How to Prevent Prediabetes from Turning into Diabetes

How to Prevent Prediabetes from Turning into Diabetes
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Approximately 1 in 3 Americans have prediabetes, but only about 1 in 10 knows it. What works better at preventing it from turning into full-blown diabetes—drugs or diet and exercise?


In just one decade, the number of people with diabetes has more than doubled. According to the Centers for Disease Control and Prevention, by 2050, one out of every three of us may have diabetes. What’s the big deal?

Well, the consequences of diabetes are legion: the #1 cause of adult-onset blindness, the number one cause of kidney failure, and the number one cause of surgical amputations. What can we do to prevent it?

Well, the onset of type 2 diabetes is gradual, with most individuals progressing through a state of prediabetes, a condition now striking approximately 1 in 3 Americans, but only about 1 in 10 even knows it. Since current methods of treating diabetes remain inadequate, prevention is preferable, but what works better, lifestyle changes or drugs? We didn’t know until this landmark study was published in New England Journal of Medicine.

Thousands were randomized to get a good double dose of the leading antidiabetes drug or diet and exercise. The drug, metformin, is probably the safest diabetes drug there is. Causes diarrhea in about half, makes 1 in 4 nauseous, about 1 in 10 suffer from asthenia, from the Greek meaning lack of strength, physical weakness and fatigue, but only about 1 in 67,000 are killed by the drug every year.

And it worked. Compared to placebo, in terms of the percentage number of people developing diabetes within the four-year study period, fewer people in the drug group developed diabetes.

But diet and exercise alone worked better. The lifestyle intervention reduced diabetes incidence by 58 percent, compared to only 31 percent with the drug. The lifestyle intervention was significantly more effective than the drug, and had fewer side-effects. More than three quarters of those on the drug reported gastrointestinal symptoms, though there was more muscle soreness reported in the lifestyle group, on account they were actually exercising.

That’s what other studies have subsequently found: non-drug approaches are superior to drug-based approaches for diabetes prevention. And the 50% or so drop in risk was not for people that actually improved their diet and lifestyle, but just for those instructed to improve their diet and lifestyle, whether or not they actually did it.

This is one of the most famous diabetes prevention studies. 500 people with prediabetes randomized into a lifestyle intervention or control group, and during the trial, the risk of diabetes was reduced by that same 50-60%, but only a fraction of the patients met the modest goals. Even in the lifestyle intervention group, only about a quarter were able to eat enough fiber, meaning whole plant foods, and cut down on enough saturated fat, which in this country is mostly dairy, dessert, chicken, and pork. But they did better than the control group, and fewer of them developed diabetes because of it. But what if you looked just at the folks that actually made the lifestyle changes, met at least 4 out of 5 of those wimpy goals? They had zero diabetes. None of them got diabetes. A 100% drop in risk.

Bottom line: Type 2 diabetes can be prevented by changes in lifestyle even in high-risk prediabetic subjects.

The fact, then, that type 2 diabetes, a largely preventable disorder, has reached such epidemic proportion is a public health humiliation.

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.

Image thanks to feverpitched via 123rf. Image has been modified.

In just one decade, the number of people with diabetes has more than doubled. According to the Centers for Disease Control and Prevention, by 2050, one out of every three of us may have diabetes. What’s the big deal?

Well, the consequences of diabetes are legion: the #1 cause of adult-onset blindness, the number one cause of kidney failure, and the number one cause of surgical amputations. What can we do to prevent it?

Well, the onset of type 2 diabetes is gradual, with most individuals progressing through a state of prediabetes, a condition now striking approximately 1 in 3 Americans, but only about 1 in 10 even knows it. Since current methods of treating diabetes remain inadequate, prevention is preferable, but what works better, lifestyle changes or drugs? We didn’t know until this landmark study was published in New England Journal of Medicine.

Thousands were randomized to get a good double dose of the leading antidiabetes drug or diet and exercise. The drug, metformin, is probably the safest diabetes drug there is. Causes diarrhea in about half, makes 1 in 4 nauseous, about 1 in 10 suffer from asthenia, from the Greek meaning lack of strength, physical weakness and fatigue, but only about 1 in 67,000 are killed by the drug every year.

And it worked. Compared to placebo, in terms of the percentage number of people developing diabetes within the four-year study period, fewer people in the drug group developed diabetes.

But diet and exercise alone worked better. The lifestyle intervention reduced diabetes incidence by 58 percent, compared to only 31 percent with the drug. The lifestyle intervention was significantly more effective than the drug, and had fewer side-effects. More than three quarters of those on the drug reported gastrointestinal symptoms, though there was more muscle soreness reported in the lifestyle group, on account they were actually exercising.

That’s what other studies have subsequently found: non-drug approaches are superior to drug-based approaches for diabetes prevention. And the 50% or so drop in risk was not for people that actually improved their diet and lifestyle, but just for those instructed to improve their diet and lifestyle, whether or not they actually did it.

This is one of the most famous diabetes prevention studies. 500 people with prediabetes randomized into a lifestyle intervention or control group, and during the trial, the risk of diabetes was reduced by that same 50-60%, but only a fraction of the patients met the modest goals. Even in the lifestyle intervention group, only about a quarter were able to eat enough fiber, meaning whole plant foods, and cut down on enough saturated fat, which in this country is mostly dairy, dessert, chicken, and pork. But they did better than the control group, and fewer of them developed diabetes because of it. But what if you looked just at the folks that actually made the lifestyle changes, met at least 4 out of 5 of those wimpy goals? They had zero diabetes. None of them got diabetes. A 100% drop in risk.

Bottom line: Type 2 diabetes can be prevented by changes in lifestyle even in high-risk prediabetic subjects.

The fact, then, that type 2 diabetes, a largely preventable disorder, has reached such epidemic proportion is a public health humiliation.

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.

Image thanks to feverpitched via 123rf. Image has been modified.

Doctor's Note

I often hear the diet and exercise intervention described as 60% effective. That’s still nearly twice as effective as the drug, but that other study really showed it may be more like 100% in people who actually do it. So is diet and exercise 100% effective or only 60% effective? On a population scale, since so many people won’t actually do it, it may only be 60% effective. But on an individual level, if you want to know what are the chances you won’t get diabetes if you change your lifestyle, then the 100% answer is more accurate. Lifestyle interventions only work when we do them. Kale is only healthy if it actually gets into our mouth. It’s not healthy just sitting on the shelf.

How about preventing prediabetes in the first place? See Preventing Prediabetes By Eating More and my next video How to Prevent Prediabetes in Children.

Some things we may want to avoid can be found in my videos Eggs and Diabetes and Fish and Diabetes.

And what if we already have the disease? See Diabetics Should Take Their Pulses and my new live presentation From Table to Able: Combating Disabling Diseases with Diet.

What if you don’t have time for exercise? Check out Standing Up for Your Health.

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

162 responses to “How to Prevent Prediabetes from Turning into Diabetes

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  1. public health humiliation = huge private accumulation (profit)… because a chronic disease “managed” using chronic prescription drugs it’s the best way to make money… but maybe i am a pessimistic guy and big pharma is really a good entity, they just did their job after all…

    1. No, you are right. Humiliation? That’s putting it lightly. This is an immense fraud committed against the people. On the other hand, the people are equally responsible.

      1. We have policies in place that make a healthy lifestyle hard right? How many people can walk to work or the grocery store? We have policies in America that have subsidized sprawl, and put limits on the kind of density that makes walking, biking an easy choice.

        We also subsidize the production and sale of junk food.

        If we actually had a democrat system here… Instead of a two party, money based system i think things we be different. Healthy lifestyle choices might be easier

        1. If people can see that they’re being setup by the medical system, or whatever demonic system this is, to be dependent on the medical system, in state of compromised health, for the last 15-20 years of their lives, maybe we’d see a change. I see this in my own family, with a history of heart disease, as soon as I found out, I was able to drop my cholesterol from high risk to normal, 245 to 187, and that’s only 4 months after changing diets. Someone else in my family is faces a similar situation BUT with this DR beginning to tell him he’ll likely need statins to get the cholesterol down. Meanwhile, we’re discovering with another family member that his statins are likely causes nerve damage and making it harder for him to walk and go down stairs, setting him up for a fall. What a detestable scenario. Eating has become a sport, not something we enjoy because it’s giving us the nutrients we need.

          1. I think that it isn’t really a suburb vs cities thing. There are really great walkable, bikeable suburbs out there. And there are also cities that are so dangerous you wouldn’t think of walking to the bus stop. It just seems to me that there are very big structural things that we could be doing to make America more healthy. Those structural things are really hard to implement when our government is as dysfunctional as it is now.

            If we were able to get some voting reform (anti Gerry-manderying reform, ranked voting) we would probably start getting candidates in office that more represented their constituents (not super extreme candidates). These kinds of candidates would probably be more helpful in planning policies that led to a more resilient America (like moving subsidies away from junk food and dairy to kale and berries, ).

            I am not an urban planner or a policy maker or a public health official. I’ve just read a lot of books… but it seems to me these larger structural issues have largely determined where we have gotten to today with our epidemics of chronic diseases.

        2. Tbatts666, you are right to some degree, BUT a healthy lifestyle is available for anyone who chooses it and the information is out there for anyone to find IF they are interested. Most want to have their cake and eat it too, but it is a slow suicide.

        3. Tobias, I largely agree with you, but was wondering if, by “subsidize the production and sale of junk food,” you simply mean our tariffs on imported sugar. I don’t see how our subsidies for making ethanol from corn, for example, spill over to the production of high fructose corn syrup. What did you have in mind? Subsidies to big businesses like McDonald’s to sell their hamburgers overseas?

          1. We could start by lowering the subsidies to the big three: corn, wheat, & soy; they get over $100 billion annually. That’s why so much of our food, drink, & livestock is directly or indirectly related to these three. For just a fraction of a percent of that cost, we could invest in nutritional education, and lifestyle intervention, saving us hundreds of billions in health care costs. But, who in government wants that? Answer: no one. There’s no money in health, and seemingly, limitless funding by those who want to perpetually treat disease. Just try to win a presidential primary in Iowa, where Monsanto’s GMO corn is the state’s life line by proposing a cut in corn subsidies.

      2. I hope we could became much more informed until we will free ourselves from the most common disease… and change the future of our society…

    2. Big Pharma a problem? There’s change afoot. Big Insurance is getting tired of paying Big Pharma, and the industry has gotten wind of the power of lifestyle change. Expect more of this…

  2. I know many people who have diabetes and what I have observed is they just do not get this information from their health care providers. They get prescriptions and are maybe advised to go to the diabetes diet class (which they rarely do.) The diabetics I know would need a residential program such as the McDougall program in California to understand the science and adopt the lifestyle changes. We need more residential programs to educate diabetic patients on the facts of the disease and how diet and exercise can prevent and cure. Out-patient programs providing regular education and vegan meals would be far better than the care diabetics are getting presently. And, it would be nice if health insurance would reimburse the costs of these programs.

    1. I have type I diabetes and I am convinced that many of the same dietary factors could have prevented it because of the auto immune factors. However the side effects mentioned are equally important to me. I had diabetes for over 6 years when I came across an article in the Journal of Chronic diseases that accounted for improved control limiting side effects from diabetes. Side effects?! I didn’t know about any side effect! So I asked my doctor why I was not informed of this fact that poor control is associated with all the mentioned side effects and others. “Most people just don’t want to know,” he said. Well they never asked me and I believe this patronizing BS is at the root of much of the reluctance to pursue this. Then of course there is the fact of the level of ignorance in the medical profession.

      1. Patronizing attitudes probably come from doctors advising patients to watch their diets but not really educating them on how to change. My family members who have diabetes would need a comprehensive approach with meals and education provided. They won’t take or follow the advise. A doctor would waste his/her time just telling them what they should eat and not eat. And more importantly, as you said, most doctors are unaware and uninterested in the vegan diet/exercise treatment. I have tried to convince family members that a trip to the McDougall program would ultimately cost less than the numerous doctor visits and medications they currently pay for even with insurance. They won’t listen to me, but after 10 days of listening to Dr. McDougall and the other experts, they would get it. And, they would know how to follow the program. All they do now is take their pills/injections and play with watching their diet (and get sicker.). It is upsetting to watch.

        1. Actually you’re into something really important here. You are obviously, and I think appropriately, frustrated with those close to you deliberately hurting themselves.
          I think the comprehensive program is a tremendous idea. But this needs to be handled on all levels. We do have a ubiquitous barrage of nonsense from the meat, dairy and egg industries which makes it all the harder. With fish and chicken presented as a healthy alternative in most recommendations, it is no wonder that people have continuing trouble taking seriously any sound science. So what can we do that might be constructive? I think that for one thing we need to show a positive example. Use your own example and those of others you read about here.

          I plan on handing my new doctor the pamphlet put out by Kaiser Permanente on universal recommendations of a plant based diet.
          I’m betting she has no idea that this is an important idea. I’ll also give her a dvd of Dr Greger’s latest on living better and not just longer. After all she is dealing with lots of diabetics and I’ll bet her nutrition knowledge is very poor.

          Not likely she will listen to me but the more everyone hears such things the more effective it will be. Good luck on your endeavors. Do what you can and don’t expect too much.

          1. Yes, you are right about setting a good example. I know my sick family members are impressed with my excellent health, know what I am doing with diet and exercise and they do ask questions. I attended the McDougall Costa Rica adventure trip in June and later told family about the people I met who had attended the 10-day program and reversed health problems. Family members think about what I tell them and agree they need to make changes, but then I fly back home from my visit and no one is there to reinforce the message – certainly not their doctors.

            1. It all has to do with choice. You can lead a horse to water, but you cannot make him drink. It would be nice if Dr’s reinforced the message, BUT, IF they truly wanted to get well they would make the changes without the Dr. or anyone else. We have to act on our own.

          2. Stewart. Where do you get the Kaiser pamphlet? I am a member of Kaiser and have lowered my A1C to 6.2 (from 8) by following a plant based diet for the last year. My doctor never heard of changing diet to “cure” diabetes. I have recommended
            Neil Barnard’s book to her for information but she does not seem to be interested. I have never been told by any doctor to try changing my diet to control type 2 diabetes. It is very frustrating. Thanks

            1. I found it on this web site. and if you go to the sources sited tab you will find the pamphlet. ( You obviously want to educate your doctor, wanting to do the same thing of course I think this is great. I plan to give it to the new doctor I will be seeing this month and just remark that I wish this had been available years ago. Given the source there is a better than even chance that it will be read.

              I’m curious Lynne, how long have you been diabetic? And how strict are you regarding oils. Your record is outstanding 6.2 from 8 is a wow. With type 1 I am generally delighted with a 6.3. The reason I ask is, rather than referring to sources like McDougall or Greger et al, I am going to try referring to individual stories like yours when talking with friends and family. It depends on the situation.

              I think that for a doctor, the Kaiser Permanente pamphlet will be a credible source. Michael Greger does a good job examining peer reviewed studies so his presentation is very credible and will likely carry an impact provided you can get it seen. The Kaiser Permanente pamphlet in effect has credibility stamped all over the cover.

              With the things listed that can be salubriously impacted with good nutrition this should be in every doctors office. I have cured my psoriatic arthritis, reduced my weight to an appropriate level, seem to have eliminated colds, improved my diabetes control and hopefully not made myself too obnoxious telling people how I have done it. The latter is hard when I see a neighbor who is almost 20 years younger than I, is obese, has migraines, colds and all sorts of minor ailments so that she misses work about once a month. She can barely walk some days. Oh yes there are some overt symptoms of coronary artery disease and her mother has had a stroke and the neighbor might still predecease her mother. (She thinks having the hot dog without a bun might make it healthier.) I only run 4 miles on a bad day and I am applying for medicare this month. The difference is not magic or luck or even discipline. It is knowledge.

              Sorry Lynne, you can see I do get would up and rant but I was absolutely delighted to see your efforts at education as well as the medical results you brought about for yourself. I tell every diabetic that he/she should be their own primary care giver. A good doctor can be very important as a coach. But it is your body and your responsibility. You have obviously taken that to heart with better results than what the doctor has done. .

              1. I have been diabetic for about 10 years. Started with neuropathy (said I didn’t have diabetes) for 5 years before that. I started by watching and reading Forks Over Knives and read Neal Barnard’s book. I am not a vegan – having trouble giving up cheese! But I eat very little cheese and mostly vegetables and good grains and I do cook with a little olive oil. I have lost 40 pounds and have taken myself off of all medications ( with my Doctor’s knowledge if not her approval). I have taken no metformin, Blood pressure or cholesterol meds in about a year. Never felt better in my life but I still have the neuropathy and have to watch my feet all the time. I am going to take the pamphlet in to my next appointment. I wish Kaiser and other health providers would do a better job of educating their doctors and nurses! Thanks so much for the info.

                1. Lynne, just interested if your B12 levels are good. I had peripheral neuropathy years ago and come to find out I had pernicious anemia. PN is one of the symptoms of PA. I was taking B12 but absorbing none.

                  1. I do take B12 5000mcg daily. My neuropathy never seems to improve but I guess I am getting used to it. Not much pain involved after all these years – just numbness

                2. Lynn, try the supplement alpha lipoic acid. A book written by Dr Wes Youngberg has in his book called “Goodbye Diabetes” says it works very well to help “greatly reduce symptoms associated with diabetic neuropathy”. He recommends 300 milligrams twice a day. Also he says ” first make sure you are manage your blood sugars real well. This will go along way toward halting nerve damage.”

            2. “Forks over knives” Diabetic example who was cured and went back to her Diabetic clinic job, showed them her recovery and the doctors lack of interest is well documented It’s the I can’t make any money on prescribing food They have lost sight of do no harm

  3. I was diagnosed with pre-diabetes eighteen months ago (A1C of 6.0) and about the same time watched “Fat, Sick and Nearly Dead.” I started juicing and then migrated to Dr. Fuhrman’s nutritarian approach. Today, with no animal products in my diet, I’ve lost 50 pounds, cut my blood pressure medicine in half, dropped my cholesterol from 200 to 130 and my A1C is 5.5. Dr. Greger is spot on.

    1. What Veganrunner said! I have a similar story to tell, and I am never going back to the SAD situation in which this country’s overfed and undernourished population finds itself. I know I’m just preaching to the choir, but in addition to the most cynical comments here with which I totally agree, the real problem is that most non-WFPB folks out there cannot see past the tips of their tongues. Their taste buds have been taken hostage by the processed food industry to the point that most Americans (and increasingly, the entire world population) have no idea anymore what real whole food is supposed to taste like. Real food is so unpalatable to them they cannot and will not give real food a chance long enough to allow their taste buds to clear out. And, of course, the food industry wants it that way. The tongue is the MASTER ORGAN of the body; the tongue RULES their behavior so that every bite gets the dopamine rush they have been conditioned to expect from food. It is a huge problem and no amount of talking or explaining or directing to this or other reputable websites will make any difference to them. It is a hopeless situation. Which is just the way the profiteers of all stripes connected to this problem want it. And they have won, as far as I can tell.

      1. They’ve won a hundred years ago. The people must lead others out of this situation by example. The horrible “silver lining” is when too many addicts get too sick to function then change becomes compulsory. We will reach that tipping point soon.

    2. I agree with you TucsonJim — I watched FS&ND and followed nutritarian to transition to 100% plant-based wholefoodist and am no longer pre-diabetic, lost 150 pounds, reversed heart disease and a whole host of other chronic and degenerative ailments. It took some time to fully transition, but Dr. Greger, Dr’s Campbell, Dr. Barnard, Dr. Esselstyn, Dr. Klaper, Dr. Fuhrman all gave me the scientific backing to pursue the lifestyle and succeed with dietary sanity. :)

  4. I don’t see any mention of Type 1.5 (LADA) diabetes. It is estimated that 10% of diabetics are actually LADA–Latent Autoimmune Diabetes in Adults. When diabetes cannot be controlled with exercise and/or oral medication, one should check for pancreatic antibodies, which is what I have. In other words, many thin adults are late starters for Type 1 diabetes.

    1. You make an outstanding point. In effect I believe most type I diabetics begin as type 1.5. I began with symptoms on or about my 21st birthday. I was put on insulin and the dosage gradually went from 20 units per day to about 50. This process (I believe) occurred as my beta cells were being destroyed. Of course the doctors had no idea of why this was going on. Only when I developed psoriatic arthritis did I start learning about the importance of diet in auto immune disease.

      With hind sight, I am fairly certain that my diet of today would have prevented my type I diabetes. I have reduced my insulin intake by about 25% due to almost no saturated fats and eliminating the animal proteins. OK OK the fiber certainly helps as well. I have also with a strictly plant based diet eliminated enough inflammatory factors to be free of the arthritis but the diabetes will always remain since the beta cells are now dead. The bottom line though is that the treatment might be the same, a diet that eliminates all animal products.

        1. I got my first pump back in the 70s. A pump was designed for chemo therapy and someone had the bright idea of using it for subcutaneous insulin infusion. It was the size of a brick. I had to go to a saddle maker to get a holster made for it. It also used a hard needle instead of today’s soft cannula. Let me tell you, they are much better now. You will need to do many blood tests but life will be better.

      1. It looks awesome indeed but does seem to suffer from load problems. Consider switching from apache to nginx or using nginx as a reverse proxy.

      2. On AOL the transcript and notes have missing lines but it is all there on Google Chrome. I personally have an aversion to pop up ads and don’t appreciate the window taking over the screen. I’m already signed up. That is just an annoyance. I’ll get used to the new website look and function but change isn’t always easy.

      3. I liked the feature on the old site, that the “Previous Video” was posted near the new video. Thank you for your dedication and efforts to improve this site. Monday thru Friday the first website I go to is this site.

  5. Basically diabetes is a type of malnutrition. If you watch Ebola videos you will see a similar sub-clinical malnutrition. They appear to be eating a meat and rice diet neglecting salad which has Vitamin K for clotting and Vitamin C plus other phyto-nutrients to boost the immune system. This appears to result from a violation of fixed Natural Law which results in famine even when the person is eating food. 15 times the book of Jeremiah says some form of Jer_24:10 And I will send the sword, the famine, and the pestilence,…

  6. Interesting new website design, Dr. G. However…

    I posted a reply on this page with an image. The comment initially posted, but when I refreshed the page, my comment disappeared. It’s not like this is the first time I’ve ever posted here before.

    What’s going on?

  7. This video presents information that has been established for over a decade. It’s quite clear that improving diet and moving improves metabolic flexibility. Current research has clearly indicated that insulin resistance is multifactorial and is a result of an improper diet, sedentary lifestyle, stress, sleep dysfunction and toxin exposure. Implementing a plant based diet (not a vegan diet) with sufficient protein and fat intake, training diversity, stress management, proper sleep habits and minimizing toxin exposure is the CURRENT functional medicine prescription to effectively reverse insulin resistance and T2D.

    1. What is the difference between WFPB and vegan? And do you think the United States has an issue with not getting enough protein and fat?

      1. You could be a vegan eating oily French fries, Coke and Twinkies. Whole food denotes less processed food. And protein deficiency is unheard of in this country.

        1. Oh yes. Very true. Plus I like the term WFPB for just that reason. Maybe I should change my name!!

          Ryan seems to think there could be a problem with sufficient fat and protein. I wasn’t clear from his statement.

          Yes I know a couple of vegans who eat badly with the fake meats etc. Have you read those labels? Scary.

          1. The optimal diet is different for everyone based on biochemical individuality, age, gender, conditions, lifestyle, SNP’s, etc. The vegan diet for a prolonged period of time is lacking key nutrients and EFA’s that are required to maintain optimal physiology which includes proper biotransformation and conjugation, neurotransmitter and hormonal balance, and mitochondrial metabolic flexibility. Removing the SAD diet and implementing a balanced plant-based foodplan is advised for optimal health but cherry picking scientific literature to support one’s nutrition philosophy are not accurate nutrition facts.

            1. Well it is not lacking key nutrients other than B12 which I choose to get from a bottle instead of a dirty stream.

              I don’t need to link resources because they are under nutrition topics. Have a go at them.

              1. Good plan. WFPB diets are far superior to the alternatives, and supplementing B12 and maybe D make them complete. One diet works great for most everyone!

            2. Ryan, Saying the everybody has a different optimal diet is probably strictly true, but also very misleading. The main feature of a healthy human diet is how much whole, unprocessed plant food there is in it. Whether a healthy diet can have some meat in it is missing the point. The bottom line is the more whole plant foods the better. Tailoring around this general rule might be required for some individuals with unique needs, for the large majority the only rule they need to follow to be healthy is eat whole plants with meat as a rare treat if eaten at all.

              One way to see which diet is best for healthy people is see which one helps to cure sick people. I have seen numerous studies that show people prevent, halt and often reverse chronic disease deemed “incurable” by modern medicine using a WFPB diet. Most studies like those referenced in this video have very high response rates to changes in diet that simply adds more plant foods along with exercise, like the 100% avoidance of diabetes by those in the study that actually fully implemented the diet and lifestyle suggestions. Other studies stressing a WFPB diet have very similar high response rates.

              Dr. Caldwell Esselstyn in July published results to the follow up study to his 1985 study that showed that 99.4% (176 out of 177) of those with clinically established CVD who followed his low-fat WFPB diet had no major cardiac events (worsening angina, CABG, MI, etc) during the follow-up period. This compares 62% of the 21 who didn’t follow the diet, but instead received standard care by their cardiologist who suffered further adverse cardiac events, including 2 sudden cardiac deaths during the mean 44 months of follow-up.

              Dr. Neil Barnard’s study “A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes” Diabetes Care 29:1777–1783, 2006 on the effects of a WFPB diet on people who have type 2 diabetes showed a WFPB diet was more effective than the diet recommended by the American Diabetes Association (ADA) (hardly a meat heavy diet). Those in the study that didn’t change their medication during the course of the 22 week study had a drop in A1C of 1.23 points for those following a WFPB diet as compared to a 0.38 point drop in people following the ADA diet. Figure 1 of this paper also shows the WFPB group showed a steady downward trend of A1C through the entire 22 weeks, while the ADA group hit a low point at 11 weeks and had A1C actually go back up slightly by the 22 week mark. The WFPB group also lost an average of 14 pounds and dropped LDL 21% compared to 7 pounds and 11% for the ADA diet group.

              On the other hand I have never seen any study that shows sick people get healthier if they add more meat, dairy and eggs to their diet.

  8. Fear, or rather, ignorant fear keeps whole populations in the grips of the exploiters. The most successful marketing strategies seek to exploit that ignorance and fear. People are regularly driven to war over fear of an (often imaginary) foe. It is exploitation of that fear factor that has made #BigPharma the most profitable ‘businesses’ in the world. Governments, in cahoots with BigPharma, because they too don’t know any better, conspire to keep populations largely ignorant about real health to a point where they actively suppress information that may challenge the status quo. Such is not good for (BigPharma) business. Until we, with the wonderful resources we now have available, manage to open the eyes of the ignorant masses, I am afraid, nothing much is going to change. So keep up the good work and don’t get distracted by philosophical differences between groups active in this field. The common enemy is fear.

    1. I am so with you on this! I just don’t get all the in-fighting between groups whose basic philosophy is so similar…put that angst to better use convincing someone to get off a SAD diet instead of warring over vegan vs. paleo vs ____, ad infinitum! We evolved over a HUGE geographical area and era, we are so adaptable and I strongly believe our ancestry alone affects our food needs and preferences…what may be best or better for one over another.
      For example, I have never been fond of, or digested meat well, but seafood is another story, and living near the ocean is in my blood! Why? Not sure but it is as much a part of me as eye color, and the only reason I will ever only be 98% vegan! LOL! ( I use sea veggies at home but on the RARE occasions when we go out to eat, it is always sushi or seafood!) I grew up in a meat eating household too, for whatever that’s worth. In contrast, my sons and husband (and maybe a lot of men in general? Don’t throw things at me, just a personal observation!) couldn’t live a day without their animal products and the ritual of charring it on the grill was an excitement I never quite comprehended! Interestingly enough, the only time in my life I ever really craved red meat was in my last trimester when I was pregnant with my boys, so there may even be a biological component to the need for something in meat. I know I’ll get bashed for saying that , but I don’t know how else to explain my sudden desire when I normally rejected it! Gross stuff too, like almost raw liver! Ugh, makes me want to hurl just thinking about it, but it is what it is!
      I do ramble! My whole point was supposed to be, we are all different, and yet the same. We share this beautiful planet and have to stop it and us from being trashed by those whose goal is to make big bucks and elevate themselves above all else. There are too many to name, unfortunately, but there are still way more of us than there are them! I don’t have the answers, but our solidarity is crucial to drive any kind of change. Call me Pollyanna, but I still have hope for us if we stop burying our heads in the sand thinking any agency or group, gov. or otherwise, will take care of things. Look where that got us. What happened to the principles of a democracy…of, by and for the people? We need to wake up, do what we can, get back to nature to be more self-sufficient, and spread the word! Peace!

  9. My husband and me have been vegan for 2 years now. We don’t eat anything with a face a mother and do our best to stay away from anything with a label. Yet he is still overweight. What else can we try?

    1. Debbie, does hubby still eat oil? Oils are the most calorically dense foods there are. Another culprit might be not sticking to WHOLE grains. Big difference between whole grains and whole grains ground into flour.

      1. No we don’t use oils. We also eat whole grains like quinoa, barley, Bulgar, brown rice, to name a few. I make all of our almond milk, brown rice milk, all wheat breads. That’s the problem I don’t know what else to do. We eat a whole food plant based diet.

        1. How about exercise? Maybe he needs a walking desk like Dr Greger uses!
          I like to run because it is so easy. Put the shoes on, lace them up and out the door.

          Also people who need to lose weight should try out something like Cron-o-meter. There are a lot of program available. They can see where they are getting most of their calories. Few calories in veggies but quite a bit more in a bowl of hummus. And for many of us we eat so well it just does’t make sense right? But entering food into a database for a week can be really helpful.

          1. That is the frustrating part I dropped 50 lbs right away. We have tried eating only 1000 calories a day and we included every beverage and condiment used. He tried juicing fast for 23 days. We tried Dr. Fuhrman’s diet for 3 months. He has not lost a pound. I walk every day. He is also a cab driver so a walking desk won’t work. I guess he needs to do some sort of exercise.

            1. Sticking to whole grains (the wheatberry is the whole grain – not whole wheat bread), legumes, starchy veggies, non-starchy veggies and 1-2 servings of fruit a day is successful for almost everyone. Avoid nuts, nut butters, avocado, coconut. 2T ground flaxseed provides over 200% of Omega 3s.

            2. Walks are great. Huge part of staying healthy. As a Cab driver he spends his day sitting. He just might see a change by starting with 10 minutes and progressing to 30′ daily. Difficult with our busy schedules but sooooo important.

            3. Debbie, see if your husband can fit in some exercise during his day. Maybe each time he is waiting for a fare or stuck in the cab queue at the airport he could take a couple of laps around his car. That would only be a short distance, but if he did it 20 times a day, it might start to add up. He could add body weight exercises like knee bends or inclined push-ups by leaning forward with his hands on the edge of the hood or trunk of his car. And of course there are other tricks like always parking at the back of the parking lot any time you go to the store.

              As for 1000 calories a day, that is far too low and is likely driving his metabolism into starvation mode. For a nominal 2000 calorie diet, I have read that you don’t want to drop below 1500 calories. And the low calories might be making him so hungry that he is sneaking snack at work (which would almost certainly not be healthy snacks since he wouldn’t be bringing them from home).

              And I like the suggestion to weigh/measure out every bit of food for a week and enter it into Cron-o-meter to see exactly how many calories you both are actually eating. Important to do this individually since it is likely his portions are bigger than yours.
              This, like mentioned previously, can bring to light hidden calories.

              Then there are tricks like using your largest mixing bowls as individual salad bowls. We actually went to a restaurant supply store and bought 4 10-inch plastic serving bowls and use those as our salad bowls. Just make sure you dress the salads with low calorie dressings. We don’t like any of the commercial low-cal dressings, so we make our own. Our favorite is a simple mix of 2 tbsp balasamic, 2 tsp Dijon mustard and a little water if it is too intense straight. Sometimes we add a 1/2 tsp maple syrup to balance it a little.

        2. Please take a look at Dr. John McDougall’s Maximum Weight Loss plan. Thousands are successful at losing weight on this plan. I know some people run into problems by overdoing the fatty veggies like nuts, avocado, nut butters and coconut. Those foods may sabotage an otherwise healthy food plan. I myself eat this way with a 7-10% daily fat intake. I supplement with B12 and use 2T ground flaxseed for Omega 3s – no fatty veggies except the occasional walnut or two. And I’m as healthy as a horse! If you are truly interested in trying the McDougall plan, there’s a FB forum called McDougall Friends which follows the concepts in McDougall’s book THE STARCH SOLUTION.

          1. We also take B12 and add a tbls of nutritional yeast, 1/2 tsp of chia seeds, sesame seeds and ground flaxseed. To one meal a day. He doesn’t like sweets We eat twice a day breakfast and dinner. I make our own milk from brown rice and almond milk, but he hardly uses it. We both have been told we drink plenty of water.

            1. We have tried limiting calories and fat. I am trying Dr. McDougall’s recipes this week. All his blood test come back fine. He does only have one kidney. His cholesterol levels are fine and so is his blood pressure. Everyone we talk to about going vegan doesn’t believe it because he is still overweight.

              1. Exercise and healthy eating go together. Just a thought that too restrictive of a calorie intake will make the body go into starvation mode and hold onto what it has so it is important to not go under a certain amount per day. Don’t remember the formula but 1000 calories is too restrictive. Go with Dr. McDougall’s program. Good health.

    2. Debbie, you could also try eliminating all sources of wheat (including whole wheat) as modern wheat has many properties that cause weight gain. I highly recommend reading “Wheat Belly”. Although most of us here wouldn’t agree with Dr. Davis’ high fat diet advice, his explanations and references for how wheat causes weight gain is both enlightening and entertaining. It wouldn’t hurt to give a wheat-free diet a try.

      1. Have you seen Dr. Davis on Dr. Oz recently?. He’s far from svelte on his LCHF diet.

        His explanations for wheat issues are entertaining because they are so outrageously bogus. If wheat is a problem, it may be so for the reasons Dr. Greger had covered in recent videos about gluten.

    3. Debbie, whole wheat (the wheatberry) is definitely way better than whole wheat ground up into flour (processed). But before you think there is science behind ‘Wheat Belly’ please read what Dr. McDougall has to say about it. Davis has a point about processed wheat but proceeds to (1) ignore the bulk of the science, (2) exaggerate the truth, and (3) make false associations.

    4. There are many possibilities here, but anytime someone tells me they are trying everything and eating healthy and can’t lose weight, I think hormones. You may want to see a doctor and let them know the situation. Perhaps they can help you get to the bottom of the matter.

    5. Get off the dairy. Go for a walk every day. Do 3 sets of 10 push offs from the wall and 3 sets of 10 sit squats on a chair. Eat up to a fist of starchy whole grains and balance those with beans legumes or lentils and eat low carb greens too with the starchy. Eat a fruit as an appetizer and end your meal with a couple of walnuts or include avocado, extra virgin olive oil and apple cider vinegar or ground flax seeds for fat to turn on the feeling full hormone cholecystokinine. Eat within one hour of waking and don’t wait more than 4-5 hours for the next snack or meal. Eat 5 times a day, 3 meals and two snacks. A snack can be a fruit and a tablespoon of peanut butter. Take CoQ10 and magnesium to increase oxygen in mitochondria.

    6. Forget the oil. Please. Olive oil and other oils are inflammatory and the most calorie dense foods on the planet and have unacceptable Omega 6:3 ratios. Nuts and avocado should be used as infrequent very special snacks in small amounts. Stick to starchy veggies, non starchy veggies, WHOLE grains and fruits. 2T ground flaxseed (maybe in morning oatmeal) will provide all the Omega 3 you need. A diet plan like this is right out of The Starch Solution, Dr. McDougall’s book. There is a private Facebook called McDougall Friends I think would be of great help – lots of support and recipes etc. All the guidelines for the McDougall plan are online. I eat this way and am as healthy as a horse and strong as well, as are thousands of others who follow this plan. There are a lot of testimonials of major weight loss and reversal of many diseases on the McDougall website.

  10. I too adopted a WFPB diet when reality finally kicked me in the face! I was the poster granny for borrowed time…almost 60, smoking 2 packs a day, eating a SAD, weighing over 300 lbs, diabetic, RA, OA, FMS, CFS, IBS, (& WXYZ too! LOL!), high everything, on 12 different medications, depressed, discouraged, always sick and obviously dysfunctional. I had grandchildren I adored and wanted to be there for, but felt totally disheartened and demoralized, powerless, pathetic!
    Coincidentally, both of my sons introduced me to electronic cigarettes by purchasing me some to try, I had tried everything else over the years and failed miserably, and though it wasn’t quitting, it was at least harm reduction and doable. It was the kick I needed! I know the debate still rages, but in short order my lung capacity greatly increased, I stopped getting every cold that went around and the respiratory infections that would linger afterwards, and was able to painlessly reduce the amount of nicotine I “vaped”. Feeling better made me realize I could take responsibility for feeling better still, if only I knew what I needed to do!
    When I had started on the diabetic medications, I was not encouraged to find I experienced a quick 20 lb weight gain! It seemed counter intuitive to me, and I found it disturbing, but it was, apparently, “expected”. When even the ADA website basically said that once you were diabetic the best you could hope for was “control”, I didn’t hold a lot of hope for a cure, and every “knowledgeable” author that promised one seemed to counter the previous one. The best take-away advice I could find at the time that wasn’t too controversial was adding a green smoothie or two to my daily regime instead of skipping breakfast or lunch like I usually did. (Even I always thought fat people spent the whole day stuffing their faces, before I was one, and that just is not true!) Anyway, just that change alone was a small miracle! Not only did my blood sugars drop, but the weight started falling off, a totally welcome bonus!
    Then, in a timely turn of serendipity, I saw “Forks Over Knives”! I think I had actually seen it before, but this time I was more than ready to be receptive to the whole message! As I learned it was fat that was responsible for diabetes, a low fat WFPB diet became my new passion, and I set out to scour the internet and use my imagination to create tasty and imaginative recipes that met the guidelines to cover all bases! Lack of variety is never an issue if you open your mind! I love my new way of eating!
    Let me try to condense this a little! My doctor was astonished at my first set of bloodwork after starting on my program. I think I was 2 months into it and everything that was high was normal or below. My A1C was 5.5 from 7.8 with medications. She reluctantly agreed to try to wean me off my meds when I informed her I already had, as my fasting BS in the mornings was 60 with just half the meds, so I stopped them. With a BP of 90/60 I would also be weaning off my BP pills, not to mention diuretics, statins, and so on. Oh, and I had also lost about 35 lbs too, which I was ecstatic about to say the least, because I was eating all I wanted, whenever I wanted! No dieting per se, just eating real food! Every visit I would drop more weight, more pills, and gain more health, confidence and joy! My doctor said she’d read about people treating illness with diet, but she had never seen it first hand before! How sad is that?
    It’s been about 4 years now since I ditched the diabetes and all the other ills, (and then some!) got off all the meds, lost about 150 lbs and started a new life! It is amazing how much better I feel! It is never too late to start, you CAN do it and you are so worth it! One more thing…the excuse that it is too expensive to eat well is BS! I am on a fixed income and legumes and starches make up about 50% of my diet and are cheap, I sprout a lot of my own seeds for sprouts and micro greens, have a tiny salad/herb garden…in pots if need be, watch sales, barter, trade…where there’s a will there’s a way! It’s waaaaay cheaper than doctors and medical care in any event! Sorry this was so long but I am so enthusiastic!!!

    1. Wow, what a testimonial to this WOE. Char, thank you so much! I have a very overweight friend with a lot of health issues, and I wonder if I could send her what you wrote? It would give her hope I know. I’ve given her some reading material but reading your story will bring it to life. Thank you too for your honesty. Much appreciated.

      1. Be my guest JoAnn! It would please me greatly if i could help in any way! It breaks my heart knowing what I do, to see people losing limbs, vision, and even just their zest for life, because of health problems related to diet, that can all be changed with just some knowledge and a bit of action. Thank you for caring, you are a good friend!

      1. My pleasure and honor if i can help in any way! There is no doubt this works! We just need to realize that these foods are the gifts from the earth to nourish us, and our bodies need them to do what they were meant to do…keep us healthy! We would think it was ridiculous if someone tried to stick coke and fries into their gas tanks to fuel their car, and yet so many of us expect our bodies to run on the same without a second thought…until something goes wrong!
        Corporate brainwashing in the forms of advertising and subsidies, etc., start us early down the wrong path, (look at school lunches) but it is up to us to take responsibility for our health and welfare, because certainly no one else will. Sadly, often not even the medical professionals we entrust our health to have as much knowledge of the broad range of health benefits a nutritional approach can accomplish as you or I! A huge thanks to Dr Greger and other REAL doctors like him who truly care about us and continue to inform and educate all of us who deserve to know!

    2. I keep seeing more and more people who try to take care of themselves (except for he occasional “little cheese and milk chocolate or yoghurt every day) getting pre diabetes and high cholesterol. I am also seeing more and more cases of fibromyalgia and the alphabet soup of ailments you were afflicted with. Your story is one of the best I’ve seen. I will be printing and distributing it.

      My notorious pre 50 yr old neighbor weighing 300+ with numerous ailments and gray skin will be the first to receive it. If she isn’t already she will soon be about where your were when you changed your diet except that she does not smoke. Not much of an improvement though. She is currently on a diet and trying to exercise,,,, even making it to Zumba Fitness an average of 2 times per month. She has lost 15 lbs but I expect that it is totally unsustainable because the basis of her diet is still a bad version of the standard American diet. She is doing it by just reducing how much of the bad stuff she puts in her mouth. But when exercise means she can reward herself with a muffin,,,not gonna work.

      You on the other hand lost the weight with out dieting. Your statement, “I had also lost about 35 lbs too,,,,,,, because I was eating all I wanted, whenever I wanted! No dieting per se, just eating real food!” is extraordinarily compelling. I know your post is old but I hope you see this and can respond. Your experience is relevant for my neighbor in an obvious way. But,, I got my sister to cure her fibromyalgia by changing her diet and am firmly convinced others could do so as well. I would very much like to hear how you are doing with the auto immune issues and the joint issues. You did say that you ditched the diabetes and other ills which is phenomenal but I would like to hear more about the auto immune factors and how long and etc it took to eliminate these. I changed my diet when I developed psoriatic arthritis and the rheumatologist wanted to put me on something to suppress my immune system. It’s been almost 8 years with no arthritis and so I explain to any doctor that says I am in remission that “no this is not remission this is cured.”

      As I say, I’ve seen some great posts here but have not been inclined to print one for distribution before so gotta tell you it is going to happen this time. Thank you very much.

    1. Even nicer for you to offer a critical analysis Christian. Was the design really low-fat? Was the data collected “self-reported”? Do you think it ran long enough to be useful? How about some sort of comment in the comment section.


    2. Hi Christian. Here’s Dr. G’s thoughts on the low carb (i.e., Atkins) vs. low fat ‘debate’. (I’m pretty sure if you buy his book it is a contribution to this website; otherwise I also think the book is available for free…maybe the NF Team will provide the link.)

      BTW, “<30% fat" self-reported is not a 'low fat' diet. It is just SAD masquerading as low fat for the purposes of discrediting a real low fat diet. If you want to see the late Dr. Atkins have his hat handed to him by Drs. McDougall and Ornish, others on the panel and the entire audience so many years ago, please check this out. And keep coming back. We need inquiring minds like yours; no disrespect intended.

      1. I watched the entire video just now. Not only did Atkins have his hat handed to him, he certainly appeared to be the most unhealthy person on the panel. He certainly was not thin, nor did he appear to be healthy. I don’t believe the story that his heart disease was caused by a virus, I believe it was caused by his own diet. Westman might have appeared to be healthy, but he was a lot younger than Atkins. Lately, he seems to have gained some weight, such as in his debate with T Colin Campbell. Many low carbers criticize the Vegan diet for necessitating supplements, but Atkins certainly did recommend these for persons on his diet. Basically I agree with Ornish and McDougall about the importance of high fiber complex carbohydrates, I eat these, but I eat a lot of whole food plant based fats, such as nuts and seeds and do not gain any of the 100 pounds that I lost. I even lost more weight lately, even though I eat 4 ounces of nuts a day and sometimes more. Dr Greger has stated that nuts don’t necessarily lead to weight gain. I do budget my calories for these, however. I also eat starchy foods, such as potatoes, air popped popcorn, brown rice, beans and oats and don’t gain any weight from these, either. I also exercise quite a bit. I believe it is the *animal* fat that you eat is the fat that you wear, not necessarily the fat from whole food plant sources. Vegetable oils, which aren’t whole foods, can also possibly cause weight gain, if they put a person in a calorie surplus. The key is to be “whole foods, plant based,” not necessarily low fat and most certainly not low carb, except low in refined carbs.

    3. Here is a report of this study, One thing is that the low carbers lost 12 pounds during the year. Come to think about it, that truly is not that impressive. I lost at least 60 pounds in one year and have kept the total 100 pounds completely for four years now- and I certainly consume far more healthy carbohydrates than were on this diet.. Another aspect is that the low carbers did not stick the low carbohydrate (40 grams a day), they usually went up to 127 grams of carbohydrate a day. Another aspect is that low carb diets do not support exercise. This article states,

      “Angelone also pointed to another issue with the study: Sedentary study participants were discouraged from taking up exercise, to isolate the effects of the diet changes. But in real life, people would ideally change their diets and exercise.
      “Muscles use carbohydrates as fuel,” Angelone said. “It can be hard to exercise on a low-carb diet.” Plus, she added, people on the low-fat diet, who were eating more carbohydrates, might have shed more weight if they’d been exercising.

      Basically my diet is as whole foods plant based as possible. I exercise regularly and I eat lots of healthy plant fats (nuts and seeds) and carbs (fruit, legumes and whole grains)- a vegan version of Mediterranean that Angelone suggests. I also eat a very high fiber diet- something that would be missing in a truly low carb diet.
      Lastly, I wouldn’t rely solely on blood tests to measure cardiovascular health. A person can have a normal EKG, as well as good cholesterol numbers and still have clogged arteries. A better test is an angiogram, which can detect plaque buildup in arteries. This is far more accurate than the blood tests. Many studies find that low carb diets which are high in saturated animal fat do cause plaque build up in arteries. You just have to do more sophisticated tests to detect this. Autopsies are also another means to detect this as well, but of course, that is not always a feasible way.

      1. i think that the calcium score and the carotid ultrasonography are a good way to assess arteries state… and … probably the first gave more general information (but it”s a CT scan, X rays are invoved), while the second is specific for carotid arteries (and not invasive at all)… then of course there is the angiogram (you need a contrast agent that is not risks free, but it’s an higly informative technique)… i found a book that talk extensively about this kind of techniques applied to assess cardiovascular health: from page 197 (Section II)…

        1. My internist specializes in lipids and he requests (almost insists) on carotid scans for all of his patients…3 years ago, I was a new patient at age 53 and had the test done. “zero plaque burden” is the result on the Cardio-risk report…and my arterial age is YOUNGER than my actual age according to the report. Doc said he was not too surprised based on my blood work and what I told him about my lifestyle. He said “Something might get you, but if you keep up your lifestyle, it won’t be heart disease.” It’s an easy test…20 minutes, non-invasive and covered by most insurance. Hope everyone will consider doing this.

      2. I am a middle-aged woman, and I lost 12 lbs in FOUR WEEKS, following a low-fat, whole-food, plant-based eating plan. :-)

    4. An excellent analysis from David Katz:

      “Diet Research, Stuck in the Stone Age”:

      Key points from Katz’s article:

      Both diets contained only 15-16 g fiber, indicating that the “low fat” diet was nothing close to a naturally low fat diet based on whole plant foods, but rather a diet rich in refined flour and sugar containing substances.

      The “low fat” diet was 30% calories from fat, a 5% reduction from what the obese study participants had been eating previously, while the low carb diet contained 40 g carbohydrate, a 75% reduction in carbohydrate from baseline. In Dr. Katz’s words “a study to compare a really big change from baseline diet to a really small change from baseline diet.”

      Most importantly in terms of weight loss results, those on the lower carbohydrate diet were eating 100-200 fewer calories per day.

      Both diets were of extremely poor nutritional quality and provided relatively unimpressive benefits after 12 months of adherence. Neither of them should be recommended by professionals. That the NIH funded this at best meaningless and at worst misleading and damaging study is a disgrace.

  11. When a pregnant mother or baby do not get enough vitamin D, that is really a neurosteroid hormone according to PubMed, the islets of Langerhans are destroyed and the person cannot create insulin. That is how type 1 diabetes is caused. In Finland they gave over 10,000 newborn babies 2,000 IU of vitamin D daily for the first year of their life and it reduced type 1 diabetes by 80% according to The Lancet. You can get vitamin D free from the sun.

  12. Will someone help me respond to the emails I am getting about the NYT article “A call for a low-carb diet that embraces fat?” “The new study was financed by the National Institutes of Health and published in the Annals of Internal Medicine. It included a racially diverse group of 150 men and women — a rarity in clinical nutrition studies — who were assigned to follow diets for one year that limited either the amount of carbs or fat that they could eat, but not overall calories.” The result: greater weight loss, and good blood results (thought LDL size was not studied). The low fat group lost more lean muscle mass. Has anyone read and integrated the small print? 40% fat!

    …”The high-fat group followed something of a modified Atkins diet. They were told to eat mostly protein and fat, and to choose foods with primarily unsaturated fats, like fish, olive oil and nuts. But they were allowed to eat foods higher in saturated fat as well, including cheese and red meat.”

    …”Nonetheless, those on the low-carbohydrate diet ultimately did so well that they managed to lower their Framingham risk scores, which calculate the likelihood of a heart attack within the next 10 years. The low-fat group on average had no improvement in their scores.”

    A number of vegans responded to the article, but not by citing a few pointed articles and relevant research. I would love to see how some in our group here would respond!

    1. it’s the same article posted above by Christian… to me the low fat diet in the study is not really low fat, you can read it in the abstract… unfortunately i cannot access the full study.

    2. Hi Gayle, I’m not sure if you saw my comment to someone else above, but Dr. David Katz has an excellent article about it at Huffington Post:

      I would not try to challenge this article by directing readers to other research to combat this study’s “findings”. To try to do so would lend credibility to this study when it has none. The experimental setup in the Annals study is shamefully inept; no meaningful conclusions comparing low fat and low carb diets can be drawn from it. It’s a repeat of the “mediterranean vs low fat” diet study from last year, where a medi diet of 39% fat with omega-3s beat a “low fat” diet of 37% fat without omega-3s and convinced everyone they should be eating more fish and olive oil.

    3. High protein diets increase satiety and reduce calorie intake 1. However, prospective cohort studies have also found long term high-protein / low-carb diets associated with a 30% greater risk of death 2.

      I believe both effects can be attributed in large part to activation of mTOR, and inhibition of AMPK and GCN2, by excess protein; in the brain’s hypothalamus for satiety signalling 3, and systemically for adverse effects like cancer, diabetes and aging 4, 5, 6.

      We know that plant based dieters have lower BMIs in the long term, but that’s little solace when working off winter excess for bikini season. Plant proteins tend to be “incomplete”, and their lower level of some amino acids may permit high-protein weight loss diets with less adverse effects 7, 8. Another option is to enlist other satiety signals (such as stomach stretch) with a low calorie density approach 9.

  13. How come anemia is never included as one of the side effects of Metformin? About 70% of the diabetics taking Metformin who came to me, had anemia the harbinger of every risk factor, neuropathy, heart failure, cancer alzheimers, parkinsons, etc. No one puts this together. Doctors think anemia is nothing, not true. Even when they think anemia is something they prescribe oral folic acid. B12 and folate must be supplemented but not the oral route, a dosage form that will be utilized is essential especially in those with methylation defect.

  14. It’s easy to blame others. But ultimately you have a choice: what and how much you eat, if and how much you exercise, etc. Don’t buy the excuses or finger pointing.

  15. I’m probably stumbling right over it, but 1) can I access my previously-saved favorite videos from the old website?, and 2) on the new
    website, can I save a video to Favorites? Thanks!

  16. What are the five lifestyle changes? I could see eating 15 g. of fiber per 1000kcal a day food, and increase exercise but that is only two modifications. I presume reducing dairy, desert and chicken foods are one of the others.

  17. Help Dr Gregor! About a year ago my wife turned us onto you and the vegan lifestyle as a result of looking for help for our 10 year olds diagnosis of Hashimotos disease… We were sold! And have been pushing towards a plant based diet ever since, for all of us. Recently our daughter has been diagnosed with insulin resistance.. via your videos i have concluded that vegan is still the way to go, however my newly divorced wife, thanks to our GP, is putting meat back into her and our daughters diet. And now i’ve seen some info that says the lectin in legumes are harmfull, especially in insulin resistance… since this is our base form of protein in my and my daughters (when she’s with me) diet i’m concerned.. please give me your input… thanks Doc!!

    1. DWB: I’m sorry you are in such a tough spot. I can just imagine how stressful the situation must be when you care so much for your daughter.

      I *highly* recommend reading the book: Dr. Neal Barnard’s Program For Reversing Diabetes: The scientifically proven system for reversing diabetes without drugs. Dr. Barnard was able to get people on a program that is clinically proven to be 3 time more effective than the ADA diet for diabetes. And meat is definitely on the no-no list. I will also mention that the program does nothing to discourage beans. In fact, some of the recipes in the back of the book include beans. My understanding (as a lay person who has done some research but who is no doctor herself) is that Dr. Barnard’s diet is the best diet to get your daughter on so that her condition doesn’t turn into full blown diabetes. (And note that Dr. Barnard’s diet is just a tweaked/specialized diet that is promoted here on NutritionFacts by Dr. Greger.)

      Another part of your post that cause my attention was, “…since this is our base form of protein…” Eating beans is wonderful food for a whole bunch of reasons. But I think you would be greatly helped if you had a better understanding of protein and human protein needs. I recommend taking a bit of time to work through these sources: (check out December 2003 for McDougall’s site, “A Brief History of Protein: Passion, Social Bigotry, Rats, and Enlightenment”. Also April 2007, “When Friends Ask: Where do you get your protein?”)

      I don’t know anything about Hashimotos disease, but any disease in a 10 year old can’t be good. I wish you all the best. I hope this helps.

  18. My office mate got type II in a big way. Having watched him go through this, I decided to simply buy a tester, and started to do experiments since my blood sugar seemed to hang around 105 a lot. By making very simple changes like not eating between meals, it was pretty easy to get it into the low 90s. However, my wake-up blood sugar was always the highest. I found that whenever I ate meat for supper, my wake-up blood sugar was high the next morning. By not eating meat for supper, I was able to keep my wake-up sugar around 96. After marrying my second wife (who is a vegan), my blood sugar continually fell, and now it hangs around the mid 80s even at wake-up. I recommend that anyone who is pushing into the 100s get a tester and start watching it. It’s pretty easy to make simple changes that have big effects. Also after marrying the vegan, my doctor took me off my statin.I still eat meat on occasion, but only small amounts now and then. Even so, continued testing has shown I don’t need the statin and my blood sugar stays stays in the mid 80s.

  19. Please can someone help! I am VERY Confused! My doctor told me I am a “pre-diabetic”. I am very dizzy all the time especially when I drink milk. I am 40 years old and 5’10” but I only weigh 159 pounds! For 10 years I have gone to the gym 4 days a week. I don’t have an inch of fat on me. The doc gave me Metformin, but I had to stop because its making me loose more weight, I did weigh 180 pounds but now I only weigh 160. I can’t use Metformin anymore. I am now very dizzy and have tingling in my fingers and harms & legs at times. I tried not eating no sugar and carbs but its not enough. Should I switch to a no fat diet instead?!!! I don’t want to use that poison Metformin again! And the dairy is killing me, but I need it for strong bones right?! I am scared now because I think I am about to be labeled “diabetic”. I need some serious advice and help. Please someone have mercy and respond. I need guidance on where to go. The doctors won’t help, the just want to prescribe me poison.

    1. Aaron: I can understand your fear and frustration. And I applaud you for wanting to find a ration fix for your problem. I strongly feel that your best approach is to take a moment and take a breath. Then, get a copy of the book, “Dr. Neal Barnard’s Program for Reversing Diabetes: The scientifically proven system for reversing diabetes without drugs”. This way, you don’t have to take my word for what to do. This book is based on published, clinical trials on people who had full blown diabetes.

      This book is a fast and easy read. But more importantly, all of the information is fully backed by sound science. This book will explain *why* the diet works. It also gives you a ton of information about how to implement the diet – including some sample meal plans and plenty of recipes. Once you understand what type of food will help you, you will see a ton of options out there for more and other exciting dishes. You might then get a copy of McDougall’s “Starch Solution”, which will have more recipes for you. I have lots more ideas, but I’ll stop there so you can get started.

      I see nothing but good things for your future. It is all up-hill from here. I hope you will read that book, give the diet a real try and report back here what happened. Good luck!

      PS: No, you do not need dairy for strong bones!

    1. monika: Assuming you are talking about Type 2 diabetes: Here is a really great book for dealing with pre-diabetes: “Dr. Neal Barnard’s Program for Reversing Diabetes – the scientifically proven system for reversing diabetes without drugs”. Dr. Barnard’s diet is clinically proven to be 3 times more effective than the ADA diet. I know, I sound like a commercial. But it is all very good science and tested out on real people. And the best news for you is that this diet also works great for pre-diabetes as well as just general health for the whole family. So, you can all get on it to support your son if you want.

      This diet is right in line with the NutritionFacts/Dr. Greger recommendations. I highly recommend that you give it a shot. The back of the book includes recipes, but if you need more help than that to actually implement it, you could check out the free 21 Day Kickstart program. The 21 Day Kickstart program is 21 days of hand-holding: recipes, videos, forums, etc. The program is sponsored by PCRM, Physician’s Committee for Responsible Medicine, which is headed by Dr. Barnard and involves the same type of diet as his diabetes book.
      (Click the green “Register Now” button.)

      Good luck to you and your son!

      1. Thank you so much for the info! I want to see tomorrow if our library has Dr. Neal Barnard’s book! I have watched now several of his short videos and wished I had a list of foods he talked about that are good to order in a restaurant and/or buy in the grocery store since he likes to eat out a lot and I have bought AMY’s canned vegan vegetable chillies in the past and he liked that once in a while. Our son is 18 now. And my husband has been diagnosed with stage III or IV lung cancer last year and a 3″ c. tumor removed. Now he is supposed to start on full chemo Tu.

        1. monika: I’m sorry to hear about your husband. Your family is facing some difficult times. But I still think there is a lot of hope.

          After hearing about your husband, I thought I would recommend that you watch the many videos on about cancer. You may get some good ideas on what foods might be especially helpful and especially harmful so you/he can tweak your husbands diet accordingly.

          Best of luck to all you.

  20. I have heard that metformin has anti-cancer properties, related to insulin resistance. I wonder if this is true and if it would be safe to take in addition to a healthy lifestyle.

    1. Cheryl – I’m not a doctor, but just wanted to offer my two cents… I’ve read some of the studies on this, and they do suggest that it may have benefits for those taking it at a dose prescribed for diabetes. It makes sense that if your insulin resistance and glucose is improved, your cancer risk (and heart disease) risk will also be lower. But I’m not sure we really know what all of the long term negative effects of taking Metformin – or most other drugs -might be. Healthy lifestyle and plant based diet can have even better results with improving insulin resistance as Dr. Gerger discusses in his video [] AND do the most to prevent many types of cancer, heart disease etc. Personally, I’d stick with that.

  21. One of the best foods to prevent prediabetes and diabetes type 2 is to include daily sources of whole starches especially beans, beans and more beans as well as eliminating fat from added fat, oils and animal products to decrease insulin resistance

  22. I’m aware that with a diagnosis of diabetes or pre-diabetes, the reflex is for the physician to prescribe metformin. And I understand why it’s done (fear that patients won’t comply with lifestyle changes, the preferred reliance on medication in allopathic medical practices, metformin is a relatively safe, relatively cheap drug, etc,.etc.) And yes, I still take metformin daily for my diabetes. I’m hoping to reduce my dose at the next doctor’s visit.

    So I was thinking about metformin at PCOS (polycystic ovarian syndrome). Again, when a woman is diagnosed with PCOS, the first treatment is to prescribe metformin.

    What are your thoughts on that? Are there any studies comparing metformin vs. plant-based eating for PCOS? Do they know why metformin helps with PCOS?

    Just an idea for your video topics.

    Lori Hopkins

  23. Great video. About the source document “Prevention of type 2 diabetes…” The exercise program consisted of aerobics daily plus circuit training with resistance so all major muscle groups were activated. Only 15 to 60 seconds rest between exercise stations in the circuit. The resistance training might not be daily, the study didn’t say. In general resistance training is on alternate days to allow recovery time if it’s seriously challenging the muscles. So this success wasn’t based on just 30 minutes of walking around. I think that success might depend strongly on the use of the major muscle groups in resistance training several times per week, afterall, muscles burn sugar and if they aren’t in shape they become resistant to insulin. Both diet and exercise were supervised, including meeting with a nutritionist 7 times per year. Reading the whole study is great, it is free, just click the ‘sources cited’ tab on lower right of video, then on the abstract summary version see the upper right, there’s a free link to the complete article. This article was from 2001 !

  24. I am fully dedicated to Plant Food Diet. I consider it as my main life experiment/project. As a researcher in my experiments/projects I appreciate feedback, especially positive! Positive feedback encourages me to keep being “plant based”. The only 2 parameters can be measured easily at home are- Blood Preassure and sugar level. I take over 40 of the top plant foods (fresh, frozen or powder) highly recommended by Dr. Greger to lower blood pressure and sugar level And nothing “non cosher”- i.e. no meat, diary, fish. I am on such diet for couple of month. I do exercises every day 1h 30min. I measure B/P and sugar everyday. My weight dropped (within 5 month) on 7%, then reached plateau and start to climb up, back…to 5%…
    Any thoughts, clue, advise?

    1. Hello! Would you be willing to tell me a little more? I’m a registered dietitian and nutrition moderator for – I’d be happy to help! How are your portions? Have you eliminated all processed foods? Are you consuming large amounts of olls or plant-based foods that may be naturally high in calories? What are you doing for exercise?

    2. Jeff Novick has an interesting article on the Principles of Calorie Density which may be of help…….


      Unlimited does not
      mean unlimited in the sense that you can eat all you want of anything.

      What it means : If you follow the principles of the program, especially of the
      Maximum Weight Loss program, you will be able to eat all you want of the
      recommended foods, until you are comfortably full, NOT STUFFED and still lose

      The reason is due to calorie density. Many many studies have been done in the
      last few decades confirming this. If you allow people to eat “ad
      libitum” or all they want till they are comfortably full, from low calorie
      dense foods, they will lose weight, not be hungry and do not have to count

      Of course, calories still count, but it becomes almost impossible to over
      consume calories from the foods you choose if you follow these recommendations.

      These are averages for each category of food.

      Fresh Veggies are around 100 cal/lb

      Fresh Fruits around 250-300 cal/lb

      Starchy Veggies/Intact Whole Grains around 450-500 cal/lb

      Legumes/Cooked Pasta around 550-600 cal/lb

      Processed Grains (even if they are Whole grain) around 1200-1500 cal/lb

      Nuts/Seeds around 2800 cal/lb

      Oils around 4000 cal/lb

      (***According to
      Jeff Novick in his full Calorie Density video, cooked pasta is the only
      processed flour product that is NOT a high calorie density food. Cooked Whole
      Wheat pasta comes in at about 560 calories per pound. Regular pasta about 590
      calories a pound.)

      Food choices are based on where you are at and what
      your health goals are. For weight loss, neither puffed cereals or air popped
      popcorn or shredded wheat would be the best choice. Oatmeal would be far
      superior. You want food with volume and weight, not food with volume and air.
      Rice cakes are about 1750 cal/lb. Grape nuts are about 1640 cal/lb. Food For
      Life corn tortillas are 1134 cal/lb.

      If the calorie
      density of the food is below ~400 calories per pound, you will likely lose
      weight no matter how much you eat.

      Between ~400-~800 calories per pound, with some moderate exercise, almost
      everyone loses weight.

      Between ~800-~1200 calories per pound, most people gain weight, except for
      those with very high activity levels

      Over ~1200 calories per pound, everyone seems to gain weight.

      Remember, the physical sensation of “fullness” is influenced in a
      large part by the filling of the stomach and the triggering of the stretch
      receptors. This would happen regardless of the calorie density of the food, as
      long as enough food was consumed. WE TEND TO EAT THE SAME ‘WEIGHT’ OF FOOD NO

      However, between 400-800 calories per pound is the range where people either
      maintain, gain or lose a little, often depending on the activity level. The mid
      point of the range is around 600 cal/lb.

      If you follow the MWL program, you will be applying the principles of calorie
      density. If it is not working as well as you would like then you can adjust the
      calorie density of your intake by making slight adjustments in your food

      The Okinawan diet, before Western influence, was around 600-650 calories per

      A starch based diet, made up of starchy vegetables and intact whole grains
      along with some fruit and veggies, will have a calorie density under 500
      calories per pound and maybe even 400 calorie per pound. It would be near
      impossible to overeat.

      You can also see the problem with many of the “low fat” diets that
      focused on processed whole grains, like whole wheat bread, crackers, dry
      cereals. At 1200-1500 calories per pound, if they become a large part of the
      diet, they can raise the overall calorie density and make it much easier to
      overeat on calories and easy to gain weight and/or not lose weight, even with a
      higher activity level.

  25. The suggestion in a number of studies is that insulin resistance now being called ‘brain diabetes’ or Type 3 diabetes is part of the progression towards minor cognitive impairment and eventually to Alzheimer’s Disease. Would Dr Greger please look into this topic?
    I have also read that the consumption medium chain fatty acids (coconut oil) can also feed the brain as an alternative source of energy for people who may be suffering from insulin resistance. This may contradict a previous video however suggesting that coconut oil had absolutely no health benefits. I myself (53) am insulin resistant and have some minor cognitive impairment and I feel cardiovascular concerns over the consumption of fat – the lesser of the two evils.

    Alzheimer’s Disease Is Type 3 Diabetes–Evidence Reviewed J. Diabetes Sci and Technol. Nov 2008

    1. Please become acquainted with the work of Dr. Neal Barnard in diabetes and also Alzheimer’s. Dr Barnard with a low fat (10%) high carb whole foods plan had much better success in reversing diabetes than does the American Diabetes Association. The root cause of insulin resistance is intramyocellular lipids – get all overt fats like oils, avocado out of the diet and insulin resistance will improve very quickly. Those HCLF plant based docs are able to get diabetic patients totally off medication. Re Alzheimers, The Chicago Health and Aging Study showed that saturated fat was a risk factor for the disease. Same HCLF plant based diet showed a reduction in risk of getting Alzheimer’s.

  26. Diabetesdevelops very gradually, so when you’re in the prediabetes stage—when your blood glucose level is higher than it should be—you may not have any symptoms at all. You may, however, notice that:
    you’re hungrier than normal
    you’re losing weight, despite eating more
    you’re thirstier than normal
    you have to go to the bathroom more frequently
    you’re more tired than usual
    All of those are typical symptoms associated with diabetes, so if you’re in the early stages of diabetes, you may notice them.

  27. Just an FYI. Somewhere before I mentioned the higher rate of diabetes in Native Americans, compared with the general population, which is bad enough. In case of interest, a new study from Alberta, Canada quantifies this, “About 8 in 10 First Nations people and about 5 in 10 non-First Nations people of young age [~18] will develop diabetes in their remaining lifetime.”:

    The risk was higher among First Nations people for all age groups and for both sexes.
    Differences included:
    1. Rural First Nations people had a higher risk of lifetime Type 2 diabetes compared with urban First Nations people.
    2. Type 2 diabetes onset was earlier among First Nations people than non-First Nations people.
    3. Men had a higher lifetime risk of diabetes than women of similar age groups in the non-first Nations group, but women had a higher lifetime risk than men in the First Nations group.

    TC Chowdury et al. 2016. Lifetime risk of diabetes among First Nations and non-First Nations people. CMAJ
    September 19, 2016.

  28. A year and a half ago i had high cholesterol and i’m only in my late 20s! So i got interested in health, ate “fish and oil” and took up jogging and walking and 5:2. In May i decided to go plant based – though cheating with cheese, chips, chocolate and the rare taste of meat but cleaned up my act to WFPB recently and only still eating chocolate and cheese in moderate amounts (no oil…salt…flour etc).

    I just got my results back, i lost 10 kilos and now am in a healthy BMI range of 22, no longer have high cholesterol….but…get this, now I am pre diabetic!?!?! What gives!!?! I will now have to cut out the dairy and chocolate, and get back into jogging which are the only 3 improvements I can possibly make in my life. I don’t get it…I basically did most of the steps to lower my chances and before i was NO WHERE NEAR diabetic!!! Could eating healthy CAUSE diabetes?! Why did this happen to me… :(

    Could the caloric restriction for weight loss cause this?

    1. Teesha: I wonder if it was a good test? Sometimes (more than we would like) lab results are incorrect.
      Assuming the lab results are correct for the moment, I would refer you to the following NutritionFacts video which explains the cause of type 2 diabetes, which is too much fat in our diet: You can be a healthy weight and still have too much fat inside your cells, blocking the insulin from working correctly to get the glucose into your cells.
      If this is what is going on with you, then the solution is to cut out the high fat foods in your diet such as the cheese, any other dairy, and chocolate. A small amount of nuts a day, about one ounce, is probably fine for most people (it’s on Dr. Greger’s Daily Dozen list), but if you are very concerned about diabetes, you may want to temporarily cut those out too just to see what happens to your lab work.
      If you can get your hands on Dr. Barnard’s book about preventing and reversing diabetes, then you will get a very good understanding of what causes diabetes *and* how to prevent it, with a set of recipes to use or to use as examples of what is a healthy dish.
      Good luck!

      1. I’ve been told to go back in for a “confirmation” test (the 2 hour one). I wonder since my iron levels are only 11 and RBC count is high that they might have something do to with my raised blood sugar levels.
        I’ve watched all the videos on diabetes already and have since indeed cut out all dairy, and nuts. Even banana. I am not eating anything with fat as far as i know and trying to keep my daily % of fat under 10. (this is hard when I eat flax!)
        I will continue this way for a fortnight and re-test to see if the results still show pre diabetes. I am also increasing my exercise to 80-120m a day (from about 10-60).
        Once I am in the clear- can i just never re-introduce nuts and avo??? Is this a life sentence of low fat diet? (I was previously eating about 30% fat but from plants and no oils). I really enjoyed eating this way and cutting it down to 20% is very dissatisfying and 10% depressing! I’m not sure how i will last the fortnight :( (My daily TDEE is 1400cals so 10% is only 140 cals of good fats which we know is easy to fill up. Flax being 40% of my daily fat allowance already down and not even savoured)
        Thank you for your advice!

        1. Teesha: I am not a doctor, but it’s my understanding that a little avocado now and then and up to about 1/4 cup of nuts a day (on top of 1 Tbls ground flax) is fine for most people. I don’t think most people need to go as extreme as your testing now. I can’t imagine needing to cut out bananas! I don’t think even the most fat-conscious plant based doctors go that far. (But wow, you are very committed to figuring out what is going on and trying to address it. I admire you.) If I remember correctly, some people who have tracked their nutrient intakes on and who follow the Daily Dozen (Dr. Greger’s recommended way of eating) have reported between about 12 to 25% fat.
          Then again, note that some people fall into extremes and have to eat a bit differently. For example, most people can eat that 1/4 cup nuts a day and maintain a completely healthy weight. But there are people who gain weight when they eat nuts and they simply have to refrain. Chef AJ (a person you can look up) is a famous example of this.
          One thing that I think is very important is enjoying your food. It sounds like your current diet that you are testing out is not enjoyable to you. Even if you add back in some foods that are high in fat after your experiment, you might want to search around/further experiment to find ways to eat that are *both* very enjoyable to you and low in fat. (Not *no* fat. Just lowish fat.) Examples of places to find recipes to experiment with: the free 21 Day Kickstart program (which includes menu plans, receipes, etc), an on-line recipe source called something like Lighten Up? (can someone remind me what that site was that Dr. Greger recommended at one point?). Also, the sites for Forks Over Knives and McDougall has a ton of recipes to try. I understand that Dr. Greger is coming out with a cookbook soon.
          The point of what I’m saying is: tastes change and while you may be having some trouble right now with the food you are eating, it may simply be that you need to experiment to find dishes that you incredibly enjoy and that meets with your goals of lower fat.
          Good luck!

          1. Thank you for replying!
            I have heard of Chef AJ and sign up to all her free webinars with Dr. Gustavo A. Tolosa. I think I am like her, quick to gain- but i think it’s because of my height.
            I have arranged a blood glucose “prick” test tonight which is quick and easy so I can see if the 2 hour test is worth going in for, hoping that my low fat diet and exercise have fixed things up (in just 2 days?) lol! I’m also hoping it was a mis-reading to start with! But alas if it is type 1 I can do nothing about that. I just don’t want to wait and have it get worse!

            Thank you so much for your recommendations, I have pinned many recipes from many sites including Forks over Knives so I will go back to them and start going from there. Thanks for the reminder :)

            I think being shy of 5ft perhaps the recommended flax etc is a bit in excess for my tiny body- but I am hanging out for Dr Greger’s cookbook that’s for sure!

            Yes I am just not used to eating very low fat, I’m sure with time my taste buds will get used to it. Fat in a dish just helps make it so much more palatable! There are a lot of HCLF vegans out there, just need to further alter their recipes to make it whole foods too (And wheat free as I’m allergic to wheat). Thank you again!

              1. I appreciate your good vibes! Thank you!

                I’m happy to inform you that my 2 hours after meal blood glucose level was 5.6mmol/l which is in the normal range of 5.00–6.1 mmol/l, which I wonder if because it was actually more like 2 hours and 30 minutes, if that means my reading was still a bit high. Dr recommended I still go on for that fasting test. So hopefully again it shows as normal!

                He did say that stress can spike blood sugar! Who knew?! haha…I will continue on this healthy low fat journey for a while but maybe be slightly less strict if I need to. :)

  29. My wife’s triglycerides were a little high. Perhaps that is why her internist tested her A1c which tested at 6.0 (prediabetic). Her resting glucose is normal. For the last two months we are on a stringent wfpb diet with lots of greens, beans, onions, berries, no oil, whole grains, very little processed food. She was only on the stringent diet for one month prior to the test, so we have to give this diet more time to see if it will work. The test reviews your body’s sugar utilization over a 3 month period. Hopefully, when retested in 2 months her a1c will be in the normal non diabetic range. My concern is that we were already vegan diet , but not as stringent as we are now. We have added amla (indian gooseberry powder) to green smoothies for the last two weeks, as Dr. Greger indicated on a recent video that diabetics have had remarkable improvements in reducing insulin resistance including amla in their diets. Nevertheless, he says the cure for prediabetes is not amla but a WFPB diet. We are just adding the amla for insurance.. I am a bit unsure about the use of plant based foods with a high fat content, nuts, peanuts, avocado, seeds. Dr. Greger seems to indicate they will not cause insulin resistance as animal fats do. Any recommendations on nuts, seeds and avocado usage if one is prediabetic? Dr. Greger seems to indicate that whole fruit (berries, bananas, mango even apples) are okay and whole grains( oats, wheat, barley, quinoa, etc.) are okay if prediabetic, and starches such as sweet, regular and purple potates. He highy recommends beans which we are attempting to add to our three meals throughout the day.. So any recommendations are appreciated. Dr. Greger indicates green smoothies, with berries, mango and bananas and almond mile are okay, which is opposite of what Esselstyn says.

    Any recommendations to put us on the right track are appreciated.

    1. You mention smoothies. If they have fruit, you may have lot of free fructose which will up the triglycerides. Esselstyn says to cut fruit servings to 1-2 and of course ditch all high fat foods like Nuts.

    2. Hi Ken,
      I appreciate your situation. Hard to know what to do next sometimes.
      As far as the amla goes, my friend, who is diabetic (type II), in his 70’s, tried it and it didn’t seem to make any difference in his daily glucose numbers. However, my friend is a restaurant eater and does not cook at home where he can control what goes into his food. He has increased his control over his numbers and got off a number of medications but still needs a one-day dose of metformin. He eats at Asian restaurants and because he chooses shiracha tofu (cooked in grease even if it is stir fried) he thinks he’s eating a healthy diet. He does see better numbers when he has added exercise to his day (which he never did before, very sedentary). He also munches – with no controls – on waltnuts which are very high in fat.
      I’m going to take a guess that when one is in the process of trying to reverse their diabetes (type II) that eliminating the high fat plant foods as well during the reversal phase might help.

      For myself, I was prediabetic and have reversed it, fasting glucose now 90. Here’s what I have done. Eliminate all unnecessary fats (including nuts) with the exception of a sprinkling of sesame seeds on asian meals. I eat my higher carbohydrate whole plant foods like potatoes, winter squash (I eat winter squash for breakfast sometimes), grains (including pasta) in the earlier part of the day so that I have time to burn off the calories. I never eat high calorically dense foods in the evening. So dinner looks like this and in this order: large green salad of spinach or other leafy greens and whatever vegtables in a bowl. Salad dressing is balsamic vinegar with a splash of tamari sauce(no oil). Dinner plate is 1/2 green vegetables: cooked swiss chard, broccoli, cauliflower, asparagus, etc. with no oil dressing. 1/2-1C beans or a seitan (occasionally) option which is home made with no oil. Usually by then I’m stuffed and have a piece of fruit later. I do not do smoothies ever – too many calories hitting the system at once. Digestion is slow to feed teh body slowly and chewing is a part of that process.
      But here is the other part that seem to make a big different for me. I have been looking into fasting and the various ways that fasting can help us. When we were hunter gatherers he didn’t eat 3 meals/day and we often long periods of time in between. Type II is always about too many calories, ultimately. So I do not eat 3 meals/day, I eat only 2 at most. I do not eat in the morning until I am hungry – really hungry. The food industry – which has not been our friend – started the “breakfast, lunch, and dinner” motto. My breakfast – when I am hungry at maybe 11am or noon might be boiled or baked potatoes (which I keep stocked in teh fridge) with various vegetable on the side like cooked swiss chard (spice as desired). Bowl of beans perhaps.
      Very important to my diet is to make sure I get a minimum of 12-hr fasting window every night. If my evening meal is at 6pm then nothing more except no-cal herb teas until 6 am in the morning. The reason is that when the body has gone without calorie input for 10 hours, it then moves into fat burning mode. And the place where the body burns this fat is from the abdomen – the most dangerous fat stores and also the fat that contributes to diabetes. Take a look at fasting in its various forms via youtube Valter Longo, Ph.D. (director of the longevity institute at U. California – Davis), Alan Goldhammer, D.C. (who runs a fasting clinic in Santa Rosa, CA and is associated with Dr. McDougall, et. al.), Michael Moseley, M.D. who wrote The 5:2 Diet who reversed his own diabetes by intermittent fasting (meat eater but the concepts are still the same). Dr. Longo is now working with oncologists because he has discovered that fasting protects the body from chemotherapy effects but not the cancer. His work is very interesting.
      I hope I’ve said something to help you. Good luck!

    3. Ken W: You are so educated on the topic already. I’m most impressed. I particularly think your outlook/approach is so spot on. re: “We have added amla (indian gooseberry powder) to green smoothies for the last two weeks, as Dr. Greger indicated on a recent video that diabetics have had remarkable improvements in reducing insulin resistance including amla in their diets. Nevertheless, he says the cure for prediabetes is not amla but a WFPB diet.”
      Here’s my suggestion: Get Dr. Barnard’s book (which I’ll talk about in a second). While Dr. Greger’s suggestions are great and (solid) evidence-based, by following the suggestions in Dr. Barnard’s book, you will be following suggestions that are clinically proven to work for diabetics and pre-diabetics. Are nuts and avocados OK? Up to certain amounts? I don’t know. What I know is there is a whole food plant based WFPB plan you can follow which is fully compatible with Dr. Greger and Dr. Esselstyn’s recommendations.
      So, who is this Dr. Barnard and what is his book? Here’s what I typically share with people: Following is a book I have read more than once. It is really great. It’s about plant based eating. Even better, it is based on solid, published research. Dr. Barnard has studies on diabetics where he only changed their diet. He published in peer reviewed, respected medical journals and was able to prove that his diet is 3 times more effective than the ADA diet. Both in research and on this website, people have reported being able to reverse their insulin sensitivity. What’s more, note that Dr. Barnard is not the only researcher who has proven that the diet works.
      The book is called “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs”. It is a whole food plant based diet, specifically tweaked for fighting diabetes. In addition, the book contains meal plans and recipes at the back of the book. So, you will get a lot of support. There’s also a free 21 Day Kickstart on-line program I could tell you more about if you are interested.
      Here’s the book:

      I hope this helps.

  30. I’m currently struggling with pre-diabetes. I also struggle with oxalate issues, thus eating too many moderate to high oxalate containing fruits and vegetables cause me severe pain. I load up on the probiotics, but oxalobacter formigenes bacteria is anaerobic and difficult to get in a probiotic form. I’m trying calcium citrate with meals. I haven’t gotten kidney stones yet, but it’s so frustrating to not be able to eat the right foods!!! – spinach, nuts, avocados, green tea, etc…. Anyone else have this problem and if so what have you done to get around it? I hate the processed money making powder drinks. I do bone broth daily, l-glutamine, 50 billion cfu probiotics…. I’m so frustrated.


    1. Lee, it’s hard to know what you mean by ‘oxalate issues’ – have you been diagnosed with oxalate stones? You may benefit from reading Dr G’s blog post at: or watching one of these videos (

      If you need to lose weight, this might also help with reducing stone formation risk. Pre-diabetes involves insulin resistance, which is part of ‘Metabolic Syndrome’ (see “Relationship between Calcium Stone Disease and Metabolic Syndrome” at:

  31. The CDC has produced a “National Diabetes Prevention Program” that is targeted primarily at people with prediabetes. However, the information in this program is only available through private for-profit “coaching” programs. The cheapest online “coaching” program that provides this information is $199. Aside from the obvious ethical problem with a government agency preventing poor people from accessing health information, is this even legal for the CDC to develop a program with taxpayer money and then sell it to us?

    They don’t even provide the information in this program to government healthcare professionals whose duty it is to foster self-care in the population.

  32. As a nurse, I certainly agree with you that such a diabetes prevention coaching program through CDC should be available without charge. Perhaps you’ve already checked into this more than I did, but when I checked about this program there seemed to be an indication this program would not charge a not-for-profit organization using this program, except perhaps for materials. I may be reading it wrong, but Terms and Conditions of Use state:

    With proper attribution and credit, the CDC DPP curriculum may be used as follows without further
    permission or license from the University of Pittsburgh:
    a. Non-profit research and non-commercial education purposes;
    b. Charging a fee solely for cost recovery of materials and operations related to delivery of the
    c. Use of the curriculum for the purpose of third-party reimbursement so long as no profit is made
    on this specific effort by the party delivering the lifestyle change intervention or administering
    these curricula as it is described above, for third-party reimbursement.
    Conditions in which usage of the CDC DPP curriculum requires obtaining written permission and/or
    license from the University of Pittsburgh:
    a. For-profit research or for-profit education activities; …
    Why not contact the University of Pittsburgh’s Office of Technology Management at 412-648-2206 for clarification? Good luck!

  33. I switched to a vegan diet about 10 days ago. I was eating wild salmon every night along with veggies and a smoothie with whey protein. Lunch included sardines, veggies and various kinds of berries. So I eliminated the salmon, sardines and whey protein and replaced the fish with a modest bowl of black beans at lunch and dinner and no whey protein in smoothie. After 10 days my fast blood sugar rose about 6 to 10 points. What gives? Exercise and work schedule remained unchanged. Only change was the above mentioned removal of fish and whey protein and the addition of beans. Do I need to give it more time?

  34. First, I congratulate you on making more healthy eating choices and reducing your high protein meals. Since you mentioned you are having a smoothie every day. I was wondering what you are putting in your smoothie. Any way to ensure it does not have juice or other refined carbs? Or would half a smoothie satisfy? You are right that 10 days is not very long so I’d give it more time and carefully review if you’ve substituted any foods that might cause the rise in blood glucose. It sounds like you are eating lots of veggies (all prepared with no added fats, sweet sauces, I’m presuming?) and beans and that’s a great start, so perhaps just a bit more tweaking will give you the results you’re looking for.

    1. Thank you for your response Joan, I appreciate you taking the time. No juice, just berries and spinach in the smoothie. However more importantly is that *nothing has changed* except I dumped the whey protein and now I use unflavored, unsweetened soy milk instead of whey protein isolate. And for the other part of dinner I stopped the salmon and replaced it with a bowl of beans. So carbs obviously went up since salmon, I presume, would have zero or close to zero carbs and the additional carbs are apparently showing up in my blood glucose 10 hours later. Maybe things will change so I’ll give it more time. Thanks again.

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