Is it Worth Getting Annual Health Check-Ups?

Is it Worth Getting Annual Health Check-Ups?
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What are the risks and benefits of getting an annual check-up from your doctor?

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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.

“Physicians and patients have come to expect” the annual check-up as a routine part of care. “However, considerable research has not demonstrated [it has any] substantial benefit[s].” And so, “[a] revolt is brewing against the tradition of periodic” check-ups. “Even the Society for General Internal Medicine [has] advised primary care physicians to avoid [such] “routine general health checks for asymptomatic adults.’”

Check-ups seem to make sense, but “historically, medical practice has included [all sorts of things that seemed to make sense], such as hormone replacement therapy” for menopause—until it was put to the test, and found to increase the risk of breast cancer, blood clots, heart disease, and stroke. Or, like when doctors killed babies by making the so-called “common sense” recommendation that infants sleep on their tummies, whereas we all know now “Face Up to Wake Up.” 

“We should always demand evidence.”

“We check our cars regularly, [though], so, why shouldn’t we also check our bodies…”? Well, unlike cars, our bodies have “self healing properties.” To see if the benefits outweigh the harms, researchers decided to put it to the test.

So: “What are the benefits and harms of general health checks for adult populations?” The bottom line is that check-ups “were not associated with lower rates of…mortality,” meaning not associated with living longer, or a lower risk of dying from heart disease, stroke, or cancer. So, general check-ups may not reduce disease rates or death rates, but they “do increase the number of new diagnoses.” And, the “[h]armful effects of [the] tests and subsequent treatment[s] could have balanced out [any benefits].”

“Possible harms from [check-ups include] overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, possible continuation of adverse health behaviours due to negative test results, adverse psychosocial effects due to labelling, and difficulties with getting insurance” now that you have a pre-existing condition—not to mention all the associated costs.

For example, diabetes. Wouldn’t it be great if we picked up a case of diabetes earlier? Perhaps not, if they were given the #1 diabetes drug at the time, Avandia—which was pulled off the market because, instead of helping people, it appeared to be killing people. “Adverse drug events are now [one of our] leading causes of death.” When it comes to lifestyle diseases, like type 2 diabetes, maybe we should instead focus on creating healthier food environments—like my new favorite organization, Balanced—to help prevent the diabetes epidemic in the first place.

How many times have you tried to inform someone about healthy eating, about evidence-based nutrition, only to have them say, “No, I don’t have to worry. My doctor says I’m okay. I just had a check-up; everything’s normal.” As if having a normal cholesterol is okay in a society where it’s normal to drop dead of a heart attack—the #1 killer of men and women. I mean, if you went to see a lifestyle medicine doctor who spent the check-up giving you the tools to prevent 80% of chronic disease, that’s one thing. But given the way medicine is currently practiced, it’s no wonder, perhaps, why “[t]he history of routine check[-up]s has been one of glorious failure, but generations of well meaning clinicians [just don’t want] to believe it….Policy should be based on evidence,” though.

“Poor diet” is on par with cigarette smoking as the most common actual cause of death; yet, the medical profession is “inadequately” trained in nutrition. Worse, nutrition education [in medical school] appears to be in decline,” if you can believe it. A “shrinking” of nutrition education among health professionals. So, the advice you get in your annual check-up may just be from whatever last tabloid your doctor skimmed in the check-out line.

“[S]creening [opportunities] should not be regarded as a form of ‘health education,'” one medical journal editorial read. “People who are obese know very well that they are, and if we have no means of helping them…, then we should [just] shut up.” Well, if you really have nothing to say that will help them, maybe you should shut up—especially doctors who say they “have no idea what constitutes a ‘healthy’ diet,” though veggies and nuts are a good start.

Please consider volunteering to help out on the site.

Icons created by Edwin Prayogi, Kate Maldjian, Artem Kovyazin, and Mello from The Noun Project.

Image credit: geralt. 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.

“Physicians and patients have come to expect” the annual check-up as a routine part of care. “However, considerable research has not demonstrated [it has any] substantial benefit[s].” And so, “[a] revolt is brewing against the tradition of periodic” check-ups. “Even the Society for General Internal Medicine [has] advised primary care physicians to avoid [such] “routine general health checks for asymptomatic adults.’”

Check-ups seem to make sense, but “historically, medical practice has included [all sorts of things that seemed to make sense], such as hormone replacement therapy” for menopause—until it was put to the test, and found to increase the risk of breast cancer, blood clots, heart disease, and stroke. Or, like when doctors killed babies by making the so-called “common sense” recommendation that infants sleep on their tummies, whereas we all know now “Face Up to Wake Up.” 

“We should always demand evidence.”

“We check our cars regularly, [though], so, why shouldn’t we also check our bodies…”? Well, unlike cars, our bodies have “self healing properties.” To see if the benefits outweigh the harms, researchers decided to put it to the test.

So: “What are the benefits and harms of general health checks for adult populations?” The bottom line is that check-ups “were not associated with lower rates of…mortality,” meaning not associated with living longer, or a lower risk of dying from heart disease, stroke, or cancer. So, general check-ups may not reduce disease rates or death rates, but they “do increase the number of new diagnoses.” And, the “[h]armful effects of [the] tests and subsequent treatment[s] could have balanced out [any benefits].”

“Possible harms from [check-ups include] overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, possible continuation of adverse health behaviours due to negative test results, adverse psychosocial effects due to labelling, and difficulties with getting insurance” now that you have a pre-existing condition—not to mention all the associated costs.

For example, diabetes. Wouldn’t it be great if we picked up a case of diabetes earlier? Perhaps not, if they were given the #1 diabetes drug at the time, Avandia—which was pulled off the market because, instead of helping people, it appeared to be killing people. “Adverse drug events are now [one of our] leading causes of death.” When it comes to lifestyle diseases, like type 2 diabetes, maybe we should instead focus on creating healthier food environments—like my new favorite organization, Balanced—to help prevent the diabetes epidemic in the first place.

How many times have you tried to inform someone about healthy eating, about evidence-based nutrition, only to have them say, “No, I don’t have to worry. My doctor says I’m okay. I just had a check-up; everything’s normal.” As if having a normal cholesterol is okay in a society where it’s normal to drop dead of a heart attack—the #1 killer of men and women. I mean, if you went to see a lifestyle medicine doctor who spent the check-up giving you the tools to prevent 80% of chronic disease, that’s one thing. But given the way medicine is currently practiced, it’s no wonder, perhaps, why “[t]he history of routine check[-up]s has been one of glorious failure, but generations of well meaning clinicians [just don’t want] to believe it….Policy should be based on evidence,” though.

“Poor diet” is on par with cigarette smoking as the most common actual cause of death; yet, the medical profession is “inadequately” trained in nutrition. Worse, nutrition education [in medical school] appears to be in decline,” if you can believe it. A “shrinking” of nutrition education among health professionals. So, the advice you get in your annual check-up may just be from whatever last tabloid your doctor skimmed in the check-out line.

“[S]creening [opportunities] should not be regarded as a form of ‘health education,'” one medical journal editorial read. “People who are obese know very well that they are, and if we have no means of helping them…, then we should [just] shut up.” Well, if you really have nothing to say that will help them, maybe you should shut up—especially doctors who say they “have no idea what constitutes a ‘healthy’ diet,” though veggies and nuts are a good start.

Please consider volunteering to help out on the site.

Icons created by Edwin Prayogi, Kate Maldjian, Artem Kovyazin, and Mello from The Noun Project.

Image credit: geralt. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

But won’t a check-up allow your physician to do a comprehensive physical exam and routine blood testing? The pros and cons of those are discussed in my next video: Is it Worth Getting an Annual Physical Exam?

Did I say lifestyle medicine? Yes! Check out this exciting growing field in my videos, like Lifestyle Medicine: Treating the Causes of Disease and Convincing Doctors to Embrace Lifestyle Medicine.

Still don’t understand how there can be risks? See Why Prevention is Worth a Ton of Cure. Unfortunately, physicians and patients alike wildly overestimate the benefits of pills and procedures. See, for example, The Actual Benefit of Diet vs. Drugs.

The fact is Physicians May Be Missing Their Most Important Tool.

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

137 responses to “Is it Worth Getting Annual Health Check-Ups?

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  1. While wanting to create a healthier food environment is all well and good, we know how hard it is to break bad habits. If I were asymptomatic and didn’t get checkup, how would I know my BP, cholesterol, or blood sugar levels? Even if I were eating optimally, what if I had a genetic variant that caused something bad in me, wouldn’t it be picked up or at least triggered in a checkup?




    11
    1. I get what you’re saying and we all want to be able to peek under the hood, don’t we? But here’s my question. If you found that your cholesterol was high, or your fasting blood sugar, or your blood pressure, what would your first choice of action be? Would those “hard to break” habits become easier to address? Why not eat optimally now? Most communities offer easy, even free, access to cholesterol and blood sugar testing, and every drug store has a blood pressure check station. But why not do everything you would do to be optimally well and healthy from the get-go? The odds that you have some undetected genetic anomaly as an adult are exceedingly slim; that likelihood certainly won’t increase from one year to the next, so an annual checkup doesn’t factor in at all. In a risk-benefit analysis, the risks of participating in the current medical model far outweigh the benefits outside of trauma or acute, emergent illness. If I break a bone or develop a serious infection, that’s something we deal with pretty well. A yearly exam to look for trouble tends to benefit pharmaceutical companies and compromise patients.




      15
      1. Because I went in for a yearly physical check up my doctor was able to hear a bruit or a swishing noise with her stethoscope while placed over my carotid artery. This led me to doing a sonogram of the carotids and it showed that I had blockage. If it were not for the detection of this carotid artery disease by my doctor during a yearly check up I would have never known and might have died. Because I was given this diagnosis I was able to do research on the internet and discovered Dr. Esselstyn, Dr. Greger, Dr. McDougal, and many others which led me to the intervention of adopting a whole food plant diet. Thank God for a yearly medical check up.




        9
    2. WjM, I think the point is that if you *were* experiencing a problem, then you *would* go see a doctor. The question is whether, if you are *not* experiencing a problem, the benefit of a periodic battery of standard tests exceeds the potential risks.

      But I have to admit that I’m not entirely convinced by this video either. It seems possible that if a person *is* taking responsibility for his/her own health — eating well, getting exercise, etc. — then some of the downsides are absent. I think too that there is a spectrum of willingness to be treated among patients which runs from total aversion all the way to a strong desire to be treated, and that the extremes make doctor visits problematic.

      I suspect that if you were to consider only people who take care of themselves and have realistic expectations of and misgivings about modern medicine, then periodic standard testing would not appear to be quite so problematic.




      1
      1. I agree. And if we are good at following our intuition, we’ll know when we are “nudged” to get a checkup. Our cells, which are very much alive and eager to please, should be thanked for doing a good job at keeping us healthy. :-)




        3
  2. Except in an emergency, I avoid doctors. They feel they always have to find SOMEthing wrong. In Dr. Pam Popper’s most recent book, I think she said she hadn’t had a checkup in 19 years.




    12
    1. And when they do find something “wrong,” they often prescribe an ineffective and even harmful drug to “fix” it.

      Link to a Nature news article (I’d rate Nature as the most preeminent and most reliable scientific journals in the world.) that has that rather astounding chart on the amazing ineffectiveness of the top ten highest grossing pharmaceutical drugs:

      http://www.nature.com/news/personalized-medicine-time-for-one-person-trials-1.17411

      I made a print optimized version of the rather astounding NNT (Number Needed to Treat for one person to get a beneficial effect) Chart as a jpeg file, so that I can easily share this information with others.

      In the case of many of these drugs, they have proven records of shortening life while at the same time doing a very poor job of suppressing symptoms, and no evidence at all of them actually curing a disease, something quite different than suppressing symptoms.

      The chart does seem a bit of an eye-opener. I wish every patient received a copy of this, as well as of the NNT’s and NNH’s of the drugs a doctor prescribes for them so they could make better informed decisions about whether to take them or not. (And if doctor’s had NNT’s and NNH’s, easily to hand, ethical doctors could make more informed choices about whether to prescribe them or not . . . ) And as far as ruining the placebo effect goes, even placebos work poorly or not at all for drugs that seem intrinsically harmful.

      And as far as informed consent goes, it seems fair that doctors who actually care about the well-being of their patients in fact should to tell their patients of the likelihood of a particular drug helping them, by giving them the NNT, while also giving them information on the likelihood of a drug harming them, the NNH – and in what ways – so they can make an informed choice. For an older woman who seems a potential candidate for statins, letting them know research indicates it has a 1/50 chance of it helping her, and a 1/3 chance of it giving her diabetes (http://www.medscape.com/viewarticle/877626?src=wnl_mdplsnews_170324_mscpedit_wir&uac=66042FN&impID=1315045&faf=1 ), as well as significant odds of causing cognitive impairment, memory loss, and cataracts.

      What a world.




      8
      1. I think you have posted this argument before. It is not unreasonable but, on the other hand, it is not an issue that has escaped the medical profession either.

        On lipid modification and statins for example, in the UK, the National Institute for Health and Care Excellence (NICE) clinical guidelines require doctors to advise patients on absolute risk (NNT), adverse effects etc. The guidelines include a whole chapter on communication of risk just as they have a whole chapter on a cardioprotective diet and another chapter on lifestyle modifications. Similarly, NICE has a separate guideline on patient communication in general in cluding discussion or risk. Similarly, guidelines re statin use also consider the side effects of statin use and make recommendations about whether statin use is of net bebenfit or not. The study of older women. statin use and T2D is interesting but did not discuss rates of cardiovascular events in older women who took statins versus women who did not take statins. We do not know if those women taking statins had fewer adverse events than women not taking statins. Without that information, how can one judge whether the invcrteased risk of T”D was ana cceptable risk or not.

        Personally, I am very sceptical of anti-statin arguments. They usually ignore certain crucial facts. I would encourage people to read the relevant US, UK and European guidelines (anbd Cochrane reviews) before making a decision and not just rely on the glib arguments of anti statin crusaders. I am very grateful to statins. They were prescribed for me 20 years ago but gave me liver damage so I had to discontinue them. It was that event which led me to researching and adopting a WFPB diet. That is by far the best solution. But for people who will not do this, statins may be suitable and helpful.




        0
        1. Useful NNT/NNH website: http://www.thennt.com/home-nnt/

          “Quick summaries of evidence-based medicine. We are a group of physicians that have developed a framework and rating system to evaluate therapies based on their patient-important benefits and harms as well as a system to evaluate diagnostics by patient sign, symptom, lab test or study.
          We only use the highest quality, evidence-based studies (frequently, but not always Cochrane Reviews), and we accept no outside funding or advertisements.”

          Two links to NNTs for statins, for those with no known heart disease, and those with known heart disease:

          http://www.thennt.com/nnt/statins-for-heart-disease-prevention-with-known-heart-disease/

          http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease-2/




          2
          1. Thanks. I have seen this website before. However, I have reservations about it. Itt seems to omit certain relevant data and present some figures for adverse side effects which are apparently not actual figures but estimates by the website owners.

            For example, when the NNT site looks at adverse events prevented it considers only mortality, heart attacks and strokes. These are very important but the Cochrane reviews and eg UK NICE assessment also took into account the number of revascularisation and angioplasty surgeries prevented. Obviously, this will result in quite different totals for the number of people benefitting from statins.

            As I noted above, the number of new diabetes cases seems to be an estimate by the author rather than an actual figure. There may also be some doubt about the muscle damage figures presented on this site. The site does not mention, for example, studies that show that people unaware that they are taking statins do not report increased muscle pain “A contested issue is the rate of muscle pain and weakness, with observational studies in general practice finding that up to a fifth of patients report symptoms, with little to no increase identified in randomised trials.” and “When patients were unaware they were taking statins there was no reported increase in muscle-related symptoms. But, when patients knew they were taking a statin, they were more likely to report symptoms, a finding consistent with the nocebo effect.” The lead author commented “We know that statins can prevent a significant number of heart attacks and strokes. We know there is a small increase in the risk of diabetes, and at high doses there is a very small increase in myopathy, but overall the benefits greatly outweigh the harms. Widespread claims of high rates of statin intolerance still prevent too many people from taking an affordable, safe and potentially life-saving medication.”
            https://www.sciencedaily.com/releases/2017/05/170502204933.htm

            The third and most glaring omission from this site also concerns side effects. It happily and uncritically discusses adverse side effects. real or not, but makes no mention of beneficial side effects. For example, in your post you quoted the Nature.com article. The first and possibly most important reference from that article notes benefits of statins for dementia risk reduction “Thus, normal individuals with the apo ϵ4 allele should be aggressively treated with statins not only to prevent cardiovascular events but also to reduce risk of dementia.”
            http://www.onlinepcd.com/article/S0033-0620(02)70021-2/fulltext

            Statins have also been associated with reduced risk of prostate cancer, ms, Parkinsons and inflammatory disease. These supposed beneficial side effects are briefly discussed here
            http://www.todaysdietitian.com/newarchives/060111p32.shtml

            In short, I do not see the NNT site as a reliable source of information. It omits key information and appears – well – biased. I do not want to appear as a defender of statins – they gave me extremely unpleasant liver damage (imagine being seasick 24 hours a day for months on end, and you will have some idea) – but let’s assess the information (all the information) honestly. I will continue to rely on clinical guidelines and Cochrane reviews for credible information on statins until new and better information comes along. Unreliable websites purporting to provide unbiased information about statins by individuals who are in fact dedicated anti-statin crusaders may prevent many people taking these drugs who could obtain significant benefit from them.




            1
            1. Everyone has the right to make their own judgments, based on the information they have available to them, and the degree of trust that they have with respect to the sources that provide the information, and the degree to which they have the ability to accurately separate “the wheat from the chaff.”

              As far as the NNT group goes, they describe themselves as “a group of physicians that have developed a framework and rating system to evaluate therapies based on their patient-important benefits and harms as well as a system to evaluate diagnostics by patient sign, symptom, lab test or study.” who use “only use the highest quality, evidence-based studies (frequently, but not always Cochrane Reviews), and we accept no outside funding or advertisements. with an advisory board consisting of objective individuals who have no financial ties to corporate interests.” Even if one assumes that this seems true, and I have no reason to doubt it, I still find it probable that they significantly overestimate the effectiveness of the drugs that they rate.

              Why? Because the objectivity of the scientific literature itself has become heavily compromised, and not just through the inclusion of corporate funded studies designed to produce a specific result, but through a variety of different mechanisms.

              Dr. John Ioannidis, a professor at Stanford University, summed up the situation as follows: “There is increasing concern that in modern research, false findings may be the majority or even the vast majority of published research claims. However, this should not be surprising. It can be proven that most claimed research findings are false.” (Ioannidis, J.P.A., (2005) “Why Most Published Research Findings Are False,” PLoS Medicine, 2(8), pp 0696 – 0701, August. http://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0020124&type=printable )

              For a detailed description of how published scientific research has become compromised, read the article.

              Dr. Richard Horton, the current editor-in-chief of The Lancet, perhaps the most respected peer-reviewed medical journal in the world, agreed. He wrote: “The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.” (Horton, R. (2015) “Offline: What is medicines’ 5 sigma?”, The Lancet 385 (9976) p 1380, April 11 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60696-1/fulltext?rss%25253Dyes ) “

              Even if one assumes that the NNT group has done the best they can with respect to sorting out the evidence as to what degree different drugs have beneficial as well as harmful effects, they work with a stacked deck. Published studies, designed to show a particular result, from corporate interests that have money to burn dominate the literature, while independent researchers go begging for money, and should they happen to scrape up enough money to at least fund a small study, find their work discounted or ignored specifically because they did small studies, and because the majority of well funded studies – funded or influenced by corporate interests – present contradictory results. And many mainstream scientists – not funded by corporate interests – fall for it, which not only results in publication bias, but in a further lack of funding for studies that go against what a majority of scientists may believe, with respect to the effectiveness of pharmaceutical drugs.

              With respect to published medical research, especially medical research in which corporate interests have a strong interest with respect to which kind of information comes to light, caveat emptor has unfortunately become an indispensable principle.

              In the early days of computing, the phrase “”garbage in garbage out” (GIGO) became deservedly popular. Feed false information into a computer, no matter how advanced, and false conclusions will come out. Garbage in, garbage out applies not just to computers, but to humans. Intentional frauds routinely perpetrated by the pharmaceutical industry, from which the FDA has failed to protect us ( see for example http://www.nejm.org/doi/full/10.1056/NEJMsa065779#t=article ), added to numerous other problems in scientific research has undoubtedly and unfortunately filled the heads of today’s medical professionals with a great deal of garbage.

              We unfortunately now live in a post-truth world. Invalid but compelling misinformation has become increasingly abundant, and trustworthy information has become ever harder to find. Developing effective ways of enhancing our ability to discriminate between the two, through tuning into our own inner guidance, becomes increasingly important. As Dr. Greger has pointed out, research into the effects of diet and lifestyle have made it clear that our bodies have an incredible ability to heal, so long as we give them what they need to heal, and so long as we stop doing what makes them sick. Of course, in practice this can prove rather tricky, as many people don’t have a clue to what their bodies need to heal, and have become sadly out of touch with respect to what they’ve done that made them sick.




              3
              1. Yes but you have ignored the fact that, however they choose to describe themselves, theNNH.com owners have omiitted relevant information from their analysis. As a consequence of which, their analysis significantly underestimates the benefits of statins and oversestimates the reported harms of statins. Further, for reasons which aren’t entirely clear to me, you still choose to think that their analysis in fact overestimates the benefits of statin use. You also talk about the unreliability of published research yet you do not choose to apply this argument to the non peer reviewed research which is what theNNH.com website is. You also appear to think that theNNH.com data and arguments are somehow more valid or more credible than the data and analyses set out in Cochrane Review and major national and international reviews of lipid modification and statin use. Your reasons for choosing to believe this are also not clear to me.

                But yes, where research takes place with very small numbers of individuals and there is active drug company involvement in the funding or conduct of trials then we should indeed be very wary. As for your (unsubstantiated) argument that the benefits of statins are overestimated (by virtually everybody except you?), we have to bear in mind the opposite argument that “it is important to be aware of “confounding by indication” in making comparisons between patients prescribed and not prescribed specific treatments.12 This phenomenon arises because the risk of bad outcomes is intrinsically higher in patients selected for treatment and because most treatments reduce, but do not remove, risk. Thus, comparisons of treated patients with not treated patients may spuriously imply that drug treatments are actually harmful”
                http://www.bmj.com/content/330/7495/821.long

                In other words, the benefits are likely to be undereatimated contrary to your assertion. That particular quoteabove is from a study of 4,892 patients discharged from hospital following a heart attack. So it is a large number of study subjects and the study was funded by the UK National health service. There was no drug compoany involvement. Approximately half (2,463) were prescribed statins on discharge and half (2429),were not. Over an average of 3.7 years follow-up “319 deaths occurred in the statin treated group (age adjusted rate 4.1 per 100 person years, 95% confidence interval 3.2 to 4.9), and 1200 in the statin untreated group (12.7 per 100 person years, 11.1 to 14.3).” That is a mortality rate of 13% in the statin treated group versus 49.4% mortality in the group not treated with statins. That seems to me like a fairly robust demonstration of the net benefits of statin use in appropriate target group, and helps explain why the great majority of the scientific and medical communities continue to endorse use of statins for appropraite target groups.

                It is also one of the reasons why I continue to urge people to look to high quality, credibel sources of information about the benefits and harms of statin use instead of relying solely on partsan websites of little or uncertain credibility operated by people with a clear anti-statin agenda, or on the unsupported claims of opinionated bloggers and YouTube video makers where quality control, peer review and scientific credibility are just not recognised concerns.

                As well as the sources referred to in my previous posts, there are other evidence based guidlines that can be reviewed and broader commentaries on these issues by internationally respected experts eg
                http://www.acc.org/latest-in-cardiology/articles/2016/11/17/09/03/summarizing-the-current-state-and-evidence-on-efficacy-and-safety-of-statin-therapy
                http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31357-5.pdf
                https://www.health.harvard.edu/blog/studies-support-broader-use-of-cholesterol-lowering-statins-201507168142

                To quote from that first reference
                ‘ ” the concept that statin intolerance is a common problem and might outweigh statin-associated benefits has been introduced in the medical literature and emphasized by the public media.6-8

                This has profound public health implications with studies in the United Kingdom, Denmark, and Australia linking adverse media coverage with significantly increased reluctance among physicians to discuss and prescribe statins, and reduced patient adherence to statins. In the UK, an estimated 10% increase in the statin discontinuation rate among patients with or at risk for ASCVD is estimated over the next decade, resulting in an excess of 2,000-6,000 cardiovascular events that could be prevented with statin use.9″

                My concern therefore is that circulating false claims about statin benefits and side effects, and advising people to accept misleading statements made by websites of doubtful credibility, could lead to an increased rate of adverse cardiovascular events. We should instead recommend that people should examine the evidence statements set out in the clinical guidelines and scientific reviews, and not solely rely on the often incorrect claims made by “alternative health” advocates.




                2
                1. As far as other – presumably reliable sources of information – who have expressed doubt about the effectiveness of statins goes, I don’t think you can do much better than Nature, that I’d rate as the most preeminent and most reliable scientific journals in the world, who wrote:

                  “Every day, millions of people are taking medications that will not help them. The top ten highest-grossing drugs in the United States help between 1 in 25 and 1 in 4 of the people who take them (see ‘Imprecision medicine’). For some drugs, such as statins — routinely used to lower cholesterol — as few as 1 in 50 may benefit (1). ”

                  http://www.nature.com/news/personalized-medicine-time-for-one-person-trials-1.17411

                  Link to ref. 1. http://www.onlinepcd.com/article/S0033-0620(02)70021-2/fulltext

                  See also this 2014 article from Medscape, not exactly a hotbed of uniformed alternative health information, on “Growing Doubt on Statin Drugs: The Problem of Drug-Lifestyle Interaction” :

                  https://www.medscape.com/viewarticle/827675

                  or this paper: http://www.clinmed.rcpjournal.org/content/2/6/527.full.pdf+html

                  ““Even high risk patients have less than 5% chance of benefiting from a cardioprotective drug taken for 5 years; 95% of patients will take the drug for 5 years without benefit, but suffering all of the side effects.

                  These statistics are seldom shared with patients

                  In this study we found the median value for the lower limit of benefit below which subjects would not wish to embark on a preventive drug strategy was 20% over 5 years. This included patients just discharged from the Coronary Care Unit

                  The study suggests that informing patients of the percentage chance of benefit from preventive drug strategies will substantially reduce the uptake of such drugs. For the individual, this is unlikely to be detrimental. For the population at large, reduced uptake of the drug will lead to an increased prevalence of the target event.”

                  As far as statins go, I just see them as just another typical example of over-hyped oversold pharmaceutical drugs that work very poorly, and that have harmful side effects, on pretty much everybody aside from the stockholders of the companies who make them. (http://www.forbes.com/sites/toddhixon/2011/12/07/the-high-stakes-games-around-generic-lipitor/ 130 Billion by 2011 for Pfizer’s Lipitor alone, sold at an astounding 99.7% profit margin)

                  You wrote: “My concern therefore is that circulating false claims about statin benefits and side effects, and advising people to accept misleading statements made by websites of doubtful credibility, could lead to an increased rate of adverse cardiovascular events. ”

                  I agree. As far as effectively decreasing the rate of cardiovascular events goes, if doctors really wanted to decrease the rate of adverse cardiovascular events, they’d do their very best to promote dietary changes, not ineffective drugs.

                  When someone comes up with a drug that works even a tenth as well as the low fat plant based diet Esseltyn used to reverse CAD (Coronary Artery Disease) I’ll feel happy to recommend it. A recurrent CAD event rate of < 1% for the patients who could stick to the diet diet – and of 62% adverse events for those who could not who only took drugs instead. http://dresselstyn.com/JFP_06307_Article1.pdf




                  1
  3. WMJ:”how would I know my BP, cholesterol, or blood sugar levels?”

    Invest in a good BP machine. I have an Omrion which is spot on with reading my Doc uses with the BP cuff and was under $50. My dental clinic uses them also. You can purchase a blood glucose device for little money. If you have a friend or co worker who has diabetes offer to split the cost of strips for a month or so. If you give blood they do your cholesterol for free!! A home made colonoscopy would be a bit more difficult ;^)
    My GP keeps speeding up the “annual” checkups to 9 months.. I guess he as to make a boat payment. More frequent Physicals are low hanging fruit if you need cash flow.. I know, cynical me…
    mitch




    13
    1. In lieu of the colonoscopy, there’s a “poop test” you can do annually. Minimal ick factor for 5 minutes in your own bathroom and off it goes. Insurance covers it. None of the risks of the colonoscopy.

      It’s apparently widely used in Europe. My docs have signed off without any concern.




      5
      1. CG, I also prefer to do the fecal test in the privacy of my own bathroom.

        My doctor wanted me to do a bone density test until I told him that I had recently slipped on ice in my driveway & fell full weight on one of my wrists. An exam, which included an x-ray, revealed a sprain but no break. When I told him that was good enough for me, he laughed & referred to it as the poor man’s bone density test.




        4
      2. My UK GP refused to do one when considering a colonoscopy for repeat anaemia, as they said there was a high risk of a false negative with it…. In fact they said that even if they did one the hospital would refuse to test it….

        However once i hit 50 I will be expected to do one as part of yearly screening (50 is like 2 years off)…. its almost funny how daft it is.




        0
    2. Donating blood is like a regular check up…you can call and obtain your Total Cholesterol a few days after donating…AND they won’t let you donate if your iron count is too low…and they always take your blood pressure before donating too. Just a thought…I haven’t had a routine physical in a few years either due to feeling great and donating blood just about every 2 or 3 months!




      1
    3. Get your checkups. While you can monitor BP from home, those home glucose meters and lipid tests are not reliable, at least not when I tested them a few years ago. Yes, diabetics use them, but mostly as a reference. I think everyone over 40, or those that have high risks would be foolish to skip something as simple as, and as covered by insurance, as a wellness checkup. I don’t know why the doc posted this video, or what his recommendations are, but to suggest skipping annual checkups is irresponsible.




      0
  4. If you’re in the US, and while we still have Obama care, you need to ask the doctor to write screening tests only on the requisition form or you will get billed. Also say everything’s fine or you will be billed for 2 visits at once. You can ask about issues as they’re walking out the door.




    3
    1. This is absolutely right!! My doctor just charged me for a sick visit as well as the well visit I was there for. All because I said my shoulder hurt (nothing he could do or recommend) and he found an infection while doing a pap smear and I asked about something else in passing – also nothing he could do.

      I can’t find the Balanced website he mentions during the video.




      2
  5. The health checkup, particularly colonoscopies, can lead in short order to the operating room, a guy I know just had a $70k operation. The experts point out that colorectal cancer is the third most common and most cases arise from adenomatous polyps. http://www.aafp.org/afp/2008/1215/p1385.html

    Its concerning when all the experts have a financial and professional stake on one side, and simply not doing anything is on the other side. I am still weighing when to get on the cologard, sigmoidoscopy, colonoscopy, and polyp removal train.




    3
    1. My mother in law never had a colonoscopy, and at age 80 it was discovered she has stage IV colon cancer. Colon cancer is one of the more easily treatable cancers. If she had had one much, and polyps were discovered and removed, she’d likely be fine today as in every other way she has been very healthy (slim, energetic, active). We were shocked. This is why I object to well meaning doctors recommending to people not to have colonoscopies, prostate exams, breast mammograms, basing their arguments on statistics of populations (“odds are you won’t die from prostate cancer”). One thing I do know is that it is essential to make sure any doctor performing a procedure on you is highly competent.




      4
      1. Did she ever have a stool test for Occult Blood? A much simpler and safer way to screen for possible polyps. My objection is about doctors not giving people all the facts so they can make informed decisions about screening tests. Sadly, each person is on their own trying to figure out what is best.




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        1. I don’t know but I doubt it. I agree completely about the issue of not giving all the options. A sigmoidoscopy is safer than a colonoscopy and that along with a fecal occult blood test is recognized in the US, as I recall, as a viable option, although colonoscopy is considered the gold standard. I have had 2 colonoscopies without a problem – one finding polyps, one not. I switched from being a vegetarian to vegan after the first one, and so think I am in the clear and might not get another (I’m 70). The bottom line, in my view, is that there’s no obvious right or wrong decision in a number of cases. People should educate themselves and make their own decisions based on their individual situation. Here are two other more minor examples:

          1. After being a vegan for more than one year, my blood serum iron level was found to be abnormally high. have never taken iron supplements. I know from genetic testing that I do not, unlike my father and brother, have hemochromatosis. However, I am genetically predisposed to absorb more Fe than the general population in the presence of vitamin C. I had forgotten this and was taking a vegan multi with some C (not much, just 100 mg per day.
          I stopped the multi, started eating citrus fruit only between meals, and also began drinking coffee/tea with or after meals. After 3 months, my iron was returned to normal.

          2. I went to my GP for follow up on my iron level. She then discovered my B12 was off the charts, so high that the report merely said >1000. I was taking 1000 mcg a day (plus 300 mcg in the multi), and it was too much, the amount typically recommended for a 70 y.o. I dropped my B12 to 500 mcg per day. My level is now slightly above the high end of normal, but has dopped considerably.

          How often have you heard one cannot absorb too much B12? The only doctor I recall pointing out that one can is Dr. Fuhrman. I would not have known about either of these issues if it were not for going to doctors even though I had no specific complaints.




          8
          1. … my general point is that people are individuals. Recommendations are general. General statistics would have indicated my iron and B12 should have been fine. On the other hand, I have had many doctors tell me nonsense e.g. that I could not have sleep apnea because I am thin. My brother has serious sleep apnea and he is also quite thin. So, it is not the case that I blindly accept what doctors tell me. In fact, I usually wind up irritating them since I often question their conclusions/advice.




            6
        2. In addition to the stool test, there is a DNA test which, bye-the-bye, is covered by Medicare if the patient has refused the colonoscopy.




          0
      2. Mass screenings of men using prostate palpation (DRE) can’t be justified epidemiologically but every GP who has performed them routinely over a career can cite more than a dozen cases which led to early life-saving treatment. If the rationale is containing total healthcare expenditures, you must condemn the dozen. If you take control of your care as a patient, you insist on a DRE and pay the physician out of pocket. You obtain lab work on-line (e.g. HealthOneLabs) and bring it to the physician before the exam (cheaper lab cost, no follow-up visit to review lab results). Be in the dozen who survived and own the cost. And keep teaching med students to perform a DRE.




        1
        1. >>>You obtain lab work on-line (e.g. HealthOneLabs) and bring it to the physician before the exam (cheaper lab cost, no follow-up visit to review lab results)

          I agree that would be optimal but in my state (NY) individuals cannot order blood tests online. I agree with your general viewpoint – I believe in high deductible health insurance, which means paying for all the small stuff.




          1
          1. I also am in New York. If you are able, have results mailed to a contact outside of NY. If you are sending samples don’t include a return address. I have done this with some testing by my NP. They have another business address outside of NY.




            0
        1. I’m not sure on any details, but she’s Japanese, so has always eaten “a little bit of everything” as they are taught to do in Japan.




          0
      3. I facilitate a support group for women with cancer. One woman discovered she had cervical cancer as the doctor was delivering her baby and palpated a lesion on her cervix. There are several women as young as in their 30’s with advanced cancers. Three with stage 3-4 colon cancer. My belief is that if you’ve got insurance that covers an annual exam, take advantage of it: get a FIT test to rule out colon cancer, get a blood test to monitor A1C, vitamin D & B12, cholesterol levels, etc. I like knowing my levels and adjusting my diet/supplements, sun exposure accordingly. I don’t always follow the advice of my doc and I know as much, if not more, than she does about nutrition. But I take advantage of the lab work that is covered by my insurance plan.




        6
    2. Now available online in its entirety, George Bernard Shaw’s “Preface on Doctors” written in 1909(!) for his play, The Doctor’s Dilemma. In my opinion no one has written a more devastating, accurate – and funny! – critique of medical doctors and the problems of the medical history before or since. Shaw’s preface begins:

      “It is not the fault of our doctors that the medical service of the community, as at present provided for, is a murderous absurdity. That any sane nation, having observed that you could provide for the supply of bread by giving baker’s a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity. But that is precisely what we have done. And the more appalling the mutilation, the more the mutilator is paid. He who corrects the ingrowing toe-nail receives a few shillings: he who cuts your inside out receives hundreds of guineas, except when he does it to a poor person for practice. …”

      And: “As to the humor and conscience of doctors, they have as much as any other class of men, no more and no less. And what other men dare pretend to be impartial where they have a strong pecuniary interest on one side? Nobody supposes that doctors are less virtuous than judges; but a judge whose salary and reputation depended on whether the verdict was for plaintiff or defendant, prosecutor or prisoner, would be as little trusted as a general in the pay of the enemy. To offer me a doctor as my judge, and then weight his decision with a bribe of a large sum of money and a virtual guarantee that if he makes a mistake it can never be proved against him, is to go wildly beyond the ascertained strain which human nature will bear. It is simply unscientific to allege or believe that doctors do not under existing circumstances perform unnecessary operations and manufacture and prolong lucrative illnesses. . . . ”

      (To read the entire preface see: http://www.bookrags.com/ebooks/5069/1.html#1&gsc.tab=0 )




      3
      1. Shaw was also a vegetarian to lived to the ripe age of 94.

        I share a wide range of beliefs with him, but his assertion that vaccination for smallpox is “a peculiarly filthy piece of witchcraft” is a profound bit of ignorance. If there’s anything that modern medicine can offer, its prevention and treatment of infectious disease, indeed the profession’s modern prestige is in large part based on this. I wonder how this will change with increasing antibiotic resistance and more widespread perception of hospitals as hotspots for lethal contagion.




        4
        1. poem by possibly Bernard Shaw

          LIVING GRAVES
          We are the living graves of murdered beasts,
          Slaughtered to satisfy our appetites .
          We never pause to wonder at our feasts ,
          If animals , like men can have rights .
          We pray on Sundays that we may have light ,
          To guide our footsteps on the path we tread .
          We are sick of war , we do not want to fight ,
          The thought of it now fills our heart with dread ,
          And yet – we gorge ourselves upon the dead .

          Like carrion crows we live and feed on meat ,
          Regardless of the suffering and pain .
          We cause by doing so, if thus we treat ,
          Defenceless animals for sport or gain .
          How can we hope in this world to attain .
          The Peace we say we are so anxious for .
          We pray for o’er hecatombs of slain ,
          To God while outraging the moral law
          thus cruelty begets it’s offspring – War




          5
  6. A checkup literally saved my life.

    I know that anecdotes aren’t data, but I’m not sure it’s a great idea to discourage the average American from getting a checkup.

    I got a checkup at age 42 because I wanted to know my lipid numbers. I was just slightly overweight, jogging regularly, and had no noticeable symptoms. My doctor heard a heart murmur, which I never had before. An echocardiogram and MRA revealed that I had a very advanced aneurysm of the aorta that was keeping the valve from closing. It could have easily ruptured at any time if I hadn’t had open heart surgery just a few weeks later. I had no symptoms, except perhaps that I didn’t have great stamina when jogging, but I thought it was just because I was out of shape. Happily everything went well, I didn’t need a replacement valve, and I’m doing well 9 years later.

    Without that checkup I would almost certainly not be around anymore.

    Stay healthy, everyone!




    15
    1. I have a similar story Russ. My new doctor suggested getting a checkup and stress test even though my bp was 110/70 often, and I was very fit swimming lengths, and splitting 7 cords of wood every winter etc . 6 weeks later I was having open heart surgery. Ya just never know…




      8
      1. I’m glad your condition is being well-managed. My main point remains — occasionally a checkup can reveal a serious hidden condition, though that’s obviously not typical.




        5
      2. Jan, perhaps you can trust Susan and Russ around how dire their heart conditions were. A “bad heart” can mean many things. Many folks have murmurs that need no intervention. Sounds like you’re one of those people.

        A WFPB diet can prevent and help so many health conditions but it isn’t foolproof. I facilitate a cancer support group in a community that eats exceptionally high amounts of organic, healthy plant based foods. Vegans in my group are always in shock that they’ve got cancer, thinking their diet would completely protect them. Sadly, it doesn’t.




        5
  7. Really good stuff! I am going to show this to all my colleagues.

    It should be stated that science doesn’t care about our opinions!

    We all need to remember that!

    Thank you Dr. G

    My deepest regards,
    HemoDynamic, MD




    6
  8. This is off topic. Has anybody else noticed that the button you click below, after making a comment, which says “Participate in this discussion via email.” hasn’t been working lately? I’ve noticed that for at least three weeks.




    2
    1. I’ve noticed that I can no longer sort comments from oldest to newest. So I have to read from the bottom up to fully understand the comment threads, which is very frustrating. Am I doing something wrong or missing something?

      BTW, on this “Leave a Reply” there is an option to “Participate in this discussion via email”

      Thanks!




      0
      1. This is not really a reply to your query, but it reminded me that in the Discus system, if someone commented on a post of mine, there was a link in the email that took me right to that reply, which greatly facilitated dialog on a particular thread. That seems to be missing. I find it way to difficult to locate comments on my posts in this system. Frankly, the new system is almost unusable for dialogs on particular threads. Maybe I am missing something….




        3
        1. David E. Johnson – I agree with your point that it is difficult, now, to follow the thread of a conversation. Who’s speaking to whom? That’s why I try to direct my comments to the person I’m speaking to – like you, “David E. Johnson”. Then we can try to follow our lines of communication. I agree to the frustration you expressed.




          2
          1. RBG –
            I do that too but it’s still hard to locate the thread…. I do it with ctrl f search but that does not always/often work well. It’s so bad in fact, that I’ve thought about giving up…




            1
            1. I find the “improvement” to be counter-intuitive and sometimes makes the comment threads difficult to follow.

              It seems that some people prefer newer comments at the top of the thread, but I don’t. (Who reads from the bottom up anyway?) It was very helpful to be able to change the sorting order from newest comments first to oldest comments first.




              1
  9. I wanted my iron levels checked because they were on the low side the last time they were checked. Following info. on this wonderful site, I learnt not to drink my tea with my meals and hoped that would bring them back up. (My Dr had told me to take iron supplements, but I wasn’t happy with that advice). Dr couldn’t arrange test without a annual checkup – which included advice to go an have a mammogram – no thanks. I did get my iron levels checked along with some other tests which were left on there from previous visits (which I didn’t ask for). As my new insurance doesn’t fully cover lab work related to annual checkup, guess I’ll be footing the bill for those! Next time I’ll be more careful. Most positive thing from the visit: I told my Dr that I have eaten WFPB for more than a year, lost 15lbs (without dieting) and no more aches in my hips from arthritis. Oh, my and iron levels are still on the low side but hgb is in the normal range. My Dr’s response..which iron supplement are you taking??




    5
    1. The same thing happened to my wife. Doc wanted her on Fe pills, which she objected to. Her solution has been to eat some citrus with most meals. Her iron is now normal. On the other hand, as I detailed in another post, my Fe was way too high (I have a genetic predispostion to absorb too much iron in the presence of vitamin C). My solution was to stop citrus/fruit generally with meals, stop my vegan multi that had C and to start drinking tea/coffee with or after meals. Neither of us were aware of our iron status, so without tests we would have remained in our respective suboptimal states.




      2
  10. I think the answer isn’t necessarily to forego the annual physical, but instead to learn enough about how the body works so you can make informed comparison with last year’s test results. In this way you may spot a trend, such as rising blood sugar or pressure, even if your doctor is one who doesn’t comment on such things until s/he is ready to pronounce you diabetic or hypertensive as the old prescription pad comes out.

    My doctor knows I decline colonoscopies and mammograms and he’s OK with that. He had me do the stool test to check for more than just occult blood. I don’t recall the name of the test, but he sent it home with me and I mailed it in. He also knows I rely on my diet to keep me healthy. He recommends a Mediterranean diet, but he admits that eating vegan is probably better. He understands something about the importance of diet, which is something I was looking for when I found him. He is an OD, not an MD, and I’m pretty sure they get more training in the power of diet.




    5
  11. I will say Yes and No to regular checkup. Yes if you are informed and can resist doctor overdiagnosis and over prescription then see your doctor at least yearly, No if you are not.

    So just like the video said, you should rely on nutrition to prevent diseases in the first place, which most if not all doctors know nothing about it, yes MD knows nothing despite their degree.

    But at the same time, you need to see your doctor regularly for 2 main reasons: 1) to have regular blood test, at least once a year, and 2) to build a good rapport with your doctor just in case something serious happens and then he/she can refer you to a specialist.

    So I am just using my case as an example so that I can explain. I see my doctor twice a year and my work insurance pays for it so that I can have blood test twice a year, and to have good relationship with my doctor. So I understand that blood test is just an indication and most blood tests are inadequate because it does not measure important data such as CRP, but you get the cholesterol reading (which is also very misleading) and you get the glucose reading (A1C). I monitor those 2 measurements regularly on top of getting measurements by paying my own blood test. You get also the blood pressure but I measure myself twice a day anyway. What I am looking for is a sudden change in the measurements which may signal something is happening, but not an absolute measurement. My doctor knows nothing and he generally tries to prescribe me some drugs for which I say No. Sometimes I use him to “prescribe” myself some tests such as the EKG test. So for me, doctor is very useful because without him ordering some tests then my insurance won’t pay. I am not abusing the system and consider myself very inexpensive to my insurance company because I never ever take FDA drug in my lifetime and all I do is lab tests.

    So now on the flip side, I have seen friends and relatives who are overprescribed with statin drug to “lower their cholesterol” or drug to “lower the blood pressure” when their cholesterol or BP are perfectly normal. But whether they are really healthy or not then I don’t know because they need to have other measurements, but prescribing FDA drugs just makes it worse. Then I have 2 relatives currently paralysed of a stroke but they have perfectly “low cholesterol” and “low BP” and they are vegans, but I don’t know what they eat and I only know that they don’t eat animal foods, but they can eat tons of vegetable oil, who knows. But their doctors knew nothing and didn’t warn them of any stroke because they had “low cholesterol”. I also have another relative who died of cancer. For a year he had great pain but his doctor misdiagnosed him as having arthritis and prescribed him arthritis drugs. If he knew earlier then at least he can tried to overeat tons of antioxidant foods or at least said goodbye to his family while he was conscious. In those cases then doctors are worthless.

    In other less developed countries in the old days, people ate healthy and clean foods but never saw a doctor in their life but lived healthy until 80-100 and then died one day peacefully in their sleep.




    7
    1. “My doctor knows nothing and he generally tries to prescribe me some drugs for which I say No.”

      Jerry, if you don’t mind my asking, what drugs could your doctor be possibly trying to prescribe you?

      The reason why I’m asking is because my doctor has never tried to prescribe any drugs because there isn’t anything he could possibly prescribe me. As a matter of fact, he’s always in awe of my blood work & the few other tests I’m willing to do about once every 4 or 5 years. Especially for someone my age.

      If I was going to a doctor who was trying to prescribe drugs for issues I don’t have, I’d change doctors. Just sayin’.




      5
      1. My doctor wants to prescribe me statin because my cholesterol is above 180 or whatever number he has in mind. But my HCL is way high, my triglyceride is way low, but my LDL is semi high but I know it’s due to good LDL. For vegans who eat zero fat, of course your TC and LDL are way low, but that is not necessarily healthy, but that’s a long story. I know what I am doing and I need to eat some foods on purpose, especially healthy fats, and I can easily cut down some foods to have “vegan” kind of TC but I don’t want to do because it’s not healthy. CRP is a better measurement than TC and my CRP is almost zero. Of course when I showed him my CRP and my own lab test results then he has no idea.

        I kept my doctor, who is now retired, because he is a nice guy and I can “order” through him any kind of tests that I want.




        2
    2. Jerry Lewis –
      For once, I agree with you 100%. I always have a list of specific blood tests I want when I go for a check up (I cannot get them onlline in my nanny state of NY). I also almost never take any prescription that’s been recommended, from statins to antibiotics. My cholesterol was 156 (LDL 93) at last check up and the doctor said, apologetically, that according to the new guidelines I should be on a statin. I laughed and told her that was ridiculous. She did not fight me on it, because I think she actually agreed with my opinion. Later I checked the recs on an online cholesterol test, and found that indeed, no matter how low I set total cholesterol and LDL and no matter how high I set HDL, the recommendation was I should be on a statin.




      2
      1. Ok, that explains it. So according to their new guidelines, everyone should be on statins. So glad my doctor doesn’t do this. As a matter of fact, my levels are not that far off from yours, except that my HDL is only about 10 points lower than my LDL. My doctor told me that he only sees numbers like that when people are on statins.

        My CRP is also very low. It went down after eliminating oils.




        3
    3. I thought I’d comment on the comments about having a relative who had a stroke despite low blood pressure and low cholesterol. I am a Neuroscientist and have worked in clinical Neurorehabilitation for decades. There are other causes of a stroke other than a hemorrhage from high blood pressure or a blockage from cholesterol gumming up the works. There are congenital structural abnormalities that can also cause stroke. AV malformation, for example. The prevalence of AVM is estimated at 18 in 100,000. … AVMs are the second most identifiable cause of subarachnoid hemorrhage after cerebral aneurysms, accounting for 10 percent of all cases of subarachnoid hemorrhage. AVM’s are a malformation of the venous structure of the brain that simultaneously harbors inherent structural weaknesses in the sides of the veins and arteries. You don’t know you have this until you have a blow out. This is a set of structural malformations that have nothing at all to do with blood pressure or blockages as it is a matter of time until a problem occurs. One is born with this insidious malformation but it is unfortunately found only when it ruptures. Sometimes the AVM does not do a full blow out but oozes through various weaknesses.
      I point this out to remind us all that it can be ill-informative to jump to conclusions about simplistic concepts like just blood pressure or just cholesterol.




      9
  12. I disagree with you in this instance. An annual check up is personally very helpful as you age and can save lives. Every person is different and has different needs.

    I agree that doctors should have more
    nutrition education.

    Thank you for all your other great videos!




    4
  13. Jerry, to your point – in the “old days” people died young (of infectious diseases, typically, or during childbirth). When they managed to old age – if you’re working every day until you can’t – and it’s Physical labor – you do wear out.

    The Blue Zones studies that look at centernarians around the world show that they ARE physically active, walk a lot, Garden, etc, but they are NOT out in the fields and understand that it’s important to stay out of The Sun at peak hours in the summer and not get dehydrated.

    It’s all balance, and glorifying the “old days” – throughout history people have always done that. In Plato’s day they were complaining about the youth and glorifying the “old days” – ignoring the negative and only bothering to remember the positive.




    6
    1. Rick, good points. What I was trying to say is that in modern days, you can avoid infectious diseases by having vaccines and to have better sanitation, and not stay in the sun for long, and eat the best foods that ancient people ate to prevent diseases, etc. I don’t have any statistics to prove anything but my hunch is that on average, if you never see the doctors until you get sick then for most people they are better off. In fact, there are also studies that show that on average, you should not have mammograms or colon test until you reach certain age, because statistics show that most people will be over diagnosed.

      But when you are very well informed, such as in my case (pat pat on my shoulder), then regular visits to the doctor are advantageous.

      And not getting into a political discussion, on average, if we have zero health care in this country except for some during childhood and pregnancy, then it is better. Of course there are always special cases for people who have diseases due to their genetic. And the guy who murdered people in Las Vegas took valium, and it is said that that drug causes people to be overaggressive.

      “Rage, aggressiveness and irritability are among the possible side effects of taking diazepam — better known as Valium, according to a manufacturer of the drug.”




      4
  14. No yearly physical exam for me. I have never had a pap smear, mammogram, colonoscopy, etc. No thanks. I have been vegan for over 30 years and a person could not ever get better health insurance. All of these tests are for just one thing: To get a person into the health care system soon so as to suck off the insurance. After all, that doctor, et al, needs to make his BMW payment. In all my years of working as a nurse I have seen only despair and anguish when people get into the “health” care system. Don’t get me wrong, if I were involved in a “crunch case” I would take advantage of the repair modality, but surely don’t need that help with my innards. I am 72 years old and always well as is my husband who is 68 years old and has been vegan also for many years. Best decision I have ever made. I did so for the animals but the side effect is good health and clear conscience.




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    1. I refuse to have colonoscopy. Nowaday, there is a non intrusive test that detects blood in the stool, and until you see it then you may consider colonoscopy. I never have flu vaccine despite my doctor reminder every time he sees me. I may take the shingle vaccine because almost everyone gets when you get older no matter how healthy you are.




      2
      1. The only issue with fecal occult blood tests only detect a problem once you already have cancer. And, as I recall from studying this issue some years ago, FOBTs are not 100 per cent accurate as some cancerous polyps do not bleed. For me, having at least one colonoscopy at around 60 years of age is quite rational, as long as one’s GE is highly skilled. On the other hand, there are newer tests on the horizon that might well obviate colonoscopies,




        1
        1. David, I agree with you that there are more than just looking at blood in the stool and just like any test, it is only one indication. But I look at a number of factors such as constipation, bad stool composition and shape and smell :) (there is a whole science behind this), digestive issue, pain, blood pressure that shoots up for no reason, etc. When you have zero symptom then a colonoscopy becomes a risk rather than a benefit. It’s always a trade off with probability.

          For lab test that you pay yourself, you can look up online and there are a number of labs that will get your blood sample locally through a medical clinic which will send your blood sample to the lab. I do it occasionally for specific tests. But for standard blood test then I go through my regular doctor so that I can get paid by my insurance.

          Every month, I spent a lot of money on specific supplements and I have to pay myself. But what I pay is way cheaper than the FDA drug but my insurance will pay if I take them. Go figure. Case in point is that my top brand fish oil costs 1/100th of the FDA approved fish oil that is worse because it contains less DHA and EPA, but my insurance will pay if my doctor prescribes it to me.




          1
    2. Congratulations on being a long term vegan. Unfortunately, most people, even if vegan now, were not for most of their lives, and so would not have the protection you would have derived from your diet.

      >>I did so for the animals but the side effect is good health and clear conscience.
      Me, too. Last to go was fish, about 2+ years ago. Would never go back.




      5
  15. Dear Dr. Gregor,
    Your video on annual checkups came a couple of days after my annual checkup. Perfect timing as I was about to write a letter to my doctor apologizing for my attitude but now I am writing to you to thank you. The exam consisted of me filling out a questionnaire and him trying to recommend treatments based on the form I filled out. Since I didn’t have any problems, he tried to push a mammogram and vaccines on me. I resisted. When he asked me how I felt about vaccines, I said I would never volunteer and he’d have to tie me down. His face looked crestfallen and he shook my hand and exited. I felt sad because it seems doctors are caught in between big pharma and their dedication to helping people. How can they admit that big pharma is a monster when it is a huge basis for their profession?




    3
    1. You can see your doctor but ignore his/her “recommendations”. You are an adult and can say no to anything. If your doctor is mad at you then switch doctor.

      In the news, there is a story of a mom in Michigan who goes to jail for refusing vaccines to her young son. She didn’t quite said No but she said to wait until he gets older and to spread out the vaccines. But she goes to jail no matter what. In some states, you cannot say no to vaccines for your kid. My kids are all grown up now and so I don’t know. But I heard that they have herpes and HIV vaccines for young kids. It is just insane.




      3
      1. Yeah- I feel like people just don’t think…. Wait a second WHY does my 5 minute old baby need a hep b vaccine? WHAT?? You don’t want a vaccine??? Uh I just asked a question…. Give me a break.




        3
        1. Just for logical thinking without having to be a scientist, the principle of how vaccine works is that they inject a small amount of disease germ so that your body will think it is a disease invading your body and develop the antibody to counter the germ, so that next time when there is a real disease then your body is ready. So it assumes two things to work, 1) you can develop the antibodies and so how can a baby or elderly person develop it, and 2) you are not overwhelmed by the small amount of disease germs in the vaccine in the first place. So they are subjecting babies to an onslaught of vaccines at once, and the babies and elderlies are too weak to combat the small amount of germs from the vaccine. That’s why a lot of babies and elderlies die because of the vaccine. And flu vaccine only contains one strain of flu and they are mostly ineffective.

          Japan has fewer vaccines but is now catching up, sadly.

          https://www.japantimes.co.jp/life/2014/10/04/lifestyle/vaccination-choice-two-unknowns/#.WdvohRO3wW8




          1
      2. Interesting, my vet recommends vaccinations be spread out, and only those necessary be given. He also always asks about diet, maybe we should take our kids to veterinarians instead?




        4
        1. But vets are also bottom-line doctors.

          Case in point, I’m involved in a distribution company that provides vets with a stem cell repair solution that has been proven to heal soft tissue injuries… bowed tendons for instance, in horses. One of the more prominent vets in the country has been using this treatment and endorses it.

          But big time veterinarians have invested in very expensive machinery that spins a horse’s own blood to derive stem cells (that the horse already has) to treat with. And by doing this type treatment, the vet gets to keep the horse on site for about a week of expensive horse hospital boarding as it requires quite a number of injections.

          Our treatment allows the owner to take the horse home after getting one injection along the length of the injury.

          Their treatment doesn’t work very well, but they still push it because they have expensive machinery they bought because there was nothing better available at the time.




          1
  16. Good video. But for me personally, the more check-ups the better. For me a check-up consists of labs, a Dr. checking lungs and heart performance with a stethoscope. A nurse takes my BP and asks me questions about my health as I see them. I have a “no drugs” designation on my records and reject any and all extra testing, like prostate for instance.

    But I recognize I am different from most patients. That is, I read my labs and compare them to my last check-up and act accordingly if I feel something needs addressing. Most people just want to turn their well-being over to someone else because they don’t want to do the work.




    7
    1. I used to have a doctor, actually a pretty good one, who told me he only does tests if he knows what he’d do with the results, i.e., no “fishing”, have to have some symptom or other. That happens to be the ‘opposite’ of my motivation – I want to track key measurements and make sure I am on the “right path”. My current doctor laughed when I told her that, but she was willing to do the tests I asked for e.g. hs-crp. Unfortunately where I live I cannot order lab tests online or I would not routinely get a physical.




      3
  17. I don’t go to doctors. My dentist checks my blood pressure, I take herbs and I eat vegan. That’s how I spend my health dollars. I’m afraid of doctors, actually! I don’t want a test result to cause me emotional stress. My mom died of oral cancer so I’ve seen the worst of it.




    2
  18. There is an economic incentive in finding things wrong. It is the same as the free car checkups in shops. Once the customer is in, there is a window of opportunity to make professional recommendations and to bring dollars. So it is pretty much a grey cloud. I know well from my dentist. He pushes xrays hard and that’s why I don’t do checkups even if they are covered.




    2
    1. Right, dentists act like one is crazy if they refuse xrays. Mine makes me sign a waver. He told me with a straight face that I’d have to be responsible for the outcome. I laughed. Luckily he didn’t toss me out of his office,




      3
      1. Right. My dentist once walked me into a big xray machine to take an xray of my head (different than for teeth). He was smooth and it was like getting shampoo after a haircut. Once he had everything setup I asked what was he doing. I had to man up to get out of the trap and the junk.




        4
        1. Every time I get my teeth cleaned, the tech wants to do X-Rays even though I told them to put “No X-Rays unless asked for” on my records. Have to tell them again why not. Really irks me, but the dentist is excellent so I go back.




          2
  19. Fully agree, the basis is a healthy life. But how I was able to anticipate the development and solve my prostate cancer w/o a regular PSA check? A doctor who gives only pills is not a reason to avoid check-up, escape from the doctor




    2
  20. What about tests, blood, urine, nutrition? I had a vitamin D test done and my vitamin D level was zero, yikes! Since I have been eating vegan-ish for a while, I had a nutrition profile done and my glutathione was low.




    6
  21. Here is a novel idea… Let’s address the root cause of why this revolt against routine check ups maybe brewing. Insurance companies, all third-party payers, and healthcare system administrators are the reason why nutrition as medicine is left by the wayside during the annual physical exam. Practitioners are focused on addressing the benchmarks of screening that are currently valued, required, and reimbursed by insurance companies. The average American cannot afford to pay out-of-pocket for lifestyle medicine. If patients and lifestyle medicine practitioners joined together in a political battle to provide coverage through insurance for preventive nutrition education it would do the greatest good for the greatest number of people in this country. Every day I am witness to at least one practitioner, in the trenches of primary care medicine, who sees amazing results from the nutrition facts about a plant-based diet that he encourages his patients with every day! However, since many lifestyle medicine practitioners have abandoned work within a third-party payer system, he seems to be fighting the battle alone, working with the people who are in most need of hearing the merits of a plant-based diet and exercise. The current progress in the field just seems to make the healthy, healthier and the sick, sicker!
    Thank goodness, Dr. Greger, that your resources are free for all and we are so grateful for what you do!




    5
    1. You make good points.

      As I am through the VA and haven’t had health insurance since the 70s (I cancelled when my agent said wisdom tooth extraction was covered and the Insurance company said it wasn’t and I had to pay for the hospital stay for the extraction) I don’t know if a trained professional that works in alternative medicine is recognized. But if they were, then anyone could seek prevention through more knowledgeable practitioners in re: diet and natural alternatives to drugs, and be covered.

      Insurance companies may have to legislatively be divorced from Big Doctor/Big Pharma.




      1
  22. interesting topic. i turned 50 in January 2017, been vegan for over 10 years and have not seen a doctor in over 15 years. i receive a free annual blood test as part of my employers insurance plan and my results are always great. in fact i have only used the health insurance once in the 16 years i have been at my job and that was for a kidney stone due to being dehydrated – it was also long before i went vegan. meanwhile my non vegan siblings and their families are all on medication and having surgeries.

    i think Noble prize winning author and Holocaust survivor Isaac Bashevis Singer said it best: “I did not become a vegetarian for my health, I did it for the health of the chickens.”

    i am vegan for moral, ethical and environmental reasons but also do greatly appreciate the tremendous health benefits of a balanced plant based diet.




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  23. If I don’t go for my annual checkup how do I find out if I have High Blood Pressure or sugar in my urine or a 300 cholesterol?




    3
  24. Mark, As a nurse I appreciate your efforts to know those important numbers; cholesterol,BP, etc. Some earlier commenters have mentioned their approaches to avoiding annual checkups (having good home monitoring equipment, for example.) There are ways such as an employers’ well-run company health program, that would do regular blood, glucose checks. However, for most people having an regular check up (it needn’t be annual, especially if you have reliable testing outside that doctor’s office) and perhaps limiting scope and intelligently questioning routine, over-aggressive testing/follow-up is perhaps the most practical way to getting those important health measures evaluated. Hope that gives some perspective.




    1
  25. Option is revoked if you take a prescribed drug. The label lists the # of refills for the year, with dispensation available from the Senate if you need a few days early for maybe travel. The next year requires the check up. All in the name of my, is it my money or my health, and if you don’t like it the receptionist will cheerfully share that you’ll need to find a new doctor. I’ve heard “well, you don’t come in very often” as though it’s suspicious. Well, I haven’t been sick doesn’t change the tone of the visit.




    1
  26. I am seeing an OBGYN who prescribes hormone cream. I am 15 years past menopause. He claims that recent research and new formulations have overcome the earlier objections to hormone therapy and that organs are healthier and women live longer with the therapy than without.




    0
    1. Marilyn, if I were you, I’d ask the doctor to show me the recent research & info on the new formulations. I wouldn’t take his/her word for it, since it’s possible that s/he is is parroting what a drug rep said during the sales pitch.




      3
    2. You need to know if it’s bioidentical hormone and what kind, or a drug?
      I would be concerned about using even a bioidentical estrogen. There is a reason they ask how many years you had periods when doing a mammogram. Even your own, natural, estrogen makes you more likely to get cancer. At least get a second opinion from a doctor you can trust!




      1
  27. This video would have benefited from emphasizing that patients that do experience symptoms do benefit from consulting their doctor. It’s the routine fishing expedition for ailments in the non-symptomatic that is, from a population perspective, fruitless.

    Lots of personal anecdotes in the comments miss the lesson from the statistics. While its possible that an abnormalities will be seen upon routine exams of asymptomatic patients and that subsequent treatment will improve outcomes, it’s just as likely that the subsequent further screening and treatment will result in poorer outcomes. There’s no significant difference in overall outcome.

    In all manner of policy issues, from (medicine, nutrition, gun control, economics, climate change), people choose to believe the statistics don’t apply to their personal situation. They do. The fact that some who suffered overtreatment aren’t alive to comment here represents a selection bias. Statistics exist to overcome our biases, permitting more objective assessment.

    Which is not to say that statistics can’t be used to mislead. They are, simply because most have so little education in how to distinguish statistics intended to illuminate from those intended to deceive. As an aside, I find it unfortunate that there was only perfunctory coverage of probability and applied statistics in my high school curricula, as I believe more would benefit from its insights than the usual mathematical foundation geared toward those bound for STEM college majors.




    5
  28. Hello Dr. Gregor,

    I am a 2nd year medical student and am currently on a plant-based diet thanks to you.

    Quick question about Cancer: Are strict water fasts unhealthy? Could water fasts bring about any benefits? Also, could you please weigh in on the use of water fasts, as an adjunct to conventional cancer therapy, as a method to treat cancer? I came up with this question after reading about the Warburg effect.

    Thank you.




    2
  29. In Colorado, USA, we have a local TV station that sponsors a health fair every year. You can get a complete blood panel (CBC) for $30. This test includes all of the major and standard blood test measures: cholesterol, HDL, LDL, iron, thyroid, fasting blood glucose and many many more. This year they threw in a B12 for free. For $20 you can get an occult blood stool test, another $30 will get you your A1c . Free finger stick glucose. You can get a free breast exam, physical therapy exam, blood pressure, and information on all sorts of health measurements that one might be interested in. This health fair is supported by the community – many volunteers show up to perform the medical testing and other non medical people support the events in other ways. You can take your results to your physician or just keep them for your own records. I bring this up because it may be helpful for others who frequent this site to use this model to create a similar program in their community. This program has saved me hundreds and hundreds of dollars over the years. Here is the link. Take a look and see what they do. The program is most active in the Spring, April through June or so.
    https://www.9healthfair.org/
    Here is a list of the screenings
    https://www.9healthfair.org/attend/available-screenings/




    3
  30. My most recent annual check up almost cost me a bundle…. and I only went because my insurance company incentivizes “healthy behaviors” with a $100 Visa card if I go. So… I went, only to be incorrectly coded as an office visit, rather than preventative check up, and my mammogram was prescribed as diagnostic (with an ultrasound suggested as well) rather than the routine screening, which is free. My doc also did “routine” blood work before she’d ever seen me, to the tune of $450 for tests that aren’t considered routine. As an ACA customer, it would have cost me $1600 if I hadn’t spent hours on the phone asking questions and pushing back on the incorrect coding and over the top recommendations I didn’t end up doing. (Mammogram came out perfectly normal – no need for the more costly ones). All in all, my “free” check up and $100 reward almost cost me $1600! Not sure I’ll try again next year – not worth the hours of time I had to spend untangling it all.




    8
      1. Walk-in Lab similarly offers insurer pricing for LabCorp and Quest diagnostics. I’ve done it a few times, mostly for motivational feedback. They have seasonal sales, but the form one takes can be used for up to a year thereafter.

        I only ordered one “non-routine” diagnostic, for methylmalonic acid, which rises in B12 deficiency. Alas, the more sensitive and specific holotranscobalamin II test doesn’t seem to be offered by these outfits.




        1
  31. And Dr. Greger, you don’t even mention the fact that some Insurance companies are now telling us that we aren’t allowed to talk to our doctor about any problems we might be having when we go for the annual physical. Instead we’re told, “You’ll have to make a separate appointment for that.” I’m also a little fed up with having to convince my doctor about the way I eat and why I am politely declining to follow through on all the routine testing he wants me to do. The last few annuals have been pretty much a (expensive) waste of time.




    2
  32. USA Healthcare now mandates everyone have a comprehensive plan. And that they give Preventitive testing at no charge.
    So – I guess my question/observation is that now they are compounding our problems by forcing unqualified people to test Americans and diagnose ailments based on a standardized set of test results.
    Are they doing more harm than good with these FREE ‘health’ screenings?




    1
  33. I’ve always been healthy and only saw a doctor when sick; never had regular checkups. About 15 years ago I began having tingling in my feet and went to see a doctor about it, thinking it might be gout. Turned out to be Type 2 diabetes. I believe, if I had been getting checkups, they would have caught my high blood sugar, before I developed peripheral neuropathy. Would have saved me much discomfort! True, they might have prescribed something harmful, such as Avandia, but I would have had the chance to adopt a healthier diet before damage was done and might have never needed medication.




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  34. Is there a site to get help on doing a wfpb diet properly (i.e. sustainably)? I’ve read Dr Greger’s nutrition recommendations and I’ve done most of the recommendations but I’m stuck on the iodine problem. The options are seaweed, iodised salt or a supplement. I have many questions. First question is about using seaweed to supplement iodine.

    Seaweed has b12 analogues apparently and they can make b12 deficiency worse. I’ve searched the web for videos and such and Dr Klaper’s recommendation is to leave a gap of a few days between the b12 supplement and the seaweed. For example, take the b12 on Sunday and the seaweed on Wednesday and Thursday. However I’ve been taking 1000mcg every second day and on the weekends. To use the seaweed method do I have to use a weekly b12 supplement? Can I take the seaweed in between the b12 days or will that affect my b12 intake? How do you use the seaweed method sustainably and safely?

    I’ve been using the iodised salt method for now but I can’t consume a teaspoon of salt every day. It’s just too much salt for me now. I’m not eating many processed foods, just the bread, and it’s not iodised. Other foods have iodine but the iodine in those foods depends on where they’re grown and I don’t think the foods and salt combo will get me to 150mcg/day. My parents have hypertension anyway so I don’t want to use the salt strategy. I think i’ve probably been getting under the rda for many months, plus I’ve been eating the goitrogenic foods.

    I’d like to try the supplement approach but I’m worried I’ve hurt my thyroid. I feel some discomfort around my throat area now. I felt it after I took an iodine drop that allegedly gave a 96mcg dose, though I forgot to shake the bottle so I might have gotten much more than that. Should I lay off on the goitrogens for a few weeks before I try the supplement again? Should I get tested for thyroid issues? Should I wait a few months before I try the supplement, in case I got an excessive dose? This leads me to my next question. How sensitive is the thyroid gland to iodine intake? How much can the body tolerate over the 100mcg requirement (I found out that the thyroid requires 100mcg but the rda is 150mcg to account for goitrogenic foods)? How can you improve your tolerance to iodine intake?

    Lastly, should I consider combining strategies (e.g. salt and seaweed) or only choose one strategy? Thank you for reading this far. I’d appreciate any help.




    0
    1. Yo Arthur, I suggest you get your things in order and after that you got two options. 1) Get your iodine from adding some seaweed to your diet here and there or 2) don’t add seaweed to your diet but take a supplement in pillform that has either 150 mcg and take it daily or that has 225 mcg and take it every other day. Don’t mix the two options, it’s either seaweed or supplement. Also, if you supplement, take in consideration the country you live in. Here in Europe some countries add iodine in bread, in that case don’t supplement when you eat bread on that day. Trow away the drops and the salt man. Voila.




      1
  35. But annual health checks are a great opportunity for your doctor to prescribe you a heap of ‘preventative’ drugs.
    They may know zilch about a healthy diet, but they’re experts at dispensing medicine.

    It would be interesting to see the difference in health costs in the 2 different groups (for no difference in mortality).




    1
  36. I come back on the subject of the video … Obviously, many people are attached to this Obtaining Annual Health Check-ups, so why pit the pros and cons? because in the best case it is possible to detect and anticipate the arrival of a more serious problem but in the worst case receive the bad prescriptions. So the idea would be for the good of all to review the principle of Getting Annual Health Check-Ups!
    Why wait for the body to deteriorate? Why make the record of a bad year? why can not we anticipate? maintaining the Annual Health Check-Ups and making it pro active? The patient expresses the various findings of the year the weak points what he was able to notice and the doctor explains how to avoid getting a health problem!
    But it is very difficult to do this because doctors are trained to cure symptoms and patients expect their physician to find health problems. This is the model that is bad the western view of health that is to be reviewed. This video explains the facts! it does not shoot people who discovers they have a health problem during an Annual Health Check-Ups. She says that unfortunately it costs dear to everyone. Let’s stop we debating the debates for or against trying to think to improve things.




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  37. Does someone know Dr. Greger’s stance on eating white potatoes? Is it a green food? I suppose he would say a green food but sweet potatoes have more antioxidants, am I right?




    0
    1. hi this is Dr. Sozanski, PhD Natural Medicine and Moderator with Nutritionfacts. I believe you may have gotten your answer, however here is a link on purple potatoes https://nutritionfacts.org/topics/purple-potatoes/ and a quote from the potatoes video collection: “Sweet potatoes are a very health promoting food, and are an inexpensive cheap source of nutrients. The predominant protein in sweet potatoes may even have cancer fighting properties. Boiling may be the best way to cook sweet potatoes to preserve all the nutrients. The traditional diet in Okinawa (where some of the longest living people were once found) revolved around purple sweet potatoes” together with the link: https://nutritionfacts.org/topics/potatoes/
      In answer to your question there is positive emphasis on purple and sweet potatoes, in agreement with other comments below. Regards, Daniela




      0
    2. I did my research on white potatoes and I’m going to go against Dr. Fhurman and Dr. Greger on this one. I think McDougall is right with putting white potatoes on his book cover, the glycemic index for white potatoes is high (82), but so what, sweet potatoes aren’t much better with a GI of (70), those numbers are more a reflection of the fact that these plants are potatoes then that they are some weirdly high GI foods.

      In one of his own posts “Anti Up on the Veggies” Dr. Gregor introduces an ORAC score alternative where the cellular antioxidant activity is measured instead of the activity in a petri dish. Now, not only does the white potatoes score improve better but sweet potatoes score is slightly less good, meaning that the difference between the two is marginalised. As you can see, white potatoes still have more antixoidants in them then white onion, squash, green beans, celery or romaine lettuce…

      Things only get better when you eat them with skin on or cook them before so that the day after they are packed with resistant starches which lower the total calorie load. They are a adequate whole food and should be treated like one!

      https://www.health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods
      https://nutritionfacts.org/video/anti-up-on-the-veggies/




      0
      1. I keep my position on white potatoes. But I also read up on this before mentioned McDougall fellow, he is super weird in proclaiming that sugars don’t cause weight gain and in doing things like drinking fruit juice. These are obviously not whole foods, not going to mention him again.




        0
  38. Hope it’s OK to post this Q. Have a burning question & hoping for some collective insight. Am leaving my company to start a business, so will shortly lose the very generous employer dental/health insurance coverage. As I shop for individual insurance, I’ve been offered critical illness insurance for chronic illnesses, coma, dismemberment, blindness, hearing loss etc… stuff that would happen after an accident. I wonder if this is overkill? Hate having to pump the insurance industry needlessly. Have been vegan for a year, vegetarian for several, get my sleep, work out every AM, work from home – so stress free, and get annual physicals & dental checkups done which all come out fine. Have always been healthy, active, fit, and am in my mid 40’s and healthier than almost all I know. Only thing I’d worry about is an accident where I get disabled or such, as I’m by myself and don’t have anyone to lean on. What would you do?




    0
    1. Hi Tikiri, thanks for your comment. I am one of the volunteers at the website. I must congratulate you for your health and work and life style. I don’t know much about insurance however, it is a personal choice what one chooses and also depends on the country one lives in. Some countries one has to have health insurance other wise there is a penalty. I am sorry can’t offer much advice about your question but I wanted to say well done with taking care of yourself and wish you good health always.




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