Mediterranean Diet & Atherosclerosis

Mediterranean Diet & Atherosclerosis
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What happens inside the arteries going to the hearts and brains of those who add nuts or extra virgin olive oil to their diet?

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The heart of a traditional Mediterranean diet is mainly vegetarian, much lower in meat and dairy, and uses fruit for dessert.  So, no surprise those eating that way had very low heart disease rates compared to those eating standard Western diets. This landmark study, though, has been cited to suggest that all types of fat, animal or vegetable, are associated with the appearance of new atherosclerotic lesions in our coronary arteries, feeding our hearts.

About a hundred men were given angiograms at baseline and then two years later, looking for the development of lesions like this, before and after, all the while monitoring their diets every year. Only about 1 in 20 eating lower fat diets had new lesions, compared to about 8 in 20 on more typical American diets around 33% or more fat.  But when they drilled down, though, only three types of fat appeared to significantly increase the likelihood of the appearance of new, lesions: lauric, oleic, and linoleic. Lauric acid is a saturated fat, found in coconut oil, and palm kernel oil, which is found in junk food—whipped cream and candy bars. Oleic from the Latin word oleum for olive oil, but that’s not where these men were getting their oleic acid from. The top sources for Americans are basically cake, chicken, and pork, and linoleic comes mostly from chicken. So, the study really just showed that people eating lots of junk, chicken, and pork tended to close off their coronary arteries. To see if major sources of plant fats, like olive oil or nuts, help or hurt, ideally, we’d do multi-year randomized study where you take thousands of people and have a third eat more nuts, a third eat more olive oil, and a third do essentially nothing to see who does better.

And that’s exactly what they did. The PREDIMED study took thousands of people at high risk for heart disease in Spain, who were already eating a Mediterranean-ish diet, and randomized them into three groups for a couple years, one with added extra virgin olive oil, one with added nuts, and a third group that was told to cut down on fat, but they didn’t; so, basically ended up as a no dietary changes control group. What happened to the amount of plaque in their arteries over time?

Whereas there was significant worsening of carotid artery thickening and plaque in the no dietary change control group, those in the added nuts group showed a significant reversal in thickening, an arrest in plaque progression. There were no significant changes in the added olive oil group.

The richness of the plant-based Mediterranean diet in potentially beneficial foods, such as fruit, vegetables, beans, nuts, whole grains, and olive oil, is believed to explain its cardioprotective effects.  However, these results suggest nuts are a preferable source of fat compared to olive oil, and may delay the progression of atherosclerosis, the harbinger of future cardiovascular events such as stroke. Adding nuts appeared to cut the risk of stroke in half.

Note, though, they were still having strokes. Half as many strokes; so, the nuts appeared to be helping, but they were still eating a diet conducive to strokes and heart attacks. All three groups had basically the same heart attack rates, the same overall death rates. That’s what Dr. Ornish noted when he wrote in: there was no significant reduction in the rates of heart attack, death from cardiovascular causes, or death from any cause, just that stroke benefit. But hey, that’s something. A Mediterranean diet is certainly better than what most people are consuming, but even better may be a diet based on whole plant foods, shown to reverse heart disease, not contribute to it. The authors of the study replied that they didn’t wish to detract from Ornish’s work, noting that Mediterranean and plant-based diets actually share a great number of foods in common. Yes, Ornish’s diet can reverse heart disease— but, the Mediterranean diet proponents argue, the major problem with Ornish’s diet is that it doesn’t taste good;  so, hardly anyone sticks to it.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Philippe Put via Flickr.

The heart of a traditional Mediterranean diet is mainly vegetarian, much lower in meat and dairy, and uses fruit for dessert.  So, no surprise those eating that way had very low heart disease rates compared to those eating standard Western diets. This landmark study, though, has been cited to suggest that all types of fat, animal or vegetable, are associated with the appearance of new atherosclerotic lesions in our coronary arteries, feeding our hearts.

About a hundred men were given angiograms at baseline and then two years later, looking for the development of lesions like this, before and after, all the while monitoring their diets every year. Only about 1 in 20 eating lower fat diets had new lesions, compared to about 8 in 20 on more typical American diets around 33% or more fat.  But when they drilled down, though, only three types of fat appeared to significantly increase the likelihood of the appearance of new, lesions: lauric, oleic, and linoleic. Lauric acid is a saturated fat, found in coconut oil, and palm kernel oil, which is found in junk food—whipped cream and candy bars. Oleic from the Latin word oleum for olive oil, but that’s not where these men were getting their oleic acid from. The top sources for Americans are basically cake, chicken, and pork, and linoleic comes mostly from chicken. So, the study really just showed that people eating lots of junk, chicken, and pork tended to close off their coronary arteries. To see if major sources of plant fats, like olive oil or nuts, help or hurt, ideally, we’d do multi-year randomized study where you take thousands of people and have a third eat more nuts, a third eat more olive oil, and a third do essentially nothing to see who does better.

And that’s exactly what they did. The PREDIMED study took thousands of people at high risk for heart disease in Spain, who were already eating a Mediterranean-ish diet, and randomized them into three groups for a couple years, one with added extra virgin olive oil, one with added nuts, and a third group that was told to cut down on fat, but they didn’t; so, basically ended up as a no dietary changes control group. What happened to the amount of plaque in their arteries over time?

Whereas there was significant worsening of carotid artery thickening and plaque in the no dietary change control group, those in the added nuts group showed a significant reversal in thickening, an arrest in plaque progression. There were no significant changes in the added olive oil group.

The richness of the plant-based Mediterranean diet in potentially beneficial foods, such as fruit, vegetables, beans, nuts, whole grains, and olive oil, is believed to explain its cardioprotective effects.  However, these results suggest nuts are a preferable source of fat compared to olive oil, and may delay the progression of atherosclerosis, the harbinger of future cardiovascular events such as stroke. Adding nuts appeared to cut the risk of stroke in half.

Note, though, they were still having strokes. Half as many strokes; so, the nuts appeared to be helping, but they were still eating a diet conducive to strokes and heart attacks. All three groups had basically the same heart attack rates, the same overall death rates. That’s what Dr. Ornish noted when he wrote in: there was no significant reduction in the rates of heart attack, death from cardiovascular causes, or death from any cause, just that stroke benefit. But hey, that’s something. A Mediterranean diet is certainly better than what most people are consuming, but even better may be a diet based on whole plant foods, shown to reverse heart disease, not contribute to it. The authors of the study replied that they didn’t wish to detract from Ornish’s work, noting that Mediterranean and plant-based diets actually share a great number of foods in common. Yes, Ornish’s diet can reverse heart disease— but, the Mediterranean diet proponents argue, the major problem with Ornish’s diet is that it doesn’t taste good;  so, hardly anyone sticks to it.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Philippe Put via Flickr.

Doctor's Note

I bring up the Ornish back-and-forth in my 2015 annual live review, Food as Medicine: Preventing and Treating Our Most Dreaded Diseases with Diet, and directly address the accusation that plant-based diets are marked by poor compliance for disease prevention and reversal.

For more on the famous PREDIMED trial and the body of evidence surrounding Mediterranean diets, I’ve got a bunch of good videos for you:

What might happen to the arteries of someone who goes on a low-carb diet. You don’t want to know. (But if you’re really curious, see: Low Carb Diets and Coronary Blood Flow.)

What we eat doesn’t only have an impact on the structure of our arteries over the long-term (i.e., the thickening and narrowing described in the video), but the function of our arteries within hours of consumption. To see what your breakfast may have done to your arteries, check out:

Note, though, the benefits of plant-based nutrition can be undermined by vitamin B12 deficiency if you don’t include a regular reliable source in your diet. See Vitamin B12 Necessary for Arterial Health.

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

183 responses to “Mediterranean Diet & Atherosclerosis

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  1. so the sentence of Caldwell Esselstyn “not olive oil!!” may be not entirely right? Olive oil appear to be not good not bad either? i mean apart for the high calorie – low nutrients contain does not have an extra effect in the clot of arteries?




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      1. yes but does not shows a big correlation in case of heart attacks in this study i wonder way?.. but any way good enough to don’t eat to much of it we have better options
        but seems to me that still a bit unclear if a light use of oil is bad for your artery functions. (no high fats foods)




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        1. The effect on heart attack rates is probably partly hidden by the beneficial effects of the fruits and vegetables that are eaten with olive oil in Mediterranean diets.
          You may want to follow up the references cited in Dr Greger’s video on olive oil and artery health. However, all oils appear to harm artery function so any use of oil is likely to harm artery function to a greater or lesser extent.
          http://nutritionfacts.org/video/olive-oil-and-artery-function/




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        2. I’ve had the same question, with no real answer. What I think is these studies are done on your typical processed junk standard eaters, if you are eating a mostly whole food diet, and you use a little oil to cook with here or there (and its olive or canola) then you’ll be in good shape. If you take a salad and drench it in oil, that is bad, so I think the no oil message really aims at the salad soaking and not so much people that use a teaspoon here and there.




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            1. After an endless search for salad dressing while eating 1-3 pounds of salad a day, I totally lost desire for any oil on salad, an avocado with raw tomato and maybe some balsamic and herbs or vegan pesto after straining the oil is what I do regularly.




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              1. How do you strain the oil out of pesto? And why not sprinkle a good amount of basil on your salad. I sprinkle black pepper and thyme. For good fat I add avocado and kalamata olives. Yum!
                Joseph in Missoula




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          1. These people were generally all quite unhealthy… if you look at Table 1, you’ll see each group was on average, overweight, had high cholesterol, high fasting glucose, etc.




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          2. The reason Dr. Esselstyn says “No oil” is in large part because of the immediate impact oil consumption has on endothelial function. Blood vessels become restricted or inflexible for several hours after consuming oil. I believe the concern is that an event, such as heart attack or stroke, could be triggered by the consumption of oil. So the concern is not just about long term damage. There is potential for immediate harm. This is my understanding, anyhow.




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            1. I’ve seen that before, but I remember seeing information that when they tested different oils this action specifically, olive oil had a low impact, Canola oil was barely anything, the others were troublesome though.




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      2. yes but does not shows a big correlation in case of heart attacks in this study i wonder way?.. but any way good enough to don’t eat to much of it we have better options
        but seems to me that still a bit unclear if a light use of oil is bad for your artery functions. (no high fats foods)




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    1. The addition of olive oil was fairly neutral in the context of a pretty crappy diet in PREDIMED. These findings don’t really speak to when the nutrient exchange for introducing olive oil into the diet is better in quality, but they already suggest that nuts are better. So if nuts are a significant part of the baseline picture as a likely exchange for other fats like olive oil, then olive oil looks like a bad choice based on this study.

      A huge point that a word like “neutral” when talking about effects can be very deceptive. Many people want to take it as a solid proof of complete safety when looking at only a narrow range of variation, but obviously diet is complex and context matters a lot in determining whether a neutral effect of a change is to be expected.




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    2. Because he treats patients that already have serious health issues, his approach is more cautious to stop disease progression. But to me, that says it’s the ideal to strive for anyway if it can make sick people well. If I eat too much fat, including olive oil, my blood sugars will creep up, so I don’t use anything that isn’t part of a whole food. I was diabetic before and so I am careful. But better not to get there in the first place!




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  2. for lowering stroke risk one component was fiber ? if i dont understund bad 7 grams of fiber equal to 7% less risk of stroke http://nutritionfacts.org/video/how-to-prevent-a-stroke/ does the fiber of the nuts the benefits of them or have to do with the Omega 3 or other nutrients in nuts? do we know way nuts are good for strokes risk? and this percentage in reduction is valid for people that already have an stroke? witch other action one may take to prevent another stroke apart from lowering blood pressure?




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      1. There is an association between low cholesterol and stroke. Just like there is an association between low cholesterol and cancer, and low cholesterol and total mortality in older people. Similar associations have been found with low weight and mortality etc in older people. Hence the claims that high cholesterol and overweight may be “protective” in older people.

        In these latter cases, though, it is believed that the low weight and low cholesterol in older people associated with higher mortality are best explained by “reverse causation”. That is, certain long latency diseases like cancer, some respiratory diseases, viral infections etc cause lower cholesterol (and weight loss) – often long before overt clinical symptoms emerge. Alzheimer’s Disease is another long latency disease and example of such associations. In these cases, unexplained declining cholesterol levels and weight loss which are not the result of specific dietary changes (or statins) are most likely early pre-clinical symptoms of disease. People who have stable low weight or low cholesterol throughout life do not have higher mortality or cancer or Alzheimer’s incidence. Ditto for people who have cholesterol lowered by statins.

        The fact that people who have lowered cholesterol as a result of statin usage do not have higher stroke risk suggests that this association with stroke may also be an example of reverse causation. This 2009 editorial from “Circulation” offers an
        interesting discussion of the subject:
        http://circ.ahajournals.org/content/119/16/2131.full




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        1. This is off topic, but you hear from a lot of people and I’m beginning to wonder what is going on. Has anybody reported to you they were very dizzy last week? Dizzy and throwing up? But with no aches and no fever, nothing to suggest flu. The reason I ask is that it happened to me two days last week, then I heard about three more friends here in town with similar symptoms. Then my chiropractor said the same day I came in he had 8-10 others that day with the same symptoms, and he’d never seen anything like it before. Not all of them were nauseated to the point of vomiting. I’m in the Puget Sound area of Washington State. But here’s the thing: my cousin in California has been hearing of others with the same symptoms, and I just talked with a woman in Bend, OR who had the same thing last week. She thinks it’s radiation from Fukushima. I haven’t a clue. We’re all on the West Coast, but inland a bit, and the Oregon woman is on the other side of the Cascade Mountains. This is just too weird!




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    1. Sure thing! Just look in the “sources cited” section to see all of Dr. Greger’s references. If you still have trouble finding let me know.




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      1. That’s not a problem. I’m talking about that part: “That’s what Dr. Ornish noted when he wrote in: there was no significant reduction in the rates of heart attack, death from cardiovascular causes, or death from any cause, just that stroke benefit.”
        So I am curious about studies that show that reduction (for WFPB or any other plant-based diet), not just reduction in risk factors. I believe there are, I just don’t have them at hand. Curious, but not to the extent to search for them by myself right now.




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  3. Thing is, what tastes good on the Mediterranean diet, fresh tomatoes, peppers, whole-grain breads, pasta and beans, fresh greens and some nuts and seeds, are all allowable on the Ornish-style WFPB diet as well. So you can make a healthy diet just as “palatable.”




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    1. I agree Slim055. I use no oil, a few nuts and seeds. lots of grains. beans, White potatoes, Sweet Potatoes, Butternut Squash, Tomatoes and an several different kinds of greens.I also use some other veggies, summer squashes, eggplant, okra, etc. I use very little salt and enjoy every bite i take. Some tomatoes with my beans and grains with a little salt are delicious as far as i am concerned. Once you get used to a simple diet, to me is better than one with very many things added to the food.




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  4. My take? The oils are not exactly healthy…some kinds more than others….but it’s the plant phyto “chemicals” that overcome the negative effects from the oils. But I think some oils in the diet help allay hunger? In the real world…wherever that is…added oils are in most foods…I just try to keep the food industries junk oils minimized. I use olive and MCT oils mostly.

    What about certain phytoextracts like pomegranate and pine bark extract that have some evidence of reversing plaque buildup?




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  5. http://www.lef.org//Magazine/2014/6/Wide-Ranging-Longevity-Benefits-Of-Pycnogenol/Page-01

    “Pycnogenol And Cardiovascular Disease

    Despite all the advances in cholesterol-lowering medications and surgical interventions, atherosclerosis, coronary artery disease, heart attack, heart failure, stroke, and peripheral vascular disease remain the leading causes of death and disability in the United States.2,3

    Pycnogenol, long touted for its powerful antioxidant effects, has shown remarkable results in preventing and reversing cardiovascular disease.

    For example, a recent study of patients with stable coronary artery disease (people with chest pain, or angina, or those who have survived a heart attack) demonstrated a 32% improvement in endothelial function after eight weeks of Pycnogenol supplementation.4 No change was seen in placebo recipients. At the same time, levels of isoprostane, an index of oxidative stress, were reduced by about 8.5% in the supplemented group, again with no change in placebo subjects.

    Further demonstration of Pycnogenol’s ability to slow or prevent the progression of cardiovascular disease comes from a 2014 study of people with atherosclerosis of the femoral (leg) or carotid (neck) arteries.5 Although these patients had not yet developed symptoms, they all had atherosclerotic plaques visible on ultrasound examination of their vessels. The patients were divided into several groups that included low-dose Pycnogenol (50 mg/day), higher-dose Pycnogenol (100 mg/day), aspirin, or a combination of Pycnogenol ( 100 mg/day) and aspirin.

    In the groups that received either no Pycnogenol or just 50 mg/day, ultrasound evidence of progression (larger or more frequent plaques) was visible. In all groups receiving 100 mg/day Pycnogenol, progression was almost completely halted. The percentage of individual plaques that progressed to the dangerous and irreversible stage called “fibroatheroma” was less than 6% in subjects taking 100 mg/day Pycnogenol, but rose to 16.6% in those receiving aspirin-only, and went up to 21.3% in controls (receiving neither aspirin or Pycnogenol).5”

    Pycnogenol at around 6xs the cost of it’s generic equiv? Probably a drug in the EU?

    http://www.swansonvitamins.com/swanson-premium-pycnogenol-50-mg-50-caps

    http://www.swansonvitamins.com/swanson-superior-herbs-pine-bark-extract-50-mg-100-caps

    I’m taking both pine bark extract and white willow bark extract. I’ve always liked trees.




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    1. Thanks for your thoughts. Instead of using a supplement, I bet there are greater benefits eating a whole foods plant-based diet. Just because there’s been advances in drug companies making more statins doesn’t mean that’s the best route for lowering cholesterol. Diet and lifestyle are more powerful and help treat the cause of the disease. Perhaps for those who cannot get their LDL cholesterol down with diet and lifestyle a statin is recommended. I have not heard of studies on pine bark and cholesterol I am weary about a Life Extension Magazine promoting its claims. I am not saying don’t try it (maybe it’s safer and as effective as a statin?) but ask your doctor and try a healthy diet first! I just waned make a note of caution, as even things like Red Yeast Rice are promoted and thought off as “natural” but hardly monitored and vary too much in potency.




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    2. Thanks for your thoughts. Instead of using a supplement, I bet there are greater benefits eating a whole foods plant-based diet. Just because there’s been advances in drug companies making more statins doesn’t mean that’s the best route for lowering cholesterol. Diet and lifestyle are more powerful and help treat the cause of the disease. Perhaps for those who cannot get their LDL cholesterol down with diet and lifestyle a statin is recommended. I have not heard of studies on pine bark and cholesterol I am weary about a Life Extension Magazine promoting its claims. I am not saying don’t try it (maybe it’s safer and as effective as a statin?) but ask your doctor and try a healthy diet first! I just waned make a note of caution, as even things like Red Yeast Rice are promoted and thought off as “natural” but hardly monitored and vary too much in potency.




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      1. Quick question – my recent EndoPat test shows that my endothelium is perfect. A recent carotid artery duplex show that they’re clean with no blockages. The rate of progression for my arterial plaque on the LAD has slowed to <8% per year (from 30 in 12/2007 to 47 in 2/2014) and when get a new scan done shortly I expect either a slower rate of progression of regression.

        I eat a whole foods based diet with virtually no processed foods at all (kefir and yogurt might be considered processed) and absolutely no junk food at all. I eat fruits, veggies, nuts, seeds as well as pastured meat, eggs and full fat raw milk.

        SO – if the tests are all good can you please explain why I should make a radical switch to a WFPB diet?




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          1. I’ve had my IGF-1 and IGFBP-3 levels checked – in the middle range so they’re no problem

            As to humane – I purchase NO PRODUCTS from factory farms – however if you consider all killing of animals to be wrong then it would be useless to discuss




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                1. Charles the video MIKE linked has your answer. And read the linked studies. IGF-1 is cancer promoting. Does that answer it? That’s like asking how many cigarettes can I smoke.




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                2. Your body can create all the IGF-1 you need if you eat a well balanced diet. Dietary animal proteins increase blood IGF-1 levels above those your body would otherwise regulate.




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                    1. The IGF-1 creation is primarily in the liver and can be triggered by dietary protein intake. It’s a fairly complex process that I don’t fully grasp, but believe me. Your body can create all the IGF-1 it needs.
                      As far as animal proteins having a negative affect on IGF-1 levels in humans, this is the study referenced by Dr. Greger.
                      http://cebp.aacrjournals.org/content/11/11/1441.full

                      The main finding of this study is that total IGF-I levels were significantly 13% lower in vegan women compared with meat-eaters and vegetarians, a finding very similar to that reported in men from this cohort (19) . Perhaps of equal importance is the finding that IGFBP-1 and IGFBP-2 concentrations (not measured among men) were ∼40% higher in vegan women than in meat-eaters and vegetarians. Although the relationship between IGF-I and its binding proteins is not completely understood, it is thought that an increase in IGFBP-1 and IGFBP-2 concentrations may lead to an increased binding of IGF-I, thus reducing the proportion of IGF-I that is available to enter tissues (33) .

                      Overall, these data support the hypothesis that nutritional factors specific to a vegan diet may reduce circulating levels of total and bioavailable IGF-I.




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                    2. From the study

                      “In the FFQ, subjects were asked to state how frequently they ate each of a range of foods over the past year based on nine frequency categories, ranging from never or less than once a month to six or more times a day. These questions covered 130 foods and beverages and also allowed subjects to add food products that were not specified on the questionnaire. Data on milk intake were derived from questions on the FFQ regarding the type (full cream, semi-skimmed, skimmed, Channel Islands, dried milk, soya, and none) and quantity of milk consumed/day (none, ¼ pint, ½ pint, ¾ pint, 1 pint, and >1 pint).”

                      This is GARBAGE.




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                    3. The cohort study on men is available here:

                      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374537/

                      This study is the largest to date to investigate differences in serum hormone concentrations between meat-eaters, vegetarians and vegans. The significant 9% lower IGF-I concentration among vegan men compared to meat-eaters has not been reported before. IGF-I may play an important role in the aetiology of prostate cancer via its ability to interact with androgens to stimulate prostatic cell growth (Cohen et al, 1994), but its determinants are poorly understood.

                      Chan et al (1998) found that men who subsequently developed prostate cancer had 8% higher serum IGF-I concentrations than men who remained healthy, suggesting that the 9% difference we observed is large enough to significantly alter prostate cancer risk.




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                    4. From your study

                      The results did not support the hypothesis that meat-eaters have higher levels of bioavailable androgens than non meat-eaters. No differences in hormone levels were found between meat-eaters and lacto-ovo-vegetarians, suggesting that vegetarian diets may not alter prostate cancer risk, but the relatively low IGF-I levels in vegans might reduce their risk of prostate cancer. Prospective data have shown that vegetarians do not have significantly lower prostate cancer mortality rates than comparable non-vegetarians (Key et al, 1999), but these subjects were predominantly lacto ovo-vegetarians and there are, as yet, no data on prostate cancer rates among vegans.




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                    5. Please cite studies with strict vegetarians only. Not to state the obvious, but Ovo Lacto vegetarians, do eat ANIMAL products.

                      Also, for how long they had been vegans, it matters, for example see here:

                      The latest meta-analysis of all the best case control studies ever done on the matter concludes that milk consumption is a risk factor for prostate cancer. And the latest meta-analysis of all the best cohort studies ever done also concludes that milk consumption is a risk factor for prostate cancer. An even newer study profiled in my video, Prostate Cancer and Organic Milk vs. Almond Milk, suggests that milk intake during adolescence may be particularly risky in terms of potentially setting one up for cancer later in life.
                      http://nutritionfacts.org/2015/02/17/organic-milk-and-prostate-cancer/

                      And more about milk: http://nutritionfacts.org/topics/milk/




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                    6. http://www.direct-ms.org/pdf/NutritionNonAuto/Veg%20vs%20non%20veg%20mortality.pdf
                      Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies

                      There were no significant differences between vegetarians and nonvegetarians in mortality from cerebrovascular disease,
                      stomach cancer, colorectal cancer, lung cancer, breast cancer, prostate cancer, or all other causes combined.

                      Among vegetarians who had followed their current diet for <5 y, mortality was significantly higher than that in non vegetarians from lung cancer, other causes, and all causes. The higher mortality from lung cancer was based on only 9 deaths, but that from all other causes and from all causes was based on 123 and 218 deaths, respectively, and was observed in all 5 studies. We thought that the higher mortality rate might have been due to residual confounding among former smokers or to a recent change in diet in an attempt to alleviate ill health, but neither restricting the analysis to subjects who had never smoked nor exclusion of deaths during the first 3 y of follow-up lowered the mortality. We are therefore unable to explain this finding.




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                    7. http://www.eje-online.org/content/159/4/389.full.pdf

                      Conclusion:

                      IGF1 levels in the low normal range are associated with hypertension and diabetes in subjects without pituitary and cardiovascular diseases.

                      This study indicates that lower IGF1 levels, agenormalized as zSDS, are associated with increased prevalence of severe hypertension and diabetes mellitus in a population of control subjects without pituitary or cardiovascular diseases used to represent the general – population. These results extend and support previous reports suggesting that low circulating IGF1 are associated with an increased cardiovascular risk, in particular to develop ischemic heart disease (11–13), stroke (14–16), and atherosclerosis (17, 18).




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                    8. In the general population, low IGF1 has been associated with higher prevalence of
                      cardiovascular disease and mortality.

                      That entire study is predicated on the statement above. In the case of adult plant based eaters with low IGF1 the statement above is incorrect. In fact the study you linked to does’t differentiate for dietary possibilities, one of the problems Dr. Greger talked about.




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                    9. http://www.who.int/nutrition/publications/public_health_nut6.pdf?ua=1
                      Diet, nutrition and the prevention of cancer

                      http://www.veganhealth.org/articles/cancer
                      Diet and Lifestyle Components and Cancer

                      In 2004, Diet, Nutrition and the Prevention of Cancer was published in the journal Public Health Nutrition. Two of the authors, Timothy Key and Naomi Allen, have been involved in many of the above studies. Walter Willett of the Harvard School of Public Health also co-authored this paper which reviews what is currently known about diet and cancer. They summarize their findings based on levels of evidence:

                      Convincing Evidence
                      Physical activity lowers the risk of colon cancer.

                      Being overweight increases the risk of esophagus, colorectal, endometrium, and kidney cancer. It also increases the risk of breast cancer in postmenopausal women.

                      Alcohol increases the risk of oral cavity, pharynx, larynx, esophagus, liver, and breast cancer.

                      Aflatoxin is a mold that contaminates some foods, especially in underdeveloped countries; it increases liver cancer in areas rampant with the hepatitis virus.

                      Chinese-style salted fish increases risk of nasopharynx cancer.

                      Probable Evidence
                      Case studies have shown that fruits and vegetables lower the risk of oral cavity, esophagus, stomach, and colorectal cancer. Prospective studies have not shown a strong effect for colorectal cancer, indicating that the protective effect is probably modest. The other cancers have yet to be evaluated through prospective studies.

                      Physical activity lowers risk of breast cancer.

                      Salt preserved foods and salt increase the risk for stomach cancer. This may be only for people with H. pylori infection (a cause of ulcers), but this relation hasn’t been thoroughly examined.

                      Preserved meat and red meat increase the risk of colorectal cancer.

                      Very hot (temperature) drinks and foods increase risk of oral cavity, pharynx, and esophagus cancer.

                      Insufficient Evidence
                      There is insufficient evidence to conclude that fiber, soy, fish, omega-3 fatty acids, carotenoids, vitamins B2, B6, folate, B12, C, D, E, calcium, zinc, selenium, non-nutrient plant constituents (phytochemicals such as allium compounds in garlic, flavonoids, isoflavones, and lignans) lower the risk of cancer.

                      There is insufficient evidence that animal fats, heterocyclic amines, polycyclic aromatic hydrocarbons, and nitrosamines increase the risk of cancer.

                      The authors conclude:
                      “Since the 1981 Doll and Peto review on diet and cancer mortality (12), about one third of cancers have generally been thought to be related to dietary factors. More recent evidence suggests that this number may be too high, but a revised quantitative estimate is beyond the scope of this review. Among the diet-related factors, overweight/obesity convincingly increases the risks of several common cancers. After tobacco, overweight/obesity appears to be the most important avoidable cause of cancer in populations with Western patterns of cancer incidence. Among non-smoking individuals in these populations, avoidance of overweight is the most important strategy for cancer prevention.”




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                    10. Studies from 2004 are trailing current knowledge. Associating overweight people with cancer risk is akin to associating humans with cancer risk. The risk comes not simply from being overweight but what you are eating to be overweight.

                      Fiber intake not linked to cancer?
                      From 2012 http://www.ncbi.nlm.nih.gov/pubmed/21775566

                      Dose-response analysis showed that every 10-g/d increment in dietary fiber intake was associated with a significant 7% reduction in breast cancer risk. Little evidence of publication bias was found.

                      The main point here is we aren’t looking for the one study that says yes, if you do that, than this will or will not happen. We are using studies to provide reasonable evidence that dietary changes may provide benefit. Certainty is not there in many places. Yet, what will it hurt to eat more whole plants and less processed food an animal products? If the worst that happens is you feel good, and promote compassion, then why not be plant based?
                      If others want to keep eating animal products, keep finding studies that show the way they eat the animal products or the kind of animal products they eat are healthy. Well that’s fine. It’s still a diet that involves cruelty to animals. And if you can be healthy one way that involves cruelty, or be healthy in a way that reduces cruelty, I pick the one that reduces cruelty.




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              1. Yea Mike, lets decrease our IGF-1 levels further, so we lose all athletic ability, virility, etc. Come on, aren’t such things important to you?




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                1. You may be missing the point. A plant based diet reduces the occurrence of excess IGF-1. A meat based diet promotes excess IGF-1. It is thought that excess IGF-1 is linked to increased cancer risk.




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            1. Charles. They are not going to get it, believe me. They still believe in the one-size-diet-fits all, and, of course it is only THEIR vegan version of the one size diet that they believe in. The concept of biochemical individuality and functional medicine escapes them….and Dr. Gregor too apparently. The thing is your diet works for you, but again they are not going to get that. And they also apparently seem to not understand the limitations of epidemiological and RCT’s when it comes to nutrition.




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              1. No dear, THEY follow the latest un-bought science, and though there may be some genetic variability in what we can tolerate, just like any other animal, we DO have an ideal diet! What you chose to stuff in your face is your business, we are all going to die one day, but none of us want to hurry it or suffer from illness. We are all one species, so this bio-individuality stuff is just a hopeful way of seeing who can get away with habits that aren’t beneficial to the general population, the longest. My health and that of MANY others improved so dramatically when changing to this diet, there is no question in my mind what I can and cannot get away with, so I chose this diet based on both personal experience and valid science. I would rather not play Russian roulette, but hey, you go ahead! By the way, your dietary choices should benefit YOU, not disparage “THEM” because they don’t agree with you. You are doing exactly what you are criticizing!




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                1. “We are all one species, so this bio-individuality stuff is just a hopeful way of seeing who can get away with habits that aren’t beneficial to the general population, the longest.” Unbelievable!!!! In addition to Unsupported, Wrong, and Outrageous! Obviously you know nothing of biochemistry or bio-individuality. So go no further, Period.




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                  1. Whatever biochemical individuality you have (as everyone else) still is not a mutation to set you in a different group of species. It would take many thousands of years of evolution for that. You are still an herbivore as all other great apes.




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                  2. “Many others have had to stop a no-fat vegan diet because their health went dramatically down hill.”
                    Really? Wow, interesting we should hear this worn out, tired claim from yet another righteous individual who has issues with what others chose to eat, because I’ve been at this quite a while and barely know any other “vegans”, let alone met any of the plethora of the fabled/infamous “failed” vegans! By the way, the more appropriate designation for the people who frequent this site is more like “health conscious” or “whole food plant based”, not vegan, though some are too. I can’t help but wonder if you find the advice here so ludicrous and out of your sphere of belief, why are you even here? Do you let yourself into neighbors homes and ridicule them for eating differently that you chose to, also?

                    “But of course we are not going to hear about them on this list, because this is the vegan-diet-right-for-everyone blog. And it has now become the vegan-no-fat-diet-is right for everyone blog.”
                    Right, and have you visited the sister site to this one… “meat is right for all cats and dogs blog” or the new “no- fat grass is right for all cows blog”? Outrageous! I wonder what unsupported nonsense they will come up with next?

                    You are obviously confused, the info on this “blog” is the current consensus of what the science says, not some “vegan” club with a pre-ordained agenda. Dr Greger doesn’t make this stuff up, he actually lists all his sources. Perhaps if you have any legitimate ones, you’d like to share them too, so we could be as illuminated as you are.




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                2. That person after being lurking in this site for so long, still is unable to tell how Dr. Greger is spelled. (I guess she will rush to edit her post now)




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            2. Even if they aren’t raised in factory farms, they are sent there to be slaughtered.

              But at the end what you get is a kill-kill deal, you reap what you sow.




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      2. A major problem with big pharma’s solutions is that they all have “side effects”, meaning they are associated with other health problems. Then you have to take another pill to countermand the side effect caused by the first pill, a succession that never ceases until your medicine cabinet is filled with their junk and your pockets are emptied. Plant-based whole foods does a much better job at curing the first problem without causing another. Besides, you slim down (assuming you stay away from sweets), so you look and feel better.
        Joseph in Missoula




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      3. Not sure Pycnogenol is actually a “statin”? Not sure it lowers cholesterol…. Sort of a condensed pine bark tea? With kids having plaque buildup…pretty sure that at my age I do. I try to eat a “whole foods plant-based diet” as I navigate the grocery store minefields…but I see the supplements as added insurance. I use only a few of LEFs supplements due to the expense.




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  6. http://www.lef.org//Magazine/2014/6/Wide-Ranging-Longevity-Benefits-Of-Pycnogenol/Page-01

    “Pycnogenol And Cardiovascular Disease

    Despite all the advances in cholesterol-lowering medications and surgical interventions, atherosclerosis, coronary artery disease, heart attack, heart failure, stroke, and peripheral vascular disease remain the leading causes of death and disability in the United States.2,3

    Pycnogenol, long touted for its powerful antioxidant effects, has shown remarkable results in preventing and reversing cardiovascular disease.

    For example, a recent study of patients with stable coronary artery disease (people with chest pain, or angina, or those who have survived a heart attack) demonstrated a 32% improvement in endothelial function after eight weeks of Pycnogenol supplementation.4 No change was seen in placebo recipients. At the same time, levels of isoprostane, an index of oxidative stress, were reduced by about 8.5% in the supplemented group, again with no change in placebo subjects.

    Further demonstration of Pycnogenol’s ability to slow or prevent the progression of cardiovascular disease comes from a 2014 study of people with atherosclerosis of the femoral (leg) or carotid (neck) arteries.5 Although these patients had not yet developed symptoms, they all had atherosclerotic plaques visible on ultrasound examination of their vessels. The patients were divided into several groups that included low-dose Pycnogenol (50 mg/day), higher-dose Pycnogenol (100 mg/day), aspirin, or a combination of Pycnogenol ( 100 mg/day) and aspirin.

    In the groups that received either no Pycnogenol or just 50 mg/day, ultrasound evidence of progression (larger or more frequent plaques) was visible. In all groups receiving 100 mg/day Pycnogenol, progression was almost completely halted. The percentage of individual plaques that progressed to the dangerous and irreversible stage called “fibroatheroma” was less than 6% in subjects taking 100 mg/day Pycnogenol, but rose to 16.6% in those receiving aspirin-only, and went up to 21.3% in controls (receiving neither aspirin or Pycnogenol).5”

    Pycnogenol at around 6xs the cost of it’s generic equiv? Probably a drug in the EU?

    http://www.swansonvitamins.com/swanson-premium-pycnogenol-50-mg-50-caps

    http://www.swansonvitamins.com/swanson-superior-herbs-pine-bark-extract-50-mg-100-caps

    I’m taking both pine bark extract and white willow bark extract. I’ve always liked trees.




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  7. Linoleic acid in our diet comes mostly from chicken? The so-called vegetable oils (corn, soy, sunflower, etc.) has a lot of linoleum acid. Even olive oil has a significant amount of linoliec acid. So do nuts except macadamia.




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    1. PeterF: re: “Linoleic acid in our diet comes mostly from chicken? ” I could be wrong, but when these videos include statements like, “We mostly get X (say linoleum acid) from eating Y.”, the statement is *not* a measure of how much X is in particular foods compared to others. Instead, the statement is commenting on how much a person eating the typical diet in America gets X from various foods.

      For example, suppose Americans consume W mega amounts of chicken and W-4,000 mega amounts of corn oil. Then you can estimate how much Americans in general are getting of X (say linoleum acid) from chicken vs corn oil. Even if corn oil had the same or more X per calorie or weight, if we are eating less corn oil, then we get less X.

      You can argue whether this is a helpful type of statistic or not. I go back and forth myself. (In this case, I personally find it helpful.) I just wanted to help clarify what the video is actually saying.




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      1. “But when they drilled down, though, only three types of fat appeared to
        significantly increase the likelihood of the appearance of new, lesions:
        lauric, oleic, and linoleic. Lauric acid is a saturated fat, found in
        coconut oil, and palm kernel oil, which is found in junk food—whipped
        cream and candy bars.




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        1. Lauric acid is only one of many saturated fatty acids, and by no means the most common as it’s only found in coconut and palm oil. What about the much more ubiquitous palmitic acid and stearic acid in butter, beef and eggs?




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  8. another topic.. but interesting i just sow the video on cell phones and brain cancer..
    i will be with Olle Johansson he is a scientific of karolinska institute and he alarm about the effect of electromagnetic waves for humans
    he have compilate a 4000 paypers and studies that shows the negative effect of cell phones and wifi on fertility , allergy and other dissiases. the impact may not as big has the food industrie for the health but seems to affect learning capacity in children.
    i will really love to see a review of some of this paypers to see if a cell phone or a computer is something for a child (apart from the timi risk of brain tumor) what is saying the best science available about this? http://www.bioinitiative.org/report/wp-content/uploads/pdfs/sec01_2012_summary_for_public.pdf




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      1. thank you joseph , but even thou apparently by the reflex study cell phones have genotoxic effect .. the cancer it is not the main concern of the effects of electromagnetic waves in humanes. the normal intensity of a wifi have been liked to lowering neuro linguistic capacity among other effects like immune reactions , allergies to normal wifi and cell phones exposure. the problem is another studies shows the contrary.. and truth is lost.. i don’t know if telecommunication company pay studies and hidde results or actually is not such a thin as a biological effect of electromagnetic waves. i will love to see a video or more studies about that.
        the original meaning of intelligence is to read in between lines i hope to see some objective vio on this im happy to connect your self with Olle johansson, so he can share all the studies . and you can put them against other sources..
        i think we are all exposed to cell phones and wifi. and it will be good to know if it is safe or not or we don’t know yet and there fore better to take precaution. here the summary of 4000 publication

        http://www.bioinitiative.org/research-summaries/




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  9. another topic.. but interesting i just sow the video on cell phones and brain cancer..
    i will be with Olle Johansson he is a scientific of karolinska institute and he alarm about the effect of electromagnetic waves for humans
    he have compilate a 4000 paypers and studies that shows the negative effect of cell phones and wifi on fertility , allergy and other dissiases. the impact may not as big has the food industrie for the health but seems to affect learning capacity in children.
    i will really love to see a review of some of this paypers to see if a cell phone or a computer is something for a child (apart from the timi risk of brain tumor) what is saying the best science available about this? http://www.bioinitiative.org/report/wp-content/uploads/pdfs/sec01_2012_summary_for_public.pdf




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  10. Love the content but you need a narrator, Dr. Greger. No offense intended, but you garble and slur your words and I find it difficult to understand. Just thought you’d like to know.




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    1. dawn: Everyone is entitled to their opinion. My opinion is that Dr. Greger does an excellent job. I hear everything he says just fine. And I think these videos would loose a lot with a boring, TV-type of narration.

      Here’s a tip that may help: There is a ‘Transcript’ button at the top of the screen. It might help you to read the transcription while listening to the video? Good luck.




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      1. Since he flutters around the District of Columbia, I’m sure that Greger could get some expert training and feedback to improve his articulation and it’s almost certainly true that repeated rehearsal would make the speech quality better in this respect without losing the precious extemporaneous quality. People do this all the time. The question is whether it is worth his time as a professional advocate. I think Greger’s speaking (and writing) has improved with time, personally, but these more in-depth videos of recent years do show signs of a hectic schedule and imminent deadline affecting the number of audio takes. It’s a bit harder to do multiple takes of a longer narrative, too, and in longer bouts of speaking it’s more likely that a problem with clarity will creep in.

        Speaking well in public can take a lot of effort, and I don’t really find Greger to be particularly bad as professional speakers go, but I would grant that articulation is one of the more noticeable problems, partly due to the habit of mumbling in an expressive manner. Sometimes he over-mumbles or over-slurs. But if I had to pick between more careful research and a better written book (which he is soon to release) and clearer speaking, I’d almost certainly pick the weaker speaker.

        The other thing is that if reaching a wide audience is important, we should not hurry to use our own experience to dismiss the feedback of guests and newcomers when evaluating Greger’s speaking clarity. People who have a lot of exposure to an idiosyncratic speaking pattern can deal with a lot of its unclear aspects better than naive listeners, but surely it is important to be clear to naive listeners.

        Lastly I’d recommend subtitles over the transcript for most. The video is the only thing that gives a reasonably close idea of where claims are coming from, which is part of why clarity in the video is important. The




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    2. Seriously? I have no problem understanding Dr. Greger’s voice, and I hear it most every day—lol. His enunciation is crystal-clear, his voice warm and infused with humorous undertones. I like it.




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    3. The guy does all this work to benefit us, for free! Maybe you could hold your critical assessment for professionals who get paid to schmooze. If you find his narration so annoying, turn on the captioning and turn off the volume. I would actually love to hear him better too, but I’m hard of hearing, so I have to settle for captioning.




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  11. So the nut group had a reversal of thickening but only a stop to plaque progression? Are there are any foods that can actually clear out plaque?




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    1. Yep, that is what i took from the video S Slavin. This video about cholesterol crystrals says a lot. Perhaps avoiding dietary cholesterol and cutting back on saturated fats help clear out the arteries. We know dark chocolate and walnuts and mushrooms can help the arteries, but maybe it’s the nitrate-rich vegetables and a plant-based diet in general that helps clear out the plaque? Dr. Esselstyn and others have shown heart disease reversal in some cases.




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      1. Thanks for the reply.

        That crystal video is scary – and I have indeed been avoiding cholesterol lately. The chocolate/nut videos, from what I remember, mainly seem to base improvement on FMD, but that doesn’t necessarily mean plaque cleared or didn’t. The NO rich diet seems to help the endothelium expand/contract properly, but again, who says that clears out plaque.

        I am only in my late 20s but have been trying to make sure my blood pressure comes down since my mom has bad issues with it. For most of my teen life I’ve had tons of soda, junk food, etc, so while thankfully age is on my side, I would love to have a diet that clears any potential plaque (for all I know there is none – but why not eat healthy anyways). That’s why I’ve been trying to find some sort of study that shows break up of plaque due to certain foods, exercises, or some other natural method.

        I’ve been eating healthier regardless based on what I see on this site and elsewhere, but I still get very anxious when checking my BP so I can rarely get a non anxiety induced high reading (the few times I was able to relax it was low 130s/80, but other times I tense up the second the machine turns on and end up with 155/90 or whatever – with that “fight or flight” feeling) – however I am pretty sure the diet can only be helping, so I am sticking with it and hopefully can break that negative association which seems to make me feel like someone yelled “BOO!” every time I take my BP.




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        1. Yes indeed it may be hard to find in US unless like me, you live in California near the coast. Natto is also known for strong taste which can be best described as blue cheese in soybean form, as it is fermented whole soybean.

          You can get Nattokinase and MK-7 which are the active components of natto causing these good side effects. I sometimes take these when I don’t eat natto, like when I am traveling. I buy them on Amazon.




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        2. I take them because I inherited from the Russian side of my family, the tendency for adverse CV biomarkers even though I am slim. Also when I fly, I used to get lower extremies




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  12. Would eating unsalted raw and cooked nuts and seeds and having no added oil in my diet help in avoiding a cardiac event? Is there a maximum amount of seeds and nuts that a person should be eating? I already had a bypass operation and hope to avoid another!




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    1. It’s hard to make recommendations for everyone. Here are Dr. Greger’s Optimal Nutrition Recommendations. He likes to promote Brazil nuts, like one a day. This video highlights a study where folks ate only 4 Brazil nuts per month and had amazing results lowering cholesterol, so it can’t hurt to try plus you gets tons of selenium. ​Here is a great video by Dr. Greger that explains the research between nut intake and body weight. Make sure to checkout the bottom of the video’s “Doctors Note” to see more links and info. Lastly, a follow-up to that video is solving the mystery of the missing calories, which may also help.​ Quality likely matters over quantity. So you are right on the money eating nuts and seed with no added oil.




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    2. Nancy, once I stopped eating meat, dairy, and eggs my body began to heal. All the information in these videos will help accentuate that healing. Adding nuts, whole grains, fruits, vegetables in variety gives your body nutrients and phyto-nutrients it needs to function. Also you need to take a B12 supplement and eat flax seed daily to get your Omega-3.
      First and most important for you to get better, you need to greatly decrease or try to eliminate your intake of animal products.




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    3. Walnuts and oatmeal are strongly recommended here for heart health, as is not smoking and getting exercise. Please forgive the intrusion, but I would like to tell you of the unproven “Pauling therapy” for clogged arteries. It involved Lysine and Vitamin C (and possibly proline) to unclog arteries. The Pauling therapy involves about three grams of each of these substances. http://www.paulingtherapy.com/

      The vegan diet can greatly improve outcomes in people with heart disease, as there are some doctors who treat it using this approach. They have many fanatics here. With regards to a maximum, these Whole Food Plant Based doctors recommend getting less than 10 percent of your calories from fat sources.

      D3 and arginine where also recommended to remove plaque from arteries. Do you take Vitamin D? It can strip plaque from arteries.

      Doctor Greger explains again and again how successful the Whole Foods Plant Based diet is in treating heart disease.

      Eating and living a healthy lifestyle can reduce your risk by 78 percent, among those already on medicine. http://nutritionfacts.org/video/eliminating-90-of-heart-disease-risk/

      Oatmeal can reduce heart disease http://nutritionfacts.org/video/can-oatmeal-reverse-heart-disease/.

      Beans are also very good for heart disease. http://nutritionfacts.org/video/beans-beans-theyre-good-for-your-heart/

      Thank you.




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  13. Key questions unanswered: Which of the many Mediterranean diets were used? How does the Mediterranean diet used differ from the Ornish diet? To what degree does the Ornish diet contain nuts? So what is the bottom line for one who can make the Ornish diet taste good, what is the BEST diet regardless of taste for not having heart attack, not having a stroke, maintaining optimal blood flow, being optimally healthy?




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    1. There appears to be a misuse of the word Mediterranean. Just because people live near the Mediterranean sea, it does not mean that they eat the old type Mediterranean diet. For example, the Spanish diet is full of fat and animals products. It includes lots of bar foods. They don’t eat as much industrial foods like Americans (with loaded CYA chemicals) but most are overweight and their diets have no advantages over other diets. They may use the word Mediterranean as a marketing tool to sell products.




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  14. Is there any way to turn off the live captioning? Since I actually can understand Dr. Greger pretty well, I don’t need the running transcript–and it often obscures chart data or text I’d be interested in seeing.




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    1. That little “cc” button at the bottom of the video that pops up when your browser hovers over the video should do the trick!




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  15. It is not true that Ornish diet does not taste good. My husband and I have followed a whole foods plant based diet (no oil) for almost two years now and we love to cook this way. the health benefits have been absolutely amazing.




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    1. Right! It’s about how you prepare the food in my opinion. We all need a lesson or two in culinary skills, or how to order at a restaurant or how to stock the kitchen so at least easy to prep foods are available. Soon we’ll have a recipe page that I hope everyone can appreciate and utilize as much as me :-)




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  16. Many nutrition researchers indicate that people don’t comply with plant-based eating. Ornish indicates an 80% compliance rate. It may be possible that in studies that don’t call for major changes participants don’t experience the benefits and therefore have to work to comply instead of complying b/c they have discovered they love eating that way! Also, taste buds change and w/i 30 days plant-based diets are delicious. Also, many of the researchers themselves might not be eating a WFPB diet, so the notion of them asking their patients to change would be like a researcher who smokes cigarettes asking his/her patients to stop smoking.




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    1. So true! If only our medical system was based on prevention and if only doctors’ prescriptions were to attend the WFPB cooking classes, the fun exercise classes, etc. If only the hospital cafeterias were models for WFPB eating and were so cheap that everyone wanted to eat there, if farmers’ markets were placed at hospitals (some Kaisers have them). I know these programs are happening in some communities, but we sorely need them in all.

      I have to admit I’m one of those folks who is still clutching onto my bottle of EVOO! Just a small amount really enhances the flavor of stews, soups, etc. Yesterday I made a giant batch of veg stew with ~10 different veggies plus white beans and various spices. I used ~3-4T of EVOO. My non-veg friends love my stews and can’t believe they are vegan. But without the oil they’re really lacking in richness.




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    2. Ornish writes: Because the biological mechanisms that affect our health and well-being are so dynamic, when people change their diet and lifestyle, they usually feel so much better, so quickly. It reframes the reason for changing from fear of dying to joy of living.




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  17. “…the major problem with Ornish’s diet is that it doesn’t taste good and so hardly anyone sticks to it.” We see and hear this objection often. Physicians say that their patients simply can’t push away their steaks and chops, chicken, cheese, butter, eggs, etc”. What they miss is the fact that it’s all just habit. Habit is why people in China love to eat tofu, people in Mexico love to eat hot peppers and beans, and people in Wyoming love their beef. What you love to eat is what you’ve always eaten. Change it, and although it’s difficult at first, before too long your new way of eating becomes the new habit and what you love. But changing the habit in the first place is the difficult part. Dr. Susan Peirce Thompson helps with that. Her information on Bright Line Eating: happythinandfree.com
    Joseph in Missoula




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    1. I used to think I can’t stop drinking soda – after being off it for a while I can’t imagine STARTING again. With time and understanding (and availability!) it should be possible to change anyone’s diet!




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    2. Forming habits is difficult. There are different brains “inside” the brain. The mammalian brain is deeper than the cortex. Then the reptilian brain is deeper than the mammalian. Trying to control those two from the cortex (human brain) is difficult and it unconciously works the other way around.




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    3. I quit eating meat at the end of December 1973. People occasionally say to me (some, I have to say, tauntingly while at a restaurant), “Come on, have a steak/burger/[whatever]. Admit it: you miss beef. Right?” Honestly, no: not right! So I laugh & say “No thanks.” Nobody ever challenges me to eat pig … oops, sorry, they’d say “pork.” Again, honestly, I’d laugh & say “No thanks.” But part of me (the atavistic part that tastes!) does miss some pork products. My mouth waters like crazy when I smell bacon or ham cooking.

      BUT I don’t eat it. And I’m still alive these almost 42 years later. I like the taste, and my mouth waters. Yet, somehow—just *somehow*—I’ve found that I can survive these gustatory urges. So too, then, do the pigs whose parts I haven’t eaten!

      Yes, people’s tastes are formed early on in life. And some of those people, intelligent & hardworking & disciplined in other areas of their lives, give so little thought to anything other than the taste/satisfaction aspects of food that they choose not to be intelligent & hardworking & disciplined in what they put into their digestive systems. I’ve heard some friends say, “Oh, I don’t know how you do it. I think I’d die if I could have [fill in the blank] anymore.” Yep, well, we’re all going to die anyway (Apologies to Dr. Greger with regard to the title of his forthcoming book, which btw I’ve preordered!); but, really, not eating the cow/pig/goat/chicken/turkey/milk/eggs will likely healthfully delay the mortal event for the eater. (And it certainly will for the animals.)




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      1. Absolutely! Good for you! There is another aspect to the ability to change what you eat. It turns out that we’re not all the same on that, and almost all advisers on diet fail to notice that very obvious factor. There is a “susceptibility scale” that determines how susceptible one is to food cravings (and of course, we only crave foods that we habitually eat). Check out Dr. Thompson’s teachings on this: happythinandfree.com. She can also be reached at brightlineeating.com
        Joseph in missoula




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    1. Imagine a balance scale with a healthy pan and an unhealthy pan. The overall health impacts of a given food is the balance between unhealthy aspects versus the healthy aspects of that particular food. Fats above a certain amount for the entire diet likely count on the unhealthy side of the balance regardless of whether that oil is in the whole nuts or is refined form. Healthy aspects of whole nuts like protein, fiber, vitamins and minerals go on the healthy side. For the whole nut it appears that the balance between the unhealthy and healthy aspects tips in favor of nuts being healthy.

      So is it really that the oil in whole walnut in and of itself is healthful or is it that a) for equal weights of whole nuts and refined oils, the whole nuts contain 65 g of fat in a 100 g sample, while for refined walnut oil a 100 g sample contains 100 g of fat, and b) the part of the whole nut that isn’t oil (15 g of protein, 13 g of carbohydrate and 6.7 g of fiber per 100 g of nuts) is healthful to very healthful.

      In the case of walnut oil there is almost nothing to counteract the negative health impacts, just a trivial amounts of vitamins E and K.




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  18. If you dig into the PREDIMED study you will find it is another case of the fox guarding the hen house! Added Olive Oil was 1 liter per week per family! Olive Oil and Nut Suppliers essentially paid for the study (statements by study organizers were that the study would not have been possible without the supplied products)




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    1. True, but given that olive oil consumption was neutral while nut consumption was beneficial, it would seem that the nut suppliers got more from their investment…




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  19. As a physician who believes strongly in the evidence based benefits of a plant based diet, one of the issues i have seen which prevents full adoption by some is the relatively lower calorie level per volume. My own experience and that of my athletic or physical labor patients is that many try to eat a very low fat diet with minimal amounts of animal protein but end up feeling hungry, tired, bloated etc (not just in the short term). This is not to imply that physically active people “need meat.” Perhaps some of us need a bit more and different kinds of protein or fat to perform our activities? I have found this to be a bigger obstacle than taste issues. Plant based diets have great cuisine but for some with highly active lifestyles exclusive plant based eating can be difficult. Addition of small amounts of organic dairy or animal products seems helpful and also seems consistent with the majority of “blue zone” diets. Is this approach inconsistent with lowered cardiac risk?




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    1. Wade did you get the message from reading the Blue Zone that animal eating was rarely? For example on Holidays? As far as me personally if I run a lot of miles in a week I tend to increase my nut and starch (yams Etc) consumption. Otherwise I lose weight.




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      1. i have read the books and studies re the blue zones. Have also had the chance to visit 4 of them. It is hard to know how rare dairy fish, meat and eggs really are. All seem to eat some of these in relatively low quantities regularly, certainly more than once per week. Unquestionably, they all eat a lot less then is generally consumed in western Europe and the USA. None are Vegan, but by US standards all our primarily plant based as far as I have seen. Perhaps health wise (as opposed to ethical wise), total compliance is not necessary to promote good health. YAMS and NUTS appear to be the a common theme from athletes on this site. Appreciate the insight and will give that a try. tx you




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        1. One of the problems with complete vegetarian diets is the risk of nutritional deficiencies – primarily B12, vitamin D and omega 3. These can make such diets no more healthy than some of the better omnivorous diets.

          We can address these deficiencies in affluent Western societies with supplements and/or relatively exotic vegetarian foodstuffs. However, in less affluent countries and in times past in wealthy countries, this was more difficult. Dr Greger’s 2003 presentation (delivered before the latest 7th Day Adventist studies demonstrated a clear mortality advantage for vegetarianism) discusses some of these challenges. Some of his later videos are also relevant …
          https://www.youtube.com/watch?v=q7KeRwdIH04
          https://www.youtube.com/watch?v=F5iQxxtsGRE
          https://www.youtube.com/watch?v=VVJCHVEatqY




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          1. Whilst I probably get enough B12 and Omega3 from the very few animal products I consume (usually less than 3 servings per week), I do supplement with B12. Another doctor I listen to regularly and consistently bashes dietary vitamin D. She holds that “vitiamin” D works more like a hormone in our bodies and can _only_ be properly and safely produced/utilized by our systems from the interaction of solar radiation and skin. She is Pamela Popper, Phd, ND. As a surveyor of land and naturally out-of-doors type person, I get plenty of D.




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            1. I live in Australia so there is plenty of sun – and scarily high rates of melanoma. So I get my 30 minutes of sun every day but no more. Whatever Popper’s views, I’ve not seen any credible evidence that vitamin d supplementation is harmful and have seen some evidence that it is beneficial. I think even Colin Campbell (with whom Popper works) recommends strict vegetarians supplement with vitamin D if they don’t get adequate sun exposure year round.

              Consequently, I do take a supplement but mushrooms are apparently also a good dietary source.

              This article’s a bit old now but I think the broad analysis and conclusions are still correct:
              http://www.medscape.com/viewarticle/731722




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              1. Pam has dozens of videos on youtube on the subject. Too many to link here. The latest one involves a study that shows D building up in the tissues of the body in those taking supplements. Anything that builds up isn’t being used (or is being excessively added to the system) and can also become toxic at some point. I have made reference to these videos on multiple Dr. G video comment sections. Never a reply.

                Maybe when they get done with the next 10 salt videos (of the dozen “promised” some long time ago) he’ll look at the NEWEST research on the _results_ of the current common clamor for D supps.




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                1. I saw her presentation to the VSH but haven’t seen anything else of her’s. Nor have I seen any papers published by her but then she’s a naturopath so perhaps that’s not unexpected. Anyway, I’m more concerned with endpoints like mortality and morbidity than tissue concentrations.

                  As I understand it from the 2014 Cochrane Review, there is no convincing evidence that vitamin D supplementation is harmful. In fact, there is suggestive but not conclusive evidence that vitamin D3 supplementation decreases mortality.
                  http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007470.pub3/abstract;jsessionid=2D7DE71B85258015D5347173C22FC9A1.f03t02




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    2. It’s hard to say what Blue Zone population does the best. In Loma Linda, California, there are strict vegetarians who also do pretty well. The Okinawa diet is also very healthful. And we see how even those eating a flexitarian diet can experience health benefits, too.

      As you point out, those who are more active tend to need more calories. This is where nuts and seeds and more plant-foods in general can be helpful. Besides, ​Dr. Greger explains the research between nut intake and body weight and solving the mystery of the missing calories. Nuts (although a bit fatty) do not seem to lead to weight gain or increased disease risk. In fact, they appear super heath promoting.

      I think the level of difficulty for finding the right foods will vary for everyone. Some folks might find it pretty easy because all they need to do is just eat more!




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    3. I am an active person (sometimes amateur competitor in endurance events), and the only time I had trouble keeping up calorically with plant-based was back when I was doing 80-10-10 and relying on fruit for most calories. I was a bit carbohydrate/starch shy then, but now that I’m eating nuts and seeds and starches along with my fruits and greens, I have no trouble keeping up. Sure I eat more than most, but it makes me skinny. I walked over 3 miles off-trail today (for example).




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      1. i have seen similar effective strategies for our endurance athletes here in colorado. i have seen less success with that approach for more power based, anaerobic types: downhill skiers, hockey players etc. theoretically it should not matter i suppose. of course there are always examples of powerlifters eating a vegan diet and ultramarathoners eating a low carb, high fat diet. But, it is valuable to hear what a variety of people have done. thank you




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    4. Ascribing all these symptoms to a lack of either fat or protein seems speculative. It may be that the types of foods they eat or the changes in gut flora that accompany dietary changes that may be producing these effects, for example. However, I think it is widely accepted that protein is a significant factor in satiety and is more satiating than fat eg
      http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8724362&fileId=S0007114512002589
      http://www.nutritionj.com/content/13/1/97

      High protein vegetable foods may be a better solution. However, if animal foods are preferred, the US 7th Day Adventist Studies suggest that fish may be a safer source than dairy. Those studies indicate that pesco vegetarians have lower all-cause and cardiovascular mortality than both lacto-ovo and strict vegetarians (see especially table 4) although cancer risk is apparently greater:
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191896/




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      1. good points re seventh day adventists. gut flora dynamics could well explain individual tolerances and adaptation challenges to a plant based diet, especially in those requiring high calorie intake. thank you for the study link.




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      2. There’s a video on here that shows how any “farm-raised” fish are likely highly contaminated by the toxins present in a clay that is added to their feed. The FDA sent a real mean letter to the producers of such fish feeds saying, in essence, “Please Don’t” and of course they have been ignored. So, not that I would ever before, (because I like to reward men who choose to fish professionally) but now I flat out refuse to consume “farm” (aquatic meat factory) raised fish of any species.




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        1. I don’t eat fish of any kind myself. What the 7th Day Adventist study shows, I suspect, is that strict vegetarians need to plan to consume adequate amounts of B12, vitamin D, omega 3 fats and iodine – which are naturally present in fish. But, as you correctly note, fish comes with a lot of other unhealthy baggage. The 7th Day Adventist studies also showed higher cancer risk in fish eaters than total vegetarians, for example




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  20. Sir, with due respects, eating fruit after meal, or, as you put it: “as a desert” could not be beneficial at all, not in any diet. It will result in fermentation and poor digestion. Fruit is among best food, but only if eaten alone, on an empty stomach. Please, refer to Dr. Herbert Shelton’s book Food combining made easy.




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      1. The older the better, in this case. But the years are not relevant in this matter. The physiological law is what matters. So, again, refer to Dr. Shelton and learn more than just to exclude your chewing apparatus and gulp your food. Otherwise, I very much like Dr. Greger.




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      2. It is written many years after the Holy Bible has been written. Psychology did not change so the Bible still stands as a meter for sanity. Laws of nature, laws of digestion cannot change, not in 50 years for sure. Physiological laws nor psychological laws are not changing so quickly, if at all. Otherwise, we would now be a much healthier and saner society. And this is not the case.




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      1. Thank you, I’ve read your articles and the facts mentioned in them are covered in Shelton’s book. Not so with the illogical and superficial interpretation of these facts by the writers of these articles. The facts alone do not help you, one needs understanding and “ear” to hear them.
        Dr. Shelton gave the essence of his 60 years’ clinical observation of many thousands people in his work. I would really like to hear Dr. Greger’s highly scientific opinion about this important matter.
        Happy research.




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  21. From the first study cited, it appears that a diet containing less than 24% of calories from fat provides a very high degree of cardiovascular protection (only 1 individual in 20, i.e. 5%, showing advance of lesions), even if the diet contains some animal products or free oils. From the latter studies, it seems clear that diets containing more than 24% of calories from fat increase cardiovascular risk even if the fat comes from whole plant foods (nuts, seeds). Thus, the rational conclusion is total fat matters more than whether it is “whole” or in its original package (e.g. nuts), and that one likely can include small amounts of oil, nuts, or seeds in a whole foods plant based diet without promoting cardiovascular disease so long as one’s total fat intake does not exceed ~20% of calories. This can easily resolve the “palatability” problem. One teaspoon of sesame oil only provides only ~45 calories, which is only about ~2% of calories on a 2000 kcalorie diet, and is sufficient to enhance the flavor of vegetable dishes. Most active people can use 1-2 tsp. of oil in cooking and a small amount of nuts or seeds (~1 ounce daily) and still fall well below the 20% of calories from fat level.




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    1. To me, this just means that you are just building arterial plaque more slowly. However, still building unwanted arterial plaque. And while most of us probably (unknowingly) were building healthy amounts of plaque in our youth (SAD), slowing down the process for me in’ later life’ makes no sense.

      I prefer to stick with the premise of ‘no oil’.




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  22. Does this mean I have to curtail my nuts and seeds—Dr. Joel Fuhrman notwithstanding? I’m quite slim, and quite active. I need the calories.




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    1. The Predimed study, from which this video is based, finds a reversal of atherosclerotic plaque formation from added nut consumption. The study finds that the increase of lauric oleic and linoleic fatty acids from coconut, palm kernel and animal products contributed to atherosclerotic plaque formation.

      The take away from my listening of this video is to keep on eating nuts while minimizing/eliminating junk food and animal products from your diet.




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  23. I love that nuts, seeds and avocados do not cause atherosclerosis plaques to form onto my vascular tree. They are so tasty and make my WFPB diet a hedonistic joy. They give me all of the pleasures of my previous eating pattern with none of the pain while providing the possible that I can enjoy it to my full chronological potential in optimal health.




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    1. thank you for that phrase. “my full chronological potential in optimal health.”

      I intend to re-use it (non-commercially) do you want credit?




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  24. http://theconversation.com/ordering-the-vegetarian-meal-theres-more-animal-blood-on-your-hands-4659
    Ordering the vegetarian meal? There’s more animal blood on your hands

    It takes somewhere between two to ten kilos of plants, depending on the type of plants involved, to produce one kilo of animal. Given the limited amount of productive land in the world, it would seem to some to make more sense to focus our culinary attentions on plants, because we would arguably get more energy per hectare for human consumption. Theoretically this should also mean fewer sentient animals would be killed to feed the ravenous appetites of ever more humans.

    But before scratching rangelands-produced red meat off the “good to eat” list for ethical or environmental reasons, let’s test these presumptions.

    Published figures suggest that, in Australia, producing wheat and other grains results in:
    at least 25 times more sentient animals being killed per kilogram of useable protein
    more environmental damage, and
    a great deal more animal cruelty than does farming red meat.

    Replacing red meat with grain products leads to many more sentient animal deaths, far greater animal suffering and significantly more environmental degradation. Protein obtained from grazing livestock costs far fewer lives per kilogram: it is a more humane, ethical and environmentally-friendly dietary option.

    So, what does a hungry human do? Our teeth and digestive system are adapted for omnivory. But we are now challenged to think about philosophical issues. We worry about the ethics involved in killing grazing animals and wonder if there are other more humane ways of obtaining adequate nutrients.

    Relying on grains and pulses brings destruction of native ecosystems, significant threats to native species and at least 25 times more deaths of sentient animals per kilogram of food. Most of these animals sing love songs to each other, until we inhumanely mass-slaughter them.

    The challenge for the ethical eater is to choose the diet that causes the least deaths and environmental damage. There would appear to be far more ethical support for an omnivorous diet that includes rangeland-grown red meat and even more support for one that includes sustainably wild-harvested kangaroo.




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    1. Charles,

      “According to the USDA, growing the crops necessary to feed farmed animals requires nearly half of the United States’ water supply and 80% of its agricultural land. Additionally, animals raised for food in the U.S. consume 90% of the soy crop, 80% of the corn crop, and a total of 70% of its grain.

      In other words, if you eat meat you contribute far more to the collateral killing of field animals by harvesting machines than you would if you pursued a vegetarian or vegan diet.” (from Internet) Pasture-raised meat constitutes a very small percentage of total meat consumption.

      I assume you eat a lot of plants, therefore tua culpa as well.

      But from a purely selfish perspective, if one feels that a whole foods, plant-based diet will maximize one’s health and longevity, then compassionate and ethical meat-consumption be damned.




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      1. The meat I buy comes from small family owned farms and is entirely grass/hay fed.
        Corn and grain are not meant to be fed to farm animals.
        The food I eat is, with the exception of yogurt and kefir, virtually unprocessed. I would say my diet is probably less processed than yours.
        I eat fruit, veggies, nuts, seeds, etc. in addition to dairy, eggs and meat.




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        1. “The meat I buy comes from small family owned farms and is entirely grass/hay fed.”
          You’re the exception. Most people buy factory-farmed meat.

          “Corn and grain are not meant to be fed to farm animals.”
          But they are.

          “I would say my diet is probably less processed than yours.”
          You could say that, but how would you know?




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          1. Not the exception at all – lot’s of people are.
            Maybe if corn and grain wern’t fed to farm animals people would be healthier even if they ate meat.
            As to my diet – what do YOU eat that’s processed? And by processed I don’t mean buying frozen fruit. In my case, you could say that yogurt and kefir are and gorund beef is as well but that’s it in my case




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            1. “Not the exception at all – lot’s of people are.”
              Maybe 10% maximum. If you want your meat from a small family owned farm and entirely grass/hay fed you pay a premium price. That’s not what the vast majority of people purchase from the local grocery store or fast-food joint.

              “Maybe if corn and grain wern’t fed to farm animals people would be healthier even if they ate meat.”
              Undoubtedly, but they might be healthier still if they didn’t eat any meat.

              “What do YOU eat that’s processed?”
              I mainly buy whole-food, single-ingredient products, but processed I buy whole-grain pasta, the odd boxed cold cereal, unsweetened soy milk, Ezekiel 4:9 bread, and canned beans and canned crushed tomatoes (for pasta sauce—to which I add oregano, lemon juice, and red kidney beans).




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    2. Sorry Charles but this is tendentious nonsense. I live in Australia and believe me people don’t eat a lot of kangaroo – they are wild animals and invariably infested by parasitic worms. Meat comes from the usual sources – cattle, sheep, pigs, chicken. Cattle are almost always grain finished and livestock feed comes from the usual crop sources by and large. The arithmetic that it takes a lot more resources to produce a kilo of animal food than it does to produce a kilo of plant food is still true.
      Note too the cheap little trick in the article where it talks about “useable protein” as opposed to actual food or calories. What did he have to do to calculate this – compare a high protein animal food like beef to a low protein plant food like broccoli? What if he had compared red meat to a high protein plant food like beans? And why is protein so important here as opposed to actual food or calories from food. The answer is that it isn’t, it’s just an excuse to play with statistics and come up with a ridiculous defence of meat eating.
      Just like the stories about insects etc killed in farming – how many insects on plants are eaten by grazing animals@ How many ticks, flies etc are killed by animal drenches and the like? How many native animals starve because their environment and food is taken over by imported food animals like cattle sheep and goats? Feral imported animals like goats and pigs cause great environmental damage and compete with native animals for food.
      This story is, to repeat myself, simply tendentious nonsense.




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  25. Another great video! I find it great to link it to the arterial plaque hypothesis for Alzheimer’s patients. Would it be right to recommend a low-oil whole plant-based diet for those looking to prevent atherosclerosis (and therefore Alzheimers)? I recently finished the book “Grain Brain” by Dr. Perlmutter, who advocates for a high-fat diet, and calls Alzheimers “Type 3 Diabetes.”




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    1. Cory: Here is an article that contains information that I think everyone needs to know about Dr. Perlmutter:
      http://nymag.com/scienceofus/2015/06/problem-with-the-grain-brain-doctor.html
      I understand that Jeff Novick pointed out this article:
      http://drmirkin.com/nutrition/forget-grain-brain-and-wheat-belly-eat-whole-grains.html

      As for preventing Alzheimer’s, I can’t quite tell from your post if you are already familiar with Dr. Greger’s videos on the topic. Just in case it would be helpful, I thought I would share this link:
      http://nutritionfacts.org/?s=alzheimers
      And since you mention Grain Brain, I wanted to specifically address your attention to:
      http://nutritionfacts.org/video/alzheimers-disease-grain-brain-or-meathead/
      “Grain consumption appears strongly protective against Alzheimer’s disease, whereas animal fat intake has been linked to dementia risk.”

      Also, if Alzheimer’s interests you, I would highly recommend a book from Dr. Barnard, “Power Foods For The Brain”. Dr. Barnard summarizes the latest info on diet and Alzeimers and the book is relatively new:
      http://www.amazon.com/Power-Foods-Brain-Effective-Strengthen/dp/1455512206/ref=sr_1_1_twi_pap_1?ie=UTF8&qid=1446586971&sr=8-1&keywords=dr.+barnard+power+foods+for+the+brain

      Hope this helps.




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  26. I’ve got blood test results today. What do you think?

    Triglycerides: 49.6 mg/dL (2.6 mmol/L)
    Total cholesterol: 100.5 mg/dL (0.56 mmol/L)
    HDL: 39.1 mg/dL (1.01 mmol/L)
    LDL: 57.2 mg/dL (1.48 mmol/L)
    VLDL: 3.9 mg/dL (0.1 mmol/L)

    I’m 19 years old, mostly sedentary, have a bad sleep pattern, constantly eating, but WFPB. Let’s see if I can improve it with regular sleep, exercise, meditation and intermittent fasting. My grandmother had high cholesterol, suffered from atherosclerosis and died of heart attack. I think it’s a good reason to be health conscious.




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  27. The news about walnuts changes my recent addition of walnuts as a healthy snack. In Dr. Esselstyn’s book walnuts are allowed in small amounts if you don’t have heart disease. Maybe that needs to be revised based on this study’s results. From the book I thought I could eat one ounce a day of walnuts and be safe, but apparently not. I need a no-oil whole food easy snack, and now see that walnuts are out. Back to the search for easy, safe snacks.




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    1. Nuts are great! See transcript above-

      “Whereas there was significant worsening of carotid artery thickening and plaque in the no dietary change control group, those in the added nuts group showed a significant reversal in thickening, an arrest in plaque progression. There were no significant changes in the added olive oil group.”




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  28. I just read this: http://www.greenmedinfo.com/blog/olive-oil-superior-mammography-preventing-cancer, and left a comment because though there is often some good health info on that site, I find I can’t trust it like here. For example, there is way too often a strong bias in favor of oil as some kind of magic ingredient, which infuriates me because I KNOW what the science shows to the contrary, that it can actually be dangerous… because I was sick from it. When I dropped my fat intake to less than 10%, my T2 diabetes went away. Poof! Everywhere I still read diabetes is about too many carbs/sugar, but the high glucose from diabetes is a SYMPTOM of the disease, not the cause! Intramyocellular lipids is the cause, from too much FAT in the muscle cells, so eating MORE fat is certainly not gonna help! Dump the processed crap, leave the animals in peace, not pieces, and eat 50-80% or even more of complex carbs, and key for me was getting the oil below 10%! Granted, if you aren’t already sick you can get away with a lot more than someone who already is, but if you can reverse illness by making a specific change, doesn’t that pretty much tell you it would be the ideal to practice BEFORE it catches up to you? Thanks dear Dr Greger for being straight with us, even erring on the side of caution sometimes, because you actually care! When I read that this site or you have a “vegan agenda”, it makes me flip out! Ahem, as you may have noticed! LOL! You rock, and thank you for all you do!!!




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    1. france: That’s great! Thanks for the feedback. I love knowing that I was helpful.

      FYI: There are two ways to look up information by topic on this site. One is by using the search box at the top of the page. The link I gave you was what you would get if you typed in ‘coconut oil’ in the search box. The other way to find information by topic is to use the “Health Topics” feature (see the link between ‘Nutrition Videos’ and ‘Nutrition Questions’ below the search box).

      Both options have their pros and cons. Sometimes the Health Topics page (when a topic has been filled out) is helpful because it gives you a mini-overview to go along with links to the relevant videos. There was no overview on Coconut Oil on the Health Topics, but you might check out Health Topics for future questions you may have. The topic page for ‘meat’ is a great example of what a good topic page looks like:
      http://nutritionfacts.org/topics/meat/ Just an FYI.

      Good luck.




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  29. My father has advanced coronary artery disease. I finally convinced him to go on the Ornish diet. The only outstanding question in my mind, based on the research reviewed by Dr. Greger in his videos, is the consumption of whole, raw nuts. Obviously, both Ornish and Esselstyn eschew nuts, but it seems to me that consuming small amounts of nuts should not be a problem, provided–as I said–that they are raw and not roasted, salted, etc. Do Ornish and Esselstyn have compelling evidence which leads them to proscribe nut consumption, or is it more that their diets have been shown to work, so even though new research is emerging that suggests small amounts of nut consumption is not contraindicated for heart disease, why take the chance? I am thinking more of raw nuts as condiments here–a few walnuts in oatmeal, a few cashews in a vegetable stir-fry, some ground almonds with nutritional yeast used in place of parmesan cheese, etc. Thanks for any insight.




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  30. The video does not say, which type of nuts (there is a big price difference between almond, peanuts & sunflower seeds). Also were the nuts eaten raw or cooked ? Where I live, t’s hard to find RAW nuts – most of nuts are roasted, salted or sugar-coated so that they can charge customers more.




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    1. I’m curious about this as well — Is this to say that eating coconuts as a tree nut is a healthier food choice than getting calories from a raw high-polyphenol unfiltered extra virgin olive oil over a mound of bright vegetables, and that neither of these would be as healthy as getting calories from something like 2 or 3 ripe bananas with honey, or a white potato as a virtually fat-free meal?

      I’m also curious how Macadamia nuts fit into this equation, as they don’t seem very high in polyphenols and contain a decent amount of saturated fat, oleic acid, and palmitoleic acid (which the body treats as another saturated fat.)

      Is it better to eat these very-high fat foods as a snack, in the absence of insulin / protein / carbohydrates, or is it better to eat these with insulinogenic foods as part of a “balanced meal,” or better to completely avoid them in theory, eating primarily sugars and foods that metabolize to sugars.




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  31. Most discussions about the Mediterranean diet or references to Ancel Keys’ study of the Cretan diet focus on the foods and overlook two very important factors: portion size or how these foods were traditionally consumed and the Orthodox fast days that are part of the traditional Greek diet. (The Orthodox fast proscribes all blood animals or foods derived from them, eg meat, poultry, fish.) Portion size is also a critical factor that is rarely considered: for example, today we think of olives as being a part of a meal whereas around the time that the Keys study was conducted, three or four olives and a small rye rusk were a meal.




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  32. The PREDIMED study highlights to me how selective reporting (or perhaps even mis-reporting) of the study results can be used to support differing dietary viewpoints. I have recently come around to the plant based philosophy for a healthy diet, having been a high fat low carb enthusiast for some time. A book I found inspiring at the time, albeit it is more focused on the human microbiome, was The Diet Myth by Tim Spector.

    The book references the PREDIMED study but draws different conclusions that Dr Greger. Tim Spector states that both the olive oil and nut groups had 30% fewer heart attacks and strokes, along with improved cholesterol levels. He goes on to say that the olive oil group did better than the nut group in respect of preventing diabetes and ‘several other parameters’, and they also lost more weight on average.

    Whilst Tim Spector concludes that nuts are really good for you, he states that olive oil is better, having anti-inflammatory effects and and that it is used by our microbes to produce short chain fatty acids and other beneficial compounds.

    Having been a meat eating low carb enthusiast until fairly recently, I am still struggling to convince myself that going fully plant based is the right approach. However, at the end of the day, trying it for a few weeks and seeing what happens cannot hurt.




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    1. Timparki: If you get a chance to read Dr. Greger’s book, How Not To Die, it might help you feel more comfortable with your decision. Good luck!




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  33. https://www.ncbi.nlm.nih.gov/pubmed/?term=26148926
    Consumption of olive oil within the Mediterranean diet has been long known to have many health benefits. However, only over the last decade has epidemiological research confirmed its protective role against developing several chronic diseases. The objective of this review was to give an overview of the state of art epidemiological evidence concerning the relationship between olive oil and key public health outcomes including mortality, CVD, diabetes, metabolic syndrome (MetS), obesity and cancer, with a particular focus on recent results from cohort studies and dietary intervention trials. Recent epidemiological research has shown that regular consumption of olive oil is associated with increased longevity. This benefit is partly due to the olive oil’s unequivocal cardio-protective role. There is converging evidence on the benefits of olive oil for preventing several CVD risk factors, including diabetes, MetS and obesity. Olive oil is also implicated in preventing certain cancers, with the most promising findings for breast and digestive tract cancers, although the data are still not entirely consistent and mainly from case-control studies. These health benefits are supported by strong mechanistic evidence from experimental studies, demonstrating that specific components of olive oil have antihypertensive, antithrombotic, antioxidant, antiinflammatory and anticarcinogenic action. Despite the accumulating epidemiological research, there is still a lack of consistent results from high-quality studies for many health outcomes (i.e. certain cancers and metabolism-related disorders). Further research is mandatory, above all from prospective studies and randomised dietary intervention trials when feasible, to confirm some of the still potential health benefits.




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  34. The reason I will continue to put some olive oil in my higher carb-y dishes (like rice and pasta) is because it lowers insulin auc dramatically and gets me back to fasting blood sugar levels much faster than without it (somehow it inhibits absorption of a good amount of the carbs, which means these calories also pass right through you — double win when you’re trying to get satiety in your stomach, but still have a net restriction of calories at the end). Yes, I can get the same results with red wine vinegar (and a near DOUBLING effect with both, i.e. homemade Italian dressing), but not all carbs taste good with just vinegar (or even oil and vinegar) on them.




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