Omega 3s & the Eskimo Fish Tale

Omega 3s & the Eskimo Fish Tale
4.78 (95.64%) 55 votes

The concept that heart disease was rare among the Eskimos appears to be a myth.


The revelation that fish oil appears useless in preventing heart disease, as I reviewed before, in either heart patients or for those trying to prevent heart disease in the first place, leads one to wonder how this whole fish tale began.

Well, the common mythology is that in response to anecdotal reports of a low prevalence of coronary heart disease among the Eskimos, Danish researchers Bang and Dyerberg went there and confirmed a very low incidence of heart attack. The absence of coronary artery disease would be strange in a meat-based diet, hardly any fruits and vegetables—violating all principles of heart-healthy nutrition. This paradox was attributed to all the seal and whale blubber, which is extremely rich in omega-3 fish fat, and the rest is history. The problem is, it isn’t true. 

The fact is they never examined the cardiovascular status of the Eskimos; they just accepted at face value this notion that coronary atherosclerosis is almost unknown among the Eskimo, a concept that has been disproven over and over starting in the 30s. In fact, going back over a thousand years, we have frozen Eskimo mummies with atherosclerosis. Another from 500 years ago, a woman in her early 40s – atherosclerosis in her aorta and coronary arteries. And these aren’t just isolated cases. The totality of evidence from actual clinical investigations, autopsies, and imaging techniques is that they have the same plague of coronary artery disease that non Eskimo populations have, and actually have twice the fatal stroke rate and don’t live particularly long.

Considering the dismal health status of Eskimos, it is remarkable that instead of labeling their diet as dangerous to health, they just accepted and echoed the myth and tried to come up with a reason to explain the false premise. 

Such dismal health that the Westernization of their diets actually lowered their rates of ischemic heart disease. You know your diet’s bad when the arrival of Twinkies improves your health.

So, why do so many researchers to this day unquestioningly parrot the myth? Publications still referring to Bang and Dyerberg’s nutritional studies as proof that Eskimos have low prevalence of heart disease represent either misinterpretation of the original findings or an example of what’s called confirmation bias, which is when people cherry pick or slant information to confirm their preconceived notions. To quote the great scientist Francis Bacon: “We prefer to believe what we prefer to be true.” And so, literally thousands of articles on the alleged benefits of omega-3 fatty acids, we’ve got a billion dollar industry selling fish oil capsules, millions of Americans taking the stuff, all based on a hypothesis that was questionable from the beginning.

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 born1945 via Flickr.

The revelation that fish oil appears useless in preventing heart disease, as I reviewed before, in either heart patients or for those trying to prevent heart disease in the first place, leads one to wonder how this whole fish tale began.

Well, the common mythology is that in response to anecdotal reports of a low prevalence of coronary heart disease among the Eskimos, Danish researchers Bang and Dyerberg went there and confirmed a very low incidence of heart attack. The absence of coronary artery disease would be strange in a meat-based diet, hardly any fruits and vegetables—violating all principles of heart-healthy nutrition. This paradox was attributed to all the seal and whale blubber, which is extremely rich in omega-3 fish fat, and the rest is history. The problem is, it isn’t true. 

The fact is they never examined the cardiovascular status of the Eskimos; they just accepted at face value this notion that coronary atherosclerosis is almost unknown among the Eskimo, a concept that has been disproven over and over starting in the 30s. In fact, going back over a thousand years, we have frozen Eskimo mummies with atherosclerosis. Another from 500 years ago, a woman in her early 40s – atherosclerosis in her aorta and coronary arteries. And these aren’t just isolated cases. The totality of evidence from actual clinical investigations, autopsies, and imaging techniques is that they have the same plague of coronary artery disease that non Eskimo populations have, and actually have twice the fatal stroke rate and don’t live particularly long.

Considering the dismal health status of Eskimos, it is remarkable that instead of labeling their diet as dangerous to health, they just accepted and echoed the myth and tried to come up with a reason to explain the false premise. 

Such dismal health that the Westernization of their diets actually lowered their rates of ischemic heart disease. You know your diet’s bad when the arrival of Twinkies improves your health.

So, why do so many researchers to this day unquestioningly parrot the myth? Publications still referring to Bang and Dyerberg’s nutritional studies as proof that Eskimos have low prevalence of heart disease represent either misinterpretation of the original findings or an example of what’s called confirmation bias, which is when people cherry pick or slant information to confirm their preconceived notions. To quote the great scientist Francis Bacon: “We prefer to believe what we prefer to be true.” And so, literally thousands of articles on the alleged benefits of omega-3 fatty acids, we’ve got a billion dollar industry selling fish oil capsules, millions of Americans taking the stuff, all based on a hypothesis that was questionable from the beginning.

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 born1945 via Flickr.

Doctor's Note

What’s this about no benefit for fish oil consumption and heart disease? See my video Is Fish Oil Just Snake Oil? What about fish oil for mood disorders? See Fish Consumption and Suicide. Consumption of long-chain omega-3s (EPA and DHA) may be useful for forming and maintaining brain health, though (video series forthcoming), there’s the struggle between Mercury vs. Omega-3s for Brain Development when coming from fish or fish oil, thanks to how polluted our oceans have become (even in “distilled” fish oil, see Fish Oil in Troubled Waters). The marine pollutants may explain the relationship between Fish and Diabetes and ALS (Lou Gehrig’s Disease): Fishing for Answers. Thankfully, there are now pollutant-free (yeast- and microalgae-derived) sources.

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


267 responses to “Omega 3s & the Eskimo Fish Tale

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  1. I’m not so big on fish oil, it always seemed a scam
    And now I feel bad for Eskimos, better off eating spam?
    But wait, if Twinkies are possible, why not nuts and kale?
    We know it’s tons more healthy and heck, might also save a whale!

      1. Thanks for that. As important as it is to understand diverse cultures, I’ll just accept your description. Pictures are not needed. :-)

        1. Very wise. You probably don’t want that image floating around in your… well, where ever it is that images are imprinted and retrieved.

        2. Woa – I agree with Joe Caner. This is the type of image I can really do without. I’m as open minded as the next person; however, when it comes to fermented flesh in the diet … My mind’s door opens rather slowly. If I must consume fermented food, I’ll stick to fermented grapes from a bottle.

        1. From the description, it appears to be an anaerobic fermentation process. There are several other examples of peoples using this process to preserver flesh for later consumption such as Hákarl which is basking shark where the fermentation process renders its poisonous flesh edible, just. There are also examples of wet fermentation such as Surströmming which is nasty looking preparation to preserver herring. If these “foods” wouldn’t turn one vegan, nothing will.

          But I suppose that’s the point. There isn’t enough vegetable foods at high latitudes to eat plant based so peoples foraged for what was available, and made provision so that they could make it through the winter. One eats what one has at hand. It’s not healthy, but it is better than starving to death.

      2. Read the first comment on this video on YouTube. Made me laugh and seemed plausible. Why eat twinkies when your friend dares you to eat fermented Auks. Yum!

        1. Yeah. Because nothing says down home goodness like a cheese infested with jumping maggots except perhaps the rotting bodies of small aquatic birds. Bon Appetite

          I remember having to get used to the idea of eating cheese as a child. It didn’t smell or taste good me. I had to be habituated to it.

          At least some of the thing on your list are prepared fresh. The thought of eating rotting anything is abhorrent be it animal or vegetable. When does that ever get fun. The funny thing is that I can smell the decay in the freshest cuts of meat, and I have to complete avoid or quickly pass through the meat and fish section of a grocery store. It smells like death to me.

          1. It is death! Rotting carcass! The worst is rotting fish. Seafood departments always smell the worst to me. That rotting ammonia smell. Ugh!

            1. I hear you, and the neat, white tiled walled and floored areas surrounding refrigerated glass mausoleum like display cases are as good as it gets. It’s violence against the animals; violence against the economically oppressed who work at the facilities that raise and slaughter them; and violence against the vascular, nervous and endocrine systems of those who ingest this nasty, decaying death food.

        2. Fish seem to hold a place better than other meats but worse than plant foods. What are the long term benefits and risks to a pescatarian diet? What is the impact on heart disease? Other conditions? Lots of chatter about pescatarian diet but few facts it seems.

    1. At least in Alaska, the Natives have increased processed meat and processed cereals, as well as alcohol, consumption and heart disease and diabetes have increased in past few decades. As a cultural push to return to native sustenance diet (salmon and berries), I would expect levels to drop but still remain significant.

    2. MisterImpatient When I was in Alaska in the 80’s a 16oz soda was $2.50. Gallon of milk over $5. Where these people live kale would be a $12-15 a bunch. Nuts could be a good choice though even though they are pricy shelf should be longer.

    1. Good article. I like the point about ignoring the original Inuit study and focusing on good current research to get to the truth. Of the 5,000 or so studies Dr. Greger mentioned, there should be a fair number for well designed studies which yield good useful results. The flip side is that we have to be skeptical about study results, or second party conclusions about the results, until the results are vetted by qualified peers or are so obvious that an intelligent layman can judge the validity of the study.

  2. “I’ve got a whale of a tale to tell you lads, a whale of a tale or two.” Kirk Douglas singing in 20,000 leagues under the sea.
    Great work my friend!
    I have a plethora of colleagues that are going to get a link to this eduVideo!

    1. Yes, I saw that movie. It is amazing how theories, assumptions and gut feelings that have no scientific back-up can produce enduring conclusions or in this case fish tales.

  3. from the video, re: “So, why do so many researchers to this day unquestioningly parrot the myth? Publications still referring to Bang and Dyerberg’s nutritional studies as proof that Eskimos have low prevalence of heart disease represent either misinterpretation of the original findings or an example of what’s called confirmation bias, which is when people cherry pick or slant information to confirm their preconceived notions.”
    This really hit a chord with me and got my dander up. How many times have we seen people accuse Dr. Greger of cherry picking? Or I remember one poster who lamented that experts like Dr. Greger, McDouggall, etc didn’t come right out and admit their biases. As if those promoting meat, dairy and egg have no biases… Argh! If every pro-plant researcher has to admit some kind of bias, I want to see that from the pro-meat, dairy and egg researchers too. After thinking this through for some time, I’ve come to the conclusion that the term ‘bias’, at least as used by many today, is a meaningless/useless term. What it boils down to is that people just use the term to mean that someone else has an opinion that they themselves don’t like. It would be more helpful if people started using the term as it is used in this video – ie, that someone has such a strong belief, likely unconscious, that that belief prevents that person from seeing the truth, even when clear evidence is present or not present. (OK, rant over.)
    This is definitely a video that I’ll be referring people to in the future!

    1. It’s amazing to me that Colin Campbell, who grew up milking cows and thinking we all needed more (animal) protein went full circle and gave up any biases he held and became convinced, from the evidence at hand when he studied groups of people, that we need more plants and to heck with animal protein. What a guy!

      1. Rebecca: Agreed! It blows my mind when people accuse Campbell of being biased. Similarly makes no sense when people accuse Dr. Greger of being biased. They don’t know his history. Everyone has beliefs. But for the word to be meaningful, the term ‘bias’ has to mean something more than that.

        1. Thea, if my memory serves… (and oft it does not), it seems that not only Colin Campbell, and apprin grew up on dairy and animal farms, but didn’t a few other pioneers, such as Esselstyn, and ?/ Neal Barnard?

          I tried to look it up, and found this interesting article and video on former meat and dairy farmers who Became Vegan Activists:

          1. Gayle: GREAT page!! Thanks for finding that link. Yes, I believe you are right about Essestyn. And perhaps Barnard to some degree. I think Barnard had close ties to a farm, but may not have grown up on one himself???? I”m not sure. And that’s why I didn’t want to say any more than I said.

            The subject of what it takes to turn on someone’s conscience is very interesting to me. What process and conditions have to be in place for such a radical change? I’m not sure we know the answer, but the topic is fascinating. Thanks again for that link. Great find.

            1. I’ve also often thought about what turns on someone’s conscience, and suspected that people need to experience hardship themselves, and possibly sympathy / empathy after that. It’s not always that simple though :)

            2. If my memory serves me right and sometimes it does not, but I believe that Dr McDougall grew up on a farm also. Ate lots of meat and dairy. Also had a heart problem around 18 yrs old.

              1. Alan: Thanks. I don’t remember the age, but I believe you are right about the early heart problem. That would be a serious wake up call.

              2. Dr. McDougall had a stoke at 18. If I could remember everything, I could win the $10,000 prize on …uh … what WAS the name of that early quiz show? Can’t quite get it.

            3. His grandparents were cattle farmers. His father didn’t want to continue that and became a doctor with a specialty in diabetes. That’s in one of the videos on youtube I’ve watched recently. Don’t recall which one. There was a bit more about his father ruing that there really wasn’t much that could be done for his diabetic patients. I don’t recall that Neal Barnard explained what led him to become vegan; perhaps it merged with other such stories in my mind.

            1. I love Baskin Robbins Ice Cream. I found out I had an Iodine deficiency because of that Ice Cream. I would eat it for a day if I could. I have given up milk because of an allergy, but youth shows that smiles are good for me.

              1. Robbin’s dad or uncle (can’t remember which) had bad heart problems due to all that ice cream eating. He went vegan and gave up the family business . . . and wrote a lot of great books about healthy veg eating, etc.

            1. Did you know that you can take a Magnesium pill at the start of the day and have a very powerful Alpha brainwave all day? This is my second day with this in mind. Seems to work for me, I like to share the Alpha brain wave. I wish the Alpha Brain Wave was in the Kabbalah.

                1. Hello! I take 400 mg of Swanson’s triple Magnesium complex and notice an alpha brainwave. Watch out for diarrhea when on Magnesium, according to Dr. Gaby. Matcha tea can also cause the alpha brain wave. Magnesium is a very common deficiency. A whole foods diet could be rich in Magnesium. Some people with Magnesium softened water report a mood improvement. Cartoons, math, green tea, and in my experience Magnesium can cause an alpha brain wave. Matcha tea is particularly powerful at causing the alpha brainwave.

      2. Well stated point. I also grew up milking cows. In addition, I made and smoked sausage and bacon that we produced from out own herds on the farm. In pondering the life of livestock and humans, it gradually occurred to me as a young man, Eureka! … Massive animals like horses, elephants, rinos, buffalo, cattle, etc. are vegetarian. How do they do it? I’ve never seen one of them having pepperoni pizza or cheeseburgers! I also concluded that milk is a perfect food … for young livestock. A vegan today and in my 60s, my family and friends continue to ponder that if I had never given up animal foods, I might be as healthy as them. Errr, that is – I could perhaps take my daily bicycle ride, as they do, from a recliner next to an end table loaded with various medications and a walking cane at hand. Honestly, I can say that I largely feel like an 18 year-old today and am nearly as active. Still, folks are waiting for me to fall apart because after all, one simply can’t live without their meat, milk, eggs and processed foods, right? How many of them have I visited in the hospital and watched pass from heart ailments, strokes and cancer after years of arthritic life? Bias is a very deeply entrenched tendency, possibly acquired by a lifetime of conditioning … and savvy marketing.

        1. What I don’t understand is the attraction to animal foods and junk foods. I admit that it was hard to give up cheese, but that’s because of the salt and things added. Other than cheese, I first became vegetarian (vegan later) because eating meat grossed me out and I was starting to gag anytime I looked at what I was eating or wondering if it had cancer or some disease.

          I remember dinner at friends’ house days after telling them I was vegetarian. The wife served me a chicken breast. When I reminded her that I was now vegetarian she said, “Well I know. That’s why I have you the smallest breast.” Oh, those were trying times.

          1. HA HA HA !! That sounds so familiar to so many situations that I encounter, even today. Folks just don’t get it.

            I believe you are absolutely correct about cheese and numerous other foods. The additives can be as addictive as the food itself. The subconscious attraction is very strong. Even today, I experience an occasional brief craving for foods that I know very well I do not need or desire. This may be some residual memory effect and sometimes it takes concentration to overcome it. It truly is, I believe, a form of addiction.

            Personally, I have no aversion to meat. I even hunt; however, I give my game to others who are meat eaters. Not being one of those who expects others to take on my lifestyle, my intention is to influence and assist or advise, if others show a desire to consider a meatless life. Several have approached me and have taken on the commitment. I tell them, not eating meat has little to do with politics, religion, environmentalism or other devotions (although to a point, it actually may). It has to do with a selfish desire for good health and being what one consumes. People are really surprised by the honesty and open-mindedness.

          2. I remember years ago asking a waitress which of their pies and pasties were vegetarian, and the answer was something like: “This one… oh and it’s got meat in it too.” Hmmm.

        2. You’re setting a great example. Maybe somebody is paying attention…in a younger generation of your family perhaps.

          Even though I’ve been reading about nutrition for over 50 years, trying to eat the healthiest diet I understood at the time, it took me much longer to really understand that vegan eating can be healthy, and even longer to understand that it is the most healthy way, provided one eats whole foods only. I still like my salt, but I do have low blood pressure. And it was only recently that I finally got it that all oils – olive, coconut, etc. are processed foods, not whole foods. I guess I’m just a slow learner.

          We aren’t cows, but I understand that all grass has protein and lots of nutrients, and I think if I were starving I could perhaps live on grass, by chewing it up to get the juices, then spitting it out. That was how Ann Wigmore cured her feet of gangrene following an accident. The doctor wanted to amputate but she wouldn’t let him, so she sat in the grass all day and chewed it, for lack of anything else to eat or the ability to walk. It’s an amazing part of her amazing life, available as a free download online. The book is called Why Suffer?

          1. Intriguing story! I must read the book. There’s much I have yet to learn regarding vegan living. The reference to “healthful” oils not being whole foods is an interesting topic. Thank you.

        3. Same here, the “healthy” relatives who are now requiring laser surgery to unblock the arteries.
          I tried to introduce WFPB to them , to no avail.

            1. yes Laser as in optical maser, through the vein in the thigh, which was nearly closing up.
              A doctor would be able to explain the procedure better.

    2. There is a difference between bias and having an opinion based on the best science. Thomas Kuhn wrote about progress in science in his 1950 book, The Structure of Scientific Revolutions, coining the process as a “paradigm shift”. This has been more recently popularized as the “tipping point”. So my current “paradigm” or belief is that our species is best suited to eat a whole food plant based diet with adequate B-12 intake and appropriate sun light exposure. I think the balance of science supports that conclusion at this time. At least it works for my patients. Of course there are legitimate reasons for insuring the intake of isolated nutrients such as iodine which the Inuits don’t need to worry about. It was nice to see another philosopher worked into the video. We have learned so much about food in the last 30 years and the science keeps coming. Help support your friends and family to subscribe to to keep up with the latest science. You might want to check Dr. Greger’s schedule as he travels around the country on his book tour. Encourage folks to come hear him speak in person.

    3. I realize that objectivity is such 19th century ideal, and that no one is completely neutral about anything, but there are those who exhibit a such pathological need to be right that no display of intellectual dishonesty seems beneath them. One can only speculate at the interior reasoning processes that propel their thoughts, but from their behavior, it is not difficult to conclude that it is reflexive and not reflective in nature. George Orwell must have been thinking of people so afflicted when he created the concept of “Double Think.”

      1. Ego…they need to think that they are right…otherwise they’d have to change? Inertia…takes a lot of energy/mass to alter the course of a heavy object?

        To get at the truth you need to be sort of light on your feet?

        Think of a large asteroid approaching the earth on a collision course…they have plans to use nukes to nudge them off course a bit….

      2. I’ve been criticized for changing my thinking on topics so many times. Well, such is the price of being open minded and always searching for truth.

  4. Am I right that this applies only to animal sources of omega-3’s? It should not be inferred from this video that omega-3’s as such are out the window, or should it? I have been eating ground flax seed for years. Waste of time?

    1. Video is about industry based on fiction. It’s about questioning the unquestioned studies.

      Flaxseed has much more than omega 3’s, and has been a GREAT addition to my diet. The only supplement I was taking before, Saw Palmetto, I have replaced with ground flaxseed. Either product relieves BPE symptoms, but flaxseed brings so much more.

        1. Benign Prostate Enlargement.

          My experience from the gitgo: I heard of Saw Palmetto working wonders for friends many years before I became symptomatic with BPE. So when I began to have symptoms (as a SAD eater) I began taking Saw Palmetto and it worked wonders. So I continued to take it.

          Sometimes I’d forget for a couple of days and symptoms would reappear. It would take a couple of days of double dosing SP to get back “on track”. When I changed my diet to WFPB, I started eating flaxseed daily: sprinkled on, mixed in, or straight out of the blender. I like the flavor. I stopped taking SP.

          The same thing happens now if I forget to have some flaxseed for a few days, but that is a very rare occurrence because I enjoy flaxseed, it’s cheap and available, and because of the other associated health benefits.

          I know nothing of the method of action. I know it works for me. I’m 49.

          1. I love Boron! Did you know that based on the location of Boron deposits on the Earth it seems obvious that elements can form from radiation? Boron is brought to the Earth by cosmic waves, how does the sun get any?

          2. Saw palmetto is everywhere here, and when the berries are ripe, there are a slew of people stomping through appropriating the “crop” no matter whose property it’s on. I was really curious to taste the berry because I had read they are pretty “interesting”. I think the description was something like “Blue cheese steeped in tobacco”. I know, but had to see for myself. Yeah, well, couldn’t find a one! Must be pretty popular!

            1. Unlike me, I never looked up the plant itself. I knew that it didn’t grow around here. I only ever used the packaged product (again, unlike me). I’ll gladly consume a bit more of it when I can find fresh berries! But with flaxseed, I don’t _need_ to take the supplement product anymore.

    2. plant_this_thought: Here is my understanding based on the materials I have read from Dr. Greger and Jeff Novick: There are a couple of myths (or disproven theories) floating around out there that omega-3s are good for the heart or mood. For those purposes, it doesn’t matter what the source of omega 3s are, the omega 3 is unlikely to help.
      However, omega 3s *are* still an essential fat. (The two essential fats are omega 3s and omega 6s. An essential fat is one that we have to get from our diet, because a) our bodies need the fat and b) our bodies can not make that substance ourselves. All other fats are non-essential, meaning that our bodies can make all that we need.) So, we have to get omega 3s from our diet. And just as important, we have to get omega 3s in the right ratio compared to omega 6s. (Which is a whole other topic.) What happens if we don’t get enough? Well, unlike the ideas about heart and mood health, in the case of brain health (videos coming out in the future–see Doctor’s Note above or Dr. Greger’s new book, How Not To Die), getting enough omega 3s may be vital. And in that case, you will want to make sure to get it from a plant source in order to avoid the dangers of getting it from a fish source–even one that claims to be “pure”.
      So, your flaxseed consumption is not only good for fighting cancer and other health promoting (see other videos on NutritionFacts regarding flaxseed), but it *is* good for your omega 3s, which are good for your brain and basic nutrient needs. For people who are not very good about getting their flaxseed or who are not on a whole plant food diet (which may be necessary for converting enough of the flaxseed to the substance our bodies need–an idea I have seen elsewhere), people *may* want to also take an algae derived omega 3 oil pill. This is one of the final recommendations in Dr. Greger’s book. But I haven’t seen details yet on when flax would be enough and when we might want to also take a pill. And I’m not sure we have enough evidence yet to say one way or another for sure. (That last part being my opinion.)
      Does that make sense?

      1. Thanks, Thea. I will continue to consume ground flax seed, which I like for the flavour anyway. I patiently await the final verdict on supplementing DHA/EPA via algae.

      2. Thea, you are wonderful! Thank you. My issue exactly. After 4 years of nearly daily enjoyment of this precious site with my now fiancé who taught college chemistry and is a big help in addition to our main chef, and being at page 305 of How Not to Die, we keep asking if CostCo’s promise of untainted Omega 3 pills is worthy of our taking them for brain health. Are the algae pills as good, where do we buy good quality ones? AND can we just skip them being 99.8% WFPB adding 1-3 Tbsp of ground flax daily?

        BTW, I wonder if people on this site are reading the whole book. I wonder if it would be good to do a video on the book’s layout and content. Then invite “members” to comment on their reading and learning. Even those who have a great familiarity with this content can learn a few new things and most importantly it is a way to gain mastery of the information– useful for questions such as the O3s. Also when we get drawn into discussing dite with SAD eaters, the less vague and confused we are, the more clearly we can cite percentages of reduced risk, etc. the better.

        As much as I APPRECIATE and ADMIRE Dr. Greger and you, and the team (HUGELY), I found myself resisting the title (unrealistic) and the chapter organization around depressing and for me around many unlikely diseases. But I plowed through my resistance because no one has done so much for my health and so my life, and my friend Marion Nestle early on assured me of Dr. G’s top science even though she often says “Moderation…” Well! EACH chapter, no matter how dismal the topic, taught me much about illnesses and then moved on to include a broader spectrum of subjects, most of which I or my friends would do well to know.
        I worry that others might feel this initial reluctant to reading the book and would like to encourage them to read one chapter a day.
        One more thing: Could we interest Dr. Greger to write another book that takes for granted the material covered in the first and works at level 2? Say one aimed at nutritionists and physicians?

        1. I think the controversial title was intentional. As the Dr explained, it doesn’t mean *how to NOT die* or that we can hold off death indefinitely, it means how to avoid the many ways you don’t want to suffer and die slowly from…*how NOT to die*.

        2. Gayle: *Great* post. I was overwhelmed with all the good ideas and interesting points I wanted to respond to. That’s why it took me some time to get back to this one.
          Charzie covered one point for me. As near as I can tell (I’m still not all the way through), Dr. Greger does not explain his title choice in the book itself, but I heard him explain it in a recent interview. I would put the stress on “how”. It’s *how* not to die – not in terms of never dying, but how/the bad ways to die that one can have a good chance of avoiding. I personally think the title is equally a strength and a drawback for the book.
          I like your idea of a second book that works at “level 2”. I love the current book and think it is the right level for the general public and perfect for reaching people who would never wade through over a thousand videos. But I’ve seen most of the information already. And I can see how it would be nice for professionals to have something different.
          For myself, in addition to the book we have, I want a second book with the same information re-arranged with different topics such as: chicken, pig, … berries… There are times when someone says, well I don’t eat red meat any more. I eat chicken! I would love to be able to show them a chapter in a book that covers say chicken in detail all in one place. The topic pages on this site are sometimes very good, but often fall short of what I could like to see. (Of course, I can’t complain too much because those topic pages are volunteer driven and if I want more, I should put up or shut up!)
          I think the way that Dr. Greger organized that incredible breadth of information was well done. But I also agree that looking at the chapter titles alone, you would never guess the range of topics that Dr. Greger covers. All the stuff for kids, moms, losing weight, etc, etc, etc, is all in there, even though the chapter title might make one think the chapter was only about a certain disease.
          Your idea of doing a video on the book layout and inviting people to comment reminded me of someone else who wants to do a book club type event on the book with our vegan social group. Your idea is kind of an on-line book club meeting for How Not To Die. I can just imagine the very interesting contributions we would get. We have a good group of people here.
          I’m glad you made the effort to check to the book despite the initial turn offs. It is worth it!

        3. Titles are picked for a variety of reasons including marketing considerations. If folks won’t buy the book they can’t read the book. On the surface it isn’t accurate since we all die. That said it’s format is excellent and the science is sound at this time…. keeps changing as you know. Educating practitioners who are in a position to recommend changes in nutrition to others don’t need alot of information. I believe the number of studies and their biases are a problem. Let reader beware. We need to rely on trusted professionals with minimal financial stake in helping sort through the studies for us in the field. The ones I have found helpful in addition to Michael are John McDougall, Neal Barnard, Jeff Novick, Doug Lisle along with their associated staffs and products. That doesn’t mean others aren’t doing some good but I believe we need to provide the best available science based information. The second step is for the professionals to apply the information. The real education is when professionals start seeing the results. One of the problems is that if we are successful we don’t often hear back or see the patients because they no longer have their initial problem. It of course helps if we practice what we preach. The challenges are substantial but we can all do our part by spreading the information to others whether that is fellow professionals, friends or family. Books are one way to get the word out in a complex world. My patients have found the China Study to be of interest for conceptual change. How Not to Die is another one to lay the basis for change. The details of how to change are supported by information from PCRM such as their 21 Kick Start programs (available in multiple languages with a new program every month. Clinical support is easily available from John McDougall’s website which also has a lot of free lectures posted. His book, The Starch Solution, and his website is a good resource for information and recipes. Jeff Novick as produced some excellent DVD’s on shopping and making fast inexpensive food. There are other products too numerous to list. I comment on the ones that I and my patients have found to be the most useful in a general sense. For specific problems or diagnoses there are other resources as well. The ones I recommend I have posted on my website. The difficulty is there is individual variations that need to be made. Colin Campbell’s book, Whole, is a good introduction to the limitations of reductionistic science when figuring out what works when working with complex or adaptive systems which is what we are. I would guess that Michael’s annual presentation will be centered on and maybe even titled, How Not to Die. For professionals it is also helpful to have a good understanding of statistics to sort through the issues. One of the many things that How Not to Die does is to discuss the common cancers. Dr. Greger has done excellent presentations in the past on blocking cancer at the key stages. However I haven’t found a good reference which pulls together all aspect of the complexity that is cancer. Thanks for your post.

      3. Many people do not make the conversion well from the parent omega 3’s (and 6’s) and thus cannot benefit from the downstream metabolites. A vegan algae supplement is a good choice….unless one is violently sensitive to soy and glycerin, because I have yet to find a vegan Omega 3 source that does not have this and other junk that I cannot tolerate. And I cannot eat the fish itself due to histamine intolerance. But histamine is water soluble so for me you better believe I take a good quality fish oil supplement. I also take a black currant oil supplement as well.

        Oh and flax seeds are very high in cyanogenic glycosides which some people (like me cannot detox very well. (Flax seeds and oil make me very sick!) Also flax oil gets rancid extremely quickly. More so than good quality fish oil.

        1. Linda N: I’m aware of at least one study showing that people who are on a whole plant food diet (the one recommended on this site and others) do have bodies which convert the parent omega 3s in adequate amounts. (I don’t have a link to that study. I’ve just read about it often enough.) That’s why eating flaxseed in the context of a healthy diet may be all that we need. Since I believe that you have reported in the past that you eat animals, it is quite possible that flaxseeds would not be sufficient in your case, even if your other medical problems were not an issue.

          You will note that it is not a recommendation to eat flax oil (which you mentioned in your post for some reason), but a recommendation to eat ground flaxseed. Dr. Greger has a video showing how consuming ground flaxseed can easily be done without having to worry about it going rancid. Also, as I mention in a post above, the recommendation to eat ground flaxseeds addresses health benefits which go way beyond the need for omega 3s.

          From your post, you have some special medical needs. That’s a bummer. Sounds like you are doing the best you can with your situation and choices. Good luck!

          1. See my other post on this issue. I cannot get near Flax or Flax oil. Cyanogenic glycosides! And Flax also goes rancid very very quickly. The conversion of parent omega 3’s to their down stream products is 7 to 1. In others words one has to take a LOT of flax oil to push the conversion to a tiny bit of EPA and DHA. And I still do not convert well and need all the anti-inflammatory help I can get. Also vegan EPA and DHA supplements all contain glycerin and/or soy derivatives in them and other crap that I also cannot get near. And they are low dosing enough that they would not serve me well. But others, of course may find they work fine.


          2. Whole flax seed keeps for ages, certainly a year or more. I buy food grade flax seed in 44 lb. bags. Dirt cheap. Grind as much as I need for that meal, and there is never a rancidity issue.

        2. Linda: Fatty acids don’t occur in nature in pure form. They occur as triacylglycerides, phosphoglycerides, and waxes. In the gut, the digestion of the first two creates glycerol. So when you take fish oil or flax oil or algae oil, glycerol forms in the gut, so if you want to avoid glycerol, there’s no advantage of taking fish oil. (Glycerol is an essential nutrient anyway.) As for CGs in flax, they’re heat sensitive so can be destroyed by cooking.

          1. Correct. Fatty acids occur as triacylglycerides, phosphoglycerides, and waxes. It is isolated glycerine in supplements that I cannot tolerate. For many with histamine intolerance problems we react to that isolated form as it is a sugar alcohol. As for CG’s in flax, maybe they can be destroyed by cooking but either way I simply cannot tolerate Flax. No matter which way I try them. They make me so ill I cannot get near them. I tolerate fish oils just fine, as long as glycerine has not been added to the supplement. (For which that is the case for so many. Either way I do not make the conversion of ALA to EPA very well (even with extra B6 and zinc) and I need too high a dose to create the anti-inflammatory prostaglandin.

            1. Linda: I suffer from very mild histamine insolence, reacting only to two things: tomatoes and sea food. I didn’t know that sugar alcohols are histamine liberators. The only sugar alcohol I use directly is xylitol, which is to irrigate the sinuses, so I don’t swallow it, but I have to be careful. Thank you for mentioning sugar alcohols. Any supplements you’ve found useful in controlling HA? As for the omega-3 issue, have you tried chia seed? I personally don’t like them because they stick to my throat, but they’re known to be a rich source of ALA.

      4. Omega 3s are good for people living in the temperate environment, Omega 6s are good for the people of the tropics. Both Orthomolecular and Vegan-based doctors agree about that. They also both agree that fiber is good for you. Plants have fiber. Fat of plants from the northern region are good for people living in the temperate region.

        1. Tom Goff: Thank you for your note. In trying to understand what you are saying, I re-watched the organic chemistry part of Jeff Novick’s From Oil to Nuts lecture. I also looked at the PCRM page you linked to. And I re-read Dr. Greger’s discussion of omega 3s.
          I think you are saying that there are multiple types of omega 3s and 6s and that only one of those types is essential. That’s interesting, because everyone and their mother glosses over that distinction when they say statements like the following from PCRM: “It is vital for everyone to eat foods that are rich in omega-3 fatty acids on a daily basis. … The recommended amount for adequate omega-3 intake is 1.1 and 1.6 grams per day for women and men over the age of 14, respectively.11”
          But the page does go on to say, “Omega-3 fatty acids are derived from linolenic acid. The principal omega-3 is alpha-linolenic acid (ALA), which is then converted into eicosapentaenoic acid (EPA) and docosahexaenonic acid (DHA) by the body. This makes ALA the only essential omega-3 fatty acid. ALA can be found in many vegetables, beans, nuts, seeds, and fruits.” So, I think I understand what you are saying. The *principal* omega-3 is ALA, but there are more types of omege 3. There are more types of omega 3, but all we need from our diet is the ALA.
          Most people don’t make that distinction when talking about recommendations for omega 3s though. So, I don’t think you are correcting what I said so much as helping me to understand some details. Did I get that right? Or am I missing your point???

          1. No, you have it correct. It is the same with Omega 6s – only one Omega 6 fatty acid is essential (Linoleic acid) just as only one Omega 3 fatty acid (alpha Linolenic acid) is essential. The body can synthesise the other fatty acids from the diet. Both these essential fatty acids are obtained from plants.

            The issue is that synthesising other Omega 3s from linolenic acid (ALA) is thought to be relatively inefficient in humans and direct ingestion from animal sources is thought to make those other Omega 3s more available to humans. We have to be wary of Wikipedia of course, but I thought that the article on essential fatty acids was informative. And short!

            The key text for me here is the 2010 WH0/FAO report of an expert consultation on fats and fatty acids in human nutrition. It is fairly long though.

            1. Tom Goff: I know what you mean about wikipedia, but every once in a while, they have a page that just hits the spot.

              re: “The issue is that synthesising other Omega 3s from linolenic acid (ALA) is thought to be relatively inefficient in humans and direct ingestion from animal sources is thought to make those other Omega 3s more available to humans.”
              It’s my understanding that a) vegan bodies who have been on a WFPB diet for a while adjust and increase how much ALA gets converted. And b) while vegan bodies have been found to be lower in DHA (and EPA?), there is zero evidence that this lower amount is linked to any harm. I’ve heard both of these claims made often. I haven’t seen actual source material though. Do you have any thoughts on the matter?

              1. I don’t have any original thoughts on this (or, sadly, many things for that matter!).

                It may be an issue not so much of “harm” from low levels but rather whether higher DHA/EPA levels confer benefits. For example, in the 7th Day Adventist studies the “pesco–vegetarians” had lower mortality than the “vegans”. Of course, it may not (just) be the omega 3s in fish that account for the lower mortality – it may (also) be the B12, vitamin D, iodine, zinc found in fish or indeed other factors. However, it’s a possibility.

                On Omega 3s in general, I find Jack Norris’ views on this topic broadly convincing – except I don”t use oils but prefer whole chia seeds, ground flax seed, green leafy vegetables etc. He also provides a lot of useful references. As I think I mentioned earlier, I also take a vegetarian DHA supplement since I am now over 60.

    3. For me, the point is that omega 3, from fish oil, is not going to protect you’re heart from a bad diet. Omega 3 is still an “essential” fatty acid, needed for good health. Best source is from plants, which is where the fish get it.

    4. I’m writing this not in support of fish oil – I don’t consume fish oil or fish – nor against flaxseed – I eat 1 tbsp of flaxseed daily – but to remind a weakness of flaxseed as a source of omega-3 fatty acids. The omega-3 fatty acid in flaxseed is alpha-linolenic acid (ALA). The other two omega-3 fatty acids human body needs are DHA and EPA. In theory, the body can make DHA and EPA from ALA but in practice the process is very inefficient because the American diet contains a lot of the omega-6 fatty acid linoleum acid (LA). The same , competitive enzyme processes ALA and LA and the latter, being the more abundant of the two, wins the competition. The simplest way to solve the problem is to minimize the consumption of LA, which is hard because most foods, including healthful ones like nuts, have a lot more LA than they do ALA. So the only practical solution appears to be taking DHA from algae.

    1. Wade, would you know what is in the “fish sauce” used by Thai Restaurants? I have given up my favorite dishes because I have never managed to see the bottle from which they get their base. I have no idea how much they use, and would guess that they use enough salt to cross this delicious and fragrant cuisine as offered in restaurants off my list in any case. I would like to know how you balance the pros and cons.

      1. Gayle: FYI: Miyoko’s new Vegan Pantry book includes a recipe for vegan fish sauce. The fishy flavor comes from seaweed. I haven’t tried that particular recipe yet, but most of her recipes from that book that I’ve tried so far have been *excellent*. I understand that isn’t the question you are asking. I just thought you would find the information helpful or at least interesting.

      2. I don’t eat much of it. I average one Thai restaurant visit per year and have yet to use up the first two bottles of fish sauce I ever bought. A LITTLE dab will do you. Just because I like something doesn’t mean I employ the “more is better” gluttony of Western society to it. Cheers.

        1. I’m with ya Wade. I’ve had a bottle in the fridge forever, but when I am craving that seafood flavor, I’m sure a small dash of it with a bunch of sea veggies is still better than indulging in the fish itself. I’m very prudent, but not “religious”.

  5. Isn’t Omega 3 proven (even by your own videos) to be very anti inflammatory which in turn should help heart health and basically every other part of your body? Why would it so bad from fish but so good from, say, flax?

    1. S Slavin: Because fish oil, even one that claims to be pure or distilled is often contaminated to the point where the cons outweigh the pros. Take a look at the links Dr. Greger provides in the Doctor’s Note above.

      1. Ya I’ve seen those, so the ONLY negative is the contamination? And are we to never trust the fact that certain brands (supposedly) guarantee the purity? Just trying to get a handle on it – I don’t even use fish oil – just curious.

        1. S Slavin: My other thought is to question what fish oil means. Are they *only* including the pure omega 3s? Or is it “whole” fish oil? If whole fish oil or whole fish, then the other problems are saturated fat and cholesterol–which you are not going to get (or more proper to say are going to get in very small amounts) from say flaxseed.
          As for me personally, because the oceans are the world’s sewers and I don’t know how good our technology is, no I would never trust a company’s claim of purity.

            1. They aren’t even testing for all the flame retardant congeners in fish oil. For example there’s 209 possible chemical configurations that may represent flame retardants, such as brominated Tris, or Firemaster 550, but these are ignored. They only test for PCBEs. I’m not sure if they test for other compounds such as lead, dioxin, thallium, and other toxic metals, but it is unlikely.

          1. If the ocean’s are sewers, or any body of water for that matter, how can one be sure that nutrients derived from water substances (algae, etc.) such as B12 are not contaminated as well?

            1. Dennis: Good question. The algae based pills come from controlled tanks of farmed algae. It is not based on algae harvested from the ocean.

              I don’t believe that the ‘any body of water’ is a good phrase to include in the discussion. It is my understanding that some bodies of water are known to be much more contaminated than others. It is, I believe, possible to get relatively clean, healthy water in facilities such as those that make the algae based omega 3s.

          2. Well the soil is now the world’s sewers as well. And ultimately most water comes from the oceans. With Fracking chemicals, pesticides, gmos and companies burying all sorts of stuff, including radioactive waste, their is no such thing as clean food anymore. Just organic food which those who grow it try to build up the soil more and try not to add anymore crap. The rain still falls on these plants as well.

            1. Linda N: I never understand the ‘throw up your arms and accept everything, because it’s all bad’ thinking. There are measurably cleaner foods and environments than others. It’s about making the best choices we have when there are real choices to make.

              As you know, there is a lot of evidence on this site that shows how toxic fish is compared to other foods. There are studies coming out every day showing whole plants foods as being health promoting, despite that “the rain still falls on these plants as well.” Plus, as I understand it, water that goes through a condensation process filters out some of the toxic stuff. On the other hand, fish as food is shown time and again to be disease promoting, especially when you consider the whole body of evidence. (I know you can find individual studies claiming fish is healthy.) I understand your concerns about soil and the state of our planet–and for some of what you write about, I deeply share those concerns. But I don’t agree with the point of your post at all.

              1. Well see my other posts first. I have good medical reasons for choosing fish oil over Flax oil. And frankly I don’t get your idea that somehow the ocean is more contaminated than the rest of the earth we have destroyed so horribly. Mercury and other contaminants are filtered out of fish oil. Who says I am throwing up my arms and accepting everything. I am quite the activist, but you do not know that. Of course there are cleaner foods than others and I eat almost totally organic whenever possible. I just do not agree with you that the evidence shows that fish as food has been shown time and time again to be disease promoting. In fact if one critically examines the video, the reason the Eskimos did not fare well is not because fish or Omega 3’s are bad, it is because, in that frigid environment, they had practically no access to fresh fruits and veggies. Fish was not contaminated for millennia before factories started spewing out mercury and all kinds of radiation and stuff started to get dumped into the ocean. Fukushima is just the lateest horror (and probably the worst yet) in mankind’s continued decimation of this planet with no regard for its future or the present and future health of the people and animals that inhabit it. When they come out with a vegan EPA/DHA supplement without glycerin, gmo soy residues, and the other crap I will be very glad to take it, Until then, since Flax oil contains cyanogenic glycosides which I cannot detoxify, and goes rancid very quickly, I will have to stick with the best fish oil I can find from a reputable company.


      2. The Answer is much more complicated than that. Yes Omega 3 fatty acids are anti inflammatory, however you can get to much of a good thing and to much Omega 3 will thin the blood and cause clotting issues should you get a cut. The fact is that our ancestors did not have this problem because if you look at the Omega ratios in plants they are within the ratio recommended as optimal for human health. It is only when you add unnatural free oils and meats to the mix that a problem arises. Once you have thrown the natural balance off. You then have to figure out how much extra Omega 6’s you have eaten so you can supplement with the proper amount of Omega 3’s to get back to a proper balance. Unless you can keep exact records of exactly what you eat and the Omega makeup of those foods it is impossible to know how much of what to take when. Having said that even if you do eat a whole foods diet with no added oils, you are going to get some extra Omega 6’s from somewhere unless you’re a hermit. So the recommendation to eat a little ground flax seed in the morning is a good one. It will help regulate your blood pressure along with its other benefits.

        1. I think Dr. Greger is saying Omega 3s are good for you. Can you imagine? Fat being good for you? What a blessing. Domestic beef and meat is mostly Omega 3, where would you get omega 6s here besides from tropical beef or plants like Avocado and cashews?

  6. Native Canadians seem even more susceptible to diabetes than
    most–something like 80% of adults on Manitoulin Island in Lake Huron
    have Type 2 diabetes–so western diet as consumed there is no panacea.
    (Fresh fruits and vegetables can be extremely expensive in Canada’s
    north. In fact, with today’s declining loonie, “Fresh vegetables were
    … up 13.3 per cent in December on an annualized basis”
    ( Traditionally, some Inuit at least regard fermented meat
    & innards as a delicacy, so I assume traditional diet is certainly
    different, maybe better (more vits?) than western diet that includes
    fish. (I think they prefer to be known as Inuit rather than Eskimo.
    “Kabloona” is fascinating memoir of Frenchman living with such folk.)

  7. I had triglyceride levels > 2,000 in my thirties at a weight of 157 pounds(165 lbs in high school) I was involved in lipid studies but Lipitor 80 mg lowered my triglycerides still to > 500 but also gave me myopathy and an elevated CPK. On Zetia and fish oil my triglycerides dropped to 160 and I now weigh 174 lbs at 67 years old. I had gained to 198 but dropped when I became vegan with all food organic made from scratch: no junk food. I also exercise about 2 hours a day, have no car, and walk or bike everywhere. Unfortunately 15 years ago, I had Gleason 8, locally invasive, node +, prostate cancer with prostate resection at John’s Hopkins and 5 years of treatment at Dana Farber Institute. I am concerned that fish oil increases the risk of recurrence of prostate cancer and severity of malignancy, though I have an undetectable PSA 15 years later. Before fish oil and Zetia my plasma and urine were white with Triglycerides. What would you do?( Triglycerides > 2,000 not only cause heart disease but severe pancreatitis and possibly death. ) I am an MD, follow Dr Greger closely and am 3/4 of the way through How Not to Die. In my own practice I always stressed diet and lifestyle changes and, as you may be able to ascertain, have the willpower to change. I have changed my diet not only for myself, but for the environment, animals, and future generations. ( Meat production produces more polluting, climate changing gases than all transportation combined in addition to its cruelty.)

    1. Had you tried either fish oil or Zetia by themselves to see if one or the other might have been responsible for this dramatic drop in triglycerides?

    2. Robert Haile: You sound like an awesome doctor. I love people who walk their talk and know their profession.
      I’m no doctor, but I wanted to ask: Could you try replacing the fish oil with an algae derived omega 3 pill? That should do the same thing for you, but without the drawbacks of fish oil and oceans destruction. Just an idea. (Or maybe I didn’t understand the question/situation?)

      1. what about amla powder? my husband used it successfully (per Dr. Greger’s nutritionfactsorg info) to reduce his LDL-p level by more than half after trying the time release niacin that he hated.

        1. Do you know of a good brand of Amla powder that can be purchased on-line? I can’t seem to find any locally where I live. Thanks.

          1. I should have been more clear in my comment. although my husband also has a good LDL profile, he used amla successfully to reduce a specific portion of the LDL profile (numerical count of small particle LDL), and I wondered if amla might have another benefit since it is so powerful (see

    3. I agree with Thea. I take 250 mg of algae oil a day, and when I stop, my VLDL-3, an extremely atherogenic triglyceride particle as I’m sure you know, jumps up from 8 to 12-15, and gets a flag, despite my strong plant-based diet. There is a theoretically increased link to prostate cancer, according to a recent meta-study (which is why I don’t double my dose), but your PSA sounds very safe and manageable and it sounds like a relatively low-concern.

      1. I’d like to know the source about the theoretical link to prostate cancer, as I have a high PSA (but so far no prostate cancer detected after 4 biopsies and an MRI). I take 500 mg algal DHA/EPA supplement (Ovega-3) per day. I take that because conversion of ALA to DHA/EPA, particularly in men, seems to be quite limited, and my undertsanding is that there’s evidence it is essential for brain/neural health and that vegans blood serum is typically quite low.

        I also currently take 2 TBL of flaxseed for the ALA (and eat walnuts every day) based on Ornish’s work but I’m still a bit concerned about flaxseed since I’ve read several studies indicating there could be a positive association with advanced prostate cancer. I’d be interested in opinions on that issue too, especially from anyone who has studied this from the perspective of one with high PSA (~ 9) but also known BPH, presumably the cause of the high PSA.

          1. Thanks very much for the link. I find the conclusions very disturbing, in particular, the finding that *dietary* DHA (docosahexaenoic acid) “intake showed a non-linear positive association with PCa risk” (as opposed to blood levels, where there was a marginal association). This argues against taking even an algal Omega-3 supplement (and Ovega-3 is higher in DHA than EPA), which I find disturbing since DHA is a key component of brain, retina, skin, etc. I had concluded that it is risky for one’s neurological health to rely on ALA conversion, especially for males as mentioned above. Dr. Furhman regards this as so serious an issue for older vegans that he recommends supplementation.

            Also, ironically for vegans at high risk for prostate cancer, they identify DPA (Docosapentaenoic acid) as having a negative association with PCa risk but DPA, according to wikipedia, comes primarily from certain fish sources, meat and dairy. I gave up dairy because of its association with PCa, so I’m quite surprised.

            It seem almost impossible for someone not trained in interpreting the quality of these studies, etc. to draw solid conclusions, given conflicting goals – for me, reduction in both PCa risk and cognitive/neurolgical problems later in life. I’m left hoping that this metastudy is flawed and the associations are artificial.

            Thanks again for the pointer.

            1. Sure, but keep in mind that there are other meta studies too. They conflict a lot so its hard to get to the bottom of it. Just go on PubMed and you can search them and try to figure out which are the best sources, best studies, etc.. Anyway, its all about tradeoffs, I think. There’s no free lunch!

          1. Right – still searching for a “consistent lunch”. I think I’ll pick brain health – can’t surgically remove a brain. Question is, how much DHA is really needed and how can one best achieve that…. open questions.

    4. Robert, my suggestion would be to go see a functional medicine physician. Find one at The Institute for Functional Medicine. EVERYONE is an individual biochemically, and these are the guys that will sort out what will work best with YOUR individual gene snps and find out what is right for YOU. Dr. Greger and other diet doctors, whatever their biases, can only give generalizations. But these fellows (and ladies) trained in functional medicine are pros at what they do. Worth a shot!

    5. High triglycerides are a sign of a Niacin deficiency. People can take 2 or more grams of Niacin. I personally think any blood lipid problem is a result of a Nitrogen deficiency and your liver is trying to feed your mitochondria. You should try Niacin in Orthomolecular doses (up to nausea). I have mood disorders and it could be a Niacin deficiency. For your prostate, you should consider Boron (Kiwi), K2, and Phosphorus (from pumpkin seeds, dark cola, or other source). Most food is heated, milled, and soaked.

      1. Mr. Smith I’ve had to dig through many of your short and oddly disconnected comments here to find your “boron/prostate” connection. It appears that you have a very narrow approach to ailments in general. It’s the reductionists’ approach where every little thing can be fixed by digging out every little isolated related thing. NOthing works in isolation. We are a magnificent symphony of chemical/elemental/electrical/energy composition, complete with onboard microorganisms facilitating many processes. Food is the answer and it’s WHOLE, not the parts and pieces that matter. Every time you reduce a food to elemental components you are necessarily eliminating co-elements. Thousands of years of mankind evolved without such silliness and I choose to pursue that dietary regime, not one filled with pills and potions.

  8. Thank you Dr Greger for a great clip, I’ve been a bit suspicious about the Inuits tales. But what about the other benefits that are attributed to Omega 3, like better mental capabilities, and better vision in newborns (you posted a clip about it)

  9. The next China Study should be done in Vietnam. In Japan, they showed a documentary on the burgeoning problem of type 2 diabetes in Vietnam in recent years due to dietary changes. At a major health clinic, they used to see an average of about 100 type 2 diabetes patients a day, and now it is over 1000 such patients. Dietary changes (for the worse) are to blame, as the documentary goes on to show middle-class and younger Vietnamese consuming more animal products and Western foods like pizza and burgers. Since Asian cultures value taking meals together, the parents and grandparents are affected by these changes as well. A grandfather was shown saying he eats American foods like pizza and burgers regularly now since those are the types of foods that his grandchildren enjoy eating. Very sad.

  10. Wondering if you are familiar with the work by Brian Peskin or read his book the PEO solution. He is being called by many the authority on essential fatty acids. After reading his book, which actually made so much sense, at least in regards to the Omega 3’s and 6’s I have become a big fan of his. I don’t agree with all that he speaks of as he is still a meat eater but after co-writing this book with Dr. Rowen, a raw food vegetarian/mostly vegan he has come to the conclusion that less meat is better. I would love to hear you thoughts, on his science regarding our need for daily intake of unadulterated Omega 6 in greater proportion than daily omega 3. So many people, doctors, health experts etc. still think too many omega 6’s are the enemy and he says that is wrong. He claims we are getting to many “adulterated” omega 6 from plant seed oils from processing and that is what is harming us when in fact what we need is plenty of “unadulterated”, pure omega 6 due to the fact that all of our cell membranes are made of 30% omega 6, of which transfers oxygen from the blood stream into the cell. By replacing the adulterded “clogged up” omega 6 membranes with pure omega 6’s there is increased oxygen transfer across the cell membrane as well as other hormones etc. thereby decreasing inflammation, cancer and many degenerative disease. Please comment if you are familiar with his work and what your opinion is as I have for 3 months been on a product of pure plant seed oils and have seen so many incredible results within myself and friends that prove its anti-inflammatory and anti-aging power.

    1. Kim – Peskin is a total fraud. Look it up. He is not a scientist.

      “Brian Peskin has a permanent injunction against him from the Attorney General of Texas because he misrepresented his credentials and made illegal medical claims for supplements

      Permanent Injunction against Brian Peskin

      IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that Defendants Perkins Management, Inc., dba Maximum Efficiency Products, and Brian Scott Peskin, their successors, assigns, officers, agents, servants, employees, attorneys, and any other persons in active concert or participation with them who receive actual notice of this order by personal service or otherwise shall be permanently restrained from engaging in the following acts or practices:

      16. Representing, expressly or by implication in any labeling or advertising of food products, that such products will mitigate, treat, cure, or prevent specific classes of diseases, as well as performing any role in the human body’s response to a disease, which subjects such products to regulations as a drug;

      17. Labeling and advertising products of any kind as drugs without prior FDA approval;

      20. Introducing or delivering for introduction into commerce any new drug without a new drug application being approved by the FDA as required by TFDCA § 431.114;

      25. Including health claims on the label or in labeling that expressly or by implication characterize the relationship of any substance in a food product to a disease or health-related condition other than those which are complete, truthful and not misleading in regard to the product and have been approved by the FDA;

      26. Representing expressly or by implication, in any advertising of any product, that Defendant Brian Scott Peskin is a “Professor,” or “Doctor,” or that Brian Scott Peskin is the “holder of the Emeritus Life-Systems Engineering Chair, College of Pharmacy and Health Sciences at Texas Southern University;”

      28. Exaggerating, expressly or by implication, the credentials, expertise, or educational background of Brian Scott Peskin or any other person, employee, associate, or agent of Defendants associated in any way with the manufacture, production, marketing, distribution, or sale of any food or drug related product;

  11. To paraphrase Walter Sobchak from the The Big Lebowski, “Also, Dude, ‘Eskimo’ is not the preferred nomenclature. Inuit, Inuinnaq or Inuktitut, please.” :-)

  12. I don’t know if it matters so much to this discussion, but I believe that the strokes among Eskimos are largely hemorrhagic (bleeding) rather than ischemic (clot). Fish oil affects bleeding factors. Also, I believe I read once that the Inuit who stuck to ancient ways and ate raw fish did not have the same vascular risk because the lipase in the fat was not damaged by heat. I wish I could remember my sources.

  13. Give me a break! Omega 3’s are an essential fatty acid. And it is needed in the [anti-inflammatory] prostaglandin pathway. The fact that the frigid climate in which the Eskimo’s lived did not provide them with fruits and veggies does not mean that Omega 32 fats are not a necessary part of the diet. And Dr. Greger himself suggests a vegan Omega 3 supplement. Most people do not make the conversion well from the parent Omega 3’s to EPA and DHA.
    Again, Give me a break!

    1. You can have as big a break as you want, Linda, but what is your point? And what are Omega 32 fats?

      Yes, we know about essential fatty acids. The question is how much ALA and LA are needed and where can they be obtained from.

      Dr G’s point is that the traditional Inuit diet high in fish, flesh and fat does not prevent cardiovascular disease or deliver long life and good health. And that fish oil supplementation is apparently ineffective in preventing heart disease. If you have any evidence to the contrary why not present it here?

      Unfortunately there are people running around selling books and operating websites who tell us that cholesterol and fats are needed by the body and therefore the more we eat of them the better. It’s obviously false reasoning. Iron, selenium, copper and water etc are all needed by the body also but consuming too much has dire health consequences.

      PUFAs like Omega 3 and 6 are important and, certainly, in experiments replacing saturated fat with PUFAs has resulted in declines in mortality. But how much is healthy?

      1. Omega 32 fats are a typo, of course. Omega 3 fat’s ARE helpful in preventing heart disease because they fuel the Omega 3 -inflammatory prostaglandin pathway. The Eskimo’s diet lacked fruits and veggies due to the frigid inhospitable environment in which they lived. Their diet was not one of choice. The fact is not that Omega 3’s don’t help in cardiovascular disease (through lowering inflammation) because there is too much evidence that in fact they do. The imbalance is what is at the heart of the Eskimo’s diet. As you note cholesterol and fats are needed by the body, but that does not mean that the more one eats of them the better…to the exclusion of fruits, veggies, Same with iron, copper, water etc. as you also note. But that is not the way the video is presented (although if one looks past what appears to be an intent at misrepresentation, you can see through it all). The video and the comments appear to be meant to persuade one that oils from fish (a horrible animal thing again!) have no value in preventing cardiovascular disease because the Eskimos still came down with it. Poppycock!

        And if you bother to read my other posts, no flax or flax oil for me as it contains cyanogenic glycosides which I cannot detox at all, and all vegan EPA DHA supplements contain glycerin, soy derivatives and other intolerables for me. Plus the conversion rate for Flax to EPA and DHA is 7 to 1. One has to take a lot of flax oil to fuel those anti-inflammatory prostaglandin pathways, and that is even if the conversion enzymes are working, which they are not in a lot of people. Cannot eat the actual fish either due to other medical problems.

        The bottom line is that Omega 3’s are essential fats and we cannot live without as humans cannot synthesize them, and they do help in preventing cardiovascular disease…when in balance with all the other nutrients….which the Eskimos, sadly were not in position to obtain.

        1. Thanks for the lengthy response Linda but your comments are still puzzling. For example you state “The bottom line is that Omega 3’s are essential fats and we cannot live without as humans cannot synthesize them,”. This is not correct. Only one Omega 3 fatty acid (alpha-linolenic acid – ALA) is essential. The other two can be synthesised by the body. ALA is only found in plants. Good sources of ALA include walnuts, flaxseeds, soybeans (including tofu), pumpkin seeds and chia seeds. None of these links below are to scholarly references but I think they are adequate

          You also do not appear to understand what the video is saying. As I wrote previously, Dr G’s point is that the traditional Inuit diet high in fish, flesh and fat does not prevent cardiovascular disease or deliver long life and good health. And that fish oil supplementation is apparently ineffective in preventing heart disease. And I think that your claim “although if one looks past what appears to be an intent at misrepresentation, you can see through it all” is both incorrect and unfair. In fact, Dr G is not presenting a radical argument here. Even Wikipedia notes ” Dietary supplementation with omega-3 fatty acids does not appear to affect the risk of death, cancer or heart disease.[3][4] Furthermore, fish oil supplement studies have failed to support claims of preventing heart attacks or strokes.[5][6][7]”

          1. We will just have to agree to disagree here. And I understood the video perfectly. I believe you did not. Yes, the body can synthesize EPA and DHA from ALA which IS the parent Omega 3 fat. But only if the enzyme that makes the conversion is working properly, and in too many people it is not. Plus the conversion rate is 7 to 1, meaning it takes 7 parts of ALA to convert to 1 part EPA. That is a lot of flax oil…if the conversion is even being made.

            But just giving isolated fish oils in some study or other without regard to all the other factors involved is pointless.

            i do not consider wikipedia an authority on this issue. in fact Wikipedia has repeated been shown to be biased when it comes to alternative medicine

            It is obvious we are going to disagree so I won’t be responding further.

            1. As you say, we will just have to agree to disagree. I believe you have misrepresented what is in the video. It is also clear that you do not understand the difference between Omega 3s and essential fatty acids if you still persist in maintaining that all Omega 3s are essential fatty acids. I note too that you nevre provide any supporting evidence for your claims
              I also don’t understand why you keep talking about flax oil. Dr G does not advocate the use of oils. He advises consuming ground flax seeds, chia seeds etc.

  14. Perhaps the increase in atherosclerosis is due to the high rate of smoking among this population group which would negate the beneficial effects of omega-3 fats. Their use of tobacco was seen by the first European explorers in the 1700’s. Their current rates of smoking is considered to be 4 to 6 times higher than the US population.

      1. Source of this highly unlikely information please. Also the “food pyramid” is an utter joke promulgated by the USDA and WORLDFOODINC.

  15. “[Eskimos]… don’t live particularly long.” This is true; Eskimos have the lowest life expectancy of any group in North America. However, is it due to cardiovascular disease as implied, or is it because of harsh environmental conditions, primitive living conditions and infectious diseases and a lack of available medical treatment and a high rate of infant mortality?

  16. There is the unique alimentare integrator with Oil Fish in the world complet with 8 fat acids omega-3.I Take it from four years and is the best the quality is diference.You ca-n SEE details to – ID – 47- 615009

  17. This raises a good question about supplements. First, I checked my Omega 3 supplements and they smelled of bad fish and tossed them. And this raises the question about other supplements. I am 69 and a competitive power lifter. I lift on average 4 days per week and do high intensity interval training on an elliptical two days. I have been taking as supplements COQ10 (which my cardiologist recommends), Amino acids Glutamine and Arganin, branched chain amino acids, and creatine monohydrate. I consume a predominantly vegetarian diet. Any thoughts on whether or not I am wasting my money? I would appreciate hearing back on this. Thanks.

    1. From same:
      19.1. Mercury in Fish and Fish-based Supplements

      Although there are numerous toxins associated with fish consumption, mercury is the one at the forefront of concern due to its correlation with omega-3 intake in fish[668][219] and its adverse effects on child cognition when consumed by pregnant mothers, as mercury can pass the placental barrier[669] and reach the child; as assessed by umbilical cord exposure.[670] Other toxins do not have as strong a correlation in children, such as PCBs and Dioxins[671] and although a concern, are less of a concern relative to mercury.

      Additionally, mercury just has an adverse pharmacokinetic profile. When fish is cooked, the methylmercury binds to meat proteins[672] and 95% of ingested mercury is absorbed within 2 days[673] where it persists in the body for 70-90 days.[674]
      No thank you. I will just stay with the naturally high levels of omega-3 fats found in a WFPB diet. YMMV

  18. The findings, published online in the journal JAMA Internal Medicine, are the first to emerge from the university’s multimillion-dollar
    Adventist Health Study-2 investigation that links diet to specific forms of cancer.

    The study, which tracked the food questionnaires and medical records of 77,659 Seventh-day Adventists over seven years,
    determined that vegetarians are 22 percent less likely to develop colorectal cancers than non-vegetarians.

    Of those vegetarians, vegans were 16 percent less at risk of cancer, and lacto-ovo vegetarians, who eat milk and eggs, were
    18 percent less at risk, although results for these groups did not achieve statistical significance.

    The least at risk of the vegetarian groups were the pescovegetarians, or vegetarians who eat fish. They were 43 percent less
    likely to develop cancer.

    A majority of MS patients on a largely plant diet with significant added fish actually achieved improvement in MS symptoms, see “Overcoming MS”. Brain cell walls are made of fats omega 3 soft, and flexible omega 6 hard and sticky and evoke immune response in MS.

    We dither between wild caught fish low on the food chain like sardines vs. farmed algae.

    1. Apparently, another Adventist study published a few weeks ago showed that men on a totally vegetarian (“vegan”) diet had the lowest prostate cancer risk:
      ‘Dr. Gary Fraser, the director of the study, told the Adventist Review on Tuesday. “If you are not vegan, be aware that the lacto-ovo diet and the pesco-vegetarian diet did not give evidence of protection when compared to non-vegetarian Adventists.”’

  19. They probably had an Iodine rich diet. Iodine, or the dipping or dropping agent, greatly reduces heart attack risk, in my opinion. Take Iodine with some preparation, without your heartbeat some people could go into shock. I personally think any diet that is believed to be plant based is a myth. Almost all people ever asked about diet were always eating mostly, if not entirely, meat. I would love to eat more plants to please health. Even now, the number of people who eat a plant based diet is extremely small, and might be shrinking. Your advocacy for plants is legendary.

    1. I had and have serious delusions of prosecution. They happen every half hour on the :15, and :45. I believe this might be a Phosphorus deficiency. I started drinking one can of full sugar can of dark cola everyday. It seemed to go away. I suppose I could also eat pumpkin seeds or drink bone broth. One expert said bone broth is good for osteoporosis and cancer.

      1. I’d be very careful about the opinions of “experts”. There are millions of self-appointed experts out there opining away on all sorts of things from auto-urine therapy to homeopathy. As a result, I now like to see the evidence reported in credible peer reviewed scientific publications before even considering taking their opinions seriously.

  20. Hello,
    Thank you for the Video.

    I got a question and do not find an answer.
    Whats the deal with histamine and fructose intolerance. I got both. So i can not eat many of the powerfull Plants.
    Is there any science to reverse it?
    I know many People like me with the same problems.

    Thank you

      1. Hi, i got the typical reactions from both:

        diarrhea, nausea, vomitingdiarrhea, nausea, headache , stomachache and some more.

        diarrhea, nausea, vomiting
        diarrhea, nausea, vomiting
        diarrhea, nausea, vomiting

        1. Well that sounds awful. I don’t know anyone with that reaction from eating fruit. You know “many” people with the same problem? Wow. Hopefully someone else has come across this before and has an answer.

  21. Dear Dr. Greger and all, do you have any video reviewing the scientific evidence around the intake of vegetable ALA from flaxseeds (for example), and the rate of conversion? In other words, what is the evidence that those not eating fish or taking fish oil can have an healthy intake of omega3 and properly convert it? I know that it’s a quite complicated matter because it depends on the overall intake of omega-6 , but it would be useful to have a video on this. Thanks for the excellent work!


          “This meta-analysis is consistent with a lower risk of heart failure with intake of marine omega-3 fatty acids. These observational findings should be confirmed in a large randomized trial.”

          Meta and Systemetic review:

          “Available observational data indicate moderate, inverse associations of fish consumption and long chain omega 3 fatty acids with cerebrovascular risk.”

          A meta-analysis of randomized, double blind, placebo controlled trials:

          Overall, our results supply evidence that long-term effect of high dose omega-3 fatty acid supplementation may be beneficial for the onset of cardiac death, sudden death and myocardial infarction among patients with a history of cardiovascular disease.

          What I mean… there is more to it then just feel pitty for the people that do want to eat fish for their health and think they’re just uninformed.

          1. JH your articles show what this video says. Isolating out the omega 3 is not the same as eating the fish. And the articles don’t talk about how tainted the fish are we eat. And of course that is a concern.

            1. Your middle posted article:

              What this study adds

              Observational findings in this meta-analysis show that consumption of both fish and long chain omega 3 fatty acids may modestly reduce the risk of cerebrovascular diseases
              However, currently available evidence from long chain omega 3 fatty acid supplementation trials, based on both primary and secondary prevention studies, do not support the observational evidence
              The beneficial effect of fish intake on cerebrovascular risk might be mediated through a complex interplay among a wide range of nutrients commonly found in fish

              1. Cool stuff, thanks.
                I’m not a big fan either for concetrating stuff (also not fish oil), even concentrating carotene from healthy carrots seems dangerous for cancer risk, while eating it from carrots is beneficial against cancer.

                1. And what is most interesting is all the articles you posted said more “RCT” needed.

                  I do occasionally take an algae omega 3 if my skin feels dry. I don’t know but I have this crazy thought it might help?

                  But I am not at risk for heart disease. WFPB and I run. Can’t beat that combo?!

                2. I won’t be able to link the full systemic review Dr Geger listed above but here is the conclusion and probably states best the current issue regarding supplementation.

                  “Conclusion Overall, omega-3 PUFA supplementation was not associated with a lower risk of all-cause mortality, cardiac death, sudden death, myocardial infarction, or stroke based on relative and absolute measures of association.

                  Treatment with marine-derived omega-3 polyunsaturated fatty acids (PUFAs) for the prevention of major cardiovascular adverse outcomes has been supported by a number of randomized clinical trials (RCTs) and refuted by others.1- 5 Although their mechanism of action is not clear, their postulated effect on cardiovascular outcomes may be due to their ability to lower triglyceride levels, prevent serious arrhythmias, or even decrease platelet aggregation and lower blood pressure.6 Current guidelines issued by major societies recommend their use, either as supplements or through dietary counseling, for patients after myocardial infarction (MI),7,8 whereas the US Food and Drug Administration has approved their administration only as triglyceride-lowering agents in patients with overt hypertriglyceridemia,9 and some (but not all) European national regulatory agencies have approved the omega-3 administration for cardiovascular risk modification.10

                  The controversy stemming from the varying labeling indications causes confusion in everyday clinical practice about whether to use these agents for cardiovascular protection. Systematic reviews and meta-analyses of RCTs published in the field add further to the existing controversy because they report conflicting findings6,11- 16; other than the emergence of new evidence, reasons include the appraisal of a single outcome, the inclusion of double-blind–only RCTs, the inclusion of supplements only, or the exclusion of populations with specific clinical characteristics.

                  In the present study, we attempted a large-scale synthesis of the available randomized evidence under 1 updated systematic review and meta-analysis to determine the association between omega-3 PUFAs and major patient-important cardiovascular outcomes.”

    1. That is a single article from 2008 in a pretty obscure journal. Larger, more recent meta-analyses/systematic reviews published in highly credible peer reviewed professional journals have found no benefits from omega 3 supplementation. See Dr G’s “sources” above and eg

  22. This is my first post and I’m not sure if this is the correct place to put my questions but… I’ve been using the Daily Dozen app and love it. Just wondering if the tablespoon of flax seeds is supposed to be measured then ground, which gives you considerably more than a tablespoon, or ground then measured? The other question is, are the recommended servings of any particular item just a minimum? I’m having a hard time limiting myself to three servings of whole grains. And at first I could barely gak down two cups of greens but now I regularly do four and enjoy them. While three servings of beans per day is hard for me to achieve.

    Are these topics already covered somewhere that I can read the previous comments?

    1. Larry T: Welcome to the forum! I hope others will also jump in to answer your questions. Here’s what I know: Someone else asked a similar question about the daily dozen. Are those recommendations minimums? Maxiums? Dr. Greger’s reply was that they were “targets.”
      That said, I think some of those categories could easily be seen as minimums as long as the person was getting plenty of the other categories. For example, as long as someone is getting plenty of fruits, grains and beans, I can’t imagine that having extra greens would be considered a problem–as long as one is not eating above overall calorie needs.
      And yet, for other categories such as nuts, one might consider the recommendation to be a maximum target–for most people–since nuts are so calorie dense. They are so easy to overdue. And yet at the same time, someone who is extremely active and needs a large number of calories might need to indulge in extra nuts.
      The point I’m trying to make is that I see Dr. Greger’s recommendations as general guidelines and proportion recommendations that must be adjusted for your particular needs. What do you think?
      PS: I loved your statement about having trouble doing 2 servings of greens, but now doing 4 easily. Good on you!!!! That should serve as inspiration for others too.

  23. The Inuit culture had a different source of omega 3 from harp seal. Canadian explorer Valhjadmir Stefansson on the healthy benefits of the Inuit diet. Have you heard of him? It was a journey of mine to learn more about cultures and their natural diet. Cheers!

    1. Yes, Stefansson is a favourite of the low carb movement although a lot of nonsense is written about what he ate and what the experiment actually showed. Also, he did not spend a lifetime eating this way and chronic diseases like cancer, heart disease, Alzheimer’s etc take decades tt develop. You might want to read some contrary interpretations to those you find on the websites of low carb, high saturated fat enthusiasts. Or in highly sensational fad diet books. Some examples are:

      1. Thanks Tom…having read a lot of this and that. I do prefer to read things directly from the sources. I am also not so pro any one diet and put emphasis on how one feels, real food, etc. Things are not so black and white and many questions I have for people like Stefansson. I feel good about people making their own choices but what confusion exists regarding what to eat, what not to eat, etc. I have no desire to eat low carb although I stay away from the processed carbs (mainly bread) although some organic rye sourdough every now and again is wonderful with some grass fed butter. I do appreciate the share of information, the many comments people share and the response to my comment. If I only had time to write more. Cheers!

  24. I was just reading the Mount Sinai quote about fish oil in your wonderful book “How Not To Die”.
    I switched from my iBook app to your homepage which I’ve saved to the screen, and to my surprise the featured video is on the exact same subject.
    The reason I opened your site was to ask you if the use of algae oil as a DHA supplement is useful or necessary in light of the expose on the uselessness of fish oil.
    According to blood tests, I’m one of those 1/3 to 1/2 of vegans who when eating a good amount of hemp, chia and flax seeds as well as walnuts in my diet, does not efficiently convert short chain omega-3’s into a long chain DHA.
    Is it still advisable for me to spend money on algae oil supplements?

    1. I don’t think that there are any trials showing hard endpoints (ie mortality/morbidity events) and algae oil use.

      However, you might want to follow up some of the references at 14(b) here

      “1.62 g algae-derived DHA per day for 6 weeks increased DHA and EPA in vegetarian men and women. “Consumption of DHA capsules increased DHA levels in serum phospholipid by 246% (from 2.4 to 8.3 g/100 g fatty acids) and in platelet phospholipid by 225% (from 1.2 to 3.9 g/100 g fatty acids). EPA levels increased in serum phospholipid by 117% (from 0.57 to 1.3 g/100 g fatty acids) and in platelet phospholipid by 176% (0.21 to 0.58 g/100 g fatty acids) via metabolic retroconversion; the estimated extent of DHA retroconversion to EPA was 11.3 and 12.0%, based on the serum and platelet analyses, respectively.”

      1. Thanks for your quick response. Since I’m reading this on an ebook on my phone, the pages are numbered differently. The reason is that there’s fewer words on each page and the font size can be adjusted to individual preference.
        Could I trouble you to copy and paste the first line on page 410 that you’re suggesting that I read? I can copy and paste it in the search window and it will take me to the correct page, whatever number that is.

        1. Steve: re: e-book page numbering, that’s interesting.
          The part I’m talking about is in the appendix, “Supplements” You should be able to find it easily. The title of the sub-section is: “Consider taking 250 mg of pollutant-free (yeast – or algae-derived) long-chain omega-3s daily” Good luck.

  25. I think I will continue to avoid fish oil and fatty fish, and get my Omega 3 from plants (but I do take an algal DHA/EPA supplement).

    Dr G has shown here that fish oil is ineffective. A previous video showed that fish consumption is linked to diabetes risk.

    Confirmation that the link between (fatty) fish consumption and diabetes risk may indeed be causal came from a study published a year ago in the AJCN:

    “Increased ectopic fat accumulation, which is the storage of triglycerides in nonadipose tissue such as liver and muscle, is associated with reduced insulin sensitivity and other metabolic disorders (1–3). Nutritional studies have revealed that the ectopic fat content can change rapidly and is affected by diet composition. The consumption of a high-fat diet ≥3 d increases intrahepatic lipid (IHL)4 (4, 5) ….In this study, we showed that a single HF meal led to an increase in IHL as measured by using in vivo 1H-MRS at 3 T. The observed increase in liver fat occurred during the first 3 h after the meal, and the IHL concentration remained elevated after 5 h.”

  26. I wonder if the practice of the old people floating out to sea when “ready” to die had any effect on the research on heart disease among these Eskimo people. I doubt they ever checked those folks.

    1. Yes, of course. That is why it is know as an essential fatty acid. It is required by our bodies, and our bodies cannot synthesize it. We must get it from our diets.

    2. Although foods derived from plants and animals may contain some of the same components necessary for human health, it has become quite obvious that plant sources are superior in nearly every single case. Plant sources usually contain a host of known substances necessary for health that tend to work in concert with the other components of the plant material for supreme efficacy and health in the human species. Because some animal source of a substance proves to be harmful or irrelevant, does not mean that we do not need the substance from a more natural source.

  27. I started the journey towards eating a whole food plant based diet entirely out of concern for my own health. I then progressed in my understanding to the realization that the practice of raising animals for human consumption had profound negative impact on the food security of the impoverished while simultaneously causing a devastating and unsustainable environmental catastrophe. Now when I consider meat, all I can think about is the callous indifference, brutal cruelty and unspeakable violence done in the systematic slaughter of billions of sentient creatures as our civilization practices a global multi-species slavery and genocide. We are swimming in an ocean of blood, and it will destroy us if we do not give up this abominable practice.

    1. Bill G.: I finally got around to watching this video. It’s a *great* summary of the Eskimo/Inuit diet on health. The bit on breast milk is shocking. Thanks for the link!

  28. The Eskimo diet is appalling and very unhealthy.

    However purified fish oil ( not only has clear benefits but the pathway it uses to reduce inflammation is clear and reproducible. A lot of studies claiming to show that fish oil has no benefit are using sub-therapeutic doses or even placebo level doses. Dr Sears ( has covered a lot of the so called research and shows where they are faulty.

    You also say “Thankfully, there are now pollutant-free (yeast- and microalgae-derived) sources.”. I would be delighted to try them but you don’t give any links. The only one I’m aware of was the algae derived DHA from so if you have others please list.


    1. Dr Sears makes money selling fish oil (and books promoting fish oil) and therefore has a conflict of interest on this matter. There is certainly room for legitimate debate on this issue but to argue that all such trials used sub-clinical doses is improbable if convenient.

      You could check out the various vegetarian DHA/EPA products available through the iherb website

      1. I’ve never said “all” trials were done that way. Enough have been to make me suspicious and whenever I hear some negative study on fish oil I always wait for the rebuttal and then decide. Both Dr Sears and have done some very good rebuttals on studies that supposedly show fish oil not to work. For 3 examples:

        Yes they do make money selling fish oil. They also provide funding in the tens of millions for inflammation research and life extending therapies.

        I’m currently of the opinion that purified fish oil in the right amount does help. We know the pathway of various inflammation factors and we know how purified fish oil stops them.

        1. Thanks for the links. I’ve been a member of LEF for 5 years or so and, yes, many of their articles are very well researched. But the fact is that both they and Dr Sears have a real conflict of interest. They do recommend fish oil and their articles are well researched and plausibly argued. On the other hand, both of them pretty much have to reach the conclusions that they do, don’t they?

          What I personally find more convincing is what credible health authorities without conflicts of interest conclude from the evidence. While there’s certainly plenty of room for legitimate debate here, personally I gave up the fish oil supplements some years ago. A whole food plant based diet is inherently anti-inflammatory anyway but I now use chia, walnuts, ground flax seeds and a vegetarian DHA supplement. But that’s me.

          Anyway, good luck to you.

  29. Health, what an interesting hope. What I’ve seen and experienced after 60 years on this planet is:
    1. Keep the calories low, by either sticking to the “one serving” approach, or by skipping a meal.
    2. Lots of plant based foods, and especially those with higher fiber.
    3. Moderate to light exercise.
    4. Very, very moderate drinking alcohol and no smoking.

  30. New article with SOME correlations between how much fish people eat in nursing homes with and only with the ApoE4 gene and lowered risk of Alzheimer’s plaques at time of death:
    Thought it was interesting that alpha linoleic acid consumption also had clinical benefits (less strokes), the article failed to mention alpha-linoleic acid comes primarily from plants while long chain FFA comes from fish.
    Finally, fish oil was found to do: nothing.
    Thoughts on article?

  31. Great vid but key thing Confusing..debunking fish oils…ok (I’m long-time vegan)..until at the end, seems to debunk ALL (including vegan) omega-3, at 3:12 “To date more than 5000 articles have been published on the alleged beneficial properties of omega three fatty acids” which was based on a “questionable hypothesis” but here the article Dr. G. cites is, as seen in the quote, debunking not just fish oils but ALL “omega-3 fatty acids” so does this mean vegan omega-3s are not recommended either?

    And yet from Dr. G’s website this 2011 page “”2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations” which says “updated 2/4/16” so I assume current, but they recommend “250mg daily of (vegan) long chain omega 3″….so therefore contradicting statement in the article in this video claiming that benefit from ANY “omega three fatty acids” (not just fish based) are a “questionable” recommendation…the quote at 3:12 is wrong then in dismissing all “omega 3s”??

    1. H Barzilai: This video is about the relationship between heart disease and omega 3s. And it appears that there is no such relationship. However, that doesn’t mean that algae-based omega 3s can’t be helpful in some other way. And sure enough, in Dr. Greger’s new book, How Not To Die, Dr Greger says on page 410 that there is a question about whether taking algae-based omega 3s might be good for brain health. Until we know more, Dr. Greger does recommend taking such supplements as a precaution. Does that make sense? Or am I not understanding your question?

  32. Omega-3’s from marine algae (what the fish themselves eat) might be a good choice. The MIDAS study showed that 6 months of algae-based DHA supplementation improved learning & memory nearly double that of placebo. The AHA’s journal “Circulation” stated in March 2015 that fish oil may not benefit everyone equally due to differences in our ability to process it, variability in supplement quality, and the how long we’ve been taking it. It also stated that omega-3 oils decrease triglycerides, lower blood pressure, improve cholesterol by increasing HDL and decreasing LDL, improve endothelial function, reduce blood clotting, decrease stroke and heart failure risk, reduce cardiac arrhythmias, and reduce inflammation that can damage artery lining (leading to atherosclerosis). Dean Ornish, MD (himself a vegan) recommends omega-3 oils from marine algae or phytoplankton. His website: “Omega-3 polyunsaturated fats (EPA/DHA) are essential to maintaining good health and have many proven health benefits. Omega-3 is vital to our immune system, brain development and cognitive function, and prevent inflammation.” It states that our bodies must convert the Omega-3’s in nuts & seeds into EPA/DHA, and that this conversion rate is very low (5% or lower)- hence the recommendation to take algae or phytoplankton-based Omega-3’s. Thanks Dr. Greger for this interesting conversation!

  33. Wow, this definitely contradicts what I was taught in my Anthropology courses in college. Such a shame that so many things get taken for granted as fact. Reminds me of the fears of soy and wheat (beyond those who are allergic).

  34. To me this is irrefutable. But when I tried to post it on in answer to someone pushing the Eskimo myth, I got this answer. How shall I answer her?

    “A far better source contradicts your assertion. Probably the best epidemiological studies are published by the International Epidemiological Association in the peer-reviewed International Journal of Epidemiology, published by the Oxford University Press. In the study by Peter Bjerregaard (Danish Institute for Clinical Epidemiology) et. al., epidemiological studies of mortality from ischaemic heart disease (IHD) and prevalence of coronary arteriosclerosis were found to be low in Inuit populations in Greenland despite an average consumption of marine mammals and fish of 28 meals per month. Even as the diet has become increasingly Westernized, they note in their conclusions “In spite of an increased westernization of the Greenlanders’ lifestyle and a high prevalence of several cardiovascular risk factors, mortality from IHD is still low.” Here’s a link to the full article if you’d care to read: ije-oxfordjournals-org/content/2…”

  35. I noted previously that someone on Quora was arguing against this view, but I just noticed that the study they cited was only comparing Eskimos with the non-Eskimo population in the same regions, such as Alaska, Denmark and Canada. Here’s how I answered them: This study is just comparing Eskimos with non-Eskimos in Denmark, Canada and Alaska, three regions where fish consumption is also high. While noting that fish is healthier than red meat or cheese, Joel Furhman, M.D. recommends not having fish more than twice a week and preferably less, because of the pollution it contains. If you do eat fish, he says that flounder, haddock, sole, scallops, sardines, trout and salmon are much safer than large fish that have had time to take in a lot of mercury and store it in their fat tissues. Fish to avoid include bluefish, marlin, mackerel, swordfish, sea bass, shark and tile fish. By the way, we store mercury in our fat tissues too. Mercury consumption, says Dr. Furhman, is associated with dementia, breast cancer, high blood pressure, mental disorders, endocrine diseases and heart disease.

    1. Hi Clare,
      Thank you for the cultural sensitivity reminder.
      I’m not sure, but my guess is that Dr Greger used that word because most of the studies he was citing used it. Not that that makes it right, but given that his main goal is to bring us the science it’s likely easy to pay less attention to outdated cultural biases. I’m sure he had no intention of offending and will keep this kind of thing in mind in the future.

  36. Omega 3 Fish Oil is really work for the human body? I find enough blog & article about this. Some times I Can’t understand the original things. As per authoritynutrition I showed some knowledge about this topic. If possible any one can give the proper idea or share.

  37. I see the point that omega 3 may not be the miracle cure. There is a point related to omega 3 that I have not seen discussed in the videos, even those on inflammation. Omega 6 are regraded as inflammation promoters. It is also suggested that a balance between the intake of omega 3 and 6 may be a good strategy to manage the inflammation promoting role of omega 6. I have arthritis so I care about inflammation. What is the evidence on those issues?

    1. Andre,

      It’s an interplay between the oils, not exclusively a singular approach, even with arthritis. Take a look at the studies with balancing the oils at: ( essentially arguing for a higher 3/6 ratio) or ( a study on the effects of omega 3 elevation and decreased inflammation and depression)

      Having arthritis you might consider doing some of the advanced testing of your blood lipid levels for the omega 3,6,9 series. Commonly available, ask you clinician.

      Dr. Alan Kadish moderator for Dr. Greger

  38. Eating fish oil capsules is not the same as eating sardines. Eating vitamin pills is not the same as eating fruits, vegetables, and grains. Processing removes nutrients.

  39. we still need omega 3’s in our diet correct? is this saying that we still need all these fats such as omega 3 and 6 but fish and fish oil/supplements are not the way to get them?

  40. The Eskimos, just like other groups isolated from the influence of the Western diet mainly refined carbohydrates and sugar did indeed have low rates of cardiovascular diseases, diabetes, cancer,etc. Eskimos’ sugar consumption in late 1800 and early 1900 was about 6 g per day (same as the Japanese till 1950) in comparison to 1930 where that increased 25 fold to 150 g per day. Studying the Eskimos, or any other isolated group, already influenced by westernization and consuming the same amount of refined carbohydrates as the rest of population or more, in combination of high calorie diet already, will not doubt have negative results seen in the majority of the western world.

  41. I had been taking two high quality fish oil pills daily and my C-Reactive Protein was 0.3mg/L which as you know measures heart inflammation. This is where you want to be. My UCSF cardiologist told me that fish oil had no beneficial effects for heart health and told me not to waste my money on it. As a test, I went off of them for five months and my C- Reative protein went up to 2.0 which is considered moderate and not good. So, after I saw my cardiologist to review my labs I told him I was going to resume taking my fish oil pills. When I had my labs done again six months later my C-Reactive protein was back down to a healthy 0.4 mg/L. It is my understanding that heart inflammation is a major contributor to heart disease so one would want it very low. So, I will keep taking fish oil pills. I want to believe that Dr. Greger has come to his views based on research and thinking outside of the box, but now I will question what he says is scientifically proven. What a bummer. I was ready to embrace him whole-heartedly.

  42. Hi this is Dr. Daniela Sozanski PhD in Naturopathy in Atlanta GA and Moderator of Nutritionfacts.
    No, please embrace him wholeheartedly he is an awesome man with his life dedicated to the help of others. I am personally a fan of the fish oil and I believe it does work miracles in many aspects of health, including C reactive protein and high blood pressure, also in overall inflammation in the body. Here we are talking a philosophy of plant based versus not plant based nutrition. The good doctor would favor and with good reasons freshly ground flax seeds for their high content in fatty acids, the highest in the plant world. They work just as well and I do use them just as well. Nuts and seeds also work. You are doing great. And ask your cardiologist next time to show you the studies proving that fish oil/fatty acids don’t work. I hope this helps, Daniela

  43. I share this particular video often, just today even, when I received the following message after posting about the health benefits of a plant-based lifestyle. “hen explain to me why the Eskimos use to live to over 100 yrs old eating no carbs and a diet that consisted of seal fat whale blubber and protein until about 80 yrs ago man introduced carbs to there diet and now have to same rate of heart disease, diabetes, etc etc…..then it must be the carbs they are eating why don’t you study that…..” Thanks so much for doing the research, so I don’t have to!

  44. But there’s also the issue that the drug companies don’t want us to take fish oul as they want us on statins. Pollution is everwhere including in the soil and air. Mercury in fish can be limited by choosing smaller varieties eg sardines

  45. My dr had me taking 6 1000mg a day for a number of years plus 10 mg Lipitor .
    All my lipids test were good , but recently my GP listened to my heart . I’ve had a murmur
    For years but this time she suggested I get an echo cardio gram
    I just received report today saying I have severe aortic stenosis. WOW !!
    I’ve been feeling tired but I am 80 so that-seemed likely at 80. Now I don’t see cardio dr until oct 31
    And I am very anxious . Read a little , not too good for my age group . I’ve been on this diet about 6 weeks so I guess all I can do is wait and keep eating greens .
    Any ideas I’ll listen .

  46. Hi, Dianalascano! I am so sorry to learn that you have aortic stenosis. A whole food, plant-based diet has been repeatedly demonstrated to reverse this condition, so my advice is to stick with it. You might be interested in these videos, if you have not already seen them:
    I hope that helps!

  47. I go see my cardio doctor tomorrow anyone believing in prayer pray my aorta
    Stenosis is not as bad as I am predicting .
    Thank you I do believe in miracles! Diana

  48. You might want to check on the appropriateness of the term “Eskimo”, as the most common term here in Canada is “Inuit” as Eskimo is a derogatory Cree word, most likely.

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