Low-Carb Diets & Coronary Blood Flow

Low-Carb Diets & Coronary Blood Flow
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Blood flow within the hearts of those eating low-carb diets was compared to those eating plant-based diets.

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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.

People going on low-carb diets may not see a rise in their cholesterol levels. How is that possible? Because weight loss by any means can drop our cholesterol. We could go on an all-Twinkie diet and lower our cholesterol if we were unable to eat the dozen daily Twinkies necessary to maintain our weight. That’s why a good cocaine habit can lower cholesterol. Chemotherapy can drop cholesterol like a rock. Tuberculosis can work wonders on one’s waistline. Anything that drops our weight can drop our cholesterol. But, the goal isn’t to fit into a skinnier casket. The reason we care about cardiovascular risk factors like cholesterol is because we care about cardiovascular risk—the health of our arteries.

Well, now we have studies that have measured the impact of low-carb diets on arteries directly, and a review of all the best studies done to date found that low-carb diets impair arterial function, as evidenced by a decrease in flow-mediated dilation—meaning low-carb diets effectively cripple people’s arteries. And, since the meta-analysis was published, another study found the same thing. A dietary pattern characterized by high protein and fat, low carbohydrate, was “associated with poorer peripheral small artery function”—again measuring blood flow into people’s limbs. Peripheral circulation is great, but what about circulation in the coronary arteries that feed our heart?

There’s only been one study ever done measuring actual blood flow to the heart muscles of people eating low-carb diets, and this is it. Dr. Richard Fleming, an accomplished nuclear cardiologist, enrolled 26 people into a comprehensive study of the effects of diet on cardiac function using the latest in nuclear imaging technology—so-called SPECT scans—enabling him to actually directly measure the blood flow within the coronary arteries.

He then put them all on a healthy vegetarian diet, and a year later, the scans were repeated. By that time, however, ten of the patients had jumped ship onto the low-carb bandwagon. At first, I bet he was upset, but surely soon realized he had an unparalleled research opportunity dropped into his lap. Here, he had extensive imaging on ten people following a low-carb diet, and 16 following a healthy high-carb diet. What would their hearts look like at the end of the year? We can talk about risk factors all we want, but compared to the veg group, did the coronary heart disease of the patients following the Atkins-like diets improve, worsen, or stay the same?

Those sticking to the vegetarian diet showed a reversal of their heart disease, as expected. Their partially clogged arteries literally got cleaned out. They had 20% less atherosclerotic plaque in their arteries at the end of the year than at the beginning. What happened to those who abandoned the treatment diet, and switched over to the low-carb diet? Their condition significantly worsened. 40 to 50% more artery clogging at the end of the year. Thanks to the kind generosity of Dr. Fleming, we can actually see the changes in blood flow for ourselves.

Here are some representative heart scans. The yellow, and particularly red, represent blood flow through the coronary arteries to the heart muscle. This patient went on a plant-based diet, and their coronary arteries opened right up, increasing blood flow. This person, however, started out with good flow, but after a year on a low-carb diet, significantly clogged down their arterial blood flow.

This is the best science to date demonstrating the threat of low-carb diets, not just measuring risk factors, but actual blood flow in people’s hearts on different diets. Of course, the reason we care about cardiac blood flow is we don’t want to die. And, a meta-analysis was recently published that finally went ahead and measured the ultimate endpoint, death, and “low-[carb] diets were associated with a significantly higher risk of all-cause mortality”—meaning low-carbers living a significantly shorter lifespan.

Please consider volunteering to help out on the site.

Images thanks to C-Monster, seagers, and Mykl Roventine via flickr; Veronidae and Linda Bartlett via Wikimedia, and the World Lung Foundation.

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.

People going on low-carb diets may not see a rise in their cholesterol levels. How is that possible? Because weight loss by any means can drop our cholesterol. We could go on an all-Twinkie diet and lower our cholesterol if we were unable to eat the dozen daily Twinkies necessary to maintain our weight. That’s why a good cocaine habit can lower cholesterol. Chemotherapy can drop cholesterol like a rock. Tuberculosis can work wonders on one’s waistline. Anything that drops our weight can drop our cholesterol. But, the goal isn’t to fit into a skinnier casket. The reason we care about cardiovascular risk factors like cholesterol is because we care about cardiovascular risk—the health of our arteries.

Well, now we have studies that have measured the impact of low-carb diets on arteries directly, and a review of all the best studies done to date found that low-carb diets impair arterial function, as evidenced by a decrease in flow-mediated dilation—meaning low-carb diets effectively cripple people’s arteries. And, since the meta-analysis was published, another study found the same thing. A dietary pattern characterized by high protein and fat, low carbohydrate, was “associated with poorer peripheral small artery function”—again measuring blood flow into people’s limbs. Peripheral circulation is great, but what about circulation in the coronary arteries that feed our heart?

There’s only been one study ever done measuring actual blood flow to the heart muscles of people eating low-carb diets, and this is it. Dr. Richard Fleming, an accomplished nuclear cardiologist, enrolled 26 people into a comprehensive study of the effects of diet on cardiac function using the latest in nuclear imaging technology—so-called SPECT scans—enabling him to actually directly measure the blood flow within the coronary arteries.

He then put them all on a healthy vegetarian diet, and a year later, the scans were repeated. By that time, however, ten of the patients had jumped ship onto the low-carb bandwagon. At first, I bet he was upset, but surely soon realized he had an unparalleled research opportunity dropped into his lap. Here, he had extensive imaging on ten people following a low-carb diet, and 16 following a healthy high-carb diet. What would their hearts look like at the end of the year? We can talk about risk factors all we want, but compared to the veg group, did the coronary heart disease of the patients following the Atkins-like diets improve, worsen, or stay the same?

Those sticking to the vegetarian diet showed a reversal of their heart disease, as expected. Their partially clogged arteries literally got cleaned out. They had 20% less atherosclerotic plaque in their arteries at the end of the year than at the beginning. What happened to those who abandoned the treatment diet, and switched over to the low-carb diet? Their condition significantly worsened. 40 to 50% more artery clogging at the end of the year. Thanks to the kind generosity of Dr. Fleming, we can actually see the changes in blood flow for ourselves.

Here are some representative heart scans. The yellow, and particularly red, represent blood flow through the coronary arteries to the heart muscle. This patient went on a plant-based diet, and their coronary arteries opened right up, increasing blood flow. This person, however, started out with good flow, but after a year on a low-carb diet, significantly clogged down their arterial blood flow.

This is the best science to date demonstrating the threat of low-carb diets, not just measuring risk factors, but actual blood flow in people’s hearts on different diets. Of course, the reason we care about cardiac blood flow is we don’t want to die. And, a meta-analysis was recently published that finally went ahead and measured the ultimate endpoint, death, and “low-[carb] diets were associated with a significantly higher risk of all-cause mortality”—meaning low-carbers living a significantly shorter lifespan.

Please consider volunteering to help out on the site.

Images thanks to C-Monster, seagers, and Mykl Roventine via flickr; Veronidae and Linda Bartlett via Wikimedia, and the World Lung Foundation.

Doctor's Note

The reason I have so few videos about low carb diets is that I already wrote a whole book about it! Carbophobia is now available free online full-text at AtkinsExposed.org. Atkins’ lawyers threatened to sue, leading to a heated exchange I reprint on the site.

I did touch on low-carb diets in my video Atkins Diet: Trouble Keeping It Up, though they don’t have to necessarily be that unhealthy (see Plant-Based Atkins Diet).

Here are some recent videos I’ve done on conquering our #1 killer:

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

255 responses to “Low-Carb Diets & Coronary Blood Flow

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  1. Hmm..from the abstractof the first study (Bueno et.al.)

    The primary outcome was bodyweight. … Individuals
    assigned to a VLCKD showed decreased body weight (weighted mean
    difference 20·91 (95% CI 21·65, 20·17) kg, 1415 patients), TAG (weighted
    mean difference 20·18 (95% CI 20·27, 20·08) mmol/l, 1258 patients)and
    diastolic blood pressure (weighted mean difference 21·43 (95% CI 22·49,
    20·37) mmHg, 1298 patients) while increased HDL-C(weighted mean
    difference 0·09 (95% CI 0·06, 0·12) mmol/l, 1257 patients) and LDL-C
    (weighted mean difference 0·12 (95% CI 0·04,0·2) mmol/l, 1255 patients).
    Individuals assigned to a VLCKD achieve a greater weight loss than
    those assigned to a LFD in the longterm; hence, a VLCKD may be an
    alternative tool against obesity.

    The Fleming study looks for me a little bit flawed as there were only 19 people under obeservation at first, later 26 (some of theme seemed to hop on and off hier diet), so a small, inconstistent group is a little bit difficullt to make some conclusions. For more critique about Fleming’s study see also:

    http://bit.ly/1hNi2wi




    1
    1. There are flaws in every study, and in the Fleming study, the opportunity to make a comparison between two truly contrasting groups was unforeseen. So you’re going to nitpick for that?

      If the SPECT FMD scans were not conclusive, their cautionary data should certainly not be discounted, either. How can your average low-carb dieter know whether or not he could be very much like one of those Atkins dieters in Fleming’s study until it’s possibly too late? When was the last time you asked your doctor for a SPECT/FMD scan?

      At the very least, this is an opportunity for a larger study to confirm or falsify Flemings ad hoc results. Where are the Atkins Foundation and the NuSI guys when you need them?




      2
        1. The MSM/Atkins/Paleo/Low Carb reports on the Interwebs are wrong. As usual, the devil is in the details.

          Debunking News of Sweden’s “Low-Carb, High-Fat” Guidelines

          “Although the Swedish Council on Health Technology Assessment found benefits of eating healthy fats, they won’t be changing their guidelines.”

          http://experiencelife.com/newsflashes/debunking-news-of-swedens-low-carb-high-fat-guidelines/

          When we contacted Anna Karin Lindroos, PhD, a nutritionist at Sweden’s National Food Agency, to ask about the new guidelines, she set the record straight: “Sweden does not have any guidelines on low-carb-high-fat diets. The information that Sweden has guidelines on low-carb-high-fat diets is based on incorrect information circulating on the Internet.”

          As it turns out, reporters had mistaken a review published by the Swedish Council on Health Technology Assessment (SBU) in September for new national guidelines. Måns Rosén, PhD, executive director at SBU, was anxious to squelch the rumors. “First, I would like to stress that we do not do guidelines, only systematic reviews and health technology assessment reports,” he says. “Second, we have earlier focused on patients with diabetes and now obese persons, not the general population.”

          For the obese, the report found a benefit for a Mediterranean style diet with extra virgin olive oil and nuts. Low carb diets are mentioned as having a short term weight loss advantage over low fat diets. Full fat dairy may lead to weight loss in obese children and adults.

          I’m sure Dr. Greger will agree to disagree, that full-fat animal products have satiety value over junk carbs, but a high quality carb WFPB diet is better for long term health and weight loss.




          4
            1. Why are you posting a sensationalized, low carb propagandist article after I just posted an answer for you from a low carb website admitting that Sweden’s national guidelines have not been changed?




              4
              1. Checked the link you provided. It appears that Sweden is not changing their guideline, but the article seems to advocate high fat, low carb. I would be more convinced if you had more than one study. Plus the study was done over ten years ago.




                1
                1. Right. That was the point. It wasn’t a vegetarian-slanted site disputing the report but a HFLC site saying, We wish this were true, but it isn’t.

                  I wasn’t paying attention to any studies. Just the erroneous headlines.




                  2
                  1. ‘There are flaws in every study, and in the Fleming study, the opportunity to make a comparison between two truly contrasting groups was unforeseen. So you’re going to nitpick for that?’

                    There is no excuse for bad experimental design, and it’s ridiculous to paint all “science with it’s a flawed so you just have to suck it up”. Clearly some flaws are bigger than others. These are pretty big flaws in a small sample size.




                    1
                    1. That part of the Fleming’s study was unplanned. It was not designed that way. Fleming just reported what actually happened. Better that than report skewed results caused by patient non-compliance as many studies do, just adding to nutritional confusion.

                      Fact is, many people suffer deleterious cardiovascular effects from Atkins/low-carb meat-based diets despite some improvement in blood lipids due to weight loss.

                      [Edit:…and despite improvements in fasting blood glucose/A1C numbers. The map is not the territory. Tricking bio markers does not necessarily stop the disease process.]




                      2
                    2. Fine. Report the problems but disregard the results.

                      And your citations for the deleterious effects are?




                      1
                    3. Oh sorry. My mistake. When you make statements like : “Fact is, many people suffer deleterious cardiovascular effects from Atkins/low-carb meat-based diets despite some improvement in blood lipids due to weight loss”, I stupidly assumed that you had some scientific data to back you up, not just a few anecdotes.

                      The plural of anecdote is not “scientific data”.




                      1
                    4. Actually, I was interested in intelligent debate and trying to understand the scientific basis for your assertion that that “low-carb meat based diets are deleterious to cardio vascular health”.

                      But instead of producing the actual studies, you’ve gone for the old “argument from authority” logical fallacy, and given me links to two website, neither of which are credible sources, and neither of which have references to studies that support your assertion.

                      This doesn’t surprise me – I’ve extensively reviewed the literature on low-carbohydrate diets, and I’m not aware of any studies of long enough duration to pick up hard endpoint cardiovascular outcomes.

                      You should really familiarise yourself with the scientific research before making unsupportable assertions.




                      4
                    5. Utter, utter unscientific crap: “These ketone bodies are acidic, which is why when you read the research conducted by the low carb gurus they supplement with sodium and other minerals. Without this addition, the blood may become dangerously acidic.”




                      1
                    6. “These ketone bodies are acidic, which is why when you read the research conducted by the low carb gurus they supplement with sodium and other minerals. Without this addition, the blood may become dangerously acidic.”

                      —> “changes in cerebral pH have not been observed in rats consuming a ketogenic diet, nor have changes been noted in blood pH in humans consuming the ketogenic diet”
                      http://www.ncbi.nlm.nih.gov/pubmed/5166216
                      http://www.ncbi.nlm.nih.gov/pubmed/8598184

                      –>”There were no differences in blood or brain potassium or calcium concentrations in rats consuming a ketogenic diet”
                      http://www.ncbi.nlm.nih.gov/pubmed/4525180

                      –>”Serum levels of sodium, potassium, and calcium were similarly unaltered in humans consuming a ketogenic diet”
                      http://www.ncbi.nlm.nih.gov/pubmed/10047944




                      1
                    7. I am not appealing to authority. I have referred you to resources where the scientific citations have already been collected. You can do your own homework from there.

                      I have neither the time not the inclination for debate, intelligent or otherwise. Nor do I have a computer. Laboriously copying and pasting on a smartphone is more trouble than I care to impose upon myself.

                      I wish you good health. Have a good day. :-)




                      3
                    8. But none of those studies demonstrate that “many people suffer deleterious cardiovascular effects from Atkins/low-carb meat-based diets”

                      Surely you must be able to find just one…




                      1
                    9. Check these out, mate, for a start:

                      – Ted D. Barnett, Neal D. Barnard, Tim L. Radak, Development of Symptomatic Cardiovascular Disease after Self-Reported Adherence to the Atkins Diet, Journal of the American Dietetic Association, Volume 109, Issue 7, July 2009, Pages 1263-1265.

                      – Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity. Shane
                      A. Phillips, Jason W. Jurva, Amjad Q. Syed, Amina Q. Syed, Jacquelyn P. Kulinski, Joan Pleuss, Raymond G. Hoffmann, David D. Gutterman. Hypertension. 2008 February; 51(2): 376–382.

                      – Walker C, Reamy BV: Diets for cardiovascular disease prevention: what is the evidence? Am Fam Physician 2009, 79: 571–588.

                      – Ma Y, Pagoto SL, Griffith JA, Merriam PA, Ockene IS, Hafner AR, Olendzki BC: A dietary quality comparison of popular weight-loss plans. J Am Diet Assoc 2007, 107:1786-1791




                      3
                    10. – 1. article was only about death of one guy, would hardly be statistially significant.

                      – 2. Second article was strongly flawed to me because they effectively hide exact diets of 2 groups? If they supplied LC group with 20g/day of very unhealty carbs, it may very well affect their FMD in a bad way. Inversely, they stated that low fat groups fat intake would be 30% but what about the percentages of carbs and proteins? Why they omit the exacty details of diets? Are they afraid of some one would find flaws? And they did this experiment on only 20 people, I wonder if they calculated their error approximation with this low number of people.

                      I could not acces 3rd article to read, and skipping 4,

                      the 5th:
                      “Low-carbohydrate–high-protein diet and long-term survival in a general population cohort.”

                      Really? What is proven to be safe and effective is low carb- moderate protein and high fat diets. And researching LC-HP diet hardly contributes to the case.

                      It is well know that researchs promoting low fat – high carb, and demonizing high fat low carb diets tends to be flawed because of the overwhelming bias of the science community of medicince, towards the benefit of LF diets.




                      0
                    11. Stephen: if you are after a comprehensive review of the lipid hypothesis and LC diets pop onto plantpositive.com. You will find your intelligent debate there discussed by those in lipid research and cardiology.




                      2
                    12. Yeah. If you are looking for unbiased discussion on the lipid hypothesis, go to a vegan propaganda site. Brilliant suggestion. Not.




                      2
                    13. Ha ha… I get it. Looks like we are dealing with personal beliefs and preferences, not impartial reading. If you actually spent the time to fact check his primary references you will see his arguments are well supported by a wide variety of researchers following the scientific method. Vegan propaganda site? Really? Look up denialism, this is it. I’m not vegan and have read the studies he shares and the research is solid. Your response suggests you are emotionally and financially invested in your own ideas. The weight of evidence doesn’t favor LC. A feature characteristic of denialism is is selectively, drawing upon isolated studies to challenge the dominant consensus or highlighting the flaws in the weakest papers among those that support it as a means of discrediting an entire field. This is your argument in a nutshell. Its funny listening to the language people use, it exposes their critical thinking ability and underlying motivations.




                      4
                    14. Dr. Atkins first published his book in 1972, seven years after he introduced his diet to America on late night TV. At its height, his clinic purportedly treated over 50,000 patients. The Atkins corporation, which generates millions of dollars in revenue was formed in 1998. Dr. Loren Cordain first started publishing on the Paleo diet in early 2000. So I ask you why you think there is no long term data published as yet on any cardiovascular outcomes? Even a small sample study in existing heart patients ( like the one published by Dr. Ornish PMID: 20714228) would be hypothesis generating.




                      2
                    15. Because there have been no studies done. Low-carb has never been fashionable enough to influence a large enough cohort to make such studies feasible.

                      Exactly what hypothesis are you forming from the Ornish study you cite? Changing three variables at once “low-fat diet, exercise, stress management” is just bad science, especially in an n=27 study. I’d expect similar results on a low-carb diet, with intensive exercise and stress management.




                      0
                    16. Your “expectations” are duly noted, as surely they qualify as “good science” compared to peer reviewed data. It should make you wonder that with over 50 years of low carb teaching, thousands of patients treated, there isn’t a single published trial on long term positive cardiac events/outcomes, not even a small one? Especially considering that a positive trial like that would generate millions of dollars in additional revenue for the Atkins Corporation?




                      2
                    17. Peer reviewed data on what? The Ornish study involved multiple interventions. You cannot distinguish whether the outcomes observed were as a result of the diet, the exercise, or the stress management.




                      0
                    18. But of course there are multiple studies that demonstrate that Low-Carb diets reduce the risk factors for cardiovascular disease, I can list them if you like.




                      0
                    19. I think you are missing the forest for the trees. In the beginning, coronary artery blockage was felt to be irreversible. Dr. Ornish thought the cause of artery blockage was multifactorial (diet, sedentary lifestyle, stress), so he sought to see what would happen if he attacked the problem globally. His program worked. It reduced cardiac events (heart attacks, need for stenting, bypass surgery etc) and also showed reversal of artery blockage. So, he’s kept his program going as it was designed initially. Since then, Dr. Esselstyn has looked at diet alone (some patients also had statins), and demonstrated also near elimination of all cardiac events as well as reversal of artery blockage (PMID: 25198208).

                      You can reduce risk factors for cardiac disease with weight loss (which low carb diets are good at in the short term) or medications like statins etc. This does not mean that you are opening up blocked arteries, restoring blood flow to damaged heart muscle, or reducing cardiac events to the levels demonstrated by Dr. Ornish or Esselstyn.

                      My initial point was that despite 50 years of clinical experience in the low carb world, with thousands of patients treated, not a single study has been publishing with a long term endpoint of cardiac events or coronary artery disease. Why? Was it because these studies were never done, or done but never published (who would publish data that would negate their business model)?

                      I don’t buy the “never been fashionable enough to influence a large enough cohort” line. Even a simple trial of 20-30 patients matched to historical controls would be interesting ( I included Dr. Ornish’s link initially to demonstrate the use of matched controls)

                      Something for anyone to think about if pursuing a low carb diet for the long term.




                      2
                    20. You must use unbiased sources if you are truly trying to convince people. “atkinsexposed” and “plantpositive” are obviously not going to be unbiased!




                      0
                    21. I’m chiming in very late, however I have read the papers on the plant positive webite and the are high quality. Its interesting how people rationalise. Well said MacSmiley




                      2
      1. Of course they are going to nitpick for that. You do realize the very foundation of our food pyramid and so called “healthy choices” were founded on cherry picked data with inconclusive research.

        As I’ve told others, Scientists have been trying to prove with various studies for the past 60 years that a plant based, low fat, moderate to high carb (or a variation of all of those), is the healthiest diet. There have been thousands of studies and not one of them has ever been conclusive to what the scientists were trying to prove. In fact, none of the studies were ever published and their exact words were as to why was “because the results are not what we hoped for”.

        So in other words a plant based, low fat, moderate to high carb diet was never proven to be healthy in a nut shell. To further throw fuel to the fire, there were studies were they did incorporate more fatty foods coming from animal meats that completely blew the lid off their study. Of course, this never got published either.

        So when asked “are you going to nitpick for that” your damn right, everybody should.




        0
        1. Sorry you’ve been sold a bill of goods by Taubes and Teicholz.

          Diet and drugs are not the same animal. Drugs are tested for one variable at a time, the drug. Food is a much more complicated multi-variate variable. There will never be a single RCT that’s large enough, long enough and controlled enough to “prove” any diet is healthiest for most people. You just can’t lock ppl up for 60-70 years just to feed them and see what happens.

          Consensus and national dietary guidelines are drawn upon the totality of evidence of all types of studies. Not cherry-picked studies, as you’ve been taught to believe.

          Besides that, the American public was hijacked by marketing and other psycho-social and physical forces, so the guidelines were NEVER followed as written. The public was never instructed to add 300-600 kcal/day of mostly refined carbs to their already meat/dairy-heavy diets.

          I’d include graphics to demonstrate, but that’s been disabled here.

          Meanwhile, I will eat what the longest lived ppl in the Blue Zones eat. Real food. Not too much. Mostly plants.

          PS. I will give you one point: I don’t think the food pyramid as a graphic image was the best means of communicating the concept of a diet. I think MyPlate is much simpler direct “hook” and gets the point across much more effectively.




          3
  2. Low carb helped me lose weight but my lipids went to sky-high, very dangerous levels — to the point that they were as higher, or higher, than those seen in familial hypercholesterolemia, a genetic condition which I do not have. Veganism has helped me keep the weight off and lowered my lipids; now my BP is resting around 90/50 in the doctor’s office. You wear the fat you eat.

    I have not been able to get rid of nuts on my diet, but perhaps I don’t have to.

    My diet has gone from being very low carb to moderately carb without any weight gain – actually, further weight and BP reduction.




    2
    1. “helped me lose weight but my lipids went to sky-high, very dangerous levels — to the point that they were as high, or higher, than those seen in familial …”
      Same here; weird chest pains & chronic tendonitis as well.no thanks. Vegan works just fine for me




      2
    2. Why would you want to get rid of the nuts? I eat raw, natural almonds, Brazil nuts, and walnuts, as well as sunflower and pumpkin seeds (and ground flax seeds and dry-roasted peanuts—which are legumes, of course). I’ve started eating unsweetened shredded coconut—not sure if the jury is still out on this comestible (?).
      These all help me keep a steady weight. I find it hard to get sufficient calories without the above foods in the mix, and I think some good plant fat can be a healthful thing.




      0
      1. If getting enough calories is the goal, eat more food. Nothing wrong with nuts and seeds of course…great food, but eating more high carb foods like fruit and starches will up your calorie intake while still maintaining your weight. Just don’t add fat (ie go McDougall style) Btw nuts are required by law to be steamed are therefore not raw (even if it says raw on the packet)




        2
        1. Thanks for that Lucille. There is some disagreement amongst the plant docs regarding nuts and seeds. Dr. Greger seems to give them tacit approval (through his videos), as does Dr. Fuhrman. On the other hand, you have Drs. McDougall and Esselstyn toeing more or less the no-nuts line. Hard to know who to believe. Personally, I feel the addition of nuts helps to moderate the glycemic load of a meal.




          0
          1. Mike: For what it’s worth: I recently re-listened to a talk that Esselstyn gave in 2012. He said something along the lines of (not a direct quote), “If I told people that it was OK to eat a *small* amount of nuts, that’s not what they would hear. They would hear, ‘Esselstyn says nuts are OK!’ If you are a healthy person who eats a healthy whole plant food diet, a small amount of nuts, especially walnuts, is fine. But for people with serious heart disease, I would suggest staying away from all nuts. I do encourage people to eat ground flaxseed and chia seeds.” My point being that Dr. Esselstyn’s take on nuts is more complicated/nuanced that is usually attributed to him. Heck, Esselstyn even included a walnut-based salad dressing in his Prevent and Reverse Heart Disease book – just cautioning heart patients to skip it.

            ————————–

            Also, to address your original question of, “Why would you want to give up the nuts?” I recently re-watched the DVD from Jeff Novick titled, “From Oil To Nuts”. He lays a convincing argument about the importance of having the correct ratio of omega 6 to omega 3 fats in your diet. Unfortunately, most nuts (baring one type of walnuts) have an insane ratio of omega 6 to omega 3. In general, you want to keep the ratio at 4:1 or less. In other words, for every 1 part of omega 3, take in 4 parts or less of omega 6. Here is how some nuts and seeds break down:
            black walnuts – 16:1
            english walnuts – 4:1 (best bet!)
            cashews – 117:1
            almonds – 1800:1
            pumpkin seed – 117:1

            sunflower seed – 300:1
            flaxseed – 3.9:1

            chia seed – 3:1

            Another problem with nuts for many people (but not everyone) is that nuts are so calorie dense.

            Even with all of that information, Jeff Novick asks something like, “Are nuts good for you? Yes!!!!” But says we need to eat nuts in a way that is closer to how our ancestors might have – very few because it is hard to get all that many when you have to crack every shell and the food is only available/ripe a short time of the year. So, at the end of the DVD, Jeff Novick recommends that people take in 1-2 ounces of nuts (or less) a day.

            Please Note: I’m ***not*** at all pushing you or anyone else to give up nuts. For all I know, it is the perfect food for your situation. I’m just sharing one reason why some people (myself included) want to be eating less nuts if we can get there.




            1
            1. Thanks Thea. Your kind advice is well-taken. I should watch my omega ratios and intake amount a bit more closely. I do find a few nuts with a meal give it a satisfying satiety, and so I have no desire to nibble between meals.




              0
            2. I don’t worry about the Omega ratios. I really don’t think their alleged inflammatory properties have been confirmed, especially in whole foods, and it’s an issue paleo’s obsess over. If you can, eat a variety of nuts, for they each have their individual benefits, an ounce or two a day, but split them up and eat them with meals.

              I do believe part of the trouble Esselstyn may have had with patient self-control had to do with the added oils and salt in roasted commercial nuts like Planters causing addictive snacking, and the refined oils did no favors to damaged hearts and arteries.




              0
            3. The main problem with the omega-3:omega-6 story is that we don’t know if 1) it’s the overall ratio that’s really important or 2) the absolute amount of omega-6 is the real problem (no one seems to think that omega-3 is an issue, at least in excess).

              If it’s just a ratio issue, consuming more plant-derived omega-3’s and perhaps supplementing with concentrated omega-3 should counterbalance any problem from overconsuming omega-6 in the form of nuts/seeds. On the other hand, if the problem is eating too many omega-6’s from any source, then it doesn’t matter how much omega-3 is being consumed – it will not fix the problem.

              Interestingly, the recent meta-analysis in Annals that got so much attention this week seems to suggest that higher blood levels of arachidonic acid, DHA, DPA and EPA are protective against cardiovascular events (though, of course, there could be confounding, as the same review pointed out that recent randomized trials have been negative, at least for DHA/EPA administration). Arachidonic acid is a direct downstream mediator formed from omega-6 intake in the diet. This would tend to argue that omega-6 per se is not the problem, but rather achieving an optimal balance of O3:O6 is most important. Therefore, consuming flaxseed, hempseed, walnuts, canola oil and omega-3 supplementation could be beneficial. Linoleic acid, either in the diet or in the blood marker studies, did not appear to be implicated in harm, and this is the major omega-6 fatty acid. Thus overconsumption of nuts, seeds and vegetable oils does not look as problematic as we once thought, in terms of “too much” omega-6 intake. At least according to this new meta-analysis.




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            4. Thea, 10 months late, but you may want to correct the flax and probably the chia figures. For flax, USDA figures are more like .26, your calc inverted that to 1.39– and when you/anyone does that, please also delete my reply.




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              1. peseta: I’m sorry, I’m not following your comment. I believe you are responding to an old post where I re-printed parts of a table that I saw on a video/talk. And that table showed the relationship of omega 6 to omega 3 fats. In the example of flax seeds, the post/table is saying that there are 3.9 omega 6’s to each 1 omega 3. I got this information from a talk from Jeff Novick, who I think is very careful with his numbers. Or maybe I am not understanding the table myself.

                Do you still think something is wrong?




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                1. Yes, the original was wrong for flax and likely for chia; the ratio should have been 0.26, and the inverse of that is 3.9, the given amount (sorry for the typo in my 1st post, which no doubt was confusing). N3 polyunsaturates far outnumber n6 in the USDA listing for flax. Since chia n3 figures are similar, it too is off in the videotalk original. It happens to the best of us. If you correct Jeff Novick’s data in your post, just drop my replies too, since they won’t be relevant.




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          2. I decided to go the Ornish/Esselstyn route re fat as a % of daily calories, and the CRONOMETER doesn’t lie. Have you used that online tool? I can see exactly how many grams of fat I’m eating. I use it maybe twice a month but after eating this way for a long time I pretty much know my fat intake. So on 2000 calories I stick to about 22 grams of fat to come up with 10%, and I play around with the seeds and nuts depending on what I feel like eating. I always include 2T ground flaxseed for the Omega 3s. I’ll admit it took discipline and willpower at first to weigh a few nuts rather than grabbing a handful, but I looked on the exercise as a learning experience and I’m very aware now of just how much fat is in my food. It was a pain at first, but in the back of my mind I knew it was a worse pain to have surgery for blocked coronary arteries.




            0
            1. Fat doesn’t cause blocked coronary arteries, nor does Cholesterol, This has been one of the biggest blunders in medical history, we now know that inflammation is the leading cause of heart disease, as the cells in the arteries rebuild themselves. High levels of Inflammation caused by high Omega 6 corn CFO raised Meat (Grass Fed Meat on the other hand is Heart Healthy with loads of antioxidants, zinc, iron, B-12, Omega 3, CLAs , Vitamin A ), large amounts of sugar, and Refined Carbs (we are in a constant state of rebuilding our bodies as we age)

              Weather you do High Carb or High Fat (which I do) you want the bulk of your Food to be Veggies (Plants) of course , but for me I do much better on 70% Healthy fat, 20% protein (from Healthy Grass Fed Beef, Wild Salmon, Pasture raised eggs) and 10% from Carbs (no starch carbs , expect for small amounts of white rice and black beans) . The bulk of my food is Veggies like Spinach, Broccoli , Green peppers, Red Peppers, Onions, Lettuce, Tomatoes , carrots , etc, with small amounts of Grass Fed Beef, and large amounts of Grass Fed Butter and MCT (coconut Oils ) and of course Avocados.

              I have AMAZING blood lipid numbers, very very low levels of inflammation , I look and feel great, just remember that your brain is made of FAT, and you NEED Fat to survive, no need to demonize fat :)




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              1. Forgot to add after the first paragraph, that high levels of inflammation causes LDL particles to oxidize as they pass though the cell walls as our cells copy and rebuilt, this causes the arteries walls to become hard and the body creates more inflammation to try to repair this “hard” arteries which is a cycle of repeated inflammation, along with a diet high in crappy sugar carbs, processed vegetable oils (Trans fats) and CFO rasied meat (which is corn fed and toxic), (Natural Grass Fed beef is not toxic and is heart healthy this goes for Grass Fed butter vs corn fed butter)




                0
                1. Thanks Zach. I am having the same experience with a high fat low carb diet. It has relieved me of my blood sugar swings. And at the recommendation of Dr. Josh Turkett, a neurologist, who wrote ” The migraine Miracle”my migaines have diminished by more than half in 2 months, by following a no gluten, no refined sugar, low carb, high good fat diet.
                  Eating cholesterol doesnt form cholesterol in the body.




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              2. The only required dietary sources of fat for the human population come in the form of alpha-linolenic acid (ALA—the parent omega-3 fatty acid) and linoleic acid (LA—the parent omega-6 fatty acid). These are collectively known as essential fatty acids. The human body cannot produce these essential fatty acids, and, therefore, they must be consumed in the foods we eat.

                All other fatty acids are able to be assembled in the body from LA and ALA through a series of chemical reactions. This includes saturated fat, monounsaturated fat, omega 9s, docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), DGLA and arachidonic acid (AA).

                We need to consume more omega-3’s and less
                omega-6’s in our diet. Why? Because omega-3 fatty acids have an
                anti-inflammatory effect on our body, while omega-6 fatty acids have a
                pro-inflammatory effect on our body. Over the past 100-150 years there has been
                an enormous increase in omega-6 fatty acid consumption in Western diets leading
                to the surge in chronic diseases seen in today’s world. Ideally, the ratio of
                omega-6 to omega-3 fatty acids in the diet would be 2:1 or 1:1. Western
                diets—based heavily on animal-based and processed foods (including vegetable
                oils)—have a ratio of omega-6 to omega-3 fatty acids of 20-30:1. Clearly this
                is too much. The elimination—or at least a sizable reduction—in the consumption
                of rich Western foods would go a long ways in improving the health of the United
                States and other countries like us.

                According to the National Institutes of Health (NIH), only 2-3% of total calories need to come from LA and 1% of total calories from ALA to achieve adequate intake levels. This is a far cry
                from the 33% of total calories from fat we are currently consuming in the
                United States. Several physicians and clinicians have successfully reduced and/or eliminated a number of chronic diseases (heart disease, type 2 diabetes, autoimmune diseases, cancer, etc.) in their patients by helping them adopt a whole- foods, plant-based very low fat diet.
                This diet allows for the consumption of fruits, vegetables, legumes, and whole
                grains in any amounts desired, all while keeping the total fat content to
                approximately 7-10% of total calories. By including a generous portion of dark
                leafy greens and/or a small amount (1 oz per day) of walnuts/seeds (flaxseeds,
                chia seeds, or hemp seeds) plenty of essential fatty acids are obtainable to
                meet the body’s needs.

                Inflammation of the arterial endothelium is indeed the culprit. Quoting from Dr. Esselstyn: “What we are trying to do is get our cardiovascular patients to
                eliminate completely the foods that will further injure the lining of their
                blood vessels. The reason that they have heart disease in the first place is
                that their blood vessel lining has been so injured and so decimated that they
                now have the manifestation of heart disease. Now what is going to stop the
                injury to those endothelial cells? Well, we avoid the foods that have been
                shown scientifically to injure them; namely oils — olive oil, corn oil,
                safflower oil, sunflower oil, coconut oil, palm oil, canola oil; anything with
                a mother, anything with a face — meat, fish, chicken, turkey; and dairy milk,
                cream, butter, ice cream, cheese and yogurt. And now in addition, we know that
                fructose, that is to say, orange juice, apple juice, agave nectar, table sugar,
                maple syrup, molasses and honey. Now this isn’t to say that you can’t have some
                pancakes with maple syrup once or twice a month. But know every time that you
                are having them that you are injuring endothelial cells. In addition, caffeine
                with coffee, nuts, avocado. That’s pretty rigid for the patients now who have
                heart disease. But what has happened is that since this is not cancer, when the
                endothelial cells are given a reprieve, when they are no longer beaten down,
                they recover. As they recover, so does their ability to produce this magic
                molecule called nitric oxide production. Not only do you halt the disease, but
                we have shown clearly that you can begin to reverse it.”

                Compare the Lyon Heart Study results (Mediterranean diet) to Dr. Esselstyn’s. 4 years after the studies, how many patients had suffered a coronary event? Lyon: 25%. Dr. Esselstyn: 0.5%
                Check out the studies done by Vogel (BRAT) where olive oil caused a 31% constriction in the brachial artery. The science is there for the low fat regimen.




                1
          3. The Adventist Health Studies show that a handful of nuts most days in the week is significant to increasing longevity. Nowadays it is recognised that nuts are a healthy addition to diet.




            0
        2. fyi: to find truly raw nuts, shop farmers markets; since they are not being sold through retail stores, they are not obligated to pasteurize, so most aren’t.




          0
      2. “Why would you want to get rid of the nuts?”

        1) Because I feel guilty eating them.

        2) Because they are very high in fat, in particular omega-6 fatty acids, which downstream leads to linoleic acid.

        3) Because they are addictive and very easy to snack on. Other than carrots (!), I have not yet found another food that is so filling and easy to snack on, and I would prefer not to snack between meals.

        4) The fat you eat is the fat you wear. If you eat a lot of easily oxidizable fats like polyunsaturates, you end up with lipid peroxides in your cell membranes.

        On the other hand, there is a lot of data to suggest that nuts are health-promoting, at least in moderation. The cardiovascular benefits appear to be compelling. But… I would urge moderation. If I was imaginative enough, I am sure I could completely replace nuts in my diet with something else, and I’m quite certain I wouldn’t miss them. At this point I eat almonds, walnuts, pecans, brazil nuts (in moderation), pumpkin seeds, hazelnuts/filberts.




        0
          1. I do not believe there is such a thing as ‘healthy fats’. It is a myth. The supposed longest living culture (Okinawans) were reported to have a diet of 6% fat, 9% protein, and 85% carbohydrates.

            Regarding fats, I personally do not seek them out and do not recommend any to do so.




            1
            1. While picking this or that fat as ‘healthy’ may be somewhat mythic, it remains a fact that linoleic and alpha-linolenic acids are both essential in human nutrition. Some are suggesting that EPA and DHA are essential, but both greater synthesis by vegans and surprising effects of turmeric seem to mute that assertion. Saturated fats, well beyond what we make, have appeared harful for a long time now.
              So a list of fatty foods to be eaten with carotenoids could be ranked by reasonable amounts of the two and less of #3, perhaps with a cautionary note about oleic and other monounsaturates when they overload our antioxidant protection. Total amounts could be adjusted for a range of needs or desirability of the two– say, 5-10 grams a day.




              0
          1. There *is* some evidence that PUFAs, especially omega-6 rich vegetable oils, are quite unhealthy.
            For example, the Sydney Diet Heart Trial, which replaced saturated fat with a supplemental margarine containing safflower oil, showed increases in dying from heart disease in a randomized trial population. A similar trial in the 1960’s in Los Angeles veterans showed a doubling of cancer-related deaths using corn oil to replace saturated fat.
            If anything, since SFA appears to be negative, the results of both trials should have shown that death rates went down, however the exact opposite was found. Not because SFA is protective (it’s not), but because omega-6 cooking oils oxidize, and this is why the Sydney Trial showed the effects were MOST prominent in smokers and alcohol abusers.
            It’ll take me some time to dig out the references for you.




            0
              1. I tend to agree with you – moderation though is the golden principle. It’s really easy to overdo consumption of anything, even whole nuts and seeds, even with meals. I eat about 2 ramikin-sized quotients of mixed nuts per day, not more. I eat a tahini salad dressing which is crushed sesame seed paste – about 1-2 tbsp, not more. I don’t use any vegetable oil other than that. I crush my nuts/seeds into a morning smoothie. I’ve found I can replace some nuts/seeds with carrots after meals if I am still hungry.




                0
                1. [Sorry to be reading this discussion late] Ramekins can vary from 50 to 250 milliliters; I assume you mean ½ cup / 250ml, the size I first found on (excuse me) Amazon, which would total a cup of nuts a day!




                  0
            1. DGH, I would like to point out that probably all margarines during the time of that study were made up of hydrogenated oils.




              0
    3. I mostly follow the Dr. Sears’ Zone Diet – the Soy Zone mostly, I guess. I eat almost no meat – ONLY seafood, zero-fat dairy (mostly Greek yogurt) and sometimes protein bars and tofu. My triglycerides are 58, my total cholesterol is 127, my b.p. avg is 105/66. Saturated fat and maybe cholesterol seem to be the cause of problems- esp. when on the low carb diet. The Zone is a fairly low carb diet, but not as low as Atkins, I think.




      0
      1. Very interesting, thanks for sharing that. I stopped tracking my lipids when I went fully vegan (they were quite low on lacto/pesco-vegetarian diet before that). I think another source of problems on a low carb diet is excess protein, and specifically animal protein, which seems to cause IGF-1 spiking and diabetes.




        0
        1. Very true, Low carb diets are NOT high protein diets, remember Low carb and High Fat, or High Carb and Low fat, but protein should be around 20% and up to 30% (if you are doing heavy resistance training), regardless if you do High Fat or High Carb




          0
          1. Zach: You wrote: “Low carb diets are NOT high protein diets” and “protein should be around 20%”

            How did you arrive at 20%? What are you thinking the goal is with 20%? I ask because 20% is at least twice as high as protein amounts should be if you want the lowest cancer risk. Further details may be important in terms of which type of protein, but Campbell showed in numerous studies that when protein goes above the critical 10% mark, cancer starts to grow. Also note that the traditional Okinawans, some of longest lived and healthiest people on the planet, took in 9% protein as a percentage of calories – and the vast majority of that was plant-based protein.

            *If* disease prevention is someone’s goal, and low carb diets allow 20% protein, then low carb diets are indeed high protein diets. Determining “high” or “low” is something that needs to be defined in terms of health or some other goal and then the specific number ranges backed up with research.




            0
      2. I follow this debate with curiosity and also wonder the distinction between saturated animal fat and lipids from oily fish and whole plant sources. Many low-carbers/paleo types expressly favour sat fat consumption, but it is equally possible to eat low carb with lower levels of sat fat and I would be interested to see this investigated.




        0
    4. Hypotension – Both high and low blood pressure may play a role in brain atrophy, at least in populations studied so far, particularly with a diastolic below 70.




      0
    5. Hi, there. Just to put out there, it would follow from a low carb diet and the ensuing weight loss, that you would expect a very high blood lipid level as you were loosing weight….the fat has to go somewhere before it can be “dealt with”. Once the weight loss disappeared, it would follow that the blood LP levels would fall back to a healthy range. But the transient high can be disconcerting.
      I just wanted to be clear that it was likely the weight loss that created the high blood LP level directly.




      0
    6. Well DGH, instead of “low carb” helping you lose weight, what exactly did you eat. Because if you start saying “fruit & starchy vegetables”, then you have your answer as to why your lipids went sky high.




      0
  3. Low carb animal fat diets, or low carb *plant-based* diets? I’m vegan, and my doctor has me going gluten free (thereby accidentally cutting out lots of carbs) and eating lots of fat (2 T coconut oil, an avocado, and 3 T of a ground seed mixture every day). The weight is dropping off (NOT the reason for the diet, but an interesting consequence), but I can’t help but wondering if it’s healthy…. Which side of this spectrum will this fall on? The low-carb side, or the plant-based side…?




    0
    1. As long as the diet is plant based, you are likely to be ok. Check out Dr. Greger’s video on Plant based Adkins. Harvard did a large study on Low-Carb vs Plant Based Low Carb (Eco-Adkins) and found that while the Low Carb dieters had higher overall mortality rates than the general population, the Plant Based Low Carb group did very well.

      Many people do lose weight when they go gluten free, but it is most likely because they are avoiding refined flour. Most of the wheat products available are highly processed. Even the products marketed as “whole wheat” are what Dr. Fuhrman refers to as “white bread with a fake tan”. If you do not have celiac or a sensitivity to gluten, whole wheat berries would probably be ok.




      1
      1. “Plant based Low carb” not sure but you do realize that the Atkins diet, (not the EcoAdkins) but the regular Atkins diet, advocates to eating more servings of Veggies than the USDA recommendation, and the amount of Veggies it advocates is normally as high as Vegan eaters, most think that Atkins is high protein or very high meat diet, its not , its high Fat , low carb , with bulk of food coming from plants ironically.




        0
    2. Both its low carb and Plant-based, my diet has 70% of calories coming from FAT, but I still eat a Plant-Based Diet, was the bulk of my food comes from Veggies, its just that veggies have no calories (energy) but very high nutrients, so Fat happens to make up most of the calories.

      Yes Weight loss is normal , and effortless (which is why people do it, it works) and yes its very healthy if you make sure your eating the right kinds of Fats, (which you are Coconut oil, avocado, flax seeds etc,) if you can try to add some Grass Fed Meat, or Wild Salmon, if your vegan try to up avocados and eat lots of olives, nuts , seeds, high fatty things that like. If you eat the wrong kind of Fats (, sunflower oil, margarine, canola oil , trans fats, Grain-fed meat, factory meat, processed carbs with trans fats etc) These type of fats Oxidize rapidly in the body, while the others have anti-inflammatory effects on the body




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  4. PLEASE CLARIFY – If one is to incorporate carbs into a vegetarian diet – or ANY diet – I assume we’re not talking about carbs from refined grains (i.e. white bread, pasta, white rice, ext). So, Dr. G, could you please be specific about the types of Carbs we should throw into the mix?




    0
      1. I don’t know that I would call white rice “junk” considering it has fed and continues to feed world populations for thousands of years. That aside, if you are an athlete you are not going to fuel your activity on spinach no matter how hard you try.




        0
        1. Yes, there’s always been debate about white rice. It’s a significant element of several diets throughout the world regarded as healthier than ours. Perhaps it’s metabolized more slowly in those diets because it’s consumed with healthy fats and/or protein??




          0
        2. Recall that Arnold Schwarzenegger won Mr. Universe as a vegan (i.e., eating spinach). However, I agree with you on the rice. I recently came across some nutrition information to the effect that the bran on rice prevents the absorption of nutrients to the point that more are available with white rice. How about them apples?




          0
          1. Arnold was never a vegan (I have read his autobiography) No vegan has ever won any major bodybuilding competition and spinach alone while part of a healthy diet could never support the energy requirements required to be an elite athlete.




            0
            1. Yes thank you, as I acknowledged above, Arnold was not vegetarian. I don’t follow bodybuilding as a sport. I was never serious about the spinach alone for anyone, was just using it as a stand in for vegetables.




              0
            2. rsbmg: You may be interested in the information below. Vegan bodybuilders have not only won metals, but set world records. Also, you may be interested to know that a couple vegan athletes won some metals at the recent Olympics. These stories are just the tip of the iceberg.

              ————————-
              (from meatout mondays)
              Vegan Bodybuilders Dominate Texas Competition

              The Plant Built (PlantBuilt.com) team rolled into this year’s drug-free, steroid-free Naturally Fit Super Show competition in Austin, TX, and walked away with more trophies than even they could carry.

              The Plant Built team of 15 vegan bodybuilders competed in seven divisions, taking first place in all but two. They also took several 2nd and 3rd place wins.

              For More Info:
              http://www.plantbuilt.com/

              ———————
              When Robert Cheeke started VeganBodybuilding.com in 2002, being the only vegan athlete he knew of, he may not have imagined that the website would quickly grow to have thousands of members. Robert says, “We’re discovering new vegan athletes all the time, from professional and elite levels… to weekend warriors and everyone in between.”

              For More Info:
              http://www.veganbodybuilding.com/
              —————–
              There was that other guy who just did a world record in weight lifting. “Congratulations to Strongman Patrik Baboumian who yesterday took a ten metre walk carrying more than half a tonne on his shoulders, more than anyone has ever done before. After smashing the world record the Strongman let out a roar of ‘Vegan Power’…” For more info:
              http://www.onegreenplanet.org/news/vegan-strongman-patrik-babaoumain-breaks-world-record/

              —————–
              Here’s another site that I like:
              http://www.greatveganathletes.com/

              I found this story on the above site: “Pat Reeves has set a new world powerlifting record at the WDFPA World Single Lift Championships. The 66 year old lifter, who has been vegan for 46 years, lifted 94 kg to set a record for the under 50.5kg weight class while competing in France in June 2012. The lift was more than 1.85 times her bodyweight, which is exceptional for her division. Pat is now officially the oldest competing weightlifter in Europe.”




              1
        3. White rice is a product of the industrial revolution, which introduced large scale milling and polishing to lengthen the storage life of rice . This resulted in an epidemic of beriberi (thiamine deficiency) in populations that relied on rice as a main calorie source. White rice is now fortified (like most refined grains) to reintroduce some vitamins and minerals that are removed in the milling process. There are no populations that have relied on white rice for thousands of years.




          1
            1. When you said “white rice” I assumed you meant white rice http://en.wikipedia.org/wiki/White_rice. This implies milling and polishing of the grain which removes the bran and cereal germ, please read the “preparation as food” section of your own reference for a more detailed explanation (there is also a nice graphic that illustrates this process). “White rice” does not denote any particular cultivar. All rice consumed before the introduction of milling and polishing was brown or whole grain rice http://en.wikipedia.org/wiki/Brown_rice. White and brown rice of any cultivar differ significantly in their fibre, vitamin and mineral content.




              1
              1. Latest research I have read indicates white rice is healthier for us than brown anyway. Rice is good no matter how you slice it. Pick your flavor and have at it.




                0
        4. Just a thought: The Japanese do pretty well with enriched white rice, but the traditional Okinawans (centenarians) amongst them have done much better with more nutritious sweet potatoes. As the younger generation abandons the traditional foods, including swapping out the sweet potatoes with white rice, their healthy life expectancy is dropping.




          1
      2. How do you view starchy whole foods such as potatoes, yams, and bananas? Just curious….I know potatoes, in particular, are controversial in that they are a white starch – though packed with nutrients. Thanks for your thoughts.




        0
          1. A frozen ripe banana is delicious chopped-up on my cooked whole-grain breakfasts in the morning — either millet, buckwheat groats, barley, steel-cut oats, (organic) brown rice, etc — or a combination.

            I always eat a few chunks before adding them to the grains — they’re my “ice cream” kick for the day. ;-) I know we’re supposed to eat fruit separately and all that, but ….




            0
            1. There are toxins in EVERYTHING we eat, both naturally and because of our contaminated environment.

              Every item of food is a compromise, every diet a compromise, and neither is perfect. It’s always a cost-benefit trade-off. Compared to animal foods where poisons from the grains and/or grass in the natural environment they eat are concentrated in the flesh and fat, grains are comparatively less hazardous.




              1
              1. I agree but there are major toxins like arsenic mercury, others heavy metals and others one that are much less toxic or easier to excrete.
                Any grains is better than most meat yes but white one seems to be less toxic and easier to digest than whole one with the bran, just what i said~




                0
  5. Dr. Gregor,
    I appreciate the information in you video clips. Is the audio from these available to be aired on a radio station?

    Thanks,

    Luke




    0
      1. Jacquie,
        Thanks. Is there any way to get .wav or .mp3 files of the audio? I’m not sure how to extract the audio from the video clips online. You could probably get these on a lot of stations if you made the audio available on an ftp site.
        Our station is WSJL, 88.1 FM. It reaches part of Birmingham, AL.

        Thanks,

        Luke




        0
        1. Hi Luke, Thanks for sharing your station – if you have time keep me posted on when you play the video(s) for fun!

          You can convert the youtube videos to a mp3 file and download. Go youtube > nutritionfacts.org > select the youtube video you want > select the video’s url > open site: http://www.youtube-mp3.org > paste in the url. > convert > download. This should work.

          Or: http://www.convertmemp3.com/ there are more as well out there.

          Let me know how it goes!




          0
          1. Jacquie,
            We will probably use the audio clips as fillers, so I can’t predict when they will play.

            I see that you have all the videos DVDs. That would be easier for us to rip. Could we get a set of those? We could send the ripped mp3s back to you to use with other radio stations.

            Thanks,

            Luke




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  6. I love this site – but have to call out that the imagery used from 0:27 to 0:47 might be a little heavy handed. I found myself having to look away from the Tuberculosis patient who was in serious distress, under what looked like shocking conditions. I don’t live in a bubble, but as a non-medical person I am not desensitized to seeing suffering, as it was not needed to illustrate your point, I felt it was disrespectful to the patient pictured.




    0
    1. cathy: Your post is so well-worded and respectful, and I’m glad you feel comfortable posting your opinion here. While it is hard to please everyone, I’m sure Dr. Greger is happy to get people’s opinions and integrates them as best he can going forward for future videos.




      0
    2. Hi Cathy – Agreed – the TB patient was a bit over the top….I was taken aback too. I think when this approach is taken, rather than hammering the message home, the opposite occurs – the message is diluted by the overt use of “shock” images. The studies cited and Dr. G’s words should be enough to persuade – without resorting to visual histrionics.




      0
      1. For me, no it did not help make the point, perhaps it is effective for others. I am on the site for information, not to be converted, or shocked into a lifestyle change. I think I have been so used to the humorous tone of some of past videos that I was surprised by the serious visuals juxtaposed with Dr. G’s voice over. This is a minor comment – the Dr’s videos are so beneficial to many.




        0
        1. With a more respectful and sober voiceover, I wouldn’t have had any issue with the unpleasant and graphic nature of the photo. But while I usually appreciate the humor with these videos, the joking tone used in combination with that photo did seem exploitative and insensitive to me as well.




          0
          1. Hi all, thanks for sharing your thoughts/reactions about the picture and how it made you feel. I can empathize with you – since you pointed it out. I certainly didn’t think about it until then.

            Therefore, I don’t think it crossed Dr. Greger’s mind that a malnourished uber skinny man with TB would be considered graphic to some – simply because as healthcare professionals this is is not at all considered graphic. I have done medical work in developing areas and this again is not disturbing to me – looks clean and he is getting help, even an IV. A matter of perspective for sure.

            But you know – nurses and docs will talk about anything while enjoying a good dinner!

            Thanks for the feedback, Jacquie




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  7. The Fleming study doesn’t even look at low carb diets. It compares a 70% carb /15% protein /15% fat diet to 10 people in the study that didn’t stay on the instructed diet. Most studies would call this group “drop outs,” but this study calls them a “high protein group.” High protein, I guess, is anything over the recommended 15%. There’s no mention of what these people actually ate. Very very poor study.

    The preponderance of scientific data indicates the low carb diets either do not effect, or reduce heart disease risk. You forgot to mention that here.

    Seems like you really cherry picked your studies.




    0
    1. “The preponderance of scientific data indicates the low carb diets either do not effect, or reduce heart disease risk.”
      Have there been any studies taking subjects with clinically proven heart disease, and reversing this heart disease with a low carb diet? This reversal has occured with a plant-based diet. To me, this would be the gold standard test of a diet’s healthfulness.




      0
    2. “A new scientific
      truth does not triumph by convincing its opponents and making them see
      the light, but rather because its opponents eventually die, and a new
      generation grows up that is familiar with it.”
      — Max Planck (1858-1947)




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    3. Cherry picked? I’ll repeat my comment from above:

      “There are flaws in every study, and in the Fleming study, the opportunity to make a comparison between two truly contrasting groups was unforeseen. So you’re going to nitpick for that?

      If the SPECT FMD scans were not conclusive, their cautionary data should certainly not be discounted, either. How can your average low-carb dieter know whether or not he could be very much like one of those Atkins dieters in Fleming’s study until it’s possibly too late? When was the last time you asked your doctor for a SPECT/FMD scan?

      At the very least, this is an opportunity for a larger study to confirm or falsify Flemings ad hoc results. Where are the Atkins Foundation and the NuSI guys when you need them?”




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      1. Come to think of it, I’d love to see an IVUS (intravenous ultrasound) study contrasting long-time WFPB dieters v. long-time low carb/paleo/WAPF eaters.

        No more wrangling over biomarkers. We’d see who has ACTUAL plaques hiding on the outside and inside of their artery walls!!

        Let’s start with all the diet doctors themselves, and include all the propagandists like Gary Taubes, Sally Fallon, and Mary Enig while we’re at it!




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  8. DR. GREGER: A few days before this video, the New York Times published a somewhat in depth piece denouncing carbs. It also advocated some saturated fats (such as one in whole milk) saying they increase both HDL and LDL – and that the LDL increase only applies to the less harmful large particle LDL. We’d love it if you could comment on this noteworthy article – especially in the context of the video you just released…thank you. Here is the link:

    http://well.blogs.nytimes.com/2014/03/17/study-questions-fat-and-heart-disease-link/




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    1. Is Saturated Fat (Dairy, Meat, and Eggs)

      For you consideration the abstract: http://annals.org/article.aspx?articleid=1846638

      Note “Limitation: Potential biases from preferential publication and selective reporting.”

      Comments on the National Headlines about the March 18, 2014 “Annals of Internal Medicine” Article Suggesting Saturated Fat (Dairy, Meat, and Eggs) Is OK to Eat by Dr. McDougall: http://on.fb.me/1iOfvEZ.

      1) I agree with the conclusion that polyunsaturated fats (fish oil) and monounsaturated fat (olive oil) are not going to prevent heart disease. They are at least fattening and most likely promote cancer.

      http://www.techtimes.com/articles/4520/20140318/omega-3-fatty-acids-with-minimal-benefits-in-lowering-risks-of-heart-disease-study.htm

      2) However, I know that one of their main conclusions is wrong: That it is OK to eat animals. Dairy, meat, and eggs are bad for people and the planet.

      http://well.blogs.nytimes.com/2014/03/17/study-questions-fat-and-heart-disease-link/?_php=true&_type=blogs&_php=true&_type=blogs&ref=health&_r=1&

      “This March 18, 2014 Annals of Internal Medicine article will become a feeding frenzy for the animal-food-industries: a “nugget of proof” that their saturated fat-laden foods can be eaten guiltlessly. Millions of people worldwide, especially those who are looking to hear good news about their bad habits, will die of heart disease, diabetes, cancer, and obesity, and if left unchallenged, resulting increases in livestock production will accelerate global warming even faster.”

      Please read on if you are an interested in the details:

      1) The main scientific study they used showing the safety of saturated fat(reference 12), was a study supported by the National Dairy Council.(Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010;91:535-46.) This is the single study used to promote eating animals by the low-carb movement and the animal food industries.

      http://ajcn.nutrition.org/content/91/3/535.full.pdf

      Jeremiah Stamler, MD wrote an editorial in this same issue of the American Journal of Clinical Nutrition criticizing this flawed paper that has received so much attention in the lay press.

      http://ajcn.nutrition.org/content/91/3/497.full.pdf

      Letters to the editor that followed were also highly critical of this advertisement for meat and dairy (saturated fat).

      http://ajcn.nutrition.org/content/92/2/458.full.pdf

      And more Letters.

      http://ajcn.nutrition.org/content/92/2/459.2.full.pdf

      2) In the results section of the Annals of Internal Medicine (March 18, 2014) article they wrote: “Seventy-two unique studies were identified (Figure 1 of Supplement1 and theTable). Nineteen were based in North America, 42 inEurope, and 9 in the Asia-Pacific region; 2 were multinational.”

      I would like to look at the 9 in the Asia-Pacific region and the 2 that were multinational, independently. This would show the effect of different diets on health (and coronary heart disease).

      In the nineteen that were based in North America and 42 in Europe, people all ate the same diet (full of saturated fat, ie. Dairy, meat, and eggs) – how could you possibly see any difference in health?

      3) This is an incorrect statement in the discussion of the Annals of Internal Medicine (March 18, 2014) paper:

      “For example, the influence of metabolism seems particularly relevant for the denovo synthesis of even-numbered saturated fatty acids in the body, compositions of which are largely determined by dietary factors, including carbohydrate and alcohol consumption (33–35), and other metabolic pathways (36, 37) rather than direct dietary intake.”

      Excess Starch (and even Sugar) Does Not Turn to Body Fat (Easily)

      http://www.drmcdougall.com/misc/2009nl/mar/passionate.htm

      A widely held belief is that the sugars in starches are readily converted into fat and then stored unattractively in the abdomen, hips, and buttock. Incorrect! And there is no disagreement about the truth among scientists or their published scientific research.(5-13). After eating, the complex carbohydrates found in starches, such as rice, are digested into simple sugars in the intestine and then absorbed into the bloodstream where they are transported to trillions of cells in the body in order to provide for energy. Carbohydrates (sugars) consumed in excess of the body’s daily needs can be stored (invisibly) as glycogen in the muscles and liver. The total storage capacity for glycogen is about two pounds. Carbohydrates consumed in excess of our need and beyond our limited storage capacity are not readily stored as body fat. Instead, these excess carbohydrate calories are burned off as heat (a process known as facultative dietary thermogenesis) or used in physical movements not associated with exercise.(9,13)

      The process of turning sugars into fats is known as de novo lipogenesis. Some animals, such as pigs and cows, can efficiently convert the low-energy, inexpensive carbohydrates found in grains and grasses into calorie-dense fats.5 This metabolic efficiency makes pigs and cows ideal “food animals.” Bees also perform de novo lipogenesis; converting honey (simple carbohydrates) into wax (fats). However,human beings are very inefficient at this process and as a result de novo lipogenesis does not occur under usual living conditions in people.(5-13) When, during extreme conditions, de novo lipogenesis does occur the metabolic cost is about 30% of the calories consumed—a very wasteful process.(11)

      Under experimental laboratory conditions overfeeding of large amounts of simple sugars to subjects will result in a little bit of de novo lipogenesis. For example, trim and obese women were overfed 50% more total calories than they usually ate in a day, along with an extra 3.5 ounces (135 grams) of refined sugar. From this overfeeding the women produced less than 4 grams (36 calories)of fat daily, which means a person would have to be overfed by this amount of extra calories and sugar every day for nearly 4 months in order to gain one extra pound of body fat. (10) Obviously, even overeating substantial quantities of refined and processed carbohydrates is a relatively unimportant source of body fat. So where does all that belly fat come from? The fat you eat is the fat you wear.

      5) Hellerstein MK. De novo lipogenesis in humans: metabolic and regulatory aspects. Eur J Clin Nutr. 1999 Apr;53 Suppl 1:S53-65.

      6) Acheson KJ, Schutz Y, Bessard T, Anantharaman K, Flatt JP, Jequier E. Glycogen storage capacity and de novo lipogenesis during massive carbohydrate overfeeding in man.Am J Clin Nutr. 1988 Aug;48(2):240-7.

      7) Minehira K, Bettschart V, Vidal H, Vega N, Di Vetta V, Rey V, Schneiter P, Tappy L.Effect of carbohydrate overfeeding on whole body and adipose tissue metabolism in humans. Obes Res. 2003 Sep;11(9):1096-103.

      8) McDevitt RM, Bott SJ, Harding M, Coward WA, Bluck LJ, Prentice AM. De novo lipogenesis during controlled overfeeding with sucrose or glucose in lean and obese women. AmJ Clin Nutr. 2001 Dec;74(6):737-46

      9) Dirlewanger M, di Vetta V, Guenat E, Battilana P, Seematter G, Schneiter P,J Çquier E, Tappy L. Effects of short-term carbohydrate or fat overfeeding one nergy expenditure and plasma leptin concentrations in healthy female subjects.Int J Obes Relat Metab Disord.2000 Nov;24(11):1413-8.)

      10) McDevitt RM, Bott SJ, Harding M, Coward WA, Bluck LJ, Prentice AM. De novo lipogenesis during controlled overfeeding with sucrose or glucose in lean and obese women. Am J Clin Nutr. 2001 Dec;74(6):737-46

      11) Danforth E Jr. Diet and obesity. Am J Clin Nutr. 1985 May;41(5 Suppl):1132-45.

      12) Hellerstein MK. No common energy currency: de novo lipogenesis as the road less traveled. Am J Clin Nutr. 2001 Dec;74(6):707-8.

      13) Tappy L.Metabolic consequences of overfeeding in humans. Curr Opin Clin Nutr Metab Care. 2004 Nov;7(6):623-8.




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    2. Re Large and fluffy LDL being benign or even beneficial: ALL ApoB-containing particles (found in LDL of all sizes) are atherogenic.

      Large, small LDL diameters increased CV mortality risk
      Grammer TB. Eur Heart J. 2014;doi:10.1093/eurheartj/ehu055.

      http://www.healio.com/endocrinology/cardiometabolic-disorders/news/online/%7Bffe9124d-148d-4f9a-96df-acfaf47b308f%7D/large-small-ldl-diameters-increased-cv-mortality-risk

      Letter from Columbia University doctors refuting the large LDL fallacy promulgated by Dr. Oz:

      http://s.doctoroz.com/sites/default/files/dm_uploads/Columbia%20Letter.pdf

      A nice wrap up of the issue at Plant Positive:

      25 Cholesterol Confusion 8 A Large and Fluffy Distraction

      http://www.plantpositive.com/25-cholesterol-confusion-8-a-l/




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  9. People are so afraid to give up their precious meat that they go on and on trying to discredit people like Dr Gregor which silly nitpicking of studies like this. Look, I was fat, had a heart attack, and was told at 42 that I was 75% clogged around critical areas of my heart. I was on five prescription pills, unhappy, lethargic and basically on my way to an early expiration date.

    After 6 months of a whole food, plant based diet, I was off all meds, had a lot of energy, and today I am a marathon runner. What the meat-fanatics never seem to understand is THAT YOU WILL FEEL INFINITELY BETTER if you give up the meat. You’ll get off pills, you’ll be as skinny as you were at age 18, and you’ll have unlimited energy. Exercise goes from being a chore to being a joy. It is that simple.Stop nitpicking and get over your addiction to animal flesh. It’s not worth it.




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    1. Sorry to say this but its not the meat persee.

      If a person goes from a shitty diet to a vegan shitty diet, that person will probably be worse off.

      Probably best to start eating meat every other day and slowly increase vegetables, nuts and fruits to at least over a kilogram a day.

      I noticed to many details in nutrition to handle practically so I adopted a 5,5,5,5,5 system for myself to avoid deficiency issues.
      5 types of fruit, veggies, nuts(100gr), spices, starchy stuff each every day. Filling the base bulk with whatever is on sale. Plus the magic 4 veggies that are about fixed, red beets, leeks, spinach and kale/red cabbage. (+ started Natto.)

      Its a good start. Anyone on a typical diet will see the first amazing results in a few weeks. Men will be harder than they’ve ever been. (to put in an extra bit of motivation)

      Myself on 2 meat days a week now instead of every other day at start of switch, I still have fear of deficiencies. Results have been spectacular, never recorded a lower blood pressure in my life, heartbeat 55 (started woking out too) my skin is actually regenerating and thickening, eyes look clearer, hands are warm with delightfull youthfull colour.

      I’m not ready to stop eating meat altogether, for now 2 moments a week of animal product intake works wonders for me. All other foods are whole foods, nothing processed which is I’m sure as important as dropping continuous meat consumption.

      People should stop doubting and start trying. Give it a month or 2, at the very least a few weeks. The 55555 system is easy avoids having to do endless research before you start and in my experience one can have 2 steaks a week if you exclude all animal or proccessed food products for the rest of the week to get massive benifits.

      Don’t reply just try!!! :)

      Regards.




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      1. I like the sound of this 5,5,5,5,5 thing … can you work this up into a program or algorithm or something or tell us more about it.

        I agree with you at this point on meat. First, I am not sure I could quit it totally, nor am I convinced by all of the numbers that it is universally bad, but I do try to minimize it.

        What I want to know is how to you manage this diet, how do you put it together, what form to eat in, stuff like that. Where did you find out about it, is there a book or a reference site that explains it further?




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        1. You are making it more difficult then I ever intended :).

          Just start cramming your face with as many different fruits nuts and veggies etc as you can manage with the biggest possible variety without it becoming a day job or prohibitively expensive.

          Blending stuff with a scoop of soy protein works like a charm to save preperation time.

          Meat will be bad, but deficiencies because of lacking knowledge will be equally bad, and I suspect science hasn’t discovered even a quarter of what there is to know about nutrition.




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  10. I find the term “low carb diet” terribly confusing. The issue here is that “high protein” and “high fat” diets are unhealthy.

    For me “low carb” diet means eating overall less carbs, hence reducing your daily caloric intake. CRON (Calorie Restriction with Optimal Nutrition) is achieved by lowering your daily carb intake and has proven very healthy.




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    1. When you raise both protein AND fat, you ultimately get low-carb… the term “low-carb” could be seen as a “high fat AND high protein” diet, not EITHER high-protein OR high-fat.

      Your definition is simply “low calorie” and that’s not the same as low-carb. Most people don’t identify low-carb as calorie restriction, but carb restriction.




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  11. The great debate continues, judging from some of these comments. If you are as curious as I am about the mechanisms of atherosclerotic plaque progression and regression, may I offer up the following paper that I-a lay reader but digging in nonetheless- find absolutely fascinating:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209544/

    And, if you haven’t yet seen the “USDA Great Debate” circa 2000, take a few hours and witness our Favorite Doctors et al lay waste to the Masters of Metabolic Mayhem. Enjoy!

    http://www.youtube.com/watch?v=feCpP40ZHqI




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  12. An honest discussion of this topic is a worthy idea–of course I question the academic honesty of this video when it starts with Red Herring arguments (Twinkle diet, chemo therapy and tuberculosis) and the first proof cited is claimed to be a study, when it is a letter to the editor of the BJN. There is a need to have good debate on this without resorting to such tactics.




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    1. The screen shot in the video isn’t actually the study… the link in the sources cited gives you the actual study and it was a published study, not a “letter to the editor”. So there really is no problem here.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/

      or

      http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0055030

      As for the “red herrings”… I just don’t think you understand Dr. Greger’s comedy. He was bringing up the point that weight loss (REGARDLESS of the method), results in lower cholesterol.

      If you have a legitimate concern over the actual study or the the data they’ve gathered, feel free to mention them.




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      1. OK, at best these are examples of gross hyperbole, but these are classic red-herring attacks, since there are numerous studies done today that clearly show that there is no correlation between the CVD markers cited and CVD with or without weight loss.

        As to the actual study cited? I reviewed the video and transcript, no mention of the PLOS Online Article appears (that I could see), but the BJN Letter to the Editor is prominently displayed with the voice-over saying studies now show… This is false representations at best but it probably is just outright purposeful deception. If the intent was to cite the PLOS article, why wasn’t a screen shot of it shown? Why hide it int he sources cited section. Please explain the deception before you explain the validity of the study.

        One possible reason the PLOS article was not shown is the relatively greater recognition of the BJN as a peer-reviewed source. I might also surmise that the PLOS article had only one citation so far (I know it is a relatively new article), that citation was a refutation of the basic methodology used. If I can quote:

        You can find this article at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945587/

        Regarding the overall effects of ketogenic diet on health there are
        differences in opinion about the research. Recently, in a recent
        systematic review based on limited observational studies, Noto and
        colleagues suggested a possible harmful effect of low carbohydrate/high
        protein diet (LC/HP) on health: i.e., an increase of all-cause mortality risk whilst there was no effect on CVD mortality [81].
        On the other hand, for example, a large European study demonstrated
        that an increase in protein content and a reduction in the glycaemic
        index led to better maintenance of weight loss without differences
        regarding adverse effects.

        The article was published in: International Journal of Environmental Research and Public Health and for full disclosure, since its Feb 2014 publication does not appear to have been cited in other research.

        A second reason is that the PLOS model is free open access, and anyone would have been able to access the article and comment on it, where the BJN article requires a subscription. A nasty little trick to try and keep people from double checking your sources.

        I welcome valid debate on this subject, this is not valid debate.




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        1. Hyperbole, perhaps, but I found it was effective in getting the point across.

          The sources cited simply send you to the abstract. The full text will get you to the PLOS and PMC journals. Almost all these videos cite abstracts, likely for clarification, but also because most full texts require paid subscriptions to access (making the information useless to the general public). So I don’t find any conflict here either. Why you have to make assumptions attacking the credibility of Dr. Greger is perhaps part of your agenda.

          In regards to your link regarding ketogenic diets, the “large European study” did not test a ketogenic diet. in fact the difference between the “high protein” and “low protein” group was only a 5.4% difference in protein intake… then you have the fact that 29% dropped out (that’s a staggering number) and it was only a 26 week study. This doesn’t make any case for ketogenic diets.

          “… since there are numerous studies done today that clearly show that there is no correlation between the CVD markers cited and CVD with or without weight loss.”

          Could you link those studies? The only ones I’ve seen that appear to show no correlation are funded by the egg/beef/dairy industries and/or use researchers on their payroll (which won’t always show up in disclosure part of the study (as I’ve found out several times already).




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        2. Hello Marc, we actually welcome vigorous debate of the science. However, please understand that Dr. Greger has no intention to or nothing to gain by: “false representations at best but it probably is just outright purposeful deception.” You may notice this site has no advertisements and any money for Dr. Greger’s appearances, etc. are donated by him to charity.
          So please, for everyone’s benefit, help us foster a community of mutual respect by not posting any further personal attacks. Thank you in advance, Jacquie




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  13. Here we go again. The small size of this study makes it suspect right off. Who were these people..?how were they chosen? Were they picked out of a bingo parlor or a health club.? . Did any have any health problems? Did any smoke.. The study leaves a lot more questions then it answers. Just another guy that thinks he just discovered America.




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    1. “Those sticking to the vegetarian diet showed a reversal of their heart
      disease as expected. Their partially clogged arteries literally got
      cleaned out. They had 20% less atherosclerotic plaque in their arteries
      at the end of the year than at the beginning. What happened to those who
      abandoned the treatment diet, and switched over to the low carb diet?
      Their condition significantly worsened. 40 to 50% more artery clogging
      at the end of the year.” None of your questions matter- the those eating more plants = less plaque.




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  14. If you follow the first study in the sources sited, you’ll see that even meta-analysis of over 200,000 people concluded that “Low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality and they were not significantly associated with a risk of CVD mortality and incidence”

    The second study sited lists 247 patients. The study being focused on in the video only validates the evidence of the other studies… so what’s the objection?

    At some point you’ll have to concede to the fact that low-carb diets aren’t healthful.




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  15. Could someone please tell me what exactly is a Low Carb Diet? How many grams of Carbs can one eat in a day? What is the best source of carbs? Carbs are everywhere, even in vegetables. I’m 60 yrs old, 132 lbs, exercise 4x week, teach 4 low impact exercise classes a week and I consider myself a vegetarian. Please advise!




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    1. Hi Anne, A low-carb diet limits carbohydrates — such as grains, starchy vegetables and fruit. It is mainly dietary protein and fat. Many types of low-carb diets exist, each with varying restrictions on the types and amounts of carbohydrates you can eat.

      Common food sources of naturally occurring carbohydrates include:Fruits, Vegetables, Nuts, Grains, Seeds, Legumes. And of course sugar! So limiting processed carbs like cakes, cookies, sodas.

      The amount of carbs one can eat in a day, depends on health goals and which type of carbs. For instance to lose weight – one may want to decrease decrease fruit consumption and eat more veggies, etc.

      Hope that helps, Jacquie




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  16. My God, this is confusing. I just watched a video by Gary Taubes where he talks about carbs as stimulating insulin, and characterized insulin as the “fat-making” hormone. I mean, there are all these different doctors on the web and writing books, and all sound like they know what they are talking about, and all have conflicting idea, and all claim to have many testimonials from people whose lives were saved because they lost weight – doing whatever it was whatever doctor told them to do. But I did find it odd that Taubes says that rice is bad when several billion of the world’s thinnest and mostly healthy people eat rice every day without a problem. I really do not know what to think, of what to eat. I tend to be scared these days of too much meat, too many chemicals in meat, dairy, eggs, though I eat a moderate amount of these things just because I’ve eaten them most of my life and it seems silly to go go whole “hog” so to speak and cut out totally foods that I like. But I do think that if I could cut down meat to a bare minimum it would be better. But things like milk, dairy, cheese, and then to me yogurt seems to be in a different class from the rest of this stuff. I would choose yogurt here.




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    1. HI bruxe, it is confusing for sure. That is one reason Dr. Greger always points to research. I wanted to be sure you know that Taubes is a journalist not a doctor – I think you know but the way it was written I just wanted to be sure. From what I have heard and read of Taubes – there are flaws in his words.

      There is no study that drills down to the exact amount of animal product that is ok – thus many people choose to eliminate it altogether since nutritional benefit from plants is over the top. I like to suggest for those that choose to eat dairy or animal – try Meat Mondays instead of Meatless Mondays – so the balance is low on animal. Think of it as a continuum or Spectrum (Ornish), with animal on the low end of nutritional scale.




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      1. Hi Jacquie … Actually Taubes is a journalist, by way of being a scientist … so the attack the person to discredit the idea meme – at least to me is not going to work. Here is a bit about Taubes from his bio:

        Born in Rochester, New York, Taubes studied applied physics at Harvard University (BS, 1977)[3] and aerospace engineering at Stanford University (MS, 1978). After receiving a master’s degree in journalism at Columbia University in 1981, Taubes joined Discover magazine as a staff reporter in 1982.[4] Since then he has written numerous articles forDiscover, Science and other magazines. Originally focusing on physics issues, his interests have more recently turned to medicine and nutrition. His brother, Clifford Henry Taubes, is the William Petschek Professor of Mathematics at Harvard University.[5]

        After hearing Taubes speak and debate on the Internet, i.e. YouTube to be specific I find he makes a lot of sense and does not really conflict much with what others say either. One has to look very carefully at the claim made by anyway and what they really mean.

        I think Taubes is correct when he pins a lot of our obesity problem on refined/processed carbs. Just for kicks from my normal diet I cut carbs out the next day and I was amazed at how mentally clear and calm I felt. Now, I don’t know what to make of that. As a hypothesis I cut down on carbs and sugars and I feel noticeably much better … much better than when I cut out meat for week, but them much of what I was eating in its place was carbs. Which brings up my problem with vegan/vegetarianism to me now … it is very difficult to do – not to mention expensive – and not sacrifice huge amounts of convenience too.

        Taubes is saying basically much of what the vegans are saying, but that you can eat reasonable quantities of good animal protein.




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        1. No one said Taubes didn’t have credentials. What I said is that he is abusing those credentials to mislead others.

          Don’t believe Plant Positive’s mountains of evidence? Wanna hear some proof of his dishonesty from a low carb dieter? Search Evelyn (CarbSane)’a blog
          http://carbsanity.blogspot.com
          for “Gary Taubes”. When low-carber’s with their own scientific background think Taubes’s misleading rhetoric gives them a bad name, there’s a problem. There is no substance to his pet theory that ALL CARBS make us fat.

          Congrats on getting rid of the junk carbs. Anyone who gets rid of addictive hyperprocessed carbs is bound to feel better. That doesn’t make eggs and sausage for breakfast and a pound of steak for dinner (I.e., a ketogenic diet) a healthy regimen.

          PS. Taubes admits his wife is mostly vegetarian who refuses to let his kids eat the way he does.




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        2. bruxe: You wrote, “Which brings up my problem with vegan/vegetarianism to me now … it is
          very difficult to do – not to mention expensive – and not sacrifice huge
          amounts of convenience too.”

          Most people find whole plant based eating to be quite convenient once they get over the learning curve. Though I think convenience may depend in part on where you live in the country. For example, it’s really easy in say California, Oregon and Washington USA. I’m guessing it’s less easy in the middle sections of USA.

          As for cost, whole plant based eating is the cheapest (not to mention healthiest) way to eat! If you would like to learn more, check out this video:
          http://nutritionfacts.org/video/eating-healthy-on-a-budget/

          This one may also interest you:
          http://nutritionfacts.org/video/eating-healthy-on-the-cheap/

          Good luck.




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      1. MacSmiley … I never indicated that everything Gary Taubes said was right, but what I do think is – first that Taubes primary focus is on obesity and weight loss. The videos you point to as far as I can tell are disagreeing with Taubes on what I think are minor nit-picky points. I mean, the first video starts our quoting George Orwell/1984 framing the whole debate as one of propaganda. I don’t call that honest inquiry either.

        The main point I see Taubes as making is that when we eat carbs, the are processed by the body and insulin is shot into the blood, and these days we eat so many carbs almost all day that we always have insulin our blood. The second leg is that he calls insulin “The Fact Making Hormone” and backs that up with science. In some cases insulin processes so much carb to fat that an animal genetically programmed to be fat because of their insulin chemistry can actually starve to death while being hugely obese and eating all it wants.

        What Taubes said made a lot of sense and explained why people are getting fat better than other alternatives. For example Lustig from UCSC says it is all due to fructose, and he makes good points, but I think it is a subset of what Taubes is referring to. Now, when Taubes goes on to extend his ideas past that, I am not sure I buy what he says.

        Figuring out what these studies say and what they do not say is very difficult and should be more concentrated on by the people who are supposed to be reading and informing us.




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        1. Many of Taubes’s tactics are blatant obfuscation. His rewriting history (the reason for the 1984 citation), that is, his account of Ancel Keys’ research borders on libel. PlantPositive is far from nit-picking.

          One example:

          In his book, Why We Get Fat and What to Do About It, he cites 3 recommendations of the World Cancer Research Fund.

          (1) Be lean and avoid gaining fat mass. (2) Be physically active. (3) Avoid energy dense foods and sugary drinks to avoid weight gain. By themselves, those recommendations do not justify his promotion of a low carb diet. But they don’t rule it out either.

          However, Taubes fails to mention many of the other recommendations by that organization, which include (4) Limit red meats and avoid processed meats and (5) Eat mostly foods of plant origin.

          Is Taubes promoting a plant-based diet, as his source does? No. And that’s only one of a mountain of truthy detours. Follow him and he’ll take you for quite a ride.




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          1. Well since humans have been around for say 100,000 years and we do not understand how we work nutritionally, I would suspect that no one has it exactly or totally right, but more and more I see people coming out to agree with the general hypothesis that Taube is talking about, namely that carbs and sugar stimulate insulin which stimulates fat. That is basically it makes the case that a calories is not a calorie, which when you think about it should have been intuitive to any biologist or chemist just on reflection, and according to Taube it was, or at least it occurred to multiple people. We have a very serious problem with our big business when they seem to go out of their way to cause disease and sell people stuff that insults their biology.

            Your response is just a quick little dig at calling Taube misleading, i.e. character assassination, but you do not make the case that anything he said is a lie, like a hack you just wave your arms to some other paper.




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            1. Don’t take my word for it. Taubes has been misrepresenting science and scientists since his article in the NY Times in 2002. So says the people he quotes, at least the live ones…

              You can catch me on Twitter for more examples. Disqus won’t cooperate with copy and paste on my iPhone with this long of a thread.




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    2. bruxe: I second MacSmiley’s recommendation to watch Plant Positive’s Videos. You will learn all about the problems with Gary Taubes’ statements/”logic”. Good luck.




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  17. the bottom line is NO ONE has ever been able to prove you can eat more than your bodies maintenance and NOT gain weight…Atkins admitted in a court that his diet was based on if he told people to eat more protein and fat they would automatically eat less which proves cal in vs out..




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  18. Bottom line is you should feed your body what it needs. Deprive it of something your body will find alternative ways to still keep performing.
    Wasting tissues it doesn’t need, breaking down less critically stocked reserves converting it to what is needed wherever it can..

    In the end the result is the same, you force your cells/body to work harder and less efficient. Less efficient means more waste toxins/products, which means aging faster as also you do from working harder.

    You can actually see this principle happen in micro scale in your skin. Which was a very big surprise to me after switching to plant based diet. Better blood flow, more nutrients and less waste, healthier skin.

    The knowledge that that is actually happening everywhere still brings a smile on my face.




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  19. To supplement the information I provided along with others in many of the comments below: “Scientists Fix Errors in Controversial Paper About Saturated Fats”

    Willett says correcting the paper isn’t enough. “It is good that they fixed it for the record, but it has caused massive confusion and the public hasn’t heard about the correction.” The paper should be withdrawn, he argues.”
    “It’s dangerous.”
    http://bit.ly/1jxyIJv




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  20. those on low fat were also on high protein, my question is, was the blood flow in the arteries worsened because of the low carb or the high protein?




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  21. These studies are always so flawed and unrealistic.

    Why do they always have to measure the outcomes of an extreme diet?

    Why not study for e.g. a whole foods approach to nutrition perhaps on a paleo/primal template of moderate carbs (heaps of veg, some fruit, no grains/cereals), low sugar, moderate protein and fat (moderate to high) as necessary for energy and weight maintenance depending on ones activity levels?




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    1. Probably because the way a lot of ‘health conscious active people’ actually eat doesn’t show dramatic enough results to create attention and there’s no government, medical body, pharmaceutical or food manufacturer/organisation to fund it…




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    2. And also because if all you are doing is studying the way “most people eat” then why run a study at all? All you have to do is look at health effects across the population and you will have all the study results you need. If current levels of heart and other chronic disease is acceptable to you, then I agree, the average way of eating is fine. The entire reason we’re having this discussion though, is that current levels of disease should not be acceptable, especially when it’s clear that other populations in the world have disease rates that are substantially lower than ours.




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    1. YES. The only two studies before this showing actual reversal of hear disease were by Dr. Ornish and Dr. Esselstyn and both those doctors had their patients on a high carb diet with total fat intake less than 10% of total calories, for example 22 grams fat total on a 2000 calorie diet.




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  22. This information is incorrect. In general, cholesterol levels tend to fall during calorie restriction of any type, including low carb. (See the Twinkie and potato diets.)

    Atkins and other low carb proponents rig their studies to show a cardiac benefit by contrasting a hypo-caloric low carb diet with an isocaloric junk carb diet. Typically the low-carb diet shows a small improvement in lipids and Voilà! Low carb = good.

    And even that doesn’t always work. On the famous one year, all-meat diet undertaken by Stefansson and Anderson, both had increased blood lipids. Anderson’s TC went as high as 800! It lowered considerably afterwards, but neither achieved a healthy level.

    As a side note, by the end of the study, Anderson had sugar in his urine and Stefansson was pre-diabetic.




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  23. Just saw the video on the dangers of low carb diet. My young friend is
    23, married with a 3 year old son and has been type one diabetic for 13 years.
    Her last check up revealed some heart challenges and that she is now
    insulin resistant.

    Over the years she has not been too responsible about her eating and
    now she is paying for it. Also the dr said that having a baby took
    years off of her life because of the stress on the kidneys. Now she is
    counting carbs and keeping them to about 150 per day. What are her
    nutritional options if low carb is bad for her, but she is supposed to keep her carbs low for the
    type one diabetes?




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    1. bulldogltd: I’m not a doctor myself, so I can’t say specifically what your friend should do. However, I would highly recommend taking a look at the book, “Dr Neal Barnard’s Program for Reversing Diabetes”. Type 1 is more tricky than Type 2, but the book has a chapter about Type 1 and your friend might get a lot of benefit from reading the book. I found the book to be very powerful and helpful.

      http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1?ie=UTF8&qid=1400600695&sr=8-1&keywords=barnard+program+diabetes




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  24. Having just extricated myself from a discussion with some Paleo nuts, (discussion being used in its most broadest terms), it was a refreshing to come here. I know we can’t save them all, but it is really hard to just be bullied by masses who have zero interest in science or history. It is what it is, they’ll either figure it out or they won;t. But you guys here are better prepared to attempt discussion. I’m going back to what I do best. Glad you guys are here to do what you can.




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  25. Any comments on the Rosedale diet? I’ve been following the whole food/plant based/no oil approach for >5 years and it’s the best thing I ever did for my health. I’ve got a friend who’s a nutrition coach who’s touting the Rosedale diet. It seems to be a variation on the Atkins approach. Sadly, when I asked for research she responded that her clients want things simple so she doesn’t bother with citing any other than referring them to his website: http://www.drrosedale.com/#axzz38IwcNGLC




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  26. This video is a bit misleading. What about people who are on a low carb, high fat, plant-based diet? As someone following this regimen (in order to control my high glucose levels), it would be nice not to get lumped in with the Atkins folks. But then again, is a low carb, high fat, plant based diet dangerous as well? This isn’t answered….




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    1. Russell: I highly recommend you take a look at the book, “Dr. Neal Barnard’s Program for Reversing Diabetes”. He makes a very compelling claim that Type 2 diabetes is caused by high fat diets. Dr. Barnard did clinical tests showing “his” diet is 3 times more effective than other diet plans for diabetes patients.

      As a lay person, I would interpret that to mean that eating a high fat diet, even a plant based one, is the very last thing you would want to do in order to control glucose levels. Maybe I don’t know what I’m talking about here. It just sounds right to me.

      Note that the book is not only a fast and interesting read, but it has ideal recipes in the back too. None of those recipes are high-fat/low carb. If you are interested, here is the book, or maybe your library has it:
      http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_title_0_main?s=books&ie=UTF8&qid=1410907820&sr=1-1&keywords=neal+barnard+diabetes

      Hope that helps.




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      1. Thanks Thea. I had a few emails with Dr. Barnard’s colleague. They are promoting a whole carb, low fat vegan diet. I explained that my glucose goes wild with any whole (or refined )grain products, but that it was well-controlled with plant-based fats (down to A1c of 5.3), but they still believe their diet is better and unfortunately, don’t seem to have data to back it up, other than anti-Atkins type arguments. But I’m curious what the other diabetes diets were in his book, so I’ll check it out. Thanks again.

        PS My pre-diabetes was probably caused by too many whole and refined grains on an Ornish-type diet — 35 years worth — plus a hyperactive thyroid which allowed me to metabolize quickly.




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    1. It is likely, Dr. Vogel conducted a study that compared different fats and oils (olive oil, canola oil, and salmon) and how they impaired our endothelieum cells. Our endothelieum cells are within our blood vessels lining their walls. They keep clots from forming and keep our blood running smoothly. It also helps our blood vessels dilate and contract when needed. The participants of the study ate a meal containing 3.5 tablespoons of olive oil and the examiners measured their arterial damage after 3 hours. “Contrary to part of our hypothesis, our study found that omega-9 (oleic acid)-rich olive oil impairs endothelieum function postprandially.” They also make note that “In terms of their postprandial effect on endothelieum function, the beneficial components of the Mediterranean and Lyon Diet Heart Study diets appear to be antioxidant-rich foods, including vegetables [and] fruits”
      http://content.onlinejacc.org/cgi/content/full/36/5/1455

      It was even noted that “In a clinical study, olive oil was shown to activate coagulation factor VII to the same extent as does butter. Thus, olive oil does not have a clearly beneficial effect on vascular function.”

      http://www.ncbi.nlm.nih.gov/pubmed/9409274

      The soup either had 3 tablespoons of each oil OR they fried the potatoes in the oil. They too examined the extent of damage on the volunteers’ arteries. this is what they found “All the vegetable oils, fresh and deep-fried, produced an increase in the triglyceride plasma levels in healthy subjects.”

      http://www.ncbi.nlm.nih.gov/pubmed/17174226

      This 2 year study looked at coronary artery lesions of the heart after consuming different types of fat. Polyunsaturated fat (omega 3 type of fat) Monounsaturated fat (75% of which makes up olive oil) and Saturated fat (the kind found in mostly animal products). They looked at angiograms a year apart after intervening with increasing one type of fat in each group. All 3 fats were associated with a significant increase in new atherosclerosis lesions. Most importantly, the growth of these lesions did not stop when polyunsaturated fats and monounsaturated fats were substituted for saturated fats. Only by decreasing all fat intake including the polyunsaturated and monounsaturated fats did the lesions stop growing.

      http://jama.ama-assn.org/content/263/12/1646.abstract?sid=47d1d016-3c15-43f4-a013-0d10144ef8e3

      The only diet ever to reverse heart disease is a low fat plant based diet.




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  27. Am I the only one here that has noticed total blood flow percentage and percentage of plaques getting interchanged in this video?
    These 2 are not the same thing! Better blood flow is a combined result of the variables plaques AND endothelial function.
    Endothelial function you can improve in literally hours to days. Plaques require many years of attention.
    Why do these kinds of mistakes keep popping up? There is no shortage of expertise to avoid them, is it going for the shock factor again like the Alzheimers graph? Those are tactics like sprint cheats, throwing the chest forward for that 1/10th of a second.
    Those kind of tactics are useless for marathon like efforts like trying to get people to eat better, they are very detrimental for a long run.




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  28. To do a proper LC study, certain things need to happen:

    – getting the carbs from the right sources
    – increasing the satiety of the diet with healthy fats and proteins
    – basing this on an average caloric intake for the day (usually 1700-2000 calories will do)

    Most studies can’t follow this and most cant seem to ascertain just where sugar can be hiding. How many LC studies out there are done with just vegetables like green vegetables? None, because they add crap in like fruit, potatoes, and other crap. Sure it’s low carb compared to a giant plate of spaghetti and a supersized fries & coke but get real here, there is still lots of sugar present in fruit, and potatoes have a tendency to skyrocket your insulin.

    Go to study based on carb sources coming from strictly spinach, asparagus, and broccoli, and start from there. Don’t throw dairy into the picture for a fat source because it still contains sugar. Go grab your fat from almonds and pumpkin seeds, olive oil and avocados. Eat a decent amount of protein from chicken breast, fish, and eggs.

    Do a LC study based on that and you’ll have a true reflection of it. You’ll also have a result that will thwart many of your claims regarding carbs, proteins, and fat.




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  29. HOW IS IT THE AMA HAS VILLIFIED CHOLESTROL AS THE CAUSE OF ARTERIAL HEART DISEASE FOR SO MANYYEARS AND NOW YOUR SAYING ANYTHING
    CAN LOWER CHOLESTEROL LEVELS BUT THAT HAS NO EFFECT ON CARDIOVASCULAR DISEASE??

    YOU CANT HAVE YOUR CAKE AND EAT IT TOO/NO PUN INTENDED

    AND BUY THE WAY YOU THINK EATING AN ALL TWINKIE DIET CAN LOWER YOUR CHOLESTEROL? REALLY( IM SURE YOU HAVE THAT RESEARCH) THAN MAYBE WE SHOULD ALL BE ON AN ALL TWINKIE DIET INSTEAD OF STATINS THAT ARE TOUTED TO REDUCE CHOLESTEROL THE MAIN CAUSE OF CVD AS PREACHED TO US BY THE AMA.




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  30. This video is not science, it is so bogus I don’t know where to being. So I will list ALL the issues. Firstly after listening, it is clear that it still assumes that cholesterol is a cardiovascular risk factor – this is the biggest problem of all. But this is simply not the case anymore, in fact, it never was. I will post a link that SHOW that low cholesterol is co-related with heart disease.

    But lets discuss the snapshots.

    In min 0:51s with the caption, if you read the actual snapshot, it showed that those on a very low carb diet (VLC) got good results for lowering obesity, TAG (triglyceride) levels and blood pressure, and HDL even went up. BUT it raised the LDL. “AMAZING” However it did not say that the patients had health issues, just that the risk factor raised, but as I said again, high LDL is not a risk factor for heart disease anymore, unless it is small dense LDL and THAT was not mentioned..

    Also in min 1:19s of the video, it reads (quote) “Low-carbohydrate diets have become increasingly popular for weight loss. Although they may improve metabolic markers, particularly in type II diabetes, (T2D), or metabolic syndrome, (MS), their net effect on arterial wall function remains unclear” (unquote).

    If you were trying to post a point against low carbs, this will not be it.

    Min 1:48 Effects of a high protein Diets on Chronary Blood flow, I was reading the extract but I was not able to get all the information, so I found the original text that was cut out. Here it is….

    “The background for the study, as set out in the abstract, is as follows: “Recent research has demonstrated that successful simultaneous treatment of multiple risk factors [listed in detail] can lead to the regression of coronary artery disease and the recovery of viable myocardium. However, preliminary work revealed that a number of individuals enrolled in the original study went on popular high-protein diets in an effort to lose weight. Despite increasing numbers of individuals following high-protein diets, little or no information is currently available regarding the effect of these diets on coronary artery disease and coronary blood flow.””

    Also, the table II in min 2:50 ‘shows’ those on a high protein diet (HPG) he said that people’s condition got worse. But he also said low carb diet. So this was a false claim since his conclusions were about low carb but the extract was about high protein. The diagram was a treatment group (TG=???) vs a (HPG) high protein group.

    In 3:25, he refers to low carb diets, but the supporting text in the images are for high protein not low carb.

    In 3:44, the last slide, this was about lifespan in general. But he did not put in the full text. He made it appear conclusive.

    The actual final text reads…..

    “Low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality and they were not significantly associated with a risk of CVD mortality and incidence. However, this analysis is based on limited observational studies and large-scale trials on the complex interactions between low-carbohydrate diets and long-term outcomes are needed.”

    So it appears that low carbers live shorter lives, but they were not sure, and CVD mortality were not significantly higher or significantly corelated.

    Here is my link…….

    http://dietheartpublishing.com/Cholesterol/10/09




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  31. I was trying to make a post against this video but it got tore down. It shows that most of the cited evidence in the video showed very little evidence for low carb equating to heart disease.




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  32. I am only looking at my own case. No peer-reviewed scientific studies, etc. Low carbing is the only thing that has really helped me lose weight. I personally do not go overboard with fatty meats or even fat, because the “high fat” part of this is the body’s own stores and I want that burned off. I use avocados, coconut and olive oil. And yes, grass fed butter and some bacon grease. I still use leaner cuts of meat. I love my veggies. I even eat lower carb fresh fruit on occasion. At last check my cholesterol was excellent, but I am on statins. I personally think that the strict vegan diet is not for everyone. i don’t think I could do it. Drs Ornish, Barnard, Fuhrman, etc… most Americans are NOT going to do that. So for me, it is about finding what works. And re: cholesterol… I have read recently that the REAL issue in the body is inflammation. I am finding that cutting out processed food, simple starches and keeping even complex carbs to a minimum has done wonders for my joint pain and my non-ulcerative colitis. I am more leery of all the junk put into and onto our food (pesticides) than I am leery of some saturated fat in my diet.




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  33. OK, I’m calling the good doc out on this one.

    “Low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality…”, as he quoted the study,

    http://www.ncbi.nlm.nih.gov/pubmed/23372809 (the study from his own video sources)

    BUT, he left out the rest of the sentence!! Which goes on to say, “and they were not significantly associated with a risk of CVD mortality and incidence. However, this analysis is based on limited observational studies and large-scale trials on the complex interactions between low-carbohydrate diets and long-term outcomes are needed.”

    People, correct me if I’m wrong, as like many, I’m trying to figure out this dichotomy in diet recommendations. As the rest of the world is now embracing fat in the 21st century, he’s pounding away against it. But, if he’s going to give incomplete quotes, then something’s really wrong here.




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  34. Is it possible the problem is not with beef itself but rather with grain fed beef ? Paleo diet advocates recommend eating grass fed beef only. According to their data grain causes the ratio of omega 3 to omega 6 to become unbalanced or un-natural. Beef fed the un-natural diet of grain produce a higher amount of omega 6. Not good. Perhaps the problem with animal protein is the un-natural diet of the animal itself.
    I could give you an analysis of why a high protein low carb diet is the best way to loose a lot of weight quickly. So there is the damage to the kidneys in let’s say a year of a high animal protein, low carb, don’t worry about the fat dieting on one hand and the deleterious ramifications of morbid obesity on the other. Which is greater ? Can the kidney heal itself on a vegan based diet later ? What are the answers ?




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    1. thompsom: No, grain fed beef is not the problem. The following video from Plant Positive reviews data around grass fed beef: http://plantpositive.com/44-humanity-past-and-future. Also, if you review all the evidence on this site about animal protein in general, IGF-1, contaminants, saturated fat, etc, etc, etc, you will see that the tiny changes in grass fed beef do nothing to address the main health problems with consuming beef no matter how the cow is raised.
      .
      re: “I could give you an analysis of why a high protein low carb diet is the best way to loose a lot of weight quickly.” I don’t know what you mean by “best”. Do you mean the fastest? I don’t know about that. High protein is definitely an unhealthy way to lose a lot of weight. And plenty of people who understand the concept of calorie density and apply it to eating whole plant foods, lose a lot of weight quickly with the right amount of protein, AND do so in a way that is health-promoting and disease reversing. And it allows them to start on a diet that they can safely adopt for the rest of their lives. That speaks well for long term success on weight management as well as a long healthy life.
      .
      re: “Can the kidney heal itself on a vegan based diet later?” It is a generally well accepted sentient that it is easier to prevent a problem than to reverse one. While it is sometimes possible to reverse a disease, it is not always possible. People are better off preventing the disease in the first place.




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  35. How come then the LCHF diet works so well? People are loosing weight, their blood sugar, lipid levels and blood pressure are fantastic, their CRP goes down, and their arteries are plaque-free. All that after years and years mainly on meat, fish, eggs, and the staggering 60-70% fat!

    As a fervent supporter of WFPB, I’ve asked PCRM the same question and they weren’t able to respond…




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    1. First, where is the evidence of long term benefits? Studies show long term lc diets are accompanied by increased mortality.
      Second, any diet that delivers weight loss will show similar short term improvements in biomarkers. Think of the Twinkle diet.
      Third, there will always be some individuals who do well despite diet, just like some smokers live to ripe old age. But the lchf people who do well over a relatively long period seem to be ferocious exercisers which confounds the effects of diet.
      Fourth, most of the studies showing benefits for lchf are done on obese and diabetic persons. And are short term. There are metabolic diffdrences




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  36. Well of course! The excess protein turns to glucose and so gives them high blood sugar, glycation, and all the ills diabetes usually does. How about studies where people ate high fat/low carb as in 80% fat, 10-15% protein, and only a very few carbs and 100% of those complex ones from veg?




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  37. DT Gregger,
    Thanks for the great video.
    Is there any data about ketogenic diet?
    The attkins diet allows eating any kind of meat so some say you can’t compare the attkins diet to a ketogenic diet where you don’t eat processed foods.
    What is your opinion on that?
    Thanks,
    Ron.




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  38. Sir / Ma’am,
    I did some background research on Dr Richard M Fleming to see if there are and post or present conflicts of interests regarding his study but I was overwhelmed with notice regarding his this link (and many others)(link below)…What is your view of what happened. I can’t use this example from this video as opposition will do the same as I did and dis-credit Dr RM Flemings work ?

    https://archives.fbi.gov/archives/omaha/press-releases/2009/om082009.htm




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  39. Hello Dr. Greger,

    Today, Outside Magazine published an article advocating a high-fat, ketogenic diet: http://www.outsideonline.com/2113406/high-carb-low-fat-ketone-diet .

    I smelled a rat, so went to Nutrition Facts to search for information on ketones, ketogenic, etc. But I found no results.

    Would you consider addressing this topic? It seems it would be worthwhile with the publicity it is currently getting.

    Thank you,

    Michael Morrison




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    1. Michael: In case it will be helpful, here is a post from Moderator Rami on the negative impact of a ketogenic diet: http://nutritionfacts.org/video/fighting-inflammation-in-a-nut-shell/#comment-1093732992

      And here is a good one from well respected commenter Tom Goff: http://nutritionfacts.org/video/fighting-inflammation-in-a-nut-shell/#comment-2687351897

      I’m sure Dr. Greger saw your request for him to address the topic. I hope that the above 2 posts will help you in the mean time.




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  40. The actual conclusion of the Plos1 review in full was “Low-carbohydrate diets were associated with a significantly higher risk
    of all-cause mortality and they were not significantly associated with a
    risk of CVD mortality and incidence.” I am genuinely shocked that in a discussion of deaths from cardiac disease that the latter part of the conclusion was not mentioned while implying that a substantial part of the increased all cause mortality was of cardiac origin. Perhaps the author would be better employed commenting on what ever conditions were really responsible for the increased all cause mortality.




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  41. Sadly when anyone talks about low carbs or controlling carb intake everyone immediately assumes we are talking about Atkins. Many veggies have an awful health profile simply because they may eat a plant based diet but they also consume plenty of simple carb’s which damages the arteries through insulin spikes. Too many people seem to think high carb means any carbs. I try to eat a whole food plant based diet and keep the simple carbs to as close to zero as possible, would others agree with this ?.




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    1. Mark: I both agree and disagree. The part I agree with is that the healthiest foods, generally, are whole plant foods. This means avoiding foods such as those that contain white flour and sugar. As simple carbs, I agree that those are the types of carbs to avoid. If you review Dr. Greger’s Daily Dozen, you will see that he recommends fruits, veggies, whole grains, beans, etc. None of those foods are “simple carbs”.
      .
      The part I disagree with is the beginning of your post which seems to be saying that low carb diets, as long as done with whole plant foods, can be healthy. (Please correct me if I misunderstand what you are saying.) If you follow Dr. Greger’s diet, you will be eating what many people would consider a high carb diet. http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/ (Though I think it is a normal carb diet, not a “high” one.) If you look at the traditional Okinawan diet, the diet of one of the longest lived and healthiest populations on the planet, they primarily ate carbs. (I think it was 85%?) I don’t think we have lots of data on people who eat a lifetime of low carb diets, but there is generally an association of shorter life with lower carb diets. You wrote, “… when anyone talks about low carbs .. everyone immediately assumes we are talking about Atkins.” I’d assume Atkins or paleo or some variant. Isn’t that exactly what we are talking about. If someone eats a truly low carb diet, they are making up the lost carb calories with protein and fat, which is some variation of atkins or paleo as I understand it.
      .
      I guess the point I’m trying to make is that I would describe a healthy diet as Whole Plant Food Based. I think you get into trouble if you describe it as low carb or restricting carb. You actually want the majority of your calories to come from carbs which in turn come from whole plant foods. That’s my 2 cents anyway.




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      1. Yes I agree Thea but I tend to avoid carbs that quickly spike sugar so for example I avoid bread in fact I avoid wheat totally not because I have a wheat intolerance but because the highest correlation between any food and heart disease within the China Study data was assigned to wheat.




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        1. Mark: Re wheat and heart disease. Interesting. I don’t remember that. Would you be able to find me a page number easy enough so I can see that? No problem if you can’t. I’m just super curious. It sounds like one of those situations where correlation doesn’t equal causation to me, but I’m open to learning more.




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          1. There is a data analyst called Denise Minger, if you google her and China study you will see that she caused quite a furore challenging some of the findings within the China Study. It was her analysis that showed the biggest correlation, and it was big, was between wheat and heart disease. The author of Wheat Belly also agrees with this theory, arguing that wheat helps to promote small dense LDL particles which are believed to be the most atherogenic.




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            1. Mark: Thanks for that information. I’m familiar with Denise Minger. To my knowledge, she is not a data analyst. She is a person who plays with data and doesn’t know what she is doing. At least at one point, Minger listed her educational and professional qualifications on her Facebook page as writer, Catholic school teacher, summer camp instructor, and “Professional Sock Puppeteer.”
              .
              I’ll point out again that correlation doesn’t equal causation. The following video addresses Minger’s claim about wheat and heart disease: http://plantpositive.com/blog/2012/3/27/response-to-denise-minger-4-china-revisited.html You can read the script if you don’t want to watch the video. After seeing your post, I found a response from Campbell (the author of The China Study) on Minger’s claims: http://www.vegsource.com/news/2010/07/china-study-author-colin-campbell-slaps-down-critic-denise-minger.html
              .
              The author of Wheat Belly is also misleading you. For example, the argument that light fluffy LDL particles are protective is very misleading: http://nutritionfacts.org/video/does-cholesterol-size-matter/ Even people who are opposed to gluten (celiacs) point out that Wheat Belly is not backed by the science:
              http://noglutennoproblem.blogspot.com/2012/03/wheat-belly-busted.html
              .
              I’m not trying to get you to eat wheat. A perfectly healthy diet can include alternative intact grains if you prefer. It doesn’t matter. What is important is that we not spread misinformation about food/wheat and it’s relationship to health. That’s why I’m posting this.




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              1. I am not a big fan of Minger in that I get that she is a Paleo advocate and dont buy the low carb high fat/meat approach. However the Paleo approach is a whole lot better than the SAD diet and as such results in improved outcomes generally. With regards to the wheat data no one seems to be saying that she got the data wrong, perhaps misreading a decimal point. Rather we have the old correlation and causation argument which is a very valid one. However what are people prone or suffering from HD to do ?. wait until some one proves it is causation or perhaps simply take a damage limitation approach and cut the stuff out after all it is not an essential nutrient. The other thing about wheat is that when we discuss it we are invariably talking about bread as for most westerners thats the ubiquitous source of consumption. Bread causes huge insulin spikes and if there is one thing you can gaurantee to lower your BMI it would be the removal of bread, trust me I was 14st 3 years ago and I am now 11st 7lbs, the same weight as when I was 23 and I am now 60. This drop also happened within 4 months.




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              2. Hi Thea, boy, you sure get around. nIce to see you on this subject. I just received an email with this link,
                andreas@dietdoctor.com Has a very impressive website with numerous never ending links. I’m sure it’s a subscription website for Low Carbs, another Diet website. You probably are aware of it. After reading Dr. Campbell’s book, the The Carb Fraud, I sent an email to his website and promptly got a response with a link to critical .Critical Questions for Analyzing Nutrition Messages. Of course diet doctor is another fraud. Seems to have originated in another country.




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                1. ron: About me getting around: Hee, hee. I’m a volunteer moderator for NutritionFacts. So, basically I’m everywhere. ;-)

                  .
                  There are so many fraudulent sources of nutrition information out there. I really sympathize with people who are confused. All we can do is keep doing our best to educate. I believe that at some point it will make a real difference. Have a good day!




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  42. Agree Mark! Stick with starches and some non-starchy veggies and a little fruit. Skip the processed grains and processed sugars which are damaging to the arterial endothelium. Have brown rice instead of white. Have wheat berries instead of bread. Enjoy the root veggies, legumes, actual whole grains like oatmeal and winter squashes. The starches provide satiation and are nutritious. Processed grains without the bran and germ not so much.




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  43. I do. Eat the starches (whole grains, winter squash. legumes, potatoes, sweet potatoes) and skip the processed sugars and refined flour products which have the bran and germ removed. Eat the non-starchy veggies and a little fruit. Perfect nutrition. And for those who worry about getting enough fat, all foods have fat like Broccoli 9.8% fat. Tomato 9.3% fat. Corn 13.1% fat. Quinoa15.9% fat. Oats steel-cut 14.4% fat. Throw in a tablespoon of ground flax if you like. Those Okinawans’ diet was 6% fat and mostly simple whole foods with a ton of sweet potatoes.




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  44. I would like to hear your comments on Dr Dave Unwins low carb diet ?
    he is on main stream TV telling us to eat bacon and eggs rather than toast ?




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    1. chris ahrwood: Dr. Greger has a book called Carbophobia. He later renamed the book Atkins Exposed and made it available free on-line. You might want to look that up as I imagine that it is the same response that Dr. Greger would give to Dr. Unwins. There are lots of people out there right now who are preying on people with false nutrition information, telling people what they want to hear. Of course, the media soaks it up because it makes money for them. The media has long been complicit in this problem. I say, all we can do is keep fighting the good fight.




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  45. Food Unwrapped (UK Channel 4 programme) seems to promoting cod liver oil, cheese and dairy to loose weight and keep us healthy.
    I find it frustrating and don’t understand why there is so much disinformation.




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  46. I just returned from a trip to Okinawa, where my daughter lives. We ate with literally hundreds of Japanese people, in small, private settings as well as various highly-rated buffets and restaurants (we favored those filled with native Japanese and that spoke little to no English). In addition to the plethora of yams (purple yams, specifically, often used in snack foods and desserts), they eat many, many vegetables — NOT many carbs. Calorie- wise, it may calculate out that way (since veggies have so few calories & rice is a carb). But bulk-wise? Mass-wise? Absolutely not–carb dishes (usually rice) were the exception, not by any means the rule (tho again, since most veggies are very low-calorie, it *appears* in some studies that they eat mostly carbs–but only when studied by calorie instead of by actual volume amount). They teach their children to eat at least 30 different vegetables per day & 100 per week. I looked down at my plate upon learning this, and counted over 20 vegetables in one meal. They also eat a great deal of seafood and meat broths (fish, pork, & beef were the predominant ones). The seafood is both fish and various sea vegetables, like seaweed and kelp. I’ve never seen so many variations on seaweed in my life: dried sheets, cooked with fish in broth, made into at least 4 different seasoning pastes (all tasting different), soups, pates of fish, egg, seaweed, & ??, & much more. A typical Japanese meal may have 2/3 or 3/4 of the plate covered with vegetables and some fish, and maybe 1/2 cup to a cup of rice. If so, their next meal may have less rice (or none) & more vegetables. I think it is likely that the phytonutrients–including iodine from all that seaweed–skyrocketing in such a diet, may be more of their secret than the carbs in the rice they eat. Add to that a lifestyle that walks almost everywhere (thereby getting both healthy exercise and vitamin D from the sun), and there are so many positives that drive good health that the whole carb vs meat aspect may pale in comparison. Their veggies, iodine, & high-walk lifestyle may well explain it all.




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  47. P.S. The Japanese have one of the highest rates of stomach cancer in the world. They are low in breast cancer, possibly due to high natural iodine intake (an emerging hope). But there is a trade-off. It could be from the prevalence of raw foods (including sushi), leading to more cases of H. pylori, a bacteria that precedes vast numbers of stomach cancers. They also eat a lot of salted foods, another predisposing factor.
    While it is true that correlation does not necessarily equal causation, I have noted on this site no reticence to infer Dr. Greger’s promoted diet as causative for living longer and in better health.




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  48. One last comment – the nitrates and smoke they use, the fact that most of their fruits and veggies are cooked (killing vitamin C), as well as genetics, could also be in play for the astronomical rates of stomach cancer cases in Japan. I am told that other Asian countries such as Hong Kong suffer similar rates. It seems that if w avoid CVD, we risk something else. “How Not To Die” is not an option. Living longer is.




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  49. Just received the Feb 1, 2017 print of Family Practice News. Dr. Arne Astrup is promoting cheese for heart patients and that diets high in dairy fat cut the risk of childhood obesity. It seems that calcium binds to dietary fat in the GI tract and in his meta analysis of clinical studies he has found a reduction in weight and body fat with a high dairy fat diet. I do note a conflict of interest in studies that were funded by a dairy council or association. Is there truth to this claim about dairy?




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    1. Hi Nicole: We have A LOT of info on dairy here. Dairy products are not only high in saturated fat, but they are low in a number of beneficial dietary components such antioxidants and fiber. Dairy products also contain many ingredients that may raise the risk of inflammation, heart disease, diabetes, cancer and increased overall mortality risk. Dr. Neal Barnard, our friend at PCRM, has a new book (The Cheese Trap) that you might be interested in as well.




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  50. It is great to hear some face about the madness of low carbs diet
    as a ex- champion in bodybuilding and power-lifting spending 40 years involved with nutrition i feel i have a good understanding and the necessary experience how importation carbs are, now as a personal trainer i deal weekly with people who wish not to eat carbs to keep there body weight down how do i explain to them they are killing them-self’s?




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  51. The total percentage is a bit misleading as it adds up to 400% normalization. Just looking at LAD, the low fat group had 5% – already quite a big improvement in one year. It’s more in-line with statin trial results. It is really hard to get rid of atherosclerosis.




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  52. I myself eat WFPB, high carb diet but any sane low carb diet does not contain more than 15-20% protein absolute max and usually closer to 10-15%. Is possible that the high protein consumption in the studies was at least part of the problem?




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  53. Its an hour long video that I was going to watch, but as I skipped around through the content, I notice that he cites zero references for all the points he is trying to make. Without references, his arguments are not compelling in the slightest.

    Low carb diets have theoretical merit provided that they are not based on animal products. Dr. G has reviewed this literature at length. In practice, it won’t work. You were designed to eat carbs, so you’re going to crave them so much that you won’t be able to stick to a low carb diet. I’ve been there done that.

    Dr. Ben




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