Lifestyle Medicine: Treating the Causes of Disease

Lifestyle Medicine: Treating the Causes of Disease
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If doctors can eliminate some of our leading killers by treating the underlying causes of chronic disease better than nearly any other medical intervention, why don’t more doctors do it?

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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.

Though I was trained as a general practitioner, my chosen specialty is lifestyle medicine. Yes, most of the reasons people go to see their doctors is for diseases that could have been prevented, but “[l]ifestyle medicine is not just about preventing chronic disease[s], but also about treating [them].” And not just treating the disease; it’s “treating the causes of disease.”

If people just did four simple things—not smoking, exercising a half-hour a day, eating a diet that emphasizes whole plant foods, and not becoming obese—that may prevent most cases of diabetes and heart attacks, half of strokes, and a third of cancers. Even modest changes may be “more effective in reducing cardiovascular disease, [high blood pressure], heart failure, stroke, cancer, diabetes, and all-cause mortality than almost any other medical intervention.”

The key differences between conventional medicine and lifestyle medicine is instead of just treating risk factors, we treat the underlying causes of disease—as described in this landmark editorial. See, “[t]ypically doctors treat ‘risk factors’ for disease such as giving a lifetime’s worth of medications to lower high blood pressure, elevated blood sugar, and high cholesterol.” But, think about it. High blood pressure is just a symptom of diseased, dysfunctional arteries. Yes, you can artificially lower blood pressure with drugs, but that’s not treating the underlying cause—which often comes down to things like diet and exercise, “the penicillin of lifestyle medicine.”

“Disregarding the underlying cause[s] and treating only risk factors is somewhat like mopping up the floor around an overflowing sink instead of [just] turning off the faucet, which is why medications usually have to be taken for a lifetime. If a floor is flooded as a result of a dripping tap, it is of little use to mop up [around] the floor unless the tap is turned off. The water from the tap represents the cost of disease, the flooded floor the diseases filling [up] our hospital beds. [Yet] medical students learn far more about methods of floor mopping than about turning off taps, and doctors who are specialists in mops and brushes can earn infinitely more money than…those dedicated to shutting off taps.” And the drug companies are more than happy to sell rolls of paper towel, so patients can buy a new roll every day for the rest of their lives. Paraphrasing Ogden Nash, modern medicine is “making great progress, but [just] headed in the wrong direction.”

Preventive medicine, is, frankly, bad for business. “When the underlying lifestyle causes are addressed, patients often are able to stop taking medication,…or avoid surgery.” We spend billions cracking people’s chests open, but only rarely does it actually prolong anyone’s life. In contrast, how about wiping out “at least 90% of…heart disease”?

“Think about it. Heart disease accounts for more premature deaths than any other illness and is almost completely preventable simply by changing diet and lifestyle.” And, those “same…changes can prevent or…reverse many other chronic diseases as well”—the same dietary changes. So, why don’t more doctors do it? Well, one reason is doctors don’t get paid to do it. “No one profits from lifestyle medicine, so it’s not part of medical education or practice….Presently,…physicians lack training and financial incentives…So they continue to do what they know how to do: prescribe medication and perform surgery.”

After Dean Ornish proved you could reverse our #1 cause of death—heart disease—open up arteries without drugs, without surgery, just with a plant-based diet and other healthy lifestyle changes, he thought that his studies would “have a meaningful effect on the practice of mainstream cardiology.” After all, a cure for our #1 killer! But, he admits, he was “mistaken.” Physician “reimbursement,” he realized, “is a much more powerful determinant of medical practice than research.”

Reimbursement more than research. Salary over science. Wealth versus health. Not a very flattering portrayal of the healing profession, but, hey, if doctors won’t do it without getting paid, let’s get them paid.

So, Dr. Ornish went to Washington arguing that, look, “If we train and pay for doctors to learn how to help patients address the real causes of disease with lifestyle medicine and not just treat disease risk factors,” we could save trillions, and that’s just talking heart disease, diabetes, prostate and breast cancer.” The “Take Back Your Health Act” was introduced in the U.S. Senate to “induce doctors to learn and practice lifestyle medicine”—not only because “it works better,” but here’s the critical factor: “physicians will be paid to do it.” The bill “died,” just like the millions of Americans will continue to do, with reversible chronic diseases.

Please consider volunteering to help out on the site.

Images thanks to mikebairdPhilocriteshegarty_david and puuikibeach via flickr. Thanks to Dan Piraro for his kind generosity to use his amazing work.


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.

Though I was trained as a general practitioner, my chosen specialty is lifestyle medicine. Yes, most of the reasons people go to see their doctors is for diseases that could have been prevented, but “[l]ifestyle medicine is not just about preventing chronic disease[s], but also about treating [them].” And not just treating the disease; it’s “treating the causes of disease.”

If people just did four simple things—not smoking, exercising a half-hour a day, eating a diet that emphasizes whole plant foods, and not becoming obese—that may prevent most cases of diabetes and heart attacks, half of strokes, and a third of cancers. Even modest changes may be “more effective in reducing cardiovascular disease, [high blood pressure], heart failure, stroke, cancer, diabetes, and all-cause mortality than almost any other medical intervention.”

The key differences between conventional medicine and lifestyle medicine is instead of just treating risk factors, we treat the underlying causes of disease—as described in this landmark editorial. See, “[t]ypically doctors treat ‘risk factors’ for disease such as giving a lifetime’s worth of medications to lower high blood pressure, elevated blood sugar, and high cholesterol.” But, think about it. High blood pressure is just a symptom of diseased, dysfunctional arteries. Yes, you can artificially lower blood pressure with drugs, but that’s not treating the underlying cause—which often comes down to things like diet and exercise, “the penicillin of lifestyle medicine.”

“Disregarding the underlying cause[s] and treating only risk factors is somewhat like mopping up the floor around an overflowing sink instead of [just] turning off the faucet, which is why medications usually have to be taken for a lifetime. If a floor is flooded as a result of a dripping tap, it is of little use to mop up [around] the floor unless the tap is turned off. The water from the tap represents the cost of disease, the flooded floor the diseases filling [up] our hospital beds. [Yet] medical students learn far more about methods of floor mopping than about turning off taps, and doctors who are specialists in mops and brushes can earn infinitely more money than…those dedicated to shutting off taps.” And the drug companies are more than happy to sell rolls of paper towel, so patients can buy a new roll every day for the rest of their lives. Paraphrasing Ogden Nash, modern medicine is “making great progress, but [just] headed in the wrong direction.”

Preventive medicine, is, frankly, bad for business. “When the underlying lifestyle causes are addressed, patients often are able to stop taking medication,…or avoid surgery.” We spend billions cracking people’s chests open, but only rarely does it actually prolong anyone’s life. In contrast, how about wiping out “at least 90% of…heart disease”?

“Think about it. Heart disease accounts for more premature deaths than any other illness and is almost completely preventable simply by changing diet and lifestyle.” And, those “same…changes can prevent or…reverse many other chronic diseases as well”—the same dietary changes. So, why don’t more doctors do it? Well, one reason is doctors don’t get paid to do it. “No one profits from lifestyle medicine, so it’s not part of medical education or practice….Presently,…physicians lack training and financial incentives…So they continue to do what they know how to do: prescribe medication and perform surgery.”

After Dean Ornish proved you could reverse our #1 cause of death—heart disease—open up arteries without drugs, without surgery, just with a plant-based diet and other healthy lifestyle changes, he thought that his studies would “have a meaningful effect on the practice of mainstream cardiology.” After all, a cure for our #1 killer! But, he admits, he was “mistaken.” Physician “reimbursement,” he realized, “is a much more powerful determinant of medical practice than research.”

Reimbursement more than research. Salary over science. Wealth versus health. Not a very flattering portrayal of the healing profession, but, hey, if doctors won’t do it without getting paid, let’s get them paid.

So, Dr. Ornish went to Washington arguing that, look, “If we train and pay for doctors to learn how to help patients address the real causes of disease with lifestyle medicine and not just treat disease risk factors,” we could save trillions, and that’s just talking heart disease, diabetes, prostate and breast cancer.” The “Take Back Your Health Act” was introduced in the U.S. Senate to “induce doctors to learn and practice lifestyle medicine”—not only because “it works better,” but here’s the critical factor: “physicians will be paid to do it.” The bill “died,” just like the millions of Americans will continue to do, with reversible chronic diseases.

Please consider volunteering to help out on the site.

Images thanks to mikebairdPhilocriteshegarty_david and puuikibeach via flickr. Thanks to Dan Piraro for his kind generosity to use his amazing work.


Doctor's Note

By treating the root causes of diseases with plants not pills, we can also avoid the adverse side effects of prescription drugs, which kill more than 100,000 Americans every year, making them a leading cause of death. See my live presentation Uprooting the Leading Causes of Death.

For those surprised that policy makers wouldn’t support such a common sense notion as preventive health, check out The McGovern Report. What about medical associations? See Medical Associations Oppose Bill to Mandate Nutrition Training.

For those unfamiliar with Dr. Dean Ornish’s landmark work, watch the story about my grandmother in Resuscitating Medicare and Our #1 Killer Can Be Stopped.

There is another reason that may explain why the medical profession remains so entrenched; see The Tomato Effect.

For further context, check out my associated blog post: 4 Things to Help Prevent Most Disease.

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

72 responses to “Lifestyle Medicine: Treating the Causes of Disease

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  1. I’m not exactly sure, but the Affordable Healthcare Act does give better reimbursement for preventative medicine, so things are changing for the better, right?

    There is a big difference between a physician telling her patient to stop smoking, and a physician effectively counseling a patient.

    As an greenhorn medical student I think I have an ok understanding of lifestyle factors on health, but I totally lack confidence in counseling patients on lifestyle interventions.




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      1. Thanks for sharing Dr. G. I am at an infantile state in my training busting through an Anatomy course. It’s nice to reminded about the importance of clinically relevant skills.




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    1. I’m in an allied health profession, and the link to motivational interviewing is valuable. I’m not allowed to prescribe dietary interventions in my scope of practice, so I have to do work-arounds. Maybe I can look at our profession changing this regulation; in the meantime, the best I can usually do is refer patients to a dietitian or ask motivational questions. I can have literature in my office, so I should see if I can print out useful, readable, and credible documentation.




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      1. I went to medical school to have choices. I would refuse to practice in that environment. The purpose is to help the patient. It’s already hard enough but to be bound and gagged is ridiculous. I encourage you to consider seeking work elsewhere. Consider the ramifications that your contractual obligations have on your liability, your patient outcomes and your overall happiness




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    2. The “Affordable Health Care Act” is a control grid that centralizes all decision making and processes through the central government and insurance industry mega corporations. It takes from those who are proactive, who eliminate risks from processed foods, GMO food sedentary lifestyles and self destructive behaviors and forces them to pay for those who do not do the same. The most affordable health care is to take care of yourself, eat God’s food, not man’s food and take God’s medicine, not man’s medicine. This is a corporate-government takeover that has at its core the control of your life and your money.




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  2. Dr. Greger, are there any jobs/careers out there for nurses in the lifestyle medicine field? I currently work in a surgical/transplant/trauma ICU and although is it way less depressing than when I worked in the medical ICU, I find myself becoming burned out by the level of distress my patients (and families) are in and disillusioned by the attitudes toward health and treatment that my coworkers all hold. I love learning about nutrition and would love to somehow find a nursing job that incorporates that, but have yet to find anything when I have tried searching. Any input you have would be greatly welcomed. Thank you so much for the work you do. It has literally changed my life :)




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    1. You should totally check out the next American College of Lifestyle Medicine conference. I think it’s on the west coast next year. Great place to make these kinds of connections. Let’s keep people out of the ICU in the first place!




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      1. Dr. Greger, I live on the West Coast in Portland Oregon. I would love to see a Lifestyle Medicine Dr. How can we find out where these Drs are?




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    2. Sara, I do not know where you are (geographically), but I am a Board certified EM MD, who is now practicing (plant based) nutrition and lifestyle medicine on the East Coast. Check out my website http://www.NHWFFL.com. If you are in the vicinity, let’s talk.




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  3. You list 4 simple things to do to prevent disease; not smoking, exercise 1/2 per day, eat a plant based diet, and not becoming obese. So… I got the first three down pat, and am struggling with obesity. I cannot lose weight. Any thoughts?




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    1. Kathie. I also have been plant-based for 2 years and although I feel great, I have not lost weight. I have recently started replacing 2 meals per day with juicing fresh fruits/vegetables and watching out for oil, and go to the gym 3 times per week and I have now started to lose weight. Juicing is great and you can drink as many as you want, very nutritious and filling! I have lost 10 lbs and Im in my 3rd week. So far so good.




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    2. Check out the informative book by Dr. Robert Morse THE DETOX MIRACLE SOURCEBOOK. It contains a lot of information in a language taht is easy to understand.




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    3. What helped me was cutting out sugar (except that in whole fruits) and processed grains. Grains are converted to sugar very quickly by the body, and when blood sugar spikes, so does insulin. Insulin is a fat-storage hormone. I lost weight when I cut out sweets and grains. Not hard when I allowed myself a little more fat! Nuts, seeds, avocado, 86%+ cacao and coconut oil (with healthy MCT’s) are my new best friends!




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  4. I’m on the pre-med track and was fortunate to land an internship at our local free medical (and dental) clinic. As a “Diabetes Education Intern”, I follow the approach modelled in the video Dr. Greger posted. Patients who come to the clinic, already aware they have diabetes–or who are diagnosed there, are invited to find out about our education program.

    If they are interested, either I or my fellow intern who is bilingual in Spanish give them a brief overview of the program, which involves an initial in-person consultation, which first entails finding out what the patient already knows about the “treatment” of the disease, filling in any gaps (covers diet, exercise, and foot checks), and setting a very specific goal that the patient deems is achievable by rating it between 7 and 10 on the scale mentioned in the video. “Achievability” tends to be based on the patient noting not only what he/she wants to change in diet or exercise regimen–but when (days of the week, and time/mealtime) and quantity (e.g., how long a brisk walk will be, or how much of the plate will be devoted to produce). With that goal established, we interns then make weekly calls for 10 weeks to see how things are progressing. During each call (done at an agreed upon day and time), we ask them for their thoughts on their progress in achieving the goal–and may “tweak” it to make it more achievable or, if achieved, either keep with the goal or add to it.

    I love the idea of this approach–but it’s not always smooth sailing. Some people won’t take calls, some people report doing well but their tone suggests otherwise, some people lose interest, some people didn’t grow up with the “on a scale from 1-10” model so are alienated by that mechanism to pin down or adjust a goal, etc. I think so much of the problem stems from having been “brainwashed” by industry (Most everyone is middle-aged) and not necessarily believing what a plant-centric eating regimen can do for them, having established certain foods as comfort foods, and not having the structure of having weight, blood sugar levels, blood pressure, etc. measured by their physician throughout the 10 weeks. There are definitely successes, but I am eager to find out how to strengthen this model.




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  5. I think it’s more deeper than that. Adressing the root cause of this problem will send us down to the core – the very fabric – of our economic system. After all, feeding cheap food to lifestock to produce meat, the incentive behind this is the profit motive. And this generate poor health in the mean time. But guess what, more profits can be generate from sick people. And at every step of this process – animal and human suffer – but it generate growth, which our economy cannot function without. And every year it has to be more growth than the year before. NO WONDER that the low-carb is all of rage and that the mcgovern report wasn’t take into account. Our economy requiere infinite growth. This mean more ressource taken, used and trashed, more hamburgers, more obese that eat more and more, more drugs, more surgery, more stent, and more bypass to generate GDP, and low carb gurus are there to make us swallow the pills. It doesn’t take rocket science to figure this out, a finite world cannot support an infinite economic growth. One day or another, all of this will come to an end. All the question is: will we still be there to see it ?




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  6. I think the illusion of compliance is a factor as well. For example, I was watching a CME presentation about hemmorroids. There are 4 stages, 4 being the worst. The doctor was saying that most patients with stage 1 and 2 could be cured will fiber treatment (ie taking metamucil), but patient compliance is difficult. I don’t know how much is perceived vs real, but it appears many people would prefer to go under the knife than add a fiber supplement! Though i do not know if patients did not comply or were not told of that option. This was discussed in Essylstein’s book too, that patients are not told they can reverse heart disease with a vegan diet because they think they will not comply, but are all gungho to put them under the knife!




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  7. The problem is complex. Reimbursement is definitely a part of the problem, but probably to a lesser degree in some parts of the world – northern Europe – where healthcare to a lesser degree is buisness, but still the focus is on drugs and hi-tech procedures. There are national guidelines you have to follow, so if you prescribe broccoli and brussel sprouts to a heart attack patient instead of aspirin, statin, candesartan and an elektive stent, you will be in serious trouble, even though you will save government-money (and your salary will be the same). So the problem is also lack of knowledge at a higher level. I do not underestimate patients, but a lot of patients wants the easy solution – a pill, a procedure – a have spent hours trying to convince some close relatives to change their diet and habits instead of popping pills for their lifestyle diseases, but without any luck at all. I have a very skilled colleague with newly diagnosed type 2 DM (obese) and even though he totally agrees, he doesnt have the belly ( :-) ) to change his habits and diet.




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  8. In medical school long ago (17 years?), we learned an ancient Chinese adage, which went something like this:

    “To administer medicines to diseases which have already developed is comparable to the behavior of those persons who begin to dig a well after they have become thirsty.”




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    1. Karen,
      That is a very good result. NNT (Number needed to treat ) is 2. No medication can match that. Diet an exercise is a (big ) part of the equation, but it will not cure or prevent everything




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    2. Also, if you have ever heard a presentation by Dr. Joel Fuhrman, you will note that hemorrhagic strokes actually increase with vegan diets a lot of the time because people do not decrease their sodium intake when they cut out high fat foods. This leaves their smaller arteries and veins weak in their defense against blood pressure spikes. It could be worth checking into if you are still interested!




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  9. I have been a ‘good’ vegan for almost three years now and exercise every day. At first I lost some weight, but have since gained it back and then some. Also, my insulin use as a type 2 diabetic is up.

    In the past three decades I have lost and gained substantial weight in excess of ten times, and will not do so again. I am counting on the health effects of the food choices and daily exercise.

    It seems to me that it is time to give up the ‘diet’ mentality when discussing obesity. It has never worked for more than 2% of the population. Further, it does not explain the reason that Dr. Greger does not have millions of subscribers and lots of financial support, or that the findings about diet aren’t government policy in a country going bankrupt.

    My experience in successful weight loss has to do with ‘stress’ in its broadest meaning. The more I reduce my stress, the less I weight. Today I weight 245 lbs. but spent most of my life over 300 lbs. Of
    most importance, I am healthy, mobile, and very alive at age 65.

    Thank you Dr. Greger for your large part in making it happen!




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    1. HI Frank- I and a lot of my friends who are vegetarian couldn’t lost weight because we were basically “starchetarians”. What helped was eliminating the white foods (white flour, white potatoes, white rice etc.) which, although vegan, are very high glycemic. Actually, whole wheat is almost as high-glycemic as refined, and therefore wreaks havoc with insulin because it converts to sugar right away in the body! Insulin drives the body to store fat. Grains (even whole grains) & sugar used to lead me on a wild blood sugar roller coaster and vicious cycle of cravings all day long. Wheat in particular is basically an appetite stimulant for me. I lost weight by increasing my intake of nuts, seeds, avocado, cashew cream, nut butters, coconut oil (a superfood), and even dark chocolate that’s 80%cacao or more (low-glycemic). The higher fat content leads to greater satiation, so you feel fuller much longer.




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  10. As always, another great article. Thanks! My Ph.D. is in Health Psychology and Behavioral Medicine. We learned about Dr. Ornish’s work in grad school. I’m always happy to hear people talk about him, because I don’t think he gets enough recognition for his groundbreaking work. Also, I’m happy to be one of the lucky ones who makes a living by helping people address the source of their issues, and manage their health without medication and surgery in most cases! However, insurance still is a problem, because it often won’t reimburse for these services.




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  11. Doesn’t “cure” everyone. I still need antihypertensives but my blood pressure is much easier to control and a minimal dose. No type of food is going to improve upon my low HDL cholesterol. So while there can be dramatic improvement, I wouldn’t sell this as a cure all.




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  12. I think doctors today are treating the lifestyle, not the person. Maybe for some people that is exactly what they want for awhile.
    But it is another thing to convince them that there’s nothing that change of lifestyle (and/or diet) would make any difference. That is where the criminality of it all starts.




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  13. How do you get doctors to do lifestyle medicine for someone already dealing with a chronic disease like cancer ? You have a GI cancer, you test negative for Celiac’s and you have Hashimoto’s, yet no doctor is telling you to avoid gluten? Is there a connection to these or all coincidental ? Why don’t doctors look at lifestyle and make connections and give patient directions?




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  14. I have a deep respect for the work done by Dr. Greger and
    the NF team, however I have some ambivalence about this video describing the virtues of lifestyle medicine.

    To preface, I am in complete agreement that the best medicine involves prevention rather than cure. Our biggest health burdens would be very much tempered by preventive approaches to care, and it would be an absolute delight to see the reliance on pharmaceutical and biotech industries dismantled. However, the most common chronic diseases in
    North America are distributed disproportionally among those of lower
    socioeconomic status. The Whitehall studies, and the prolific research built upon the foundations of the Whitehall findings clearly highlight the inextricable link between socioeconomic position and health; the “social gradient”. Indeed, previous comments to this video have already alluded to broader issues contributing to health, such as access to affordable care and chronic stress. (Adrien makes some very compelling observations!) Our current economic situation sees a growing income disparity, time poverty, the expansion of food deserts in urban centres, environmental decay, and the commercialization of public green space…all detrimental to health and health related behaviours.

    It would be a shame if lifestyle medicine, in its disregard
    for the broader ecological influences on health, is accused of taking a blame the victim approach toward those burdened by cancer, heart disease, or type 2 diabetes.

    While I think behavioural change is virtuous and those that adhere to a clinical model of lifestyle education should be commended, I nonetheless
    have certain reservations about behavioural models for lifestyle change as a whole:

    Behaviour and lifestyle choices are strongly influenced by
    normative values; the decisions and actions of others in one’s cultural,
    physical, and social sphere strongly affect personal decisions regarding
    lifestyle. Additionally, we assume that by providing adequate information, people can—and will—make decisions about their health in a way we have predetermined as rational. We often fail to situate intrapersonal decision-making within a broader framework that includes, for example, psychological support and physical resources.

    What lifestyle medicine appears to assume is that the
    resources that enable healthy lifestyles are readily available: access to
    affordable and nutritious food, the precious time to prepare it, the safe
    places to go outdoors for exercise, the time and energy to engage in leisure activity, the social support by others that share the same lifestyle values, and the sense of self-efficacy or empowerment required for personal change. In other words, lifestyle medicine makes the assumption that all have access to lifestyle choices optimal for health.

    I hypothesize that when we look beyond intrapersonal failures
    and consider social failures for the maldistribution of poor health in North
    America, epidemiological outcomes will be much more inspiring.




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    1. This is an important perspective that is all too often left out of the conversation. Most of us are familiar with all of the recommendations on how to make a plant based diet affordable: bulk dry beans, frozen veggies, etc, but in making those suggestions we are exposing our own privilege by assuming even those basic foods are accessible. So unfortunately we have food deserts and a lack of information/outreach centered smack dab on the populations suffering the greatest from lifestyle-based disease. What to do? I genuinely don’t know. I’m no social scholar.

      I would love to see Dr. Greger or any of the other plant docs team up with someone like Ron Finley or Will Allen for a nationwide tour, focusing on venues in communities that need it the most.




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    2. Sharonmc- You read my mind. Inner city dwellers absolutely need greater fresh food access, in addition to the education piece. Healthy eating is difficult on a limited budget because unfortunately some of the worst foods are the cheapest. Exceptions: potatoes, bananas, and broccoli. All cheap but nutritious overall. We are learning more about food deserts paradoxically in rural areas as well . . . but everywhere, the tyranny of processed and fast food has robbed us of all desire to cook our own food, which is half the battle.




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  15. Geez, how un-American can you get Dr. Greger !? Eating large quantities of chicken fried streak (and chicken fired chicken…) and getting on a cocktail of heart and cholesterol meds, oils the wheels of commerce that we all depend on !




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  16. I’m a pre-med student but I really love the field of lifestyle medicine and prevention-focused care. Do you know if there are specific medical schools that focus on this, or a certain type of medicine that would be best to bridge me into this field for my career? Thank you!




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  17. You are of course correct Dr Greger. It is so much easier to prescribe a statin and dismiss a patient than to level with them and coach them to adopt a plant-based diet. The former takes less than 5 minutes, the latter usually 30-40 minutes and serial sessions. We need to change the reimbursement scheme for lifestyle-oriented medicine so that lifestyle once again becomes foundational, rather than drugs. I say this as a clinical pharmacologist.




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  18. There was recently a case in Australia where a patient successfully sued their general practitioner for failing to ensure that they had weight loss surgery. Apparently making an appointment with a weight loss surgeon was not enough. This judgement was appealed all the way to the High Court of Australia before it was finally overturned.

    See http://www.abc.net.au/news/2013-08-26/overweight-man-luis-almario-legal-battle-prompts-obesity-warning/4913292

    I wonder what would happen if a patient sued their doctor for not making them eat a healthy diet?




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  19. o dear dr gregor!!! just please keep ringing the bell and more and more you and we are getting heard, its a slow change but still saving lives along the way! bravo to you!!!!




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  20. Un buleevable. But you know what? In my 30 yrs in the health field (alternative) that is exactly the feedback I got and why I was happy to reinvent myself when the economy changed. . . healing yourself is more work than is worth the trouble. . . As my father (a neurologist) said of his obese dog, riddled with tumerous, oozing, lumps and barely able to walk, laying next to him with his spoon and half gallon of ice cream, while addressing that maybe he should not feed the por dog so much when she never leaves the house for so much as a walk – his reply, “but what else has she got to live for but her food?”. . . . Nuff said. I come from an entire family in the med profession, with as little interest in health, when money and status are the real richness in life, and indulgence and gluttony the entitled reward.. . . Well, there are those really seeking who you can touch. Folks still believe in the med profession blindly, so the coat and letters help in your favor. . . . I was just a voice in the wind of howels of diet and propaganda. . . . I love what you are doing. Makes me proud to be human and that’s something I don’t think I’ve ever said. :)




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  21. I have training in both medicine and theology. The reason that most physicians and patients cannot hear your excelent advise is that they are in violation of Natural Law which has consequences. As to why, Blackstone’s Commentaries on the Laws on England, Book 1, Sec. “2 Of the Nature of Laws in general, ” page 41 states “This law of nature, being co-eval with mankind and dictated by God himself, is of course superior in obligation to any other. It is binding over all the globe, in all countries, and at all times: no human laws are of any validity, if contrary to this; and such of them as are valid derive all their force, and all their authority, mediately or immediately, from this original.” and in the forth book which is criminal law, Blackstone said
    that the highest crime is treason against God while treason against the king was second. If you look in current books on legal analysis they totally
    ignore God. I have read that this is due to the infamous Erie v Tompkins case.
    The consequences are repeating the book of Jeremiah all over again where 15 times some variation of “Jer_24:10 And I will send the sword, the famine, and the pestilence, among them,” is stated. Famine can be bad food causing an epidemic of heart disease which they cannot hear.




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  22. Hi. I have hypotension (low blood pressure) due to low aldosterone and currently have to take fludrocortisone to keep my blood pressure up. Any suggestions or thoughts on this one?
    Thank you :)




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  23. I do have to note as an MD who cared for thousands of amputees, diabetics, stroke survivors, complicated CABG survivors, etc., I essentially took a cut in pay to perform very thorough histories and examinations, 1.5 hours, and follow up visits, 0.5-1 hour, to spend time educating my patients on lifestyle changes. On every hospitalized patient with complicated medical and surgical problems due to lousy lifestyle practices, I consulted a nutritionst to evaluate and counsel the patient and their families as well asking both nutritionists and patients to discuss the consults with me. My group of patients were particularly recalcitrant, and hospitals were no better serving the worst possible foods to my patients. Before smoking was banned on hospital grounds, patients would often complain of recurrent TIA’s, wound healing issues, and recurrent chest pain while smoking. With the way they were fed, as well as visitors bringing junkfood to the hospital, blood sugars were either through the roof or in the toilet. Patients and their families must be held accountable for compliance. We must pay doctors to educate patients, but the patients must be held accountable by some means and I would be interested in your thoughts.




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  24. maybe your best presentation to date… PPACA in title 4 (page 463) begins the tale how the cost of prevention will be funded – and justified in tangible cost saving results…. BUT the $ funding of these programs has been gutted and the delivery of disease prevention services has not been supported… the reimbursement for exercise counseling CPT Diagnosis Code V65.41 is minimal, varies by payer and location, is often denied and does not support “testing” as part of delivery … so we are back to “identifying” and “treating” a primary complaint … not avoiding it




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  25. Please help me thank dr.arugundale for his good work I really believe HIV have cure I was HIV positive over since 1year plus before I come across a comment dr.arugundale that he have cure to any disease and virus but when I saw it i have it in mind that he can’t cure HIV I just decided to give a try I contact him that night lucky to me he said yes but I don’t believe him I think it was a scam or some thing like that but I still hold on to see the work of dr.arugundale if he is saying the true he ask for different thing and some question about me I give him all the detail he needed and I wait to see his reply to my problem after all the thing is done he ask me to go for check up I went for hiv test I cant believe I was negative thanks dr.arugundale for help me for not dying at this young age if you need help contact him now dr.arugundale@gmail.com
    he can also help you on the following…………..

    1) If you want to cure HIV/AIDS.
    (2) If you want your ex back.
    (3) if you want to cure your harpes
    (4) You want to be promoted in your office.
    (5) You want women/men to run after you.
    (6) If you want a child.
    (7) You want to be rich.
    (8) You want to tie your husband/wife to be yours forever.
    (9) If you need financial assistance.
    kindly contact him on EMAIL:dr.arugundale@gmail.com




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  26. It seems to me that insurance companies who pay physicians might have much more incentive than a congress intent on insuring that nothing the other team proposes ever get enacted. If health insurers and HMO’s believe the evidence that you present, surely they would rather pay to have my physician help me change my lifestyle than later pay another physician to open up my chest.




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  27. I could not find a specific video relating to my question, so just landed on this discussion board in hopes to find some answers. I am wondering if Dr. Greger knows of any science behind being on a plant based (carb heavy) diet with traumatic brain injury. I have a friend who is considering going plant based but is concerned about the heavy carbs that are consumed. She read that alot of carbs are not good for TBIs. I would love to give her some helpful info on this topic in hopes it doesn’t hinder her from going plant based.




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    1. There has been some encouraging research regarding brain cancer and ketogenic diets but I don’t believe that has extended to non-tumorous conditions and even then the results were rather short lived. The things that I have seen research positively correlated with people improving with TBI includes supplementation with Omega 3 Fatty Acids, zinc and B vitamins – all part of a healthy diet.




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    1. Miataga, I am one of the volunteer moderators here at NF.org. Great question! Here’s an interesting link: https://nutritionfacts.org/video/preventing-liver-cancer-with-coffee/. It confirms what I already suspected (bitter foods are usually good for the liver) as well as veggies which contribute to the creation of short chain fatty acids (Veggies rule!). Short chain fatty acids can fuel the cells of the colon as well as travel through the small intestine into the portal vein and then to the liver (to be used as fuel or sent elsewhere.) The liver is an amazing complicated organ with over 500 functions. Yikes! That being said, the nutrition is an ever expanding science with much yet still to discover.

      As far as Blood Urea Nitrogen, that’s a complicated question. Per the textbook entitled, ” Nutrition Therapy and Pathophysiology for the Public Health Nutritionist, BUN can be low “in fluid volume excess”. I think I need to refer you to a health professional. Best of luck!!




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  28. I have changed my eating plan to a WFPB one and am very pleased with the results of the past 6 weeks. I do have one question. I read that green smoothies containing too many cruciferous vegetables, or eating too many of these vegetables can result in high levels of oxalate which can result in kidney stones and other health issues. Can you explain what oxalates are and if you can overdo foods that are high in this compound? Thank you and thanks for your good works. I purchased your book and it is a wonderful, very informative read!




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  29. Pat,

    May I suggest a quick view of the video: https://nutritionfacts.org/video/how-to-treat-kidney-stones-with-diet/. You can easily see how the story is a bit more complicated and not simply diet related……

    The video is a good overview and if you’re concerned with your levels, it’s an easy and inexpensive urinary test.

    On another note, there are clear associations between GI issues/Low B6 levels/ and a host of other considerations when talking about oxalate kidney stone formation. The green smoothie deal is an isolated occurrence, please see: http://veganhealth.org/articles/oxalate for a really good overview of the subject and the patient facts.

    For more on a green smoothies see Dr. Greger’s video : https://nutritionfacts.org/video/the-downside-of-green-smoothies/

    And it would be inappropriate to not suggest that of course one could overdo some foods……. Variation and an ongoing large selection of different foods is the key to getting adequate nutritional value, not focusing on a single food.

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com




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