virus infections: “why would animal protein and fat increase cancer risk? Well, as I noted in Bowel Wars, if you eat egg whites, for example, between 5 and 35% of the protein isn’t digested, isn’t absorbed, and ends up in the colon, where it undergoes a process called putrefaction. When animal protein putrefies in the gut, it can lead to the production of the rotten egg gas, hydrogen sulfide, which, over and above its objectionable odor, can produce changes that increase cancer risk. Putrefying protein also produces ammonia.”
      To learn more details about the process, check out:
      http://nutritionfacts.org/video/putrefying-protein-and-toxifying-enzymes/
      .
      Darryl at one point reminded me of the methionine issue. Egg whites have *the* highest concentration of methionine of any food:
      http://nutritiondata.self.com/foods-000084000000000000000.html?categories=1,18,9,0,13,14,5,4,42,16,17,15,6,3,2,11,7,19,21,12,10,8,22
      Dr. Greger did a nice video showing the link between methionine and cancer.
      http://nutritionfacts.org/video/starving-cancer-with-methionine-restriction/
      .
      Darryl also pointed out that, “…high methionine diets increase coronary risk in humans. In its associations with cardiovascular disease and other disorders, homocysteine may be functioning partly as a marker for the major culprit, excess methionine.”
      http://www.sciencedirect.com/science/article/pii/S0939475305001092
      .
      Dr. Greger recently posted some videos on how animal protein can raise insulin levels. The first of the following videos even specifically addresses egg whites.
      http://nutritionfacts.org/video/paleo-diets-may-negate-benefits-of-exercise/#comment-1978464793
      http://nutritionfacts.org/video/if-white-rice-is-linked-to-diabetes-what-about-china/
      .
      In summary: there are at least three pathways potentially linking animal proteins, especially egg whites, to cancer: the IGF-1, methionine, and putrefaction. And there is some good evidence that egg white consumption contributes to heart disease and potential problems with T2 diabetes by raising insulin levels in a bad way. All of these reductionist-type studies lend support the bigger general population studies showing that the healthiest populations on earth are those which eat the least amount of animal protein.
      .
      With all of the information we have about the harmful effects of animal protein in general and egg white in particular, I think it’s best to stay away from egg white. Why not get your protein from safe sources? IE: Sources which are known to have lots of positive health effects and will naturally give you a balanced amount of protein? (ie: whole plant foods)




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      1. Thea: You hit another “home run” out of the ball park with this answer/post! You are such an awesome addition to the NutritionFacts Team. Thank you for all you do :-)




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        1. Thanks WFPB-Hal! Those are probably my two best posts. Given how common those questions are, it was worth putting some time into them.

          Thanks for the lovely feedback. :-)




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  14. eat spinach, kale, eggs, onions, garlic, tumeric, apples, grapes, plant protein powder, herbs etc.
    Lost over 100# in four years. What am I supposed to eat to build muscle, burn fat, keep brain and body healthy?
    Take natural supplements esp b vitamins. Don’t eat meat except for small qty of bone broth and liver once a week for the health benefits. Eat two eggs a day, flax, chia, coconut oil, coconut milk, no dairy and no red meat or chicken. Eat a lot of vegetables and smaller quantities of fruit (lower in sugar). Carnitine and soy are crap so I avoid it. WHAT SHOULD I BE EATING THEN?
    Also eat avocados and walnuts/almonds every day. 1000 calories per day, walk ten miles, HIIT with weights 30 min at night.
    I have studied nutrition and ayurveda, chinese medicine for years now. The egg thing surprises me.




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    1. Cut out all the animal produce, esp the eggs, and replace with whole food carbs such as sweet potato, quinoa, millet, brown/red rice, oats. Everything else you’re doing looks good.

      You’ll need to slowly build up the amount of carb heavy foods you consume to ensure your body doesn’t gain fat weight (it never has with me but I know everyone is different). So now that you’re not getting these bad and unhealthy animal fats (esp from those eggs you currently eat) the increase in carbs should not cause a negative weight gain, but a positive muscle gain if you’re training smartly.

      These are def worth watching/reading:

      http://nutritionfacts.org/video/what-causes-insulin-resistance/

      http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/

      Basically, eat WFPB and regularly and smartly lift heavy sh!t in the gym :-)

      I’ve been WFPB for 8 years, a personal trainer / strength coach for 10 years and a lifter of heavy sh!t for 25yrs.

      Good luck.




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    2. govinda: Could you give us a reference to some research showing that “eating two eggs a day” is health promoting? All the research presented on this website shows just the opposite. Thanks.




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    3. govinda: You want to know what you should be eating? After spending literally years reviewing thousands of studies on nutrition, Dr. Greger came up with an eating plan called the Daily Dozen. You can learn details about the Daily Dozen from part 2 of Dr. Greger’s book How Not To Die (a book that is often available in libraries if cost is an issue for you). For a quick summary, you can download a free phone app to track your eating of the Daily Dozen. That Daily Dozen list will tell you the answer to: “What am I supposed to eat to build muscle, burn fat, keep brain and body healthy?”

      While not in the format of the Daily Dozen, the following page is also a nice overview of what a healthy diet looks like: http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

      (Note: As someone else already hinted at, eating eggs is not the way to go. FYI: On the other hand, you may want to re-think your position on traditional soy products http://nutritionfacts.org/topics/soy .)




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    1. kkalajan: I’m always fascinated by what we can learn from examining ancient teeth. Thanks for pointing out this latest article!




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  15. I found a Greek verb (Koine) that means “put [something] to the test.” Expeirazo (ἐκπειράζω). I know Dr. Greger is a bit of a logophile, occasionally making references to Greek and Hebrew texts in his videos; I thought he might be interested.




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  16. Hi Dr. Gregor. I hope you find this question. It is not related to the video, but I really want to find a solution to this problem. My father has Lupus Factor 5, the condition where your blood clots too easily. He was on blood thinners, but hated how they made him feel, so he stopped. Then he got another clot and had to start them again. This blood thinner doesn’t seem as bad as the last, but I know how dangerous most medications are and would really like to find a nutrition based solution for his condition. Are there any foods that have been proven to be as effective as medication for this condition? I know he shouldn’t eat these foods along with the blood thinner. I will not be suggesting that. He does not eat plant-based, unfortunately, nor do I ever think I’ll convince him too completely.




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  17. I have a question unrelated to this video… but there is not general question section that I can find. What’s the deal with lectins? I’ve heard of lectins being in tomatoes, beans, grains, etc (although in lower amounts than in dairy, eggs, seafood), and how they are bad for your GI tract. Would be interested to see Dr. Greger’s thoughts on this topic.




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    1. Andrea: I found one blog post on NutritionFacts which talks about lectins. Here is a quote:
      .
      “Modern paleo advocates claim that these foods weren’t part of Paleolithic-era diets, but new research challenges that assumption.5 They also argue that lectins naturally present in these starchy foods are harmful to human health. Consuming too many lectins can cause significant gastrointestinal distress. However, because legumes and grains are almost always consumed in a cooked form—and lectins are destroyed during cooking—eating beans and grains doesn’t result in lectin overload. Sprouting also reduces lectin levels in plants, although not as effectively as cooking. Generally, pea sprouts, lentil sprouts, and mung bean sprouts are safe to consume, as are sprouted grains, which are naturally low in lectins. Most larger legumes contain higher amounts and should be cooked.” from: http://nutritionfacts.org/2014/09/23/will-the-real-paleo-diet-please-stand-up/
      .
      Since I eat my grains and legumes cooked, I consider the lectin brouhaha to be much ado about nothing.
      .
      In the past, Tom Goff has posted some additional helpful takes on the subject. Here are some quotes from Tom Goff’s previous posts.
      .
      “…problem with such claims is that people in the past ate huge amounts of (whole) grains (compared to modern-day Americans). Some people still do. There is no record of such people suffering abnormally high rates of toxicity or inflammation-related diseases. If anything, the exact opposite is the case eg
      .
      “This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes. These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.”
      http://www.bmj.com/content/353/bmj.i2716
      .
      Further, reviews of the health effects of grain lectins do not support the wild claims found on the internet or sensational mass market “health ” books
      .
      “We conclude that there are many unsubstantiated assumptions made. Current data about health effects of dietary lectins, as consumed in cooked, baked, or extruded foods do not support negative health effects in humans. In contrast, consumption of WGA containing foods, such as cereals and whole grain products, has been shown to be associated with significantly reduced risks of type 2 diabetes, cardiovascular disease, some types of cancer, as well as a more favourable long-term weight management.”
      http://www.sciencedirect.com/science/article/pii/S0733521014000228
      .
      Sure, it is possible to find toxic effects from grain lectins in the laboratory or in rat studies. You can find toxic effects from virtually anything if you design the study appropriately. Even water is toxic in high doses and specific circumstances. And you can turn such findings into sensational claims that garner a lot of publicity (and sales) – if you leave out all the evidence that does not suit your argument or book sales.”
      .
      And from another post:
      “The Paleo community attitude is certainly strange because there is evidence to show that humans in the Paleolithic period actually did eat legumes – and significant amounts at that – at least in certain locations and in the relevant season eg
      http://www.sciencedirect.com/science/article/pii/S0305440304001694
      .
      However, it seems that once an idea becomes established in the Paleo canon it becomes sacrosanct and no mere inconvenient fact is powerful enough to overturn it.
      .
      On lectins and health specifically, blogger has summarized the (Paleo) argument like this:
      “There is evidence that legumes provide health benefits. There is speculation that lectins cause diseases. Unfortunately, the autoimmune diseases some speculate are caused by legume lectins appear to occur more frequently in nations like the U.S., where legume consumption is rather low, than in Asian nations, where legume consumption is higher.” http://donmatesz.blogspot.com/2011/08/legumes-neolithic-or-not.html




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    2. Lectins are proteins that bind to carbohydrates, and they exist in a variety of foods. Some lectins have cancer-fighting benefits. Agaricus binding lectin, for example, in button mushrooms helps bind cancer cells. Mistletoe lectins are similarly promising. On the other extreme, the lectins in peanuts help many kinds of cancer cells spread throughout your body (assuming you have cancer involving epithelial cells, of course.)

      One of the problems with lectins in some legumes is that they irritate the gut. The lectin phytohaemagglutinin (PHA), which concentrates in kidney, pinto, black turtle and navy beans, is particularly troublesome. And if you cook those legumes in a crock pot or slow cooker, the low heat may not kill the harmful lectins.




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  18. Let me first say that I always enjoy your videos. I would like to see you cover some of the other aspects of choline because it gets a little confusing. It seems like your videos on the topic seem to focus on the negatives of choline but what about the studies on choline and memory or fetal brain development? Choline is a good methyl donor and, thus, has impact in epigenetics. What about the genetic populations which are poor methylators and require extra intake of methyl donors (and, specifically in some studies: choline)? I would be interested in a video on this topic so that you can help us put both sides of the coin into proper perspective. Thanks!




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  19. I am still a bit confused about this video. Is L-Carnitine responsible for the TMAO, or is it specifically bacteria associated with animal food? If a person eating a diet without any animal food at all takes L-Carnitine supplements to boost a sluggish metabolism, is there still an issue of TMAO? The part in the video about a vegan person consuming a steak would seem to suggest not, but this isn’t completely clear. Thanks!




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  20. Is this research only based on Beef (“steak”)? Beef isn’t the only meat available, and how about Organic, non GMO fed, HEALTHY meats? How many of these researched are based on that, huh?




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  21. My gut doesn’t cope well with a plant based diet. I tried it for several years. My gut is much happier on a FODMAP diet where the main culprits are onion, gluten, beans and garlic amongst other foods. How do I get my gut healthy again as I’d like to return to the plant based diet?




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  22. Hi. I’m wondering about how to develop a healthy gut if your entire large intestine has been removed? I am speaking of my daughter who was born with Hirschsprung’s disease. She is now 21, but still has many bowel issues and not much help from the medical profession. I’d appreciate any advice or contacts I can share with her. Thank you.




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    1. Hello LC,
      I am a family doctor and volunteer moderator for this website. I’m sorry about your daughter’s condition. Your question is beyond the scope of what I feel comfortable answering. She probably needs a very specialized diet. I would recommend that she consult a nutritionist and/or gastroenterologist with experience in treating patients who’ve had a colectomy. I hope this helps. Good luck!




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      1. Thank you Dr. for your reply. I will try to find specialists in this field. Perhaps I can ask a specific question? Could a probiotic supplement help someone without a large bowel or do these bacteria live only in the large bowel?




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  23. Preserving food for personal storage or for transport and shelf life seems to harm the food. I started dehydrating because potatoes, garlic and onion went bad waiting to be used. Is dehydrating a reasonable way to keep food on hand? I was stunned to hear Dr. Greger say freezing broccoli stopped it’s cancer benefits but we could add mustard powder to overcome the problem. There could be many storage methods that negate the benefits of the stored food. Is there research and what are your thoughts.




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  24. Hi there. I’m scheduled to have a colonoscopy soon, nothing serious just preventative. The preparation for the test requires you to empty the digestive system. So my question is… What does it do to your gut flora and what is the best way to rebuild it?

    I appreciate your thoughts.




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