Is Alternate-Day Intermittent Fasting Safe?

Is Alternate-Day Intermittent Fasting Safe?
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Eating every other day can raise your cholesterol.

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

Are there any downsides to fasting every other day? For example, might going all day without eating impair your ability to think clearly? Surprisingly, the results appear to be equivocal. Some studies show no measurable effects, and the ones that do fail to agree on which cognitive domains are affected. Might the fasting/feasting cycles cause eating disorder-type behavior like bingeing? So far, no harmful psychological effects have been found. In fact, there may actually be some benefit, though the studies that have put it to the test specifically excluded those with a documented history of eating disorders—for whom the effects may differ.

What about bone health? No change in bone mineral density was noted after six months of alternate-day fasting, despite about 16 pounds of weight loss, which would typically result in a dip in bone mass. There were no skeletal changes noted in the control group either, however, that lost a similar amount of weight using continuous calorie restriction. The researchers suggest that this is because both groups tended to be more physically active than the average obese individuals by one or two thousand steps a day.

Proponents of intermittent fasting suggest it can better protect lean body mass. But most of the intermittent trials have employed less accurate methods of body composition analysis, whereas the majority of continuous caloric restriction trials used vastly more accurate technologies. So, to date, it’s not clear if there’s a difference in lean mass preservation.

Improvements in blood pressure and triglycerides have been noted on intermittent fasting regimens, though this is presumed to be due to the reduction in body fat, since the effect appears to be weight-loss dependent. Alternate-day fasting can improve artery function too, though it does depend on what you’re eating on the non-fasting day. Randomized to an alternate-day diet high in saturated fat, artery function worsened, despite a 15-pound weight loss (whereas it improved, as expected, in the lower-fat group). The decline in artery function was presumed to be because of the pro-inflammatory nature of saturated fat.

A concern has been raised about the effects of alternate-day fasting on cholesterol. After 24 hours without food, LDL cholesterol may temporarily bump up, but this is presumably just because so much fat is being released into the system by the fast. An immediate negative effect on carbohydrate tolerance may stem from the same phenomenon: the repeated elevations of free fat floating around in the blood stream. After a few weeks, though, LDL levels start to drop as the weight comes off. However, results from the largest and longest trial of alternate-day fasting have given me pause.

A hundred obese men and women were randomized into one of three groups: alternate-day modified fasting (25 percent of their baseline calories on fasting days, 125 percent calories on eating days), continuous daily calorie restriction (75 percent of baseline), or a control group instructed to maintain their regular diet. So, for those going into the trial eating 2,000 calories a day, in the control group they would have continued to eat 2,000 calories a day. The calorie restriction group would have started at 1,500 a day every day, and the intermittent-restriction group would alternate between 500 calories a day and 2,500 calories a day.

With the same overall average prescribed calorie cutting in both weight-loss groups, they both lost about the same amount of weight, but, surprisingly, the cholesterol effects were different. In the continuous calorie-restriction group, the LDL dropped as expected compared to the control group as the pounds came off. But in the alternate-day modified fasting group, they didn’t. At the end of the year, the LDL cholesterol in the intermittent fasting group ended up 10 percent higher than the constant calorie-restriction group despite the exact same loss of body fat. Given that LDL cholesterol is a prime causal risk factor for our number one killer, heart disease— or even the prime risk factor for our number one killer—this strikes a significant blow against alternate-day fasting. If you do want to try it anyway, I would advise you to have your cholesterol monitored to make sure it comes down with your weight.

If you’re a diabetic, it’s critical you talk to your physician about medication adjustment for any changes in diet, including fasting of any duration. Even with proactive medication reduction, advice to immediately break the fast should sugars drop too low, and weekly medical supervision, type 2 diabetics fasting even just two days a week were twice as likely to suffer from hypoglycemic episodes compared to an unfasted control group. We still don’t know the best way to tweak blood sugar meds to prevent blood sugars dropping too low on fasting days.

Even just fasting for a day can significantly slow the clearance of some drugs (like the blood-thinning drug coumadin) or increase the clearance of others (like caffeine). Fasting for 36 hours can cut your caffeine buzz by 20 percent. So, consultation with your medical professional before fasting is an especially good idea for anyone on any kind of medication.

Please consider volunteering to help out on the site.

Image credit: Debby Hudson via unsplash. Image has been modified.

Motion graphics by Avocado Video

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

Are there any downsides to fasting every other day? For example, might going all day without eating impair your ability to think clearly? Surprisingly, the results appear to be equivocal. Some studies show no measurable effects, and the ones that do fail to agree on which cognitive domains are affected. Might the fasting/feasting cycles cause eating disorder-type behavior like bingeing? So far, no harmful psychological effects have been found. In fact, there may actually be some benefit, though the studies that have put it to the test specifically excluded those with a documented history of eating disorders—for whom the effects may differ.

What about bone health? No change in bone mineral density was noted after six months of alternate-day fasting, despite about 16 pounds of weight loss, which would typically result in a dip in bone mass. There were no skeletal changes noted in the control group either, however, that lost a similar amount of weight using continuous calorie restriction. The researchers suggest that this is because both groups tended to be more physically active than the average obese individuals by one or two thousand steps a day.

Proponents of intermittent fasting suggest it can better protect lean body mass. But most of the intermittent trials have employed less accurate methods of body composition analysis, whereas the majority of continuous caloric restriction trials used vastly more accurate technologies. So, to date, it’s not clear if there’s a difference in lean mass preservation.

Improvements in blood pressure and triglycerides have been noted on intermittent fasting regimens, though this is presumed to be due to the reduction in body fat, since the effect appears to be weight-loss dependent. Alternate-day fasting can improve artery function too, though it does depend on what you’re eating on the non-fasting day. Randomized to an alternate-day diet high in saturated fat, artery function worsened, despite a 15-pound weight loss (whereas it improved, as expected, in the lower-fat group). The decline in artery function was presumed to be because of the pro-inflammatory nature of saturated fat.

A concern has been raised about the effects of alternate-day fasting on cholesterol. After 24 hours without food, LDL cholesterol may temporarily bump up, but this is presumably just because so much fat is being released into the system by the fast. An immediate negative effect on carbohydrate tolerance may stem from the same phenomenon: the repeated elevations of free fat floating around in the blood stream. After a few weeks, though, LDL levels start to drop as the weight comes off. However, results from the largest and longest trial of alternate-day fasting have given me pause.

A hundred obese men and women were randomized into one of three groups: alternate-day modified fasting (25 percent of their baseline calories on fasting days, 125 percent calories on eating days), continuous daily calorie restriction (75 percent of baseline), or a control group instructed to maintain their regular diet. So, for those going into the trial eating 2,000 calories a day, in the control group they would have continued to eat 2,000 calories a day. The calorie restriction group would have started at 1,500 a day every day, and the intermittent-restriction group would alternate between 500 calories a day and 2,500 calories a day.

With the same overall average prescribed calorie cutting in both weight-loss groups, they both lost about the same amount of weight, but, surprisingly, the cholesterol effects were different. In the continuous calorie-restriction group, the LDL dropped as expected compared to the control group as the pounds came off. But in the alternate-day modified fasting group, they didn’t. At the end of the year, the LDL cholesterol in the intermittent fasting group ended up 10 percent higher than the constant calorie-restriction group despite the exact same loss of body fat. Given that LDL cholesterol is a prime causal risk factor for our number one killer, heart disease— or even the prime risk factor for our number one killer—this strikes a significant blow against alternate-day fasting. If you do want to try it anyway, I would advise you to have your cholesterol monitored to make sure it comes down with your weight.

If you’re a diabetic, it’s critical you talk to your physician about medication adjustment for any changes in diet, including fasting of any duration. Even with proactive medication reduction, advice to immediately break the fast should sugars drop too low, and weekly medical supervision, type 2 diabetics fasting even just two days a week were twice as likely to suffer from hypoglycemic episodes compared to an unfasted control group. We still don’t know the best way to tweak blood sugar meds to prevent blood sugars dropping too low on fasting days.

Even just fasting for a day can significantly slow the clearance of some drugs (like the blood-thinning drug coumadin) or increase the clearance of others (like caffeine). Fasting for 36 hours can cut your caffeine buzz by 20 percent. So, consultation with your medical professional before fasting is an especially good idea for anyone on any kind of medication.

Please consider volunteering to help out on the site.

Image credit: Debby Hudson via unsplash. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

If you missed the last video, check out Alternate-Day Intermittent Fasting Put to the Test.

So with ambiguous cognitive, lean mass, and bone effects, plus the cholesterol findings, I wouldn’t suggest it for weight loss, but that’s not the only thing alternate-day fasting is purported to do. It’s purported to have a variety of health benefits. Stay tuned for Does Intermittent Fasting Increase Human Life Expectancy?

Then we cover the other types of intermittent fasting:

What about total fasting? See:

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

151 responses to “Is Alternate-Day Intermittent Fasting Safe?

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      1. I believe that YR is pointing out that “It depends” is the answer to the safety question.

        The video was just a way of symbolically illustrating that there are dependent variables.

  1. I have found losing weight by any method will lower cholesterol, but temporarily. With wfpb, going from 130 to 110 brought LDL down, but after time it slowly creeps back up in spite of no weight gain. The supposed benefits of ADF however might make it worth trying.

      1. Thanks again Fumbles! I am going to ask my doctor about a couple of things thanks to your link. Also, I just started on synthroid four months back so that might help too. In my case it is familial, but I am doing well compared to the others no doubt because of diet and exercise.

        1. * “doing well compared to others in my family” I meant. My Dad and brothers couldn’t get LDL down even with lipitor and crestor. My LDL is too high, but TG is low, and HDL is high.

  2. Because I’m now WFPB (and non-obese), I like fasting for convenience on road trips. It’s so easy and simple with a WFPB gut-system. Back when I ate SAD–missing meals could launch serious headaches and weakness/malaise, but no longer is the case. Now I notice the hunger, and think-nope not today, and it passes and merrily we travel along without any hunger or cravings and totally uninterested in all that highway America offers up to eat.

    Unless I see boiled peanuts or a good fruit/veggie stand!

  3. That last line is very important. “So, consultation with your medical professional before fasting is an especially good idea for anyone on any kind of medication.”

    I know countless people on meds that require them to be taken with food for proper absorption, yet most take that as a mere ‘suggestion’. Some people can not ‘fast’ because of medication schedules.

  4. This line about Diabetics is important because they can die. “If you’re a diabetic, it’s critical you talk to your physician about medication adjustment for any changes in diet, including fasting of any duration. Even with proactive medication reduction, advice to immediately break the fast should sugars drop too low, and weekly medical supervision, type 2 diabetics fasting even just two days a week were twice as likely to suffer from hypoglycemic episodes compared to an unfasted control group.”

    I was wondering about cholesterol not improving and insulin resistance. Do the Diabetics get the same type of WFPB type getting off of their meds with it?

    https://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/cholesterol-abnormalities–diabetes

  5. I am so grateful for this video- thanks Dr. Greger and team!. I was contemplating trying ADF- no way now.

    I am now doing the 1500 per day with attention to limiting calorie dense foods and it is totally doable and working.

    I was not losing using the, “all you can eat without counting calories WFPBD”- I gained not surprisingly even though, “all you can eat” really meant about 200 cals more starch. I guess my body uses food very efficiently.

    Can’t wait for How Not to Diet to come out.

    A healthy and happy monthly supporter of Nutritionfacts.org

    1. Bobbi,

      I think the WFPB diet might work if following the guidelines of Dr. Greger’s Daily Dozen (which I call the Double Daily Dozen, because there are 24 check boxes). And even then, I slightly decrease serving sizes for me, for the grains and beans, because I am older and smaller than average now and a bit less active, and don’t eat so much. I’ve guesstimated that I probably eat about 1500 – 1600 calories per day, thereabouts. I find it tough to eat so many greens, and cruciferous veggies, but I’m working on it. And I agree with you, “it is totally doable and working” — meaning that in my and my husband’s case, we are maintaining our weight (which went down even a bit further from originally healthy weights when, as vegetarians, we dropped dairy products and eggs, and tried to avoid even more processed food).

      All the best to you! I ordered the book, too, because I want to understand why so many people seem to have trouble losing weight, and maintaining that weight loss. (Maybe they don’t like to cook meals at home? Because the options for eating WFPB out or from prepared foods are severely limited.)

    2. Bobbi

      The term WFPB diet encompasses a wide range of eating practices. It is not surprising that people do not lose weight on some of those practices.

      However, I am pretty sure that everyone can lose weight on a whole plant food (WPF) diet where people fill up on high fibre foods like green leafy vegetables first eg the old BBC Evo diet – 5 kilos of food a day and they still lost weight

      http://www.bbc.co.uk/sn/humanbody/truthaboutfood/healthy/evodiet.shtml
      http://www.bbc.co.uk/sn/humanbody/truthaboutfood/healthy/evodiet2.shtml

    3. I’m in a similar situation. I’m restricting to 1200-1500 calories. Almost entirely WFPB. I’m finally slowly losing weight. And retrained myself to breathe through stress instead of eating it. (Using Noom app, I just ignore much of their diet advice)

      Apparently I needed some self supervision with the calorie counting. My endocrinologist is very happy I’m slowly losing weight 2-3 lbs a month instead of rapid weight loss.

  6. I understand the fasting information, but what about intermittent fasting that consists of not eating between the hours of 6-8pm until 12 noon the next day? Doesn’t this give the body a chance to repair rather than continuously digesting food if one were to eat several small meals a day or just eats 3 meals a day with a snack?

      1. I believe that Dr. Greger’s official position was that if you are going to do intermittent fasting, skip dinner, instead of breakfast. That was from an interview. When his book comes out, he has information on how eating at different times affects how many calories you can eat. Meaning, you can eat more calories and have the same results if you eat those calories earlier in the day.

        This series isn’t over yet. Your specific questions might be answered, but he is for skipping dinner, not breakfast.

        1. The problem with that is then you don’t have dinner together as a family. Most people can’t have lunch or breakfast together either, so the result is social isolation.

    1. Dr. Longo has pointed out (no reference handy, maybe it’s in his book) that restricting eating to less than 10 hours (fasting longer than 14 hours) raises the risk of gallstone formation, and recommends keeping the fasting window to ~12 hrs to prevent an increased risk.

      I’d like to know Dr. Greger’s take on that. Does anyone know?

      Cf.
      https://www.hopkinsmedicine.org/health/conditions-and-diseases/gallstones

      “The following are suggested risk factors for gallstones:”
      (excerpt from full list)

      “Rapid weight loss. As the body metabolizes fat during rapid weight loss, it causes the liver to secrete extra cholesterol into bile, which can cause gallstones.

      Fasting Fasting decreases gallbladder movement, which causes the bile to become overconcentrated with cholesterol.”

      1. Yes, Gengo,

        I have heard him recommend staying closer to 12 to 13 hours for that reason.

        This video makes it interesting because I have read studies that gall stones form when the amount of cholesterol or bilirubin in the bile is high.

        After reading your comment, I looked up bilirubin and insulin resistance and found this:

        https://www.ncbi.nlm.nih.gov/pubmed/26017184

        They said that moderate elevations in bilirubin levels have anti-diabetic effects.

        If fasting over 13 hours increases bilirubin and if that is the mechanism for gallstone formation, that would make the warning to Diabetics more important.

        A lot of people go WFPB to get off Diabetes meds. Having insulin resistance increase would seem to not be a good idea.

      2. gengogakusha, I have been taking tumeric daily partly for that reason, since it helps to keep the gallbladder contracting. Also, though I finish eating before 5pm usually, I will have a small apple or mandarin orange at the 11 or 12 hr mark. Maybe Dr Greger will say something about it in his new book :)

        1. Barb, >>> I will have a small apple or mandarin orange at the 11 or 12 hr mark

          That seems like a good idea.

          It’s easy for me to slip past 12-13 hrs w/o food b/c I often exercise in the am before breakfast.

      1. Hello George, thanks for your comment.

        In order to achieve weight loss, you need to create a caloric deficit, this means that you need to eat fewer calories than the ones you need or burn more energy by doing more exercise.

        No matter which food or dietetic patter you’re following, if you don’t create this deficit you won’t lose weight. And on the contrary, if you eat a lot more of what you need in this 8-hour window, your body weight will increase.

        Hope it helps

  7. I do ADF. Really like it so sorry to hear the possible LDL downside. But as a WFPB, I wonder if eating the foods that lower LDL, (oats barley, legumes, avocado and almonds, etc, etc) might cause the gut to lower the higher LDL released on day one of the fast. I also was coming across articles that stated fasting in general can cause incr LDLs. The thought occurs to me that if ADF raises LDLs, then any fast raises LDLs on the first day of a fast. Would a 2nd day of fasting be so fabulous for lowering LDS, that its more beneficial than eating LDL lowering foods on the 2nd day? I don’t know of any human trials that try to establish the ideal fasting protocol for humans. At the same time, fasting seems to be one of the healthiest things we can do for our bodies in many metabolic pathways. Hope more tests on humans come out with the nuanced metrics Dr Greger discovers. What to do? –this is all way above my pay grade.

  8. My problem with this, and many other videos, is that the data is based on a sample that is not WFPBD, so it’s hard to see how it applies to me–and probably most of the the people reading this.
    My cholesterol numbers are down in the “heart attack proof” area (59 LDL) after a few years on a WFPBD. So when I read Dr. Greger, I “throw out” data suggesting adverse cholesterol reactions.
    At 63 years old, and after half a lifetime of obesity, I’m comfortable at 28% body fat, and while I’m Type II diabetic, my A1Cs are at 5.5, and my blood pressure is great (after adding some salt as I was too low!)
    My only meds are metformin for diabetes, and I’d love to get off of it, thus I want to lose another 10% to 20% or so of my body weight. 7/2 and 16/8 seem to show the most promise, but as I haven’t paid for the videos, I can only guess as to what Dr. Greger will have to say.
    In any case, I have to take the data (and especially the metadata) with a grain of salt because very few of those subjects were WHPBD.

    My point here is that I feel that many of the clinical trials reported here have unfortunately limited applicability due to the fact that the viewership here on NutritionFacts does not share a SAD diet with the test subjects.

    For my part, I try to tease out maximum health/longevity from the MetaGregerData!

    BTW, my plan is to intermittently try both 5/2 and 16/9, not eating evenings, with aerobic morning workouts and sandwiching a midday strength training workout between two high protein meals, in an effort to decrease fat and increase lean body mass.

  9. Bruce,
    Congratulations on losing so much weight! Not to burst your bubble, but low lipids aren’t an automatic pass for suffering a heart attack. Plenty of people with great numbers have heart attacks because having a heart attack comes down to insulin sensitivity. Hopefully, you can continue your awesome progress and rid yourself of the type II label.

    1. “Heart attack proof” is one of Dr. Greger’s oft-used phrases, and as such, I qualify–the reality of your comment notwithstanding.

      The “Type II Label” cannot ever be relinquished, unfortunately. The U.S. medical establishment has decreed that once a subject shows certain Type II data on two separate  occasions, they are forever branded with a “D” on their foreheads. For now, pre-existing conditions have little effect on insurance premiums. But should that change, my premiums will go up by $2000/month for a condition that is fully under control.

      1. Bruce Twitch,

        That’s what my brother told me: Once diagnosed with type 2 diabetes, you’re always considered diabetic. He was overweight and out of shape about 18 years ago, and changed his eating to plant based (eventually to whole food) and started exercising, moderately, and eventually he lost 70 pounds and went off all his meds, including metformin for diabetes. So I asked him if he was still diabetic, as he doesn’t take any drugs for it now, and his reply was “yes.” Even though his a1c level is about where yours is. And since he continues to eat WFPB and exercise, he’s maintained his weight loss. He doesn’t plan to ever go back to the way he was living.

        BTW, he has found doctors who support WFPB eating. He switched from one or two that were skeptical or even disapproving. And he is now 72. (So you can teach old dogs new tricks!!) (And you’re never too old to benefit from a healthier lifestyle, though I’m guessing that he started when he was about 54 and first diagnosed. His progress was gradual.)

        Congratulations on your new and improving lifestyle!

      2. Hey Bruce Hi! Did you know that by eating a WFPBLOWFAT diet ( plus exercise) you can reverse your Type 2 diabetes? Eat 10g of fat only per meal for a 30g total per day. Give it a go for perhaps 1 year and see what happens! People are doing this with success!

        Dianne

        1. Dianne,

          I like your comment!

          Because I completely forgot that a few years ago, my brother took a program from https://chiphealth.com/ (where he learned what to eat, how to cook it, how to shop for it, the importance of exercise and what kind, etc), and he cut back on added oil and salt. And it might have been after decreasing added oil that he went off metformin. I don’t have all the details, and I think that he was heading in that direction anyway, having lost weight on a plant based diet (eventually whole foods) (switching to whole food after taking that program?) and exercising. But it took him years.

  10. Hello Sidqi, and thank you for your astute comments/questions.

    I am a family doctor and a volunteer for Dr. Greger on this website. You are correct that any fast will raise LDL levels in the short term, due to “so much fat … being released into the system by the fast”, as Dr. Greger states in this video.

    One point I’d like to make is that, in the study Dr. G describes, the alternate day fasting group’s LDL levels were basically unchanged compared with the control group, after 12 months — so it’s not as if your LDL cholesterol level is rising, RATHER, it’s that people in the continuous fasting group had better LDL levels after 12 months than the ADF group.

    You mention two ideas to lower LDL levels:
    1) Increase consumption of high fiber foods such as oats, etc.
    2) Instead of alternate day fasting, extend the fast to 2 or even more days.

    Those both seem like reasonable strategies. But I don’t know if either of those has been formally tested. The first is a good idea in any case. The prolonged fasting idea also strikes me as very reasonable, when you consider that for much of early human evolution, prolonged fasting was a very regular occurrence — so our genetic makeup is probably fairly well adapted to prolonged fasting. But, as Dr. G. mentions, if you have medical problems such as diabetes, and/or if you take medication(s), then prolonged fasting could have some undesirable outcomes.

    I have an advance copy of How Not To Diet, and I will look to see if I find any answers there. In the meantime I would say that since you already do ADF, get your cholesterol levels checked. If your LDL is below 70, you have nothing to worry about, and even if your LDL is 70-99, you probably don’t need to worry. If it’s 130 or above (and probably even if it’s 100-129), then you should look at various ways to lower it, especially if you have other risk factors for coronary artery disease.

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

  11. Hello, this is nothing to do with the video, but I’m reaching out to the community to see if anyone knows

    a) where can I get my telomeres measured
    b) if there are any telomere or other studies coming up soon, as I will start on a plant based whole food diet in January, and may be a great subject for studies

    Many thanks in advance, folks

    1. Cheryl,

      There are various sites online where you can find out how to get tested.

      https://www.spectracell.com/clinicians/products/telomere-testing/

      As far as new studies go, Dr. Ornish is the one who was involved in lengthening telomeres with diet.

      I am not sure what you are looking for other than the fact that they can be lengthened with diet.

      There are other things involved such as exercise and things like getting enough Vitamin D.

      Dr. Greger has a video on the topic and Dr. Ornish has spoken about it and he has videos on YouTube.

  12. Different strokes for different folks, as they say. Just because alternate fasting might not achieve the objective of weight loss in the long run, doesn’t mean this negates its efficacy of course. It is, after all, a tool, which is appropriate or not appropriate according to the circumstances. Is it not?

    1. David,

      Dr. Greger didn’t say that the people didn’t lose weight. He was concerned about their cholesterol not dropping even when they had lost weight, which is odd.

  13. Can anybody tell me who Dr. Jason Fung is — beyond what his bio states online? And why he would write an article like this (sent to me by a friend): https://medium.com/@drjasonfung/the-salt-scam-1973d73dccd. “Our belief in the benefits of low salt consumption are largely based on mis-information and myth-information.” With only one reference provided (under one graph; the other two are unattributed, which is not acceptable practice.)

    I recall his name mentioned in comments to earlier videos or blogs, and that not all comments were positive.

    1. Dr J

      Fung is a low carb guru. The low carbers love him and he specialises is telling low carbers to fast. To some extent, fasting probably mitigates the adverse effects of a low carb diet (not sure if they still call themselves low carbers – they are probably all keto diet hipsters now. Same diet, new name).

      Anyway, other low carb gurus also desperately wish that sodium wasn’t a problem …………. because meat and dairy are high in sodium. The salt, meat and dairy industries have been railing against international guidelines (including US guidelines) on sodium/salt consumption for decades. Low carb reserachers are happy to oblige. A couple of low carb researchers in universities have done associational studies which purport to show that the guideline recommendations regarding salt consumption are too low. It’s rubbish because their studies were clearly (very conveniently) confounded but the low carb community loves them.

      In brief, low carbers don’t just have one crank belief – they have a whole constellation. You know … low carb diets are actually healthy, high blood cholesterol is harmless or even healthy, saturated fat is good for us etc. They know so much more about these things than the global scientific and medical communities = or so they keep telling each other.

      You could look at some of Dr G’s videos on salt for more information. The things Fung is referring to were discussed in detail in the comments.

      1. Mr Fumblefingers,

        Thank you!!

        I’ll check out the comments to the videos (which I think I have watched, though a lot of them were “before my time” — before I discovered NF.

      2. I may have watched the whole constellation by now.

        Since Mercury is in animal products and I am not eating animal products, I think I can make an “I think my Mercury is in retrograde” joke. (Sorry, YR.)

        Dr. Fung is an intelligent man who is well-spoken, but he does come from the Keto perspective. I didn’t know that he had spoken about salt. Tom is right that people tend to be high fat, low carb, cholesterol and sodium don’t matter-oriented.

        Dr. Greger’s Diabetes video may affect that. I feel like that one was the most successful of that series. His Cancer “Why go Keto when you can do Chemo” joke may not go over that big, but they do like intermittent fasting and water fasting and autophagy, so he might get a crossover audience.

        1. “Since Mercury is in animal products and I am not eating animal products, I think I can make an “I think my Mercury is in retrograde” joke. (Sorry, YR.)”
          – – – – –

          Since yesterday afternoon I have been unable to pick up my gmail account. Am not the only one. Typical MR nonsense. And, damn, most of my newsletters come in through that email address! (I have four.) Google has (deservedly) been getting bad press for quite a while now. Their way of retaliation or what? :-(

    1. Oh no, That’s all we need … more fake protein to screw up our bodies! And where’s the fiber? I think I’ll stick with my humble beans and grains ;-)

    1. Barb

      I’d be a bit careful about trusting the claims made in that first link. It appears to be a site run by a sugar-is-the-root-of-all-dietary-evil person and that immediately raises questions about her understanding of nutrition and health.

      Also, the study she cites doesn’t demonstrate any protection form disease. Instead, it reports improved biomarkers after 1 month and also after another 6. However, since the experimental group ate fewer calories and lost weight, while the control group didn’t, the possibility exists that the reported benefits were actually due to weight loss and not to alternate day fasting per se.

      1. Fumbles, thanks, it was a site that Deb posted and the topic just got my attention. About the effects of alternate day fasting… you make a great point about confounding factors. In reading Dr Mirkin’s notes, he does speak about it as an eating plan that worked for their health goals and lifestyle. It’s more daily reduced calorie plan, one day more than the other. Some of the benefits are no doubt simply from the weight loss they experienced and maintained. Food choices, wfpb with a bit of fish once or twice per week, also factor in. Plus, exercise is a huge priority for them both. How much the timing of their meals factors into all of this, I have no idea. Timing can impact the effectiveness of some medications… just wonder if the same can be said for our food. That’s the big question isn’t it?

  14. Hello Alvaro, thanks for your comments.

    For most of people, a supplemental dose of 600 – 1000 UI would be enough. However, you will find on the internet several and sometimes very different references, depending mostly on the medical association who is giving the recommendation.

    But, what you need to do first is to check your vitamin D levels, because if you have a severe deficiency you will need to take more than that and your doctor will also need to adjust doses of vitamin D according to other factors, for example, your nutritional status. People with obesity usually need larger doses.

    Hope it helps :)

    1. People with obesity do have a lot of fats into the body, and vitamin D, in excess, is stored into fat cells. Thus, it is perfectly normal that people with obesity have lower concentration of vitamin D in the blood than thin people while supplementing, because they have much more storage capacity than thin people. Therefore, lower blood concentration for obese people do not necessarily mean that they need more vitamin D supplements, as they may already have enough vitamin D stored into their fat cells.

    2. I am a person with 1.78 m of height and 65 kilos, that is to say, I am not obese, in the last months I am not getting vitamin D because I am locked up almost all day for studies and research and when it is not sunny, I decided to buy Vitamin D for that reason and the only thing I found was 15,960 IU, in the instructions it says that the recommended for adults with insufficiency is once a month

      1. Most people are not deficient in vitamin D, they are intoxicated with vitamin D and have too much of it, because they eat animal foods already containing vitamin D.

        Unless one lives in complete obscurity with only artificial lamps, one would not worry about vitamin D deficiency. If you already eat fruits and vegetables, you have adequate intake of vitamin C that will provide you with strong bones if you exercise a minimum, like walking a bit every day (if you are not in a wheelchair), moving your members and holding weighted bags, like grocery bags or scholar bags with books inside.

        Just walk a bit everyday outside for five minutes, look some instants into the direction of the sun, but not directly at it, and you should not worry about it.

      2. I’m not sure what country you’re from, Alvaro, but I have never seen such high doses of vitamin D! It’s definitely a good idea to supplement when you’re not getting adequate sun, Dr. Greger recommends 2,000 IU per day split up, but I just take it all at once in the morning. Some doctors recommend 5,000 IU but I grew wearing of supplementing such high amounts so I went down to 2,000. I would personally be terrified to take 15,960 IU, but I’ve never even heard of it so I don’t know what kind of research is out there on such high doses at a weekly dose.

          1. I see this study with this dose and quote “Some of the participants were taking as much as 15,000 IUs of vitamin D daily without any untoward toxicity”.

            https://www.ncbi.nlm.nih.gov/pubmed/?term=15.000+international+units+vitamin+d3

            I live in spain in the valencian comunity and because i’m inside my house most of the day or studying in the high school i’m not getting enough vitamin d obiously and the recommendation in the instructions of the suplemment is for insuficienci once a month for adults and yes, i don’t have lower doses in my city of vitamin d but in the study it seems like don’t cause harm.

            1. Alvaro,

              Our ancestors living with hairy bodies and into the shadow of the jungle never had any vitamin D deficiency.

              Don’t listen to people and doctors who do not really understand what they say.

              High antioxydants, particularly supplements, are proven to increase risk of cancers over time. Vitamin D also act as antioxydant.

              1. Our ancestors also spent a lot of time outdoors and did not wear clothes.

                Captive chimpanzees can suffer vitamin D deficiency.

                https://www.ingentaconnect.com/content/aalas/cm/2007/00000057/00000004/art00010%3bjsessionid=1c51757nlj181.x-ic-live-03

                Relationship between Sunlight Exposure, Housing Condition, and Serum Vitamin D and Related Physiologic Biomarker Levels in Captive Chimpanzees (*Pan troglodytes*) “These results suggest that adult captive chimpanzees experience vitamin D deficiency when housed without regular access to unfiltered sunlight and that these effects may be more acute for adult female animals.”

                But I do think people should get outside to exercise and get some sun exposure.

                1. From the study you quoted: “Total vitamin D was significantly lower and alkaline phosphatase significantly higher when subjects were in the indoor-only enclosures compared with when they had regular access to outdoor enclosures. A vitamin D effect occurred only in young and prime-adult animals. Changes were significant in female but not in male chimpanzees. Calcium, ionic calcium, phosphorus, and albumin did not differ between indoor-only and indoor-outdoor enclosures. However, female chimpanzees exhibited significantly lower calcium and phosphorous levels while in the indoor-only enclosures.”

                  Where does it suggest a “deficiency” ? It just indicates that calcium and phosphorous levels are linked to vitamin D levels, and depend on whether the animals are indoor or outdoor. And the effect was more obvious in females than in males.

                  It shows that in female chimpanzees, being outdoor, there was lower vitamin D levels, lower calcium levels and lower phosphorous levels.

                  What does it mean ? It means that in indoor conditions, the body actually used or stored vitamin D, calcium and phosphorous molecules. Used for what ? Most likely for repairing the bones…

                  As indoor conditions somehow mimicks the night condition, it may indicate that the bones actually repair themselves at night, as it is already suggested by this study:

                  The Importance of the Circadian System & Sleep for Bone Health
                  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994176/

                  So low levels of vitamin D and calcium do not necessarily mean a deficiency, but rather potentially stronger bones than when there were high levels of those minerals and vitamins into the blood…

                  1. I’d say the last line of the abstract was pretty clear:

                    “These results suggest that adult captive chimpanzees ****experience vitamin D deficiency**** when housed without regular access to unfiltered sunlight and that these effects may be more acute for adult female animals.”
                    Why did you ignore that line (the “punch line”)?

                    1. They stated it, but the very expression “vitamin D deficiency” is an interpretation of low levels of vitamin D, it is not at all the description of medical symptoms related to a so-called “deficiency”…

                      Were their bones density weaker or higher after indoor-only conditions ? The study does not talk at all about that…

                    2. I mean: it is not because something is low, that there is actually a deficiency… as the environmental conditions may create the “low” blood level. It may just be biological adaptation to environmental conditions, and that may not be an issue at all…

            1. The way I was educated (through graduate school)to do research and to argue for conclusions was basically to form an informed hypothesis, then actually investigate the known facts and do studies/experiments to test those hypotheses, and finally report the evidence in a coherent manner. Even in informal science-based forum such as this one, the burden of proof ALWAYS falls on the one making a claim to substantiate it. Not just make things up. Sorry to say but you seem to have a very different view on these matters.

              Vitamin D and melanoma
              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897580/

              We discuss here the evidence that sun-sensitive people have lower vitamin D levels and that, in practice, it is very difficult for such individuals to achieve sufficient levels without supplementation in the UK at least. We conclude that melanoma susceptible sun-avoidant individuals should be advised to avoid insufficiency by supplementation.

              Vitamin D is ANTI-PROLIFERATIVE in vitro for some melanoma cell lines. In a large melanoma cohort we have observed that lower serum 25-hydroxyvitamin D2/D3 levels at diagnosis were associated with thicker tumors and poorer prognosis (study as yet not validated). In the UK, melanoma patients commonly have sub-optimal 25-hydroxyvitamin D2/D3 levels at and post diagnosis; we discuss approaches to management of such patients based on some new data from our group.”

              This shows low D levels are a concern.

              Show me one reference supporting your claim, and then we can have a rational discussion.

              1. Antixoydants effects on cancer cells in vitro can be vastly different from their in vivo effects.

                In vivo is an opaque environment, while in vitro, the antioxydants can be photolized by light and thus be transformed into ROS or free radicals that actually have anti-cancer effects, and not the antioxydants, which may be procarcinogenic in vivo…

                From your study: “Many melanoma patients have suboptimal 25-hydroxyvitamin D2/D3 levels at diagnosis although this is also true of the general population. ”

                So there is no cause and effect there, 言語学者.

                1. Ab30,
                  Here’s your orginal statement:
                  >>>>”A lot of melanoma may be due to high vitamin D intake from foods or supplements.”

                  In my statement I pointed out the burden of proof falls on you to provide positive support. I also linked and quote from a study finding an association between low vitamin D levels and increased melanoma risk.
                  _____
                  In your reply you said:
                  >>>>”Antixoydants effects on cancer cells in vitro can be vastly different from their in vivo effects.”

                  So what? This is NOT evidence supporting your claim.

                  >>>>”In vivo is an opaque environment, while in vitro, the antioxydants can be photolized by light and thus be transformed into ROS or free radicals that actually have anti-cancer effects, and not the antioxydants, which may be procarcinogenic in vivo…”

                  By “supporting evidence”, I mean citing scientific studies (links and quotes) in peer reviewed scientific journals. This remark is beside the point, so I’ll skip evaluating it.

                  >>>>”From your study: “Many melanoma patients have suboptimal 25-hydroxyvitamin D2/D3 levels at diagnosis although this is also true of the general population. So there is no cause and effect there,”

                  True. But I never said the study demonstrated a causal relation between low vitamin D levels and increased melanoma risk. It’s not relevant because you have the logic wrong. Note crucially that although association does not imply causation, causation does **imply** association (C ==> A).

                  And from the logical law of contraposition, that means: Not(A) ==> Not(C), i.e.
                  “NO association **implies** NO causation”
                  .
                  Further, it is reasonable to suppose that a (good) study on the association between vitamin D levels and melanoma risk would uncover such an association. But they did not (quite the contrary), which means that the study counts as one piece of evidence against your claim. One study is not, of course, definitive, but that’s also beside the point, because as I said,
                  the burden of proof always falls on the person making the claim (that’s you).

                  1. ”A lot of melanoma may be due to high vitamin D intake from foods or supplements.”

                    Kindly let me explain the reasoning: high vitamin D intake does not necessarily imply high vitamin D serum level.

                    Serum levels are what the studies actually measure, but they fail to address or to measure the vitamin D that is actually stored into the cells, particularly the fat cells, and in the case of melanoma, the subcutaneous fat cells…

                    If the melanoma starts in subcutaneous fat cells that are loaded with vitamin D, the antioxydant power of vitamin D may prevent the natural defense of the body to get rid of the cancer cells through ROS mechanisms.

                    That’s why a big intake of vitamin D through animal foods and supplements may increase the risk of cancers, like melanoma.

                    Does the logic convey meaning to you ?

                    1. ab30,

                      >>>Does the logic convey meaning to you ?
                      No, your logic is not meaningful to me for one very simple reason:
                      >>>”…the melanoma starts in subcutaneous fat cells that are loaded with vitamin D…”
                      is false. Melanoma does not start in fat cells; it starts in melanocytes, which are in the epidermis, so your attempted explanation fails to get off the ground.

                      On a more positive note, it is certainly possible that very high levels of vitamin D, at least through high-dose supplementation, could accelerate pre-existing melanoma and other cancer progression. Indeed various studies indicate that various high-dose exogenous anti-oxidants do just that see e.g. the SELECT trial). But that’s old news, and few would disagree.

                      More to the point, there are mice studies showing E and N-acetylcysteine accelerate lung and melanoma progression in mice.

                      https://stm.sciencemag.org/content/7/308/308re8
                      Antioxidants can increase melanoma metastasis in mice

                      https://www.ncbi.nlm.nih.gov/pubmed/24477002
                      Antioxidants accelerate lung cancer progression in mice.

                      So, based on this evidence, I agree that it is possible that vitamin D might have a similar effect on existing melanoma. But what I had been asking for was some evidence, not erroneous speculation. Note too that none of this shows that the anti-oxidants from whole foods are problematic (one of your earlier claims), indeed all the evidence points to the contrary.

                      If you were to ground your views in facts and provide supporting studies, your comments would be much more valuable.

                  2. It may be right that melanoma doesn’t start into fat cells, however:

                    Fat cells play key role in dangerous transformation of melanoma
                    https://www.sciencedaily.com/releases/2019/07/190723182258.htm

                    “fat cells are involved in the transformation that melanoma cells undergo from cancer cells of limited growth in the epidermis to lethal metastatic cells attacking patients’ vital organs.”

                    That is exactly what James Watson described for late-stage cancer in his article about the cancer promoting role of antioxidants, that prevents apoptosis induced by oxydative mechanisms which are a body defense against cancer…

                    Antioxidants are the same once absorbed into the bloodstream or when they accumulate into fat cells. Nothing can distinguish according to their origin or whether they are from plant foods, animal foods, or supplements.

                    What would you say, 言語学者 ?

                    1. ab,
                      Thanks for posting that link. The study is very interesting, and as it links fat cells to melanoma metastasis, it might superficially seem to support your claim. But does it really?

                      I am skeptical for the following reasons. For one thing, the vitamin D stored in cells, or most of it, is in an inactive form. As far as I am aware, only the active form has antioxidant properties. If so, you have an unaddressed problem.
                      To be completely fair, I did recently read that fat cells can produce some active D, but it was not clear to me there would be enough to have the effect you are looking for. Since I am not an expert, in my mind that is an open question; it leaves me skeptical but I would welcome being proven wrong. That burden falls to you.

                      But there is another, and in this context, more important reason: the mechanism described in the study is not “exactly what James Watson described for late-stage cancer in his article about the cancer promoting role of antioxidants…”.

                      Although I do not have access to the full article, it appears that the research did not find a role for anti-oxidants. More specifically, there was no mention of a (possible) role for vitamin D stored in fat cells. Rather, one of their major discoveries was the role cytokines secreted by adipocytes play in gene expression, indirectly resulting in an increase in a certain growth factor (TGF beta) that turns melanoma cells aggressive.

                      ” The authors found that adipocytes secreted cytokines that signaled through their receptors on melanoma cells to repress the expression of a microRNA that promotes proliferative and suppresses invasive phenotypes. The microRNA also represses the expression of a receptor for the growth factor TGF-β, which is implicated in metastatic disease and abundant in the dermal layer. Blocking TGF-β signaling prevented the invasive switch in cultured melanoma cells and, therefore, may suppress metastasis in patients.”

                      “Our experiments have shown that the main effect of cytokines is to reduce the expression of a gene called miRNA211, which inhibits the expression of a melanoma receptor of TGF beta, a protein that is always present in the skin,” says Prof. Levy. “The tumor absorbs a high concentration of TGF beta, which stimulates melanoma cells and renders them aggressive.”

                      Now, these researchers are truly impressive and clearly really know what they are doing, wouldn’t you agree? If so, do you really think it plausible that they would fail to notice a role for the vitamin D stored in fat cells or would have failed to mention this? I am lead to conclude that the anti-oxidative mechanism you keep appealing to is not relevant in this case. Ironically, the research results make me more, not less, skeptical of your claim.
                      I greatly respect Watson (who would not?), and do take seriously his views on the role of anti-oxidants in cancer development. But that does not mean that every case of cancer progression and metastasis can be traced to an overabundance of antioxidants.

                  3. 言語学者,

                    The study clearly establishes that fat cells are a driver for the transformation of cancer cells into invasive and metastatic cancers, which is quite an important point and may be relevant for all cancers and not only melanoma.

                    They establish that: “in melanoma patient samples, tumors appear to grow in a lateral, proliferative phase within the upper epidermal layer of the skin but switch to a vertical, invasive phase when they grow into the deeper layers where adipose (fat) exists”, and that involves the cytokines IL-6 and TNF-α.

                    Watson already talked about the roles of IL6-citokynes that are involved into those mechanisms in the section 4 of his article entitled “Oxidants, antioxidants and the current incurability of metastatic cancers”:

                    “4 – IL6-like cytokines drive mesenchymal cells to commence cell proliferation”

                    Watson explains that “the enhanced apoptosis capability of early-stage epithelial cancer cells, in comparison with their normal cell equivalents, reflects their higher content of activated p53 transcription factor”, and that “p53 induces apoptosis by turning on the synthesis of genes whose primary function is the synthesis of reactive oxygen species”.

                    So the body seems to defend itself against cancer by activating p53 that produces ROS.

                    Watson writes that “overexpression and amplification of the p53 repressors MDM2 and MDM4 are common across cancer types. In the case of melanomas, p53 function is commonly shut down by overexpression of MDM4.” (MDM4 being a p53 repressor in cancer cells)

                    However, some studies have already established that “p53 and its family members have been implicated in the direct regulation of the vitamin D receptor (VDR)”.

                    So vitamin D might actually play a role in the overexpression of MDM4 in melanoma cancer cells as well, and in the proliferation of cancer cells.

                    “An increasing body of evidence now convincingly demonstrates a cross-talk between vitamin D- and p53-signaling that occurs at different levels, has genome-wide implications and that should be of high importance for many malignancies, including non-melanoma skin cancer.”

                    in “Tumor suppression in skin and other tissues via cross-talk between vitamin D- and p53-signaling”
                    https://www.frontiersin.org/articles/10.3389/fphys.2014.00166/full

                    A lack of ROS synthesis due to overexpression of MDM4 is associated with melanoma proliferation. And after the description of different pathways, Watson explains, in his article, that this inhibition of p53, which is inducing low reactive oxygen species, is also related to high antioxidant levels.

                    So, if the fat cells are full of vitamin D, that is shown to interfer with p53-signaling and ROS production, they may constitute a high antioxydant ground onto which the melanoma may thrive and become metastatic.

                    But not only vitamin D might be related to cancer, also all fat-soluble antioxidants like beta-carotens and others. That may be why the supplementation of those antioxidants has been shown to increase cancer risk, and that may be why also a low-fat plant diet has been showed by Dean Ornish to reverse prostate cancer, low-fat being key here, as it allows to not absorb too much of those fat-soluble antioxidants that may promote invasive cancer development…

                  4. The fact that the body seems to defend itself against cancer by activating p53-signaling that turns on the genes responsible for the synthesis of reactive oxygen species and apoptosis lead to another very interesting question:

                    Why would the cell trigger its own death through apoptosis ? And how does it recognize that it is itself compromised ?

                    If the cell DNA was compromised, as in the current theory of cancer, it could not trigger apoptosis… But there Watson shows that the cells DNA is not compromised, that it triggers “suicide” or apoptosis, but that high antioxidant levels prevent apoptosis…

                    So, it may mean that cancer cells are not DNA compromised cells but cells that have been invaded by exogenous material growing inside the cell… In fact there is a recent hypothesis that cancer cells would actually rise from bacteria, like intracellular bacteria…

                    Cancer cells arise from bacteria
                    https://cancerci.biomedcentral.com/articles/10.1186/s12935-018-0699-4

                    and that would explain why cancer cells trigger apoptosis or suicide, indicating a correct DNA functioning, but apoptosis has been prevented by high-antioxidant content within the cell, as bacteria have been shown to be the place of “considerable antioxidant activity” and grow very well where there is fats…

                    Presence of antioxidant materials in bacteria
                    https://link.springer.com/article/10.1007/BF02531970

                  5. 言語学者,

                    I didn’t address your point about vitamin D being in a not active form within fat cells.

                    Wiseman has shown that both its inactive and active form inhibit the oxydation of lipids constituting the cell membranes (lipids peroxydation), thus effectively protecting the cell membrane. Because it inhibits the oxydation of fats, it may also explain why it is stored into fat cells, like all fat-soluble compounds.

                    “Vitamin D is a membrane antioxidant. Ability to inhibit iron-dependent lipid peroxidation in liposomes compared to cholesterol, ergosterol and tamoxifen and relevance to anticancer action.”
                    https://www.ncbi.nlm.nih.gov/pubmed/8325381

                    So when the cancer cell triggers its own apoptosis via p53-signaling, it creates reactive oxygen species that may oxyde the cell membrane and thus destroying the membrane from the inside, leading to the death of the cell. But if there is too much vitamin D, then the cell membrane is protected, and the cancer cell can survive to death…

                    Thus, vitamin D may prevent apoptosis and promote cancer progression, both in active and inactive forms.

                    1. Ab,
                      Yes, that study does, indeed, answer that question. Interesting. I have to agree with your last statement.

  15. The difference in cholesterol between the intermittent fasting group and the calorie restriction group into the study quoted by Dr Greger is easy to explain:

    In the intermittent fasting group, people are eating more calories per meal in non-fasting days resulting in the need of higher production of bile acids. Bile acids synthesis is limited by the presence of cholesterol, thus the intermittent fasting group need more cholesterol in order to keep with the need for bile acids for higher calories meals.

    In the calories restriction group, people need less bile acids per meal, thus less cholesterol is needed for bile acids synthesis.

    Bottom line, in the intermittent fasting group, more bile acids are produced because meals are higher in calories, resulting in higher cholesterol levels. As the bile acids need is higher, there is also necessarily more spillover of bile acids into the general circulation, and thus more risk of cardiovascular diseases, cancers and neurodegenerative diseases in the intermittent fasting group then in the caloric restriction group for the same kind of diet.

  16. What is the healthiest way of eating ?

    Little non fatty meals are more protective than bigger meals, because it decreases the bile acids spillover into the general circulation, and also less fat imply less absorption of cancer promoting antioxydants.

  17. Off topic, but I have two concerns. First, I recently heard a woman say she’s giving up (but at least replacing with other crucifers) broccoli because she read somewhere that it isn’t good for your good bacteria. Obviously, this is a horrible lie, but I’m extremely concerned that there yet ANOTHER evidenceless (it should probably be a word nowadays) attack on an extremely healthy plant food going around.

    Another huge concern of mine is this new vaping B12 bs…. Why do people think you can INHALE A VITAMIN? Assuming there’s even B12 in these cartridges, at BEST wouldn’t the B12 just get into the lungs? So what’s he deal with this new craze and what evidence is there for or against it, anyone know? This is especially concerning to me because I know people who are doing it. It’s maddening, it’s like how hard can it be to just take a proven EFFECTIVE approach of taking a B12 supplement the old fashioned way once a week or daily? Undoubtedly much cheaper as well.

      1. 1) Yes, broccoli, like all cruciferous vegetables, can alter your gut microbiome, depending on how healthy was your diet before starting eating broccoli, and it also varies according to each individual.

        See: “Human Gut Bacterial Communities Are Altered by Addition of Cruciferous Vegetables to a Controlled Fruit- and Vegetable-Free Diet (Li et al)”

        As broccoli is very rich in antioxydants, you do not want to eat it with fats, as absorbed antioxydants can be cancer promoting by preventing the apoptosis of cancer cells, and fats rise the production of bile acids and thus their spillover into the general circulation, as well as increases cholesterol in consequence.

        Also, better to steam them as it improves the bile acid binding properties of their fiber, so you will excrete more bile acids produced during your meal by doing so.

        See: “Steam cooking significantly improves in vitro bile acid binding of collard greens, kale, mustard greens, broccoli, green bell pepper, and cabbage. (Kahlon et al)”

        2) A vitamin is just another molecule: some of them are water soluble like vitamin B12, others are fat soluble like vitamin D or vitamin E.

        That’s why, in order to absorb THC (which is a fat-soluble molecule) through ingestion, people eating “space foods” need to have fats into their goods, like the traditional indian drink “Bhang”, which is prepared with milk, because the fat of milk is necessary to optimize absorbtion of THC.

        The same goes for many vitamins, like vitamin D: they need some fat to be absorbed when they are ingested. However, vitamin D is primarily biosynthetized by the photolization of cholesterol into the skin cells in the presence of sun.

        Fat soluble molecules like THC can enter into the system via the lungs when you vape them or smoke the plants that contain them. Thus, fat soluble molecules or vitamins can be both ingested (when associated with fat) or vaped.

        What about water soluble vitamins, like vitamin B12 ?

        They can be ingested and absorbed without fats. But can they be vaped ?

        Nicotine is also a water-soluble vitamin that can be vaped, so vitamin B12 might also be vaped, but you have to take care about what is there into the liquid that you vapote, because some ingredients of vaping products can apparently be very toxic, like vitamin E oil which is thought to be the cause of thousands of death by vaping:

        https://www.cdc.gov/mmwr/volumes/68/wr/mm6845e2.htm?s_cid=mm6845e2_w

        1. One meant: nicotine is a water-soluble molecule precursor of vitamin B3 (nicotinic acid or niacin). It is not itself considered as a vitamin, but interestingly vitamin B3 can also be synthetized by tryptophan, an essential amino acid (protein), and that’s why tryptophan is also used in smoking cessation therapy with high carbohydrate diets:

          Tryptophan and high-carbohydrate diets as adjuncts to smoking cessation therapy.
          https://www.ncbi.nlm.nih.gov/pubmed/1880796

        2. ab,

          I appreciate your take on vaping B12 and the vitamin E oil is a great example of why people shouldn’t just try these things when they haven’t been thoroughly tested. My concern for the new vaping as a means of getting B12, one of the most important nutrients, is that there’s no evidence (that I’m aware of) that indicates you can properly absorb B12 through inhalation and it should not be assumed that you can as it appears to be being and that there isn’t even any evidence (that I’m aware of) to show that it’s safe, and it should not be assumed that it is safe as it presently is being by those selling and those buying.

          But as for the antioxidants, I’m sorry, that is complete nonsense. You WANT to eat fat soluble antioxidants with a fat source so as to absorb them, because, in fact, antioxidants are proven to help protect and fight AGAINST cancer. A high antioxidant, high fiber diet is a chemopreventive diet. To eat broccoli without adding at least a couple of walnuts is missing out on all those great fat soluble nutrients like zeaxanthin, vitamin A, vitamin K, etc.

          Yes, I’m aware that all foods alter our microbiome and that plants alter it for the better, my concern is that this woman was lead to believe, based upon something she had recently read–meaning there is actually published crap going around on this–that broccoli HARMS your microbiome and thus should be cut out of the diet.

          1. S,

            If nicotine can be absorbed through vaping, there is great chance that vitamin B12 can also be absorbed by the general circulation through vaping, though, you are right, it has not been clinically assessed to my knowledge.

            Now, there is a large misconception about antioxydants that I would like to explain here. This misconception often appears in plant-based research, and leading many people to believe erroneously that the more antioxydants absorbed through their diet, the better it is for health.

            In fact, our body naturally and endogenously produces all the antioxydants it needs to defend itself against oxydative stress.

            See for example “Endogenous Antioxidants: A Review of their Role in Oxidative Stress (Aguilar et al)”

            Absorbed antioxydants through the diet may participate to oxydative homeostatis, but when one eats and absorbs too many antioxydants into the bloodstream, those antioxydants, which are often fat-soluble molecules, end up accumulating themselves into the body cells…

            Why is this accumulation of antioxydants not desirable ? Because of cancer cells. Problematic cancer cells are in fact loaded with antioxydants and are thus very difficult to get rid of by the immune system. The immune system creates oxydative stress through reactive oxygen species (ROS) in order to destroy cancer cells, but as they are loaded with anti-ROS molecules, they escape from apoptosis and can then continue to develop into the body.

            This is what explains James Watson (the co-describer of the double helix, with Francis Crick) in “Oxidants, antioxidants and the current incurability of metastatic cancers (Watson, 2013)”. In his paper, he explains why antioxydants supplements doesn’t work: “free-radical-destroying antioxidative nutritional supplements may have caused more cancers than they have prevented”.

            So, one doesn’t want our body to be loaded with exogenous antioxydants whether they come from foods or supplements, because thoses antioxydats will end up constituting the armor of cancer cells that will defeat the attempts of the immune system to destroy them.

            Antioxydants might be very useful for our microbiome and during digestion, but one doesn’t want them to be absorbed, and thus one doesn’t want to eat fats with whole plant foods…

            And even water-soluble vitamins, like vitamin C, reacts badly in the presence of fat into our digestive tracts, as they increase the production of cancer causing molecules…

            See “Fat transforms ascorbic acid from inhibiting to promoting acid‐catalysed N‐nitrosation (Combet et al)”

            As says James Watson: “All in all, the by now vast number of nutritional intervention trials using the antioxidants β-carotene, vitamin A, vitamin C, vitamin E and selenium have shown no obvious effectiveness in preventing gastrointestinal cancer nor in lengthening mortality [53]. In fact, they seem to slightly shorten the lives of those who take them. Future data may, in fact, show that antioxidant use, particularly that of vitamin E, leads to a small number of cancers that would not have come into existence but for antioxidant supplementation. Blueberries best be eaten because they taste good, not because their consumption will lead to less cancer.”

            So, one doesn’t want to eat fat with whole plant foods, and fats also increases bile acid production, which will end up in more leakage of bile acids into the bloodstream which may actually cause cancer… as well as cardiovascular and cerebrovascular diseases…

            1. Ab,

              I thought about nicotine and other chemicals, but I’m not sure how that constitutes as B12 having a great chance at efficiency through vaping. It’s unscientific to assume that you could supplement a body with an essential nutrient through vaping because certain other substances are able to enter the bloodstream through inhalation. It wouldn’t be unscientific to put the hypothesis to the test, on the other hand. In reality, unless it’s actually been studied, we have no idea what happens when you vape B12, we don’t know if it’s absorbed, if it causes damage, etc. So something that is unknown shouldn’t be commercially sold as a supplement, but as many of us know, we actually aren’t protected in this regard. The biggest danger to that, is most people have no idea how little we are protected, so they just assume something is tested and efficient and they just assume something is safe or even understood.

              And I assume it’s cyanocobalamin which of course contains cyanide and while perfectly harmless levels through normal supplementation, isn’t it reasonable to ask if there could be a consequence of regular inhalation of a substance containing any amount of cyanide?

              1. S,

                My biggest concern about B12 is about the high doses of supplementation that are promoted by doctors and sold by the supplement industry, like 1000 mcg a day, when the RDA is only actually 2,4 mcg a day.

                Vitamin B12 is alleged to have antioxydant properties.

                See: “Vitamin B12 in Relation to Oxidative Stress: A Systematic Review( van de Lagemaat et al, 2019)”

                B12 may not accumulate into the body cells as they are water-soluble, but daily intake of high doses may imply high antioxydants levels into the general circulation every day, and that may possibly interfer with and defeat the attempts of the immune system to get rid of unwanted cells, and limiting autophagy.

                That may be why high doses of vitamin B, like vitamin B12, are linked to an increase of cancer.

                As explains Thomas Campbell: “Recently, there has been some evidence that large dose B12 supplementation may be associated with an increase in cancer risk in some groups.[1] Because of these findings, and because I can’t find plain B12 supplements smaller than 500 mcg per pill, I’ve been recommending people take a multivitamin.* We only need about 2.4 mcg of B12 daily. So choose a multivitamin with a low level of B12 (perhaps 10-20mcg), and relatively low levels of everything else.”
                https://nutritionstudies.org/12-questions-answered-regarding-vitamin-b12/

                In Europe, only UK, to my knowledge, sells cyanocobalamin with relatively low doses of B12, like 25mcg, which is already way greater than the daily RDA…

                1. I agree high doses are unneeded and have found that 1000 mcg/d jacks my level above the normal range, contrary to the claim any excess is necessarily excreted.

                  I’ve taken to using a pill cutter to break up 500 mcg pills (the lowest dose I have found) into quarters and take them several times per week to keep my tested levels above 500. Below is good overview by Dr. Mirkin (who rarely recommends supplementation) on vitamin B12 needs and serious, possibly irreversible, consequences of deficiency. Note deficiency is more likely in older people. Also note the recommendation to keep your level above 400. The low end of the normal range of lab tests is quite possibly to low for optimum health.

                  1. The problem with blood levels is that they do not necessarily reflect the B12 store level of the body.

                    If your B12 store is full, you may have high levels of B12 circulating into the blood, and if your B12 blood level is low, though you may supplement it, it may not necessarily mean that your B12 store is empty, as B12 may act as antioxydant if it encounters ROS.

                    As in healthy subjects, there are ROS circulating under the form of nitric oxyde, and if B12 as an antioxydant can act as an antagonist of nitric oxyde, you may have low level of B12 because it reacts with nitric oxyde and gets oxydized as another ROS.

                    It is very difficult to assert things about blood levels in healthy subjects without actual B12 deficiency symptoms…

                    1. ” if B12 as an antioxydant can act as an antagonist of nitric oxyde ”
                      Does it?

                      In many of your posts you have, in my view, relied on too many unsupported speculations. It is very easy to produce hypotheticals. But it is really difficult to get anywhere in a rational conversation with someone who does that, because whatever the known facts are get lost in the spin.
                      As I recall you’ve appealed to two main articles to support your views on antioxidants in diet: the Watson article that I originally posted in the DHA discussion and the “double edged sword” one, which was very interesting. But as I mentioned earlier, since Watson was discussing antioxidants in the context of advanced cancer, it is a large leap to conclusions about antioxidants in whole plant foods. Besides the role of antioxidants in cancer theory is, as far as I have discovered, controversial (a large topic I am not that familiar with). The other one does not conclude that one eating a diversified WFP diet would wind up getting too many antioxidants, even with fat ingestion to increase absorption.

                      Epidemiological studies indicate eating lots of vegetables/fruits, legumes, grains, appropriate amounts of nuts/seeds, all replete with various phytochemicals, delivering quite a lot of direct antioxidants and indirect antioxidant enhancing effects, is healthful. Using some fat for better absorption has never, as far as I can discover, been implicated in increased cancer rates.

                    2. gengogakusha,

                      There is even a whole wikipedia article on “antoxidative stress”. I do not have invented everything.

                      https://en.wikipedia.org/wiki/Antioxidative_stress

                      Is vitamin B12 an antagonist of N2O ? It is quite possible and that may explain why at 1000 mcg supplementation, the absorption rate is nearly the same in healthy subjects and in subjects with so-called “B12 malabsorption”…

                      That means that the surplus in B12 in “malabsorption subjects” is used as antioxydant and counteract the ROS that may be causing the malabsorption. And that ROS may potentially be nitric oxyde at the level of the epithelial cells.

                      But now I am wondering about this theory of B12 malabsorption and where does it come from and how it has been established… Did they measure B12 in feces as well as in urine for determining that some people are malabsorbing B12 ? And how can they really know the status of the B12 store ? That sounds like a lot of suppositions to support that theory…

                    3. You have totally lost me. Here’s your original statement:

                      >>> if B12 as an antioxydant can act as an antagonist of nitric oxyde

                      Nitric oxide (NO) is a vasodilator and neurotransmitter; N2O (nitrous oxide, also known as “laughing gas”) is a sedative and atmospheric pollutant. Through biological pathways, NO can biotransform to various molecules, notably NO2(-), N03(-), NH3 and N2.

                      Not only did you switch from NO to N2O but you ***reversed the implication*** and started talking about interference OF B12.

                      Finally you made what seems to me to be an entirely fanciful claim that:

                      >>>>Nitric Oxyde (NO) can result in Nitrous Oxyde (N20) by ***chemical reactions IN the body***.

                      But the last unsupported claim is irrelevant since the initiating discussion was about the possibility of B12 interfering with NO.

                      This discussion is going nowhere fast

                    4. Nitric Oxyde (NO) can result in Nitrous Oxyde (N20) by chemical reactions into the body, and N20 can lower cobalamin serum levels.

                  2. What Dr Greger doesn’t tell you is that the vitamin B12 malabsorption in elderly is based on a scientific “fraud”:

                    “The investigators who patented the diagnostic application of metabolites to cobalamin deficiency took this one step
                    further. Observing cobalamin levels above 200 ng/L in 2.9% to 5.2% of patients with clinical signs of deficiency66 (in reality, an excellent 95%-97% sensitivity for the traditional 200-ng/L cutpoint), they raised the cutpoint to 350 ng/L.[10] This redefinition transformed a 5.3% rate of suspected deficiency in their elderly volunteers to an astounding 40.5%.[10] Only approximately 22% of the new suspects actually met MMA criteria for deficiency, less than 2% had macrocytosis, and none had evidence of PA.[10]”

                    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532799/

                    This was based on:
                    Lindenbaum J, Rosenberg IH, Wilson PWF, Stabler SP, Allen RH. Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr. 1994;60:2-11

            2. Ab,

              You are VASTLY misinformed about antioxidants. Dr. Greger is one of the most well researched people and M.D’s on the planet on the subject of nutritional science, the body of evidence on this website suggests otherwise.

              We absolutely do not produce enough antioxidants needed to combat oxidative stress, we didn’t even evolve to, we evolved getting tons of antioxidants through our diet. In fact, some scientists refer to aging as a disease, antioxidants through our diet actually slow down and can even reverse the aging process.

              You’re promoting ideas based off of no evidence and going against a surmounting body of evidence that says otherwise.
              The quote you’re going by was referring to SUPPLEMENTING with antioxidants, not eating them in the natural packages they come in with complex chemical structures. There is a massive difference between consumption of high antioxidant foods and taking a supplement attempting to isolate a single compound from these foods. That is why Dr. Greger advises people not to supplement antioxidants, he even has videos on it.

              You absolutely want and need antioxidants to be absorbed, if they’re not absorbed they will not do you any good. In fact, you’re really screwing yourself over if you eat this way, moreover you’re really screwing others over if you’re spreading this dangerous misinformation to those who may be vulnerable to believe it.
              We should only be eating whole plant foods, ideally, and yet you need vitamin A, you need vitamin E, you need vitamin K. Our retinas depend on zeaxanthin and lutein, without enough of that there will be macular degeneration and possibly cataracts, the brain also needs these things and more.

              We also need fat, it’s just a matter of what kind of fat and the source. Omega-3’s are essential for heart health and so much more and among other things, you can’t even grow hair properly without omega-6.

              You are reading studies about SUPPLEMENTS, ab, NOT antioxidnats from whole plant foods. I highly suggest browsing this website and reading “How Not To Die.”

              1. S,

                It seems to me that you have put science upside down about antioxydants, or that you have been influenced in such a way by doctors and researchers who have put antioxydant science upside down.

                What I’m saying is that a low fat plant-based diet, and it is already proven by epidemiologic studies on population and interventional studies, is more protective than a nutritatrian kind of diet (with added fats for better absorption of antioxydants). The diet of traditional population in some parts of the world with no oils, no fats, no nuts, no avocados, etc, and the diet from Esselstyn’s trials, or from McDougall’s recommendations are exemple of low fat diets that protect from modern illnesses.

                Actually, aging is not caused by a deficit in antioxydants but by an antioxydant intoxication due to fatty meals resulting in large absorption of plant antioxydants and also due to high intake of vitamin supplements. Aging is accelerated by the large absorption of antioxydants into the body. They create a so-called “antioxydative stress”.

                Why ? Because antioxydants have been shown to exerce a suppressive effect on the most critical process of the immune system, which is about getting rid of damaged cells into the body: they interfer with the processes of authophagy and apoptosis of damaged cells, as revealed for example by Watson’s work, his “most important work since the double helix” acccording to his own words.

                Actually, we mostly evolve onto low fat diets, and while antioxydants may be very benefitial for our digestive system, once they enter into the general circulation, they may become toxic for our body: they are a double-edged sword.

                Actually, what happens into the studies in petri dishes showing that some antioxydants or veggies extracts can destroy cancer cells is misunderstood by many researchers. It is not the antioxydants that destroy the cancer cells, it is more probably the photolized oxydants, or their transformation into free radicals that destroys the cancer cells. Antioxydants can become pro-oxydants through some chemical reactions, and thus they become pro-oxydant…

                Our body is the master of oxydative homeostasis, as it can generate both pro-oxydants and antioxydants by itself. So absorption of too many antioxydants through diet or supplementation can lead to numerous pathological diseases.

                Actually, plant antioxydants are the same than antioxydant supplements as they are fragmented and extracted from foods before entering into the general circulation. And plants also contain a myriad of other compounds that have antioxydants effects. So you may want to have them into your digestive system, but you do not want to have them absorbed into your bloodsteam as if they are fat soluble they can accumulate into your body cells… leading to super cells that may become very powerful cancer cells escaping the defense of the immune system.

                What is screwing people’s health are fatty plant-based diets and big meals, like people eating high calories meals, like one meal a day, as shown in this video where high calories meals are related with cholesterol (in fact high bile acids production). Ocular problems and most diseases, like cardio and cerebrovscular are not cause by vitamin deficiencies but by biles acids leakage into the bloodstream and the most essential fatty acids come from the digestion of fibers by our microbiome…

                It is not algae or plants that produce omega fatty acid, it is bacteria…
                https://academic.oup.com/femsle/article/151/1/95/535381

                1. >>>It is not algae or plants that produce omega fatty acid, it is bacteria…
                  https://academic.oup.com/femsle/article/151/1/95/535381

                  This is false. Certain strains of algae do produce DHA and EPA, and that’s what is used in producing algal DHA/EPA supplements. The paper you cite did not claim ONLY bacteria product those omega 3 fatty acids.

                  Antioxidants: No one is disagreeing that anti-oxidant supplements are to be avoided, and the reason seems to be that they upset Redox homeostasis. You are right that anti-oxidant stress is a real phenomenon.

                  But what you have NOT shown is that eating a diversified, reasonable WFP diet, along with some fat to aid absorption of fat soluble anti-oxidants like lycopene (which has been shown to help prevent prostate cancer) or lutein (accumulates in the retina and protects it), etc. is problematic.

                  Aging and chronic disease: You are dead wrong that aging and chronic disease can be simple-mindedly pinned on anti-oxidants. ROS/RNS are also implicated. I do not understand why you persist in trying to promote this biased and unsupported pet theory of yours when it contradicts every research article I have read on this topic.

                  Further, you tend to conflate studies on disease states with normal cases, e.g. in your claims about excess bile acids getting into general circulation and devouring brain matter causing dementia or causing CVD. Wrt CVD, Essestyn does not make that claim; the article by him you cited elsewhere only implicated excess bile acids in colon cancer, and wrt fat, only implicated animal (saturated) fat. He specifically mentioned plant fats do not have the same negative effect.

                  Note too that in normals, bile acids are tightly regulated by a negative feedback loop and 95% of it is captured. Yes, if someone has liver disease, then it is possible to have excess bile acids get into general circulation as shown in that rat study where the rats had biliary obstruction. But that is beside the point since you were making a ***general*** claim, and nothing supports that. Small amounts of bile acids appear not to be harmful; indeed there are receptors for them in various places including the CNS and brain, and the studies on this you did cite stated they could be therapeutic agents, not evil acids devouring as you said “the sane parts of the brain”.

                  So no matter which of your various pet claims about bile acids, dementia, fat, antioxidants that I have investigated, you seem to be either making it up whole cloth or exaggerating to such an extent that your views do not correspond to reality.

                  1. Here’s one article on the role of oxidtive stress in aging and chronic disease. There are hundreds, if not thousands, of them. These studies, the kind of studies that informs Dr. Greger’s recommendations (always cited in his work), contradict your unsupported claims.

                    Cf. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927356/
                    Oxidative stress, aging, and diseases
                    “Reactive oxygen and nitrogen species (RONS) are produced by several endogenous and exogenous processes, and their negative effects are neutralized by antioxidant defenses. Oxidative stress occurs from the imbalance between RONS production and these antioxidant defenses. Aging is a process characterized by the progressive loss of tissue and organ function. The oxidative stress theory of aging is based on the hypothesis that age-associated functional losses are due to the accumulation of RONS-induced damages. At the same time, oxidative stress is involved in several age-related conditions (ie, cardiovascular diseases [CVDs], chronic obstructive pulmonary disease, chronic kidney disease, neurodegenerative diseases, and cancer), including sarcopenia and frailty”.

                    Note that ironically, one of the more interesting articles you cited in support of your claim that we do not want to absorb antioidants,”Exogenous Antioxidants are Double-edged Swords”, says right in the abstract: “In addition, exogenous compounds with reducing capacity, such as vitamin C, vitamin E, carotenoids, and polyphenols are also ****essential*** for intact functioning of endogenous antioxidant defense system. Therefore, there is ***continuous demand for exogenous antioxidants*** to prevent oxidative stress.”

              2. Have you ever wondered why there are coprophage animals and insects ? If feces were only toxins and dangerous by-products, there would not be any life thriving on eating feces. But even rabbits eat their own poops. Though I do not recommend you to do so.

                It is that in natural environments, herbivores do not eat fatty meals, and thus they do not absorb many of the antioxydants and nutrients of the plants they eat. The feces, which are a by-product of the microbiome, then become a food source for many other animals, insects and bacteria.

                The polyphenols and antioxydants staying into the gut and released into the feces also protect the digestive tracts of herbivores, like they protect our own digestive tract by scavenging ROS into our digestive system.

                While herbivores have longer digestive tracts than carnivores, they are showed to generally excrete more fast antioxydants than slow antioxydants, while carnivores generally excrete more slow antioxydants than fast antioxydants.

                Total Antioxidant Capacity of Feces of Mammalian Herbivores and Carnivores
                http://www.znaturforsch.com/s69c/s69c0165.pdf

              3. Bottom line: wanting to absorb the antioxydants that we ingest is totally unnatural and counterproductive, as absorbed antioxydants 1) will not protect our digestive tracts from ROS and 2) will accumulate into body cells that may potentially become cancer cells escaping from the immune system defense.

                It might also be possible that some cancers themselves are caused by absorbed antioxydants that may promote DNA damage.

                1. ab,

                  you are full of 100% nonsense, I don’t even know why you are on this site since you don’t seem to be gathering the evidence presented on it. I didn’t continue to read your stories of science in a parallel universe such as Wonderland and I will no longer partake, please stop spreading lies and either educate yourself or start writing fiction if you really love carrying on with this to where you can’t stop, but post it as fiction because misinformation HARMS people. I am done with our conversation.

                  1. It is not me who is saying that B12 supplementation > 55mcg/day doubles the incidence of lung cancers in men smokers…

                    It is scientific studies, like this one: https://www.ncbi.nlm.nih.gov/pubmed/28829668

                    There is a growing body of evidence that antioxydants, when absorbed into the general circulation are actually promoting cancer…

                    Don’t forget that into the body, antioxydants are not exposed to visible light and they are not photolized like in petri dishes…

                    So the whole theory claiming that antioxydants and veggie extracts are figthing cancer cells may have no relevance into the human body… In fact, when absorbed, those antioxydants clearly increase the risk of cancer and all the studies are showing that…

                  2. S,

                    You are in denial because you believe into the benefits of antioxydants for health. And thus you think that you have to eat fats with your veggies for absorbing the more antioxydants into your body.

                    That is a recipe for disaster… like teh so called “balanced diet” proned by governments mixing animal products, oils, veggies and fruits in one big caloric meal…

                    In fact, you do not want to absorb antioxydants, you want them to stay into your guts and be excreted into your feces, so you do not want to add fats with your veggies or eat fatty foods. Fat will increase bile acids production and thus the spillover of bile acids into your general circulation, which will damage the endothelium as it has been shown in animal models:
                    Association of Coronary Artery Endothelial Injury with Elevation of Serum Bile Acids in the Rat
                    https://link.springer.com/chapter/10.1007/978-3-642-65954-6_27

                    That’s why Esselstyn’s trial which is a low fat plant based diet works well with coronary artery disease, as it diminishes the production of bile acids, and thus the spillover of bile acids into the general circulation.

                2. As just one example of your many and varied unsupported claims, >>>>” will not protect our digestive tracts from ROS ”

                  Not surprisingly, the opposite is supported by various studies (No doubt I could find more if I bothered)

                  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198716 Grape polyphenols reduce gut-localized reactive oxygen species associated with the development of metabolic syndrome in mice High-fat diet (HFD)-induced leaky gut syndrome combined with low-grade inflammation increase reactive oxygen species (ROS) in the intestine and may contribute to dysbiosis and metabolic syndrome (MetS). Poorly bioavailable and only partially metabolizable dietary polyphenols, such as proanthocyanidins (PACs), ****may exert their beneficial effects on metabolic health by SCAVENGING INTESTINAL ROS.****. To test this hypothesis, we developed and validated a novel, noninvasive, in situ method for visualizing intestinal ROS using orally administered ROS-sensitive indocyanine green (ICG) dye. C57BL/6J mice fed HFD for 10 weeks accumulated high levels of intestinal ROS compared to mice fed low-fat diet (LFD). Oral administration of poorly bioavailable grape polyphenol extract (GPE) and β-carotene decreased HFD-induced ROS in the gut to levels comparable to LFD-fed mice, while administration of more bioavailable dietary antioxidants (α-lipoic acid, vitamin C, vitamin E) did not. Forty percent of administered GPE antioxidant activity was measured in feces collected over 24 h, confirming poor bioavailability and persistence in the gut. The bloom of beneficial anaerobic gut bacteria, such as *Akkermansia muciniphila*, associated with improved metabolic status in rodents and humans may be directly linked to protective antioxidant activity of some dietary components. *****These findings suggest a possible mechanistic explanation for the beneficial effects of poorly bioavailable polyphenols on metabolic health. *****

                  1. You did not understand what I wrote. I said exactly the same thing as the article you just pointed out.

                    Non bioavailable compounds with antioxydant affects, those which are not readily absorbed, actually have a benefitial effect on our gut by scavenging ROS into our digestive tract.

                    But if those antioxydants are absorbed and thus made bioavailable because of their fat solubility, like many vitamins, then those compounds leave the digestive tract and gain access to the bloodstream and the general circulation.

                    Thus they are not anymore available as a protection into our digestive tract and they may become detrimental in the context of the general circulation…

                    1. Think for example to the THC molecule of cannabis.

                      If you eat some THC without fats, it will pass through your guts and potentially help your microbiome to be healthy, before being excreted into your feces, without any noticeable neurotoxic effect.

                      But if you eat that same THC with fats, then it will gain access to your blood stream and will end up intoxicating your brain…

                      https://hellomd.com/blogs/articles/why-you-need-to-eat-fat-with-your-cannabis

                      Thus, you do not want plant compounds with antioxydant effects to enter into your blood stream, as they may promote cancers by protecting fatty cancer cells that absorbed those antioxydants from apoptosis which uses ROS mechanisms.

                    2. Yes, I see I did miss understand you. Sorry about that. At least we agree on the value of antioxidants for intestinal health.

                      But that does not mean that absorbed antioxidants from whole foods are not healthful and that enhancing the absorption of some of them with fat as commonly recommended is to be avoided.

                    3. Adding to my last reply, if you ingest enough of them, then it would seem there would be plenty for both the intestinal tract and within the body.
                      That could be taken as a reason to get lots of them.

                      Where’s the evidence that is not so? You seem to be just assuming you cannot have it both ways.

                    4. Once again, you did not understand what I said. Exogenous antioxydants into the body through fat consumptions are creating an oxidative imbalance that are strongly suggested by data to be associated with increase cancer risk.

                      And fats into the diet is creating more bile acids spillover into the general circulation which is strongly associated with cardiovascular disease and cerebrovascular disease.

                      Antioxydants whether they come from supplements or whole plant foods are the same when absorbed into the blood. Nothing can differ them. So if supplements increase risk, the antioxydants of whole plant foods also increase risk.

                      There is absolutely no data showing that fatty plant-based diets are protective for health.

  18. I noticed in your comment an augmentation of 1 K between your first and second sentence. Do you imply that his compensation increased over time, and his compensation have become higher each time ?

      1. Another Jeff Nelson hit job.

        What exactly is the problem with Dr. Greger getting $184K from his organization?

        I am curious, just how much do you think he should pay himself for his many hours of work and providing tons of free information?

        His compensation is essentially in the middle of what GPs earn in the US, at least in urban areas. I think he deserves that level of compensation.

        The other complaint is that he is on the board of Dr. Fuhrman’s research organization, that Fuhrman makes some contribution to Dr. Greger’s organization and that Fuhrman sells a DHA supplement, resulting in a conflict of interest. Nelson, being careful, says he is not accusing Dr.
        Greger of dishonesty, it’s just that the optics look bad and he should at least mention this “conflict of interest”. (This placed in the middle of a video claiming Fuhrman is bullshitting.) Notice that Dr. Greger does not recommend Fuhrman’s multi or any of the other supplements Fuhrman sells for specific purposes (I am not happy with the growing list of supplements he sells either).

        So here we have Nelson focusing on an area of honest controversy among WFP doctors – DHA supplementation — and making a big deal out of this understandable disagreement. That does not strike me as much of a conflict of interest, if any. If Dr. Fuhrman dropped his DHA from his product list, I doubt he would notice the loss in income.

        I recall Klaper in a video praising Fuhrman for making a trustworthy, low dose multi that he was (maybe still is) taking. Quite possibly he would say the same thing about Fuhrman’s DHA supplement, if he (still) thought it was wise to take one.

        Seems like a tempest in a tea pot, exactly what I have come to expect from “Hatchet-job Jeff”.

  19. highsalaraydbag or whatever your name, I notice you didn’t post your sources and I definitely wouldn’t take numbers to heart by a post such as yours, but Dr. Greger flies all around all the time giving people free information. He writes and studies and produces things in an understandable and organized fashion so that we may all be knowledgable and up to date on nutritional science and the very answers to our health and longevity for free… In fact, he gives us an education you couldn’t pay for in college, for free. He dedicates his life to this, the guy has to live off of something and he has to afford to travel and do his work. Would you rather be sold b***s*** supplements as a means for him to sustain his incredible work?

    1. Heck, it’s great that he makes that kind of money but when I contributed to his program, I was under the impression that it would all go to the research on this site like he claims it does, even the book profits, so that is what erks me.

  20. Ok. First time posting anything here. I am T2D, since May of this year I’ve been doing LCHF and IF. I’ve lost over 50lbs – which is great. Except, I haven’t seen a big change in my BS numbers or A1C. I stopped all my diabetes meds except Farxiga…because of what I read in Dr. Fungs book. I know he’s not well received here, and I understand why. However, I do believe most meds for Diabetes only exacerbate the issue of IR. So, that’s why I stopped them (yes, I spoke with my Dr. first). I have literally just started a WFPB diet – I’m entering my second full day. My issue, or my questions are these

    1. My BS is higher than on the LCHF diet. From watching some videos here I now understand why. But, my question is how long does it take to normalize those numbers? A week? A month? Who knows? I was 152 this morning. Before bed last night I was 270. I haven’t been that high since March. And, it worries me. My BS really affects my attitude. And, I’ve had a short fuse the last few days. I really want to push through; but, feeling this way is draining. Both physically and emotionally.

    2. Should I get back on Metformin in the short run?

    3. I’ve had a

    More info about me. I was born with Transposition of the Great Arteries. I had open heart surgery as a baby. I’ve been on heart meds of varying flavors since I was 17. I’m now 42.

    I have my yearly heart appointment in the middle of December. I was hoping to have much better control over my Diabetes by that time. I’m tempted to go back to my LCHF/IF diet and start the PBWF diet in the new year. But, I’m not sure I can knowing what I know now. Ignorance is bliss sometimes.

    Also, I’m reading How Not to Die.

  21. Hello Mike and thank you for your question,

    I’m a family doctor and a volunteer for Dr. Greger on this website. A few caveats first:
    1) I’m not sure what “LCHF” means — low carbohydrate? Or low continual fasting?
    2) Without knowing your whole medical history, it’s difficult to give you good advice. For example, do you have other medical problems besides diabetes and transpostion of the great arteries? What exactly are your medications?
    3) I need to have a better idea of what you’re including in your “whole foods plant based diet”.

    But here is some general advice.
    1) Be sure to eat foods that are high in fiber and low in fat. Look up some of Dr. G’s videos on diabetes. Here is a great one about the problem with high-fat diets (especially saturated fat): https://nutritionfacts.org/video/what-causes-insulin-resistance/
    2) Try to eat foods with a relatively low glycemic index. Beans are especially good. Certain fruits (oranges, watermelon) and most fruit juices are not a good idea due to very high sugar content. Whole grains tend to be very good. Almost all leafy vegetables are good; starchy vegetables less good (but not too bad).
    3) Avoid most processed foods.

    If you’re already doing those things, then I suggest you see a nutritionist or doctor trained in plant based nutrition. Check out the website plantbaseddoctors.org.

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

    1. Hi Dr. Jon! Thank you for the reply.

      1. LCHF stands for Low Carb High Fat (“healthy” fats – that’s an oxymoron around here I’m learning ;)).

      2. Yes, I had a bad clot in my right leg back in 2007. I have had bad circulation in that leg since my surgery as a baby – long story. I’ve been on blood thinners (warfarin sodium is what I am currently taking) ever since 2007.

      Here is a complete list of my meds.

      Heart meds:

      Lisinopril 5mg half a tab once a day Metoprolol succinate ER 50mg once a day Dofetilide 500mcg 2 times a day Warfarin Sodium 10mg 1 tab once a day Warfarin Sodium 2.5mg 1 tab M/W/F/S/S Lovastatin 10mg 1 tab once per day Digoxin 250mcg 2 tab once per day

      Diabetes:

      Farxiga 10mg

      3. I’m not including anything that isn’t plant based. I’m experimenting now, trying to see what spikes my blood worse than other things. I’m planning on staying away from higher GI foods. But, I need to print off a list of both. I’m making black bean tostadas tonight – on corn tortillas.
      Probably with a salad with a homemade dressing (to avoid oils). I try not to snack throughout the day. I know fats are important to limit. Will have an avocado tonight for the tostadas.

      I eat berries mostly. But, I do love apples, grapes, pears, bananas, really any fruit. Veggies like broccoli, cauliflower, green beans, brussel sprouts, tomatoes, corn, carrots (in limited quantity). I also like snacking on pecans, cashews, pecans, most nuts. Unless it’s organic, I avoid peanuts or peanut butter. I’m going to start experimenting with Kale.
      I’ll use some spinach tonight if we do a salad.

      I know there’s a lot of options. I’m just learning this stuff. Reading and watching when I can. Thank you for the advice. And for the link to find a plant based doctor…not a lot of options where I live unfortunately.

      I avoid most processed food, since even that is a no no on what I was previously doing. I’ve dropped all diary from my diet. And, I’m surprised by how little I miss cheese.

      I will continue to read and watch videos.

  22. Hello again Mike, for a quick followup,

    A low carb high fat diet is not a good idea for anyone with diabetes. If you want to read a good book about this, here is a link on Amazon to Dr. Neal Barnard’s excellent book about diabetes, what causes it, and how to reverse it without medications:
    https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1635651271/ref=sr_1_3?crid=1AP20D46Q7T0E&keywords=neal+barnard+reversing+diabetes&qid=1574371217&s=books&sprefix=Neal+barnard%2Caps%2C136&sr=1-3

    Your diet sounds generally pretty good. Regarding fat, there are certainly healthier and less healthy choices. The approximate order from bad to better is: trans fats < saturated fats (even if they're from plants — e.g. palm oil, coconut oil, although animal sources generally are worse due to contamination with industrial pollutants) < refined oils < whole seeds and nuts.

    There are some essential fatty acids, and Dr. Greger has done a video about the importance of DHA and EPA (long chain poly-unsaturated omega-3 FAs) for brain health. Refined oils, even those thought of as "healthy" — e.g. extra virgin olive oil — can cause impaired arterial function. See this video by Dr. G:
    https://nutritionfacts.org/video/olive-oil-and-artery-function/

    Eating most types of fruit is fine; it's fruit juices that you should avoid, due to very high sugar content.

    Regarding whether or not you should continue your diabetes meds (Farxiga) or re-start your metformin, that is a question for your doctor. If your hemoglobin A1c is above 7.0, and your current random blood glucose levels are over 200, it's probably a good idea to be on some type of medication. But hopefully you'll be able to wean off of all diabetes meds as you figure out your diet.

    Dr.Jon

    1. I’ve been off all fats, except small amounts of nuts or nut butters, for almost 6 days.

      I’ll add that book to my list. However, right now I am frustrated and exhausted (mentally). My blood sugars are going the wrong way. I just sent my PCP a note to start my Metformin again. No one seems to be able to give me a answer as to how long this will take for my blood sugars to start normalizing. I can eat all the plants and beans and fruit I want, but if they’re not doing me any good (blood sugar wise) then what’s the damn point?

    2. Dr.Jon

      Firstly, I want to apologize for my last reply. Yes, I was/am frustrated.
      But, I shouldn’t have expected a dramatic change in less than a week.

      Secondly, I watched one of Dr. Barnards videos on YouTube and immediately ordered the book you linked, joined his website and downloaded the associated app. I’m going to start the 21 day meal diet on Sunday. I have a decent amount of the necessary ingredients; but, need an equal amount or more. Lol.

      Thirdly, thank you for replying. I do appreciate the help.

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