Potential Pitfalls of Calorie Restriction

Potential Pitfalls of Calorie Restriction
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How to preserve bone and mass on a low calorie diet.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

One of the most consistent benefits of calorie restriction is blood pressure improvements in as short as one or two weeks. Blood pressures can sometimes even be normalized in a matter of weeks, and blood pressure pills discontinued. Unfortunately, this can work a little too well, and cause something called orthostatic intolerance, which can manifest as lightheadedness or dizziness upon standing—which in severe cases can cause fainting. Staying hydrated can help.

What about loss of muscle mass? In the CALERIE trial, 70 percent of the lost body weight was fat, and 30 percent lean body mass. So, they ended up with an improved body composition: 72 percent lean mass, compared to 66 percent in the control group. Though leg muscle mass and strength declined in absolute terms, relative to their new body size, they generally got stronger. Is there any way to preserve even more lean mass, though, particularly among older individuals who naturally tend to lose muscle mass with age?

Increased protein intakes are commonly suggested, but most studies fail to find a beneficial effect on preserving muscle strength or function whether you’re young or old, active or sedentary. For example, researchers randomized overweight older men and women to a normal-protein diet—4 grams for every 10 pounds of body weight, or a high-protein diet—about 8 grams per 10 pounds, during a 25-percent calorie restriction. That doubling of protein intake had no discernible effect on lean body mass, muscle strength, or physical performance. Most such studies found the same lack of benefit. But, put them all together, and one can tease out a small advantage, about a pound or two difference over an average of six months. Unfortunately, high-protein intake during weight loss has been found to have profoundly negative metabolic effects; for example, undermining the benefits of weight loss on insulin sensitivity. Lose 20 pounds, and you can dramatically improve your body’s ability to handle blood sugars, compared to a control group that maintained their weight. Lose the exact same amount of weight, but on a high-protein diet, getting about an extra 30 grams a day, and it’s like you never lost any weight at all.

Though you can always bulk back up after weight loss, the best way to preserve muscle mass during weight loss is exercise. The CALERIE study had no structured exercise component and, like after bariatric surgery, about 30 percent of the weight loss was lean mass. In contrast, that proportion was only about 16 percent in The Biggest Loser contestants, chalked up to their vigorous exercise program. Resistance training even just three times a week can prevent more than 90 percent of lean body mass loss during calorie restriction.

The same may be true of bone loss. Lose weight through calorie restriction alone, and you experience a decline in bone mineral density in fracture risk sites, such as the hip and spine. In the same study, though, those randomized to lose weight with exercise didn’t suffer any bone loss. The researchers conclude: “Our results suggest that regular [exercise] should be included as part of a comprehensive weight loss program to offset the adverse effects of [caloric restriction] on [the] bone.“ You can never argue with calls for increased physical activity, but even without an exercise regimen, the “very small” drop in bone mineral density in the CALERIE trial might only increase a 10-year risk of osteoporotic fracture by only about 0.2 percent. The benefits of calorie restriction revealed by the study—improved blood pressure, improved cholesterol, improved mood, improved libido, improved sleep—would seem to far outweigh any potential risks. The fact that a reduction in calories seemed to have such wide-ranging benefits on quality of life led commentators in the AMA’s Internal Medicine journal to write: “The findings of this well-designed study suggest that intake of excess calories is not only a burden to our physical equilibrium, but also [to] our psychological well-being” as well.

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Image credit: Thought Catalog via unsplash. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

One of the most consistent benefits of calorie restriction is blood pressure improvements in as short as one or two weeks. Blood pressures can sometimes even be normalized in a matter of weeks, and blood pressure pills discontinued. Unfortunately, this can work a little too well, and cause something called orthostatic intolerance, which can manifest as lightheadedness or dizziness upon standing—which in severe cases can cause fainting. Staying hydrated can help.

What about loss of muscle mass? In the CALERIE trial, 70 percent of the lost body weight was fat, and 30 percent lean body mass. So, they ended up with an improved body composition: 72 percent lean mass, compared to 66 percent in the control group. Though leg muscle mass and strength declined in absolute terms, relative to their new body size, they generally got stronger. Is there any way to preserve even more lean mass, though, particularly among older individuals who naturally tend to lose muscle mass with age?

Increased protein intakes are commonly suggested, but most studies fail to find a beneficial effect on preserving muscle strength or function whether you’re young or old, active or sedentary. For example, researchers randomized overweight older men and women to a normal-protein diet—4 grams for every 10 pounds of body weight, or a high-protein diet—about 8 grams per 10 pounds, during a 25-percent calorie restriction. That doubling of protein intake had no discernible effect on lean body mass, muscle strength, or physical performance. Most such studies found the same lack of benefit. But, put them all together, and one can tease out a small advantage, about a pound or two difference over an average of six months. Unfortunately, high-protein intake during weight loss has been found to have profoundly negative metabolic effects; for example, undermining the benefits of weight loss on insulin sensitivity. Lose 20 pounds, and you can dramatically improve your body’s ability to handle blood sugars, compared to a control group that maintained their weight. Lose the exact same amount of weight, but on a high-protein diet, getting about an extra 30 grams a day, and it’s like you never lost any weight at all.

Though you can always bulk back up after weight loss, the best way to preserve muscle mass during weight loss is exercise. The CALERIE study had no structured exercise component and, like after bariatric surgery, about 30 percent of the weight loss was lean mass. In contrast, that proportion was only about 16 percent in The Biggest Loser contestants, chalked up to their vigorous exercise program. Resistance training even just three times a week can prevent more than 90 percent of lean body mass loss during calorie restriction.

The same may be true of bone loss. Lose weight through calorie restriction alone, and you experience a decline in bone mineral density in fracture risk sites, such as the hip and spine. In the same study, though, those randomized to lose weight with exercise didn’t suffer any bone loss. The researchers conclude: “Our results suggest that regular [exercise] should be included as part of a comprehensive weight loss program to offset the adverse effects of [caloric restriction] on [the] bone.“ You can never argue with calls for increased physical activity, but even without an exercise regimen, the “very small” drop in bone mineral density in the CALERIE trial might only increase a 10-year risk of osteoporotic fracture by only about 0.2 percent. The benefits of calorie restriction revealed by the study—improved blood pressure, improved cholesterol, improved mood, improved libido, improved sleep—would seem to far outweigh any potential risks. The fact that a reduction in calories seemed to have such wide-ranging benefits on quality of life led commentators in the AMA’s Internal Medicine journal to write: “The findings of this well-designed study suggest that intake of excess calories is not only a burden to our physical equilibrium, but also [to] our psychological well-being” as well.

Please consider volunteering to help out on the site.

Image credit: Thought Catalog via unsplash. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

This is the follow-up to The Benefits of Calorie Restriction for Longevity.

For more on calorie restriction see:

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

147 responses to “Potential Pitfalls of Calorie Restriction

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  1. The smiley plate with the weird-looking eyes does not have eyelashes and eyebrows. Uh-oh….what vitamins/minerals is it lacking?

    This looks like a “However, on the other hand….” video.

    1. YR, Maybe that plate cut back too much on those calories and wasn’t eating enuf plant foods for the vitamins & minerals ;-) I guess I’m fortunate in that I can eat all the plant foods I want and I continue to stay at a normal weight.

  2. Wow, I have it paused at

    High-Protein Intake During Weight Loss Therapy Eliminates The Weight-Loss Induced Improvement in Insulin Action in Obese Postmenopausal Women

    I am wondering if that is animal proteins or all proteins.

    Someone said to me that I was eating too much protein because of all of the beans and lentils I was eating. I have to pause and read the study but it seems likely that they won’t have teased it out. I am supposed to be having the second-meal effect, right? I guess I can be almost comforted that I didn’t lose weight and that my symptoms such as horizontal nail ridges went away, but this makes me wonder if I have to really look at things like that. I used to use sites that kept track but I hated it.

  3. The part of the video about high protein intake during calorie reduction (t= 2:00 to 2:30) appears to be yet another nail in the Keto coffin.

    1. Two great minds,Deb: I posted this comment at the same time you were posting yours (above) and contemplating the same thing.
      I have a feeling that animal proteins are the culprit, but am not sure.

      1. I am really wondering about that.

        Before my cousin started dialysis, he was losing muscle mass and every doctor told him to eat more protein and they were talking animal protein. He is a diabetic and the concept that they could have been making his insulin resistance worse is obvious, but would it still have been worse if he was eating vegetable protein?

        It is an interesting concept because they say that vegans get more protein than other groups.

        1. That’s interesting, since protein isn’t good for the kidneys. I thought people in renal failure are placed on low-protein diets.

          Anyway, I wanted to mention that in the Adventist Health Study-2, animal protein was associated with insulin resistance. Luigi Fontana’s work (and IIRC a video or 2 of Dr. Greger’s) shows that plant protein tends to be low in methionine and leucine, low intakes of which are important for the effects of CR. In fact protein restriction is a CR mimetic. Valter Longo (researcher and advocate of a Fasting-Mimicking Diet) also recommends plant-based proteins.

          1. That is interesting, Peter.

            Yeah, I was talking with him about protein restriction and every doctor that he had was telling him to go up in protein.

          2. “For patients who are in stage 5 and have kidneys that work at less than 10 percent, dialysis is needed to take over for the failed kidneys or until a kidney transplant is possible.

            Dialysis removes protein waste from the blood and a low protein diet is no longer needed. Unfortunately, some amino acids are removed during dialysis. A higher protein intake is needed to replace lost protein.”
            https://www.davita.com/diet-nutrition/articles/basics/dietary-protein-and-chronic-kidney-disease

      2. If the last 100 years of animal feeding trials mean anything , then it does not matter the source of protein . Please read Morrisons Feed and Feeding 1915 edition .
        Carbs plus high quality protein equals fast weight gains , a lot of fat gain .
        Protein plus fat makes huge muscle gains . But like Swarzenegger found out is extremely dangerous way to gain muscle .

        1. I am not sure that animal feeding trials are always relevant to humans.

          For one thing, humans are the only mammals not to synthesise/possess NeuG5c. Consuming it via meat has a range of effects on human health. Whether it affects weight loss/gain I don’t know
          https://nutritionfacts.org/video/the-inflammatory-meat-molecule-neu5gc/

          Therefore I would be cutious about accepting your argument that protein source makes no difference via-a-vis weight loss.

          Certainly it seems to make a difference when it comes to diabetes risk and CVD risk for example
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690061/
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779002/

  4. Can you do a video on the Netflix Show THE MAGIC PILL???
    A lot of craziness is spread there…..I think your intervention would be useful to many.
    Thanks a lot

  5. Thanks Dr G for the practical, encouraging, insightful look at diet details. I really enjoyed this video!

    Hal, I am close to 2 months into my experiment of trying YR’s habit of eating 3 meals, no snacks. At first I was white knuckling it, but now I’m good, and I notice I have been losing weight though I am not eating much less overall. I limit grains, beans, nuts and seeds but I do eat some.

    1. Barb, sounds like what you’re doing ( the “YR” diet) is working for you. As many have said, we all react a little differently to what and how we eat.

      Okay, YR, when are you going to write a book about your new diet? It could be come a NYT best-seller ;-)

      1. You’re too kind, Hal. A best seller? *_^

        However, it’s not really a “new” diet, just one that works for me. Basically, it’s mostly veggies, fruits and whole grains, nuts, seeds, and a small amount of animal foods. Sort of a “this and that” diet, but not too much of any of it.

        As for Barb’s statement, she’s trying not to eat between meals….no snacki-poos. At one time I posted that I haven’t eaten between meals since my late teens or early twenties. As I said, if you have three good squares a day, there’s no need to get hungry between meals. That way we can always look forward to our next meal. :-) (Yay, yummies for the tummy coming up soon!) We are born, we eat, we spend mucho time in the bathroom…. and then we die.

        “Is That All There Is?”

        https://www.youtube.com/watch?v=eAf7HcK10d0

        1. Thanks YR, Deb and Hal! Just wanted to mention too that I am not critical of people snacking… haven’t seen plant docs say anything bad about it either. I was just eating too much unnecessarily and probably out of boredom Plus it was expensive. So, I thought a little discipline wouldn’t hurt… and plus, I’m warming up for a fast. (short one)This video was interesting since they tracked this man’s fat loss, vs lean loss etc. https://m.youtube.com/watch?v=lB0zvbpjWxo

          1. Hal,

            And your mention of “Archibald” reminded me of every kid’s favorite comic book back in the day: Archie Andrews.

            http://archiecomics.com/characters/archie-andrews/

            (And now we have the Royal Archie. :-)

            I posted: “Basically, it’s mostly veggies, fruits and whole grains, nuts, seeds”
            – – – – – –

            How could I leave out legumes? Gotta have my hefty tablespoon of nothing-added peanut butter on something or other every lunchtime! And of course beans and lentils. (Still haven’t made the lentil loaf, but intend to do so.) When I eat out in restaurants I often order a black bean burger if it’s on the menu. Some of them crank out a pretty mean burger. :-)

            1. YR, Yes, the restaurants do carry a very good Black Bean Burger! They are my favorite, too. I don’t like the taste of their other alternative burgers and I haven’t even tried the “Impossible” burger yet, and have no desire to do so.

                1. Thanks YR, I hadn’t seen that before on the Impossible burger. Don’t think I will be eating any “leghemoglobin” any time soon :-)

                  BTW, I do remember Archie Andrews from back in the day. Never could quite understand that Veronica-Betty triad , though ;-)

            2. YR,

              I recently had an excellent black bean burger and I keep thinking about it.

              I haven’t eaten one in years and, honestly, it was probably something like MorningStar and I didn’t like it.

              The one I had the other day was crave-able.

        1. Fumbles, for a while there my “handle” did indeed include the word Latrine — ’twas when you were on sabbatical, so to speak.

          If anybody would know about a latrine diet, I’d think it would be you. Didn’t you once crow how often and how successful you always were regarding your visits to the latrine? Like, zillion of time a day or something. :-D

          1. I think I mentioned once that I had clogged the toilet on several occasions.

            But, nah, I was just trying to yank your chain with that suggestion for a more catchy title for a book.

            On the other hand, bundling your latrine diet book with John Newall’s ‘shit’ book would seem logical. It might just leave you both flushed with success.

            Or perhaps it’s just a crap idea

            1. Just now saw this, Fumbles. Clever lad, aren’t you? So many latrine-like words to fill up your response. Truly am impressed.

              Rather than work on a no-doubt best-selling book of shit, I rawther liked calling myself YR(Latrine) for a while there. Anyhoo, I think John wouldn’t want a co-author….he wants to keep the glory (TV interviews, etc.) all to himself. I still think he should change that title, though. It stinks big time.

  6. I have a video request too.

    I eat an apple a day to keep the doctor away (all except Dr. G.). But even organic apples have a wax-like coating on the outside. If you take a paring knife and scrape the skin you can accumulate a little pile of white goo. According to one package of apples this coating can be either vegetable based or “shellac” based.

    Shellac? Why does that sound like something you should be putting on outdoor furniture?

    Anyway, I’d like to know an effective way to remove this undesirable film from my apples.

    That, and I wanted to make Deb smile. =]

      1. I looked up shellac and it said:

        Shellac is a resin secreted by the female lac bug, on trees in the forests of India and Thailand.

        How could it be more cost-effective to use the resin secreted by the female lac bug?

        How many lac bugs do they have in captivity to fill all of those cans?

        1. [How many lac bugs do they have in captivity to fill all of those cans?]

          First they put the lac bugs in a sauna so they sweat more. Then they take a teeny, litle vacuum and …

    1. dr cobalt,

      All fresh fruit sold at WFM is coated with wax. As I recall from their informational posters, the conventional fruits are coated with a petroleum based wax, while organic fruits are coated with plant based waxes. But I can’t find any wax-free fresh fruits sold there.

      When fruit is in season, we buy from a local vendor. They don’t practice organic farming, but do practice integrated pest management, which limits pesticide use. (I just learned that our vendor graduated from Northeastern University in Boston; I think she studied biology.) Anyway, none of their produce is waxed, and it is fabulous! They really know what they are doing, and how to grow fruit! I tried to grow some in the backyard: all pretty much failures. So many pests and pathogens! And I have no idea how to deal with them.

      And I have no idea how to remove the wax from the WFM produce. I’m probably too lazy to do that, anyway. Food prep takes enough time as it is.

      1. There is a site selling a fruit and vegetable wash (so they have a monetary investment in making the wax seem as bad as possible) but their list was interesting because casein was one of the things which can be in the wax.

        Most wax is petroleum-based, can contain alcohol or ethanol and 7 fungicides are approved to be used, which adds layers of chemicals
        Wax can trap pesticide residue, pathogens, and bacteria under the surface and it may contain casein, linked to a common allergen

        The plant-based wax may at least get rid of the casein, I hope.

        It helps that I buy organic because it sure is a lot of work getting the wax off. I just tried to do it the other day and even with a brush I wasn’t touching it. (I had dropped an apple on the floor and decided that having a wax coating is sometimes a good thing because I could possibly get rid of it and might be able to invoke the 10-second rule, which the food science guy said is a myth.

      2. If you wander around in the woods of northern Vermont and New Hampshire you will find many old abandoned heirloom apple trees that produce at least some good to excellent, edible fruit under terrible growing conditions.

        1. My brother and his wife are going up to northern Vermont this weekend. I don’t think I could pay him enough to wander around in the woods looking for abandoned heirloom apple trees, but I could ask.

    2. https://singularityhub.com/2019/10/20/the-technologies-changing-how-we-grow-distribute-and-consume-food/

      “In yet another win for food-related materials science, Santa Barbara-based Apeel Sciences is further tackling the vexing challenge of food waste. Now approaching commercialization, Apeel uses lipids and glycerolipids found in the peels, seeds, and pulps of all fruits and vegetables to create “cutin”—the fatty substance that composes the skin of fruits and prevents them from rapidly spoiling by trapping moisture.

      By then spraying fruits with this generated substance, Apeel can preserve foods 60 percent longer using an odorless, tasteless, colorless organic substance.

      And stores across the US are already using this method.”

  7. I am so happy you have this back in the old format. I ended up pausing it every 20 seconds and reading all of the charts and background sentences.

    There was so much in this.

    The fractured wrist part made me think about the Adventist vegan women because they were having wrist fractures. So maybe they weren’t exercising or something like that? Or just were lower in calories maybe.

  8. Deb,

    Osteoporosis has a large genetic basis; perhaps Adventists marry other Adventists?

    Actually, there are several risk factors; theses include: sex, age, race, family history, and body frame size; hormone levels; dietary factors; steroids and other medications; medical complications; and lifestyle choices. Some of these factors can be controlled; others can’t. (https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968)

    1. Thanks, Dr. J.

      That is possible, but I am not sure that the logic works because they are comparing the vegan Adventists to the fish-eating Adventists and the lacto-ovo vegetarian Adventists, so they all could have the genetic risk factors.

      The vegan males out-survived all of the groups, but the vegan women came in third and what I remember was that they had wrist fractures.

      It might be that the vegan women didn’t eat nuts and seeds.

          1. The alcohol factor is interesting.

            Alcohol probably means more falls.

            I am not sure if there is a calcium reason or just slower reaction times of elderly.

            In Israel, they designed a shoe which slides into position for people. They said that younger people step back with one foot to catch their balance and that was what the elderly people lost the ability to do in time.

            Another factor may be that studies show that they are more likely to walk thinner people with one support person and there are less likely to be falls when 2 people are involved.

            I will add padding. I have seen that heavier people fall differently.

  9. I find it hard to concentrate on what you are saying while you highlight the sources of information. At a few points along the way you literally read the highlighted portion of the study and that was so much easier to digest. Great job though and kudos to you and your staff for offering such a wonderful service.

    Danny

    1. I agree Vz07mk… a static highlight is helpful but the panning highlighting is just the opposite. I find the movement of the highlighting very distracting.

      1. I re-watched it to see if I agreed with you.

        I liked it when the key numbers were circled and when the keyword in a sentence was highlighted, but I agree that I didn’t like the moving scrolling highlighting at 3:30 and 4:20 as much.

        Mainly, there was so much information in the video that I already had to stop the video several times to concentrate harder to get the information.

        1. The moving in toward the sentence and highlighting it with light is exceedingly helpful and I liked the 8 or 4 grams for every 10 pounds explanation at 1:37.

          If you are going to use motion, it has to be to emphasize something which needs extra explanation. Not out of the sense of wanting the video to be more entertaining through motion.

  10. I would love to see a video on the work of Victor Longo Ph.D on the fasting mimicking diet. My father in law, 83, was diagnosed with mild cognitive impairment last year and with the help of a progressive geriatrics doctor started the Longevity Diet with monthly 5 day cycles of fasting mimicking diet. It is essentially 800 calories a day 400: from healthy plant fats: olive, avocadoes, olive oil, walnuts, etc and 400 calories from low complex carbs veggies: leafy greens, brassicas, cukes, eggplant, radish, artichokes, pumpkin, etc. Short cycles of calorie restriction mimicks the positive effects of fasting (increased autophagy, decreased IGF, etc) but is more “doable” by patients, thus better compliance.

    Meanwhile, after a 5 day FMD cycle you transition to the Longevity diet which is pescatarian…but only advises 1-2 fish servings a week and especially for people 65 plus. Otherwise it is WFPB vegan and he especially advocates following the diet of your ancestors, so Mediterannean folk eat olives, garbanzoes, Irish eat oats, barley, seaweed. German/Czech/Poles cabbage family, potatoes, etc. It makes alot of sense.

    Anyway, My FIL is doing so much better, all his metabolic markers vastly improved, and his cognition has improved.

    1. All the information I’ve seen on this site says that fish is terrible for you. PCBs, dioxins, mercury, saturated fat, cholesterol, acidifying animal protein. https://nutritionfacts.org/topics/fish/
      And associated with cognitive impairment and dementia. https://nutritionfacts.org/video/fish-brain-food-older-adults/
      Valter Longo wrote a book. Why not a WFPB diet like Dr. Greger recommends? https://nutritionfacts.org/topics/dementia/
      Exactly the same diet recommended by Drs Sherzia in their book “The Alzheimer’s Solution”. https://teamsherzai.com/book/

      1. Blair,

        Yes, and I am not sure about the oil either.

        Waiting for Dr. Ornish’s reversing Alzheimer’s with diet study.

        The Sherzai work already shows that it can be prevented.

        I know firsthand that it can be reversed without fish or oil. My brain is so much better than it was.

      2. Yeah but in the Adventist 2 study so-called pesco-vegetarians had the lowest overall mortality risk (both sexes combined). Admittedly, male ‘vegans’ had the very lowest relative risk of all cohorts – 72% – but male pescatarians were right there with them at 73%

        if one doesn’t take supplements then fish may be the safest and most effective source of B12, selenium, iodine, zinc, omega 3s etc.

        i don’t eat fish myself for ethical and environmental reasons, but I can see a nutritional argument for the consumption of some wild-caught oily fish low on the food chain. And small amounts of animal food are not incompatible with a WFPB diet.

        1. Tom,

          I don’t eat fish either but I do understand the arguments from that direction.

          I take Omega 3 and chose to eat nuts because of the Adventist’s study.

          I see the fish argument as one which will change over time. I am not convinced that it is better. I found Dr Greger’s arguments against fish credible, but the Adventist’s would be a group which causes me to think the logic is close enough to not fight about it.

          Except the suicide part.

          I suspect the ones who kill themselves younger probably aren’t counted.

          1. I was just watching a fictional show which said that there has never been a documented case of a blind person getting schizophrenia.

            If that is the truth, I am wondering if something is occurring in the visual cortex.

          2. Dr McDougall talked about snorkeling at the Great Barrier Reef and how 10 years later he went back and there was no sea-life. No sharks at all.

            It caused me to look up ocean pollution again and they said that 1 billion pounds of trash is dumped into the ocean every year by ships and that 1 million sea birds and 100,000 sea mammals die from the pollution every year.

            I don’t see fish as health food, no matter what happens to the Adventist’s.

            Most of the caught fish are fed to the farmed fish and they get diseases.

            I do know that we need omega 3’s, but the runoff from all of the chemicals, plus the plastics, plus everything else, just makes me know that future generations of fish eaters will not be the same.

            Also, I watched a documentary of someone who bought the fish hype and he ate fish two meals a day for a year or something like that and he went to his doctor to get labs done filming it as a documentary and his lab results really sucked and he was so bummed.

            1. I just read it on another site and they gave the pollution from ships as:

              https://www.dosomething.org/us/facts/11-facts-about-pollution

              In 1975, the National Academy of Sciences estimated that ocean-based sources, such as cargo ships and cruise liners had dumped 14 billion pounds of garbage into the ocean.[3]

              The Mississippi River carries an estimated 1.5 million metric tons of nitrogen pollution into the Gulf of Mexico each year, creating a “dead zone” in the Gulf each summer about the size of New Jersey.[6]

              Approximately 40% of the lakes in America are too polluted for fishing, aquatic life, or swimming.[7]

              Each year 1.2 trillion gallons of untreated sewage, stormwater, and industrial waste are dumped into US water.[9]

              There are more statistics than these, but these are already enough to be quite alarmed and these are already enough to doubt that fish is the same as it used to be.

              I also went back and looked up the documentary on the man who ate fish for a year and his labs weren’t that different, but it was his blood pressure, which went up and he experienced side effects from the mercury, including slowed thinking and problems with his memory.

    2. Mims, thank you for your post.
      I have recommended Dr. Longo’s 5 day diet to patients with auto-immune diseases. They have generally only been willing to do it every 3 months though. But they did see more improvement in symptoms with each 5 day cycle.
      Another with early diabetes is now able to have some more healthy carbs in meals. Better pancreatic function, and/or improved insulin resistance?
      The diet also helps people to progress to a more plant based diet in general. They learn they can eat this way, and it helps lower cravings for junk food.
      Dr. Longo’s recommendation to eat ancestral foods makes sense to me also. People are always surprised when I ask about heredity. But many seem to be better adapted to those foods genetically. And certain problems like hemochromatosis, inability to use beta-carotene, plant omega 3’s, folic acid, etc. are genetic.
      Also finding that those who react to modern wheat often do fine on ancestral grains.

    3. Mims – Thanks for posting about Dr. Longo’s work. He is the first to admit that we still need to do a whole lot of research to get more information about the best diet for us all. He has written this book as a way to share “What we think we understand today” and never pretends that his information is definitive and final. He, too, has many more questions than answers.
      But he basically agrees with all of the other healthy diet science guru’s like Ornish, Esselstyn, Barnard, etc that a WFPB low protein diet is optimal. He suggests fish for the Omega 3’s. Greger suggests an algal oil supplement. They’re both suggesting the same thing with a different source. I see it as splitting hairs and that we, individually, can decide how we’d like to get our Omega 3’s. If you go the fish route, smaller fatty fish (like sardines) can get you there. But overall I see this as a non-issue. He eats a WFPB diet and fasts 2xyear.

      Re: the osteoporosis discussion, . . . one of the facts that has stuck in my brain over the decades from my 3rd year physiology coursework is that bones are a dynamic entity in our bodies. They are not static. They build up and release constantly over our lifetimes. Osteoblasts (bone cells) build our bones, and when our body needs to release bone components, osteoclasts deconstruct our bones. When bedridden, our osteoclasts are at work since we are not needing our bones at the moment – the body does not put resources into structures that it does not use! When we work out with weights for example and our muscles pull on the ligaments attached to our bones, the osteoblasts get to work to build up the bone that is needing to do work. This is why exercise is so important. When white elderly women are sedentary we dry up and blow away. Women who have worked physically all their lives and continue to be active, have better bone structure. Japanese women who follow the tradition of sitting on the floor have much stronger bones and muscles than typical American women because they are always using their bones and muscles to get up off the floor. This has nothing to do with calcium from cow lactation or supplementation of pills. We must use it or lose it :-)

        1. Liisa, only if you are one of those who can convert plant omega 3 to the longer chain EPA and DHA.
          Plant omega 3 and algae/ oily fish omega 3 is nit the same. The brain needs DHA.

          1. Jack Norris’ assessment is:

            ‘The evidence on whether vegans need to go beyond the Dietary Reference Intakes is mixed and complicated—more information is at Omega-3s Part 2—Research. We think it’s prudent at this time to take one of these additional steps:

            Consume an additional 2,000 mg of ALA per day using the foods in the table above, or
            Take a supplement of 200-300 mg of DHA per day.
            Your DHA supplement can contain EPA, but it’s not necessary if you’re meeting the DRI for ALA. We don’t recommend or have opinions on any specific brands of DHA supplements.

            Too much omega-3 can result in bleeding and bruising. If you bleed or bruise easily, consult a health professional before significantly increasing your omega-3 intake.”
            https://veganhealth.org/daily-needs/

  11. I’d like Dr. Greger to comment on this Sept 19, 2019 BMJ study:

    https://www.bmj.com/content/366/bmj.l4897

    “WHAT THIS STUDY ADDS
    This study showed that fish eaters and vegetarians (including vegans) had lower
    risks of ischaemic heart disease than meat eaters
    Vegetarians (including vegans) had higher risks of haemorrhagic and total stroke
    than meat eaters
    Further research is needed to replicate these results in other populations and to
    identify mediators that might contribute to the observed associations”

    Tong TYN, Appleby PN, Bradbury KE, et al. Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study BMJ 2019; 366 :l4897.
    https://doi.org/10.1136/bmj.l4897

    Although they did distinguish vegetarians (who eat dairy and/or eggs) from vegans – it looks like they did not saperate them out, but just lumped them together.

    1. alef,

      Yes, I am waiting for his comments on that study, too.

      Though, yes, they combine vegetarian and vegan, the vegetarians have a fairly high saturated fat diet with fairly low fiber and use sodium and eat oil.

      Dr. Greger had talked about it back in 2002. https://www.youtube.com/watch?v=q7KeRwdIH04&t=454s

      Honestly, back then, the vegetarian group had zero benefits compared to the meat-eaters.

      Now, there are benefits in most categories, so they might have taken some of Dr. Greger’s advice back then.

      https://www.youtube.com/watch?v=q7KeRwdIH04&t=454s

      1. But look at the logic of what Dr. Fuhrman says here:
        https://www.youtube.com/watch?v=juIfyucDSNQ Start at 1:00 or so.
        He says, and I think this makes sense to me, that cholesterol plaques seem to protect blood vessels from breaking (hemorrhagic strokes) and that in the case of vegans, (who might not have that “protection,”) the blood vessels can break if one’s blood pressure is too high–as from SALT.

        What I glean from this is that as a WFPB person, I need to avoid things with salt in them. I know I am sensitive to salt because my blood pressure is lower when I am not consuming it. I also should practice stress relief, exercise, and do whatever I can to keep my blood pressure as low as I can.

        Now would you want to increase cholesterol levels by eating animal products in order to avoid hemorrhagic strokes? Of course not–because that is dangerous in the reverse direction by blocking your vessels.

        1. Liisa,

          I will be thinking about it.

          What I do know is that a place in Japan had people having hemorrhagic strokes and improved it and not by adding in fish.

          Boy, I have to look that up again. I know that one thing was socially women were more likely to have hemorrhagic strokes if they lost their husbands and one of the things they did to prevent them was to improve the medical care of the elderly.

          My memory isn’t so good, but I had looked it up and salt was one really big factor. I think eating fiber was another.

          Okay, I have to look it all up again. I did look it up back then, but I didn’t hold onto enough of it.

          1. Liisa,

            Okay, number 1.

            I found the first one.

            Folate – eating your plant-foods is inversely associated with a risk of hemorrhagic stroke and homocysteine already made it on the list at this point.

            https://www.ncbi.nlm.nih.gov/pubmed/15933256

            https://www.ncbi.nlm.nih.gov/pubmed/12907815

            There is a a J-shaped relation between nut consumption and hemorrhagic stroke.

            Boy, I need a translator to understand what that means. Does that mean that the risk goes down and then shoots way up depending on how many you eat? Anybody?

            1. Fiber was another one and they were fairly low fiber in the UK.

              https://www.ncbi.nlm.nih.gov/pubmed/23539529

              I tried to look up the risk of hemorrhagic stroke and the Adventist vegans, but it was not mentioned. They were not dying of a greater risk of it is what I believe I remember. I think someone from the Adventists was questioned about it back then and they said that they must eat more fiber.

              Fruit consumption was another

              https://www.ncbi.nlm.nih.gov/pubmed/23294925

              In Bangladesh, low fruit consumption was the number 1 risk factor listed for Hemorrhagic stroke.

              https://www.ncbi.nlm.nih.gov/pubmed/27089632

              In HS model less fruit consumption (OR 5.0), table salt intake (OR 9.9), Stress (OR 4.1), family history of cardiovascular disease (CVD) death (OR 11.3), hypertension (OR 43), aspirin intake (OR 4.5) and increased WHR (OR 3.7) remained as significant predictors.

              I was trying to figure out what WHR meant and when I Googled, Whirlpool corporation came up first. I knew it!

              Waist Hip Ratio, came up later, but I think it must be Whirlpool.

                1. For the cholesterol, low and high may have risk, so I guess understanding where the sweet spot is could be a good topic, but only if there is a sweet spot. If raising it raises the risk of more common stroke without lowering Hemorrhagic stroke then it is probably better to just not stress out about it, since stress can trigger it.

                  those with LDL-C levels <70 mg/dL had 2.17 times the risk (95% confidence interval [CI] 1.05, 4.48) of experiencing a hemorrhagic stroke. No significant increase in risk was seen for those with LDL-C levels 130–159.9 mg/dL (relative risk [RR] 1.14; 95% CI 0.72, 1.80) or 70–99.9 mg/dL (RR 1.25; 95% CI 0.76, 2.04). There was a suggestion, although not significant, of increased risk for those with LDL-C levels ≥160 mg/dL (RR 1.53; 95% CI 0.92, 2.52)

                  1. I was looking at a study from Japan, where they looked at cholesterol and disease (because they didn’t have the same risk factors for Ischemic and it was a place where that type of stroke wasn’t the most frequent type of stroke.)

                    I might be seeing things and not understanding the sentences, but I think this means that both types of strokes increase when people are at the lowest of low cholesterol levels?

                    Although the subtypes of ischemic stroke in the present study were unknown, low total cholesterol level (<160 mg/dL) was associated with higher total ischemic stroke mortality after adjustment for clinical risk factors in a Japanese general population cohort.

                    1. Winter is a risk factor, which UK probably has and the Adventists might not be affected by.

                      …the incidence per 100,000 person-years of spontaneous cerebral hemorrhage was highest in the winter (45.5, 95% CI, 38.4-52.7) and lowest in summer (24.1, 95% CI, 21.9-26.2). Winter incidence was highest in both men and women, and in subjects younger than 60years as well as subjects 60years or older. The winter excess in stroke incidence was observed regardless of the presence or absence of risk factors. Factors that explain this excess need further investigation.

                      In women, sleeping over 8 hours per night increased the risk of hemorrhagic stroke, but I am going to already say that the fact that losing a spouse increases the risk, women maybe get depressed and decide to sleep longer? Possibly?

                      https://www.nature.com/articles/srep33664

                    2. Winter and Spring being risk factors is interesting.

                      Temperature or Vitamin D?

                      Probably D assuming levels drop to the lowest in the Winter but elderly are still in long sleeves in the Spring.

                      Temperature would be an interesting one if I can find something.

                    3. But if Spring is worse than Fall then does Spring have a greater barometer swing and why is it that the storms in the Summer aren’t triggering it?

                    4. Seasonal Affective Disorder is something they speculate on.

                      I don’t know if they have checked snow birds rates versus people who atay in the Winter.

                    5. Just had a thought about the sleeping over 8 hours…

                      I had said depression, but depression might point to something with inflammation?

    2. alef1

      Why does everybody focus on the

      “three more cases of total stroke (95% confidence interval 0.8 to 5.4 more) per 1000 population over 10 years, mostly due to a higher rate of haemorrhagic stroke.’

      and ignore the preceding statement

      ‘ 10 fewer cases of ischaemic heart disease (95% confidence interval 6.7 to 13.1 fewer) in vegetarians than in meat eaters per 1000 population over 10 years.’

      The study suggests that ‘vegetarians’ had – overall – a net 7 fewer cases of adverse events than meat eaters

      1. Fumblefingers – Thank you for pointing that out. As a neuroscientist, I’d also like to point out that there are other causes of stroke and injury to the brain that have nothing to do with diet at all. An arteriovenous malformation is a structural genetic anomaly in the venous structure of the brain that can “blow” at any time. And you never know you have it until it bleeds (i.e. a stroke). While relatively rare, it can happen. So the “extra” 3 stroke events mentioned in the research could have any number of causes that have nothing to do with diet.

  12. I love these short videos! Great job on respecting the value of your audience’s time…. But I’d actually like to read the journal articles in their entirety. Would it be possible to post links to the sources below the videos? I do realize that some sources may require subscriptions for access, but I’d think not all would.

  13. BMJ study – looks pretty useless to me. That’s why Dr G uses the term WFPB, as vegetarians might consume plenty omelettes, butter and ice-cream, and vegans might be consuming lots of fries/chips and lager.

    Apples – we had 2 trees, that produced the waxiest fruit I’ve ever had! If i didn’t know otherwise, I’d swear they’d been sprayed with something! But it was their natural state, year after year.

  14. BTW, I have been experiencing the OI … Orthostatic Intolerance, mentioned in the video for the duration of my weight loss time. It’s complicated by bouts of vertigo as well, but those stem from another origin. The OI though, is tough to deal with. I’m nearly at my goal weight and trying to figure out just what I should weigh. So this video is timely for me. And I will say, the hydration reference is also spot on. I don’t always keep hydrated as well as I should. I think the background article suggests that hydration helps, but is not the sole and direct cause. The calorie restriction is the cause. I’m working on it. But I still have issues.

  15. Not many comments were made about exercise during this topic. I’m a very senior person and my Fitbit has a fine stepcounter that has helped me immensely and strengthened my lower half. My OI has improved and weight firmed. The device has me doing 250 steps every hour and it’s very doable. (9am-5pm). It takes 3 minutes approximately for 250 steps. You can control speed and time. If you haven’t made the hourly requirement then it lightly buzz you wrist telling you that you need so many steps in the next few minutes. very easy to accomplish without treadmill etc., inside or outdoors. Noticeable results and feeling well on WFPB. What are your thoughts.

    1. Hi Ruthie, I’m senior too. And I’ve also benefited from my Fitbit. Plus I also go to Silver Sneakers exercise classes. I’ve begun the Couch to 5K program of walk jogging. But that takes only 45 minutes. And my step count is quite variable. I’m doing death by computer (and here I sit!!!!) I was an Engineer, so it’s been very long term. So I’m not yet doing all Dr G is putting on his Daily Dozen list yet. It is all a lot!

      1. Hi Kathleen, WFPB is the way to go, stick with it and do the best you can. No one on these pages are 100% perfect following it. It is an adjustment. I’m a beans (all kinds) , soaked, and pressure cooked with onions and garlic. Rice (brown) steamed in a rice cooker. Better then cans, no matter what you read. I visit the local store (yes, I still drive) everyday and pick out the freshest (most colorful) veggies & greens to fill in the rest of my food needs. It’s that simple. For breakfast, 1/2 cup of whole oats, 1/2cup blueberries, flax seed and a tbs of almond flour with water. (milky effect) and sprinkle of turmeric and a banana few times a week. No need to cook oatmeal. It softens while you dress. That’s it. Now you know my secrets. Wish you well on your journey. Be well friend!

        1. Ruthie,

          I cook everything in my electric pressure cooker!! (Mine is an Instant Pot.). Beans, as you mentioned — especially because I can cook dry beans, which is great because I frequently don’t know what I’m going to make for dinner in the morning much less the night before, so I don’t have time to soak my beans — but also grains of all kinds. Lumpy burned polenta? A thing of the past. Perfect quinoa? Oh yes. And millet, amaranth, rice, etc. In fact, I gave away my rice cooker — which I’d originally purchased to cook beans and rice. My IP is so much faster, and easier: set it up, press the button, and that’s mostly it.

          I also cook soups and stews, and veggies in my IP. In fact, today I’ll steam kale in it for lunch. Other days, I steam fresh or frozen veggies, whatever mix I choose. Oh, and I’ve just started cooking steel cut oats in it; yesterday, I added raisins and chopped apple and cinnamon before cooking it — who knew it could taste so good? I save the left-overs in the fridge, which I reheat in the microwave. Plus, I add a few chopped walnuts, sliced almonds, sunflower seeds, coconut flakes, dried fruit (blueberries and cranberries or whatever) before serving to add flavor, texture, and nutrients. I am now looking forward to breakfast. (This is my winter breakfast; in the summer, I make a muesli mix from rolled oats. And I eat beans with toast twice a week — for breakfast. Instead of eggs.)

          Last night I made a pea soup with barley (of course in my IP); very interesting. I like to try to eat beans with whole grains. But I’ve also always loved barley soups. So next I’ll try a barley with veggies soup. One of my husband’s favorites is mushroom barley soup.

          I’m a senior, too, though not yet a “very” senior senior, though I hope to get there. And I agree that exercise is important. Also, I eat less than I did when I was younger. The serving sizes that Dr. Greger suggests for beans are too big for me, so I adjust them downward. Besides, I rarely hit all 24. Wait, that’s two dozen, right? So, it’s really the Daily Double Dozen.

          1. Dr. J – What size Instapot are you using? I bought a big one and couldn’t find a place in my small kitchen to store it. So I returned it. Before I get another one I’m interested in what size seems to work best for people who are 1-2 in a family i.e., not cooking for a bunch of kids. Thanks!

    1. YR. This contains no wheat in the almond flour. It is only VERY fine ground almonds. You can make your own almond milk, but experiment with the amounts for your personal taste preferences. Mix in blender, then store in refrig. Some people put a drop or two of vanilla extract and it enhances the flavor. You can use it on your oatmeal or in tea. You can also purchase whole raw almonds ( or slivers) , soak till the skins slip off and throw away (not really necessary but tastes better), again blend them to your taste preference and there’s almond milk. This doesn’t have the additives that the popular stores brands have. But, it can be pricy using the whole almonds vs store.

      ( not really necessary, place in blender

      1. Ruthie, I know it’s possible to make almond milk, but as you mentioned “flour,” I thought you meant the kind you can make (no gluten) bread with. I’ve tried it a few times; not bad, but I can eat gluten bread (Ezekiel).

        (I always put a few almonds in my whole-grain, cooked breakfast cereal.)

        1. YR, in my area you can buy almond ‘flour’. That’s how it is labeled. The brand is Honeyville, super fine grind. Sorry for the confusion. I’m not into eating gluten free as I can eat wheat without problems. I do eat other whole grain products. There are wonderful varieties out there. So many choices!

  16. I had gastric bypass 10 years ago. I am still 100 pounds lighter than 2009. I also only eat less than 1 cup of food at any given meal. I am reading “How Not To Die”. I’m concerned that I will not get enough protein. If meats, dairy, eggs…are all the enemy, that leaves little protein. My goal has always been health, not vanity. Please help me!

    1. The enemy is junk food and all foods invented in the last 100 years. Meat, dairy and eggs in small proper amounts have stood the test of time, they are not junk food like fast foods, chain restaurants, snacks, organic potato chips, organic natural sodas, candy, cakes, microwaves, plastic bottles, fried food, 16 ounce steaks with butter on it etc.

    2. Abbie

      There is plenty of protein in vegetarian whole foods. Legumes (beans and peas) are particularly high in protein for example.
      https://www.myfooddata.com/articles/vegetables-high-in-protein.php

      And the current fad for high protein diets is just that – a fad.
      https://nutritionfacts.org/video/the-great-protein-fiasco/

      I wouldn’t believe Yerky’s claim about meat, dairy and eggs either. That’s clearly just a personal belief since he hasn’t offered any supporting evidence for his/her statement. The World Health Organization reviewed the evidence and concluded that red meat is ‘probably carcinogenic’ for example:
      https://www.iarc.fr/wp-content/uploads/2018/07/pr240_E.pdf

      As for dairy and eggs, I’d review the videos/blog posts on this site about those foodstuffs before taking Yerky’s opinions on trust.

        1. It you want evidence just ask:
          Age 105 Dr. Shigeaki Hinohara
          Age 104 Dr. Ephraim Engleman
          Age 102 Dr. Fred Kummerow
          Or use your right and left eye for evidence and go to an assisted living place and spend time and get to know the people in their late 90’s
          and spend some time in the dining hall and see with your right and left eye what they are eating.
          If you want to believe studies funded by who knows who, they are the same people for decades that said using a hard bristle toothbrush
          is best and now they changed their mind and say a soft bristle toothbrush is best.

          1. Yerky – There will always be individual outliers that exist outside the mean. When the mean age of meat eaters at death is 100 then that points toward an epidemiologically meaningful piece of information to take seriously. But until the majority of meat-eaters live HEALTHFULLY to 100 there is nothing to rave about in your example. Currently only 2892 people, out of 100,000, born in 2019, will make it to age 100. That means that 97% of people have died. See the SS actuarial table here: https://www.ssa.gov/oact/STATS/table4c6.html
            If you are interested in longevity, consider reading The Longevity Diet by Valter Longo, Ph.D., who heads the USC-Davis School of Gerontology and Aging. He works and researches internationally (for 30 years) with labs and hospitals all over the world studying aging, why and how we age, and how to live longer. You might find his research interesting – and yes, he does advocate for certain small amounts of animal protein.

  17. As a volunteer for NutritionFacts.org, I wanted to address your question Sept 26 2019
    Courtney Davison of addressed the question of “Is it unhealthy to consume too much protein from plants? In the following article in the Forks Over Knives article “The No BS Guide to Protein.” https://www.forksoverknives.com/vegan-protein-guide-athletes/#gs.bmbgyq/. She suggested that this question needs more research, focusing on the fact that plant protein could accelerate aging the same way that protein from animal product does: “…it appears that it’s leucine, specifically, and maybe some other [amino acids] like methionine. It happens that meat protein is higher in leucine and methionine than plant protein is. But if you’re going to keep pushing plant protein enough, you’re going to get enough leucine where you get that same effect.”
    Seems like getting lots of variety and not overloading with protein, following Dr. Greger’s Daily Dozen, makes sense. Hope that adds some perspective to the question you posed, Kathleen.

  18. In Australia we no longer have waxed apples, just the naturally occurring slightly waxy feel of apples. Some are polished and have no wax at all. Previously we were subjected to apples coated in paraffin wax.

  19. Dear Doctor,

    Greetings!

    We would like to solicit your gracious presence for the upcoming Paediatrics and Neonatology Conference during March 02-03, 2020 in the beautiful and unique city of Rome Italy that is focussed around the “Advancements and Breakthroughs in Paediatrics & Neonatal Health”.

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    We enthusiastically welcome you at Paediatrics 2020

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    1. EXCEPT the article acknowledges the following: FL acknowledges financial support of the Research Council of the Vrije Universiteit Brussel, including the SRP7 and IOF342 projects, and in particular the Interdisciplinary Research Program ‘Tradition and naturalness of animal products within a societal context of change’ (IRP11).”

      Virus-free.
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    2. Mike

      Well, the World Health Organisation reviewed all the scientific evidence and concluded that processed meat is carcinogenic and red meat is ‘probably carcinogenic’. Links between meat consumption and CVD risk are also well-kniwn, This why multiple studies over the years have shown increased mortality is associated with meat consumption, eg this study from earlier this year

      ‘The association between increased red meat consumption and mortality risk was consistent across subgroups defined by age, physical activity, dietary quality, smoking status, or alcohol consumption.
      Conclusion Increases in red meat consumption, especially processed meat, were associated with higher overall mortality rates.’
      https://www.bmj.com/content/365/bmj.l2110

      If you want to bet your life and your health on the dubious arguments of a couple of meat apologists, that’s your business. Most of us who are aware of the totality of the evidence, though, will stay well away from meat.

  20. Looking from guidance. I am back to a vegan lifestyle after a few yeas of slowly adding back things like eggs, chicken, fish and milk in my coffee. But now that my lifestyle can handle the efforts needed to go back to 100% vegan again I am remembering something back from the years I followed the McDougal plan. Back then I remember something like feasting on foods other than the plan were not horrible, But we don’t feast every day! So Long story short, considering Dr. Gregers research and amazing book. If I took a holiday and ate non vegan food on 4 or 5 feast days a year like family gatherings do you think the health effects would be nominal?

    Thank you for any guidance.

    1. Nobody really knows for sure and it may well depend upon the amounts and one’s overall health.

      The holiday effect of increased mortality around Xmas and New Year is well known and often attributed to increased consumption of rich foods and alcohol.

      Bingeing on anything is probably inherently risky. People have did from drinking too much water for example, A palm size serving of steak is one thing while a steak that takes up half your plate is quite another. A further matter you’ll need to consider is your overall health and other risk factors.

    2. Hello Roy and thank you for your question,

      I’m a family doctor and also a volunteer for Dr. Greger on this website. I think that if you’re talking about long-term harms from eating animal products — such as developing cancer, raising your blood pressure, causing a measurable worsening of coronary artery disease, causing you to become obese, etc., then I doubt that “feasting” on standard American holiday fare 4 or 5 days per year would harm you. The reason is that the mechanisms by which animal diets harm people are by changing the bacterial composition of the gut, and by increasing sodium intake over a long period of time, and by more exposure to toxic chemicals which tend to concentrate in animal fat. These all take more than a day to start causing significant harm. But it can take as little as FOUR days to completely change your gut flora: see this video by Dr. G: https://nutritionfacts.org/video/how-to-change-your-enterotype/.

      However, I can tell you from personal experience that feasting on animal foods which you’re no longer used to can have some very unpleasant short-term effects: acid reflux, stomach ache, gas, and throwing off your bowel function for several days — either constipation or diarrhea.

      I hope this helps.
      Dr. Jon
      PhysicianAssistedWellness.com
      Health Support Volunteer for NutritionFacts.org

  21. Look up ‘Hypometabolism: A modern pandemic’ on Youtube. A bit of woo in that video but interesting. Look up ‘Breakthrough towards the natural control of cardiovascular disease’ too. It’s strange why this theory is overlooked. A vitamin C insufficiency leads to lipoprotein A sticking to the artery walls to repair the damage, leading to plaques. So CVD is an early form of scurvy. It makes sense when you consider that our food is sitting on the shelf for weeks before being eaten and some eat lots of cooked foods. I’ve been watching my ‘watch later’ playlist and regretting not doing this sooner. I idled for too long. This may have helped me.

          1. No apologies necessary Arthur. It’s always good to be exposed to different ideas ….. especially when they challenge our beliefs.

  22. “It makes sense when you consider that our food is sitting on the shelf for weeks before being eaten and some eat lots of cooked foods.”
    – – – – – –

    What food would that be, Arthur? Are you talking about fruits and veggies? Supermarkets are pretty good about getting them off the shelves before too long although, true, they will have lost a lot of Vit. C just sitting there, and for having been shipped from somewhere. Maybe better to eat frozen veggies.

    In general, if it comes in a box with added ingredients, it’s processed. A no-no, for sure.

    I eat a fair amount of cooked foods….for instance, lightly steamed veggies.

  23. What type of foods should I eat I was
    Ted that my cholesterol is very high 200 I am 72yo active female vegetarian what should I eat

    1. Hi, Sheila Mccoyholness! This is an excellent guide for what to eat for optimal health: https://nutritionfacts.org/healthkit/ If you are lacto-ovo vegetarian, eating dairy and eggs, replacing those foods with whole plant foods should help with your cholesterol levels. You can find everything on this site related to cholesterol here: https://nutritionfacts.org/topics/cholesterol/ I hope that helps!

  24. The most recent study on calorie restriction and bone health seems to contradict the view expressed in the video by Dr Greger. It suggests exercise weakens rather than strengthening bones during calorie restriction . See the comment from the Times: “ A study in the Journal of Bone and Mineral Research this month reported how the combination of dieting and exercise can have a dramatic impact on the health of the skeleton, making bones weaker and raising the risk of osteoporosis, the bone-thinning condition that affects half of all women and one in five men over 50, and is responsible for 300,000 fractures a year in the UK.”

    This is very concerning, Would Dr Greger or someone else like to comment?

    1. Here is what they were quoting I think.
      Exercise Degrades Bone in Caloric Restriction, Despite Suppression of Marrow Adipose Tissue (MAT)
      Cody McGrath Jeyantt S Sankaran Negin Misaghian‐Xanthos Buer Sen Zhihui Xie Martin A Styner Xiaopeng Zong Janet Rubin Maya Styner
      First published: 11 September 2019 https://doi.org/10.1002/jbmr.3872

      1. Also this
        Effect of Exercise Modality During Weight Loss on Bone Health in Older Adults With Obesity and Cardiovascular Disease or Metabolic Syndrome: A Randomized Controlled Trial
        Kristen M Beavers Michael P Walkup Ashley A Weaver Leon Lenchik Stephen B Kritchevsky Barbara J Nicklas Walter T Ambrosius Joel D Stitzel … See all authors
        First published: 07 August 2018 https://doi.org/10.1002/jbmr.3555 Citations: 4
        Public clinical trial registration: http://clinicaltrials.gov/show/NCT01547182. Cooperative Lifestyle Programs (CLIP‐II).

  25. I have a problem with Dr Gregers teaching on protein. My husband and I are 65, and I am trying to loose a few kilos of weight, as I weigh 88 kegs at 5ft 10.5 inches. My problem is that I think I am chronically consuming too little protein on our largely vegan diet. As I loose weight my lean muscle mass and bone seems to decline faster than fat mass, I have constant upset stomach which improves if I eat steak and eggs . I cannot figure how to get our protein intake up anywhere near 60-80 gms per day that we need on a plant based diet, We eat protein enriched bread for breakfast and legumes, brown rice, veggies and fruit with a handful of nuts in the day, and a vegan protein shake for dinner. All this seems to come to 40-50 Gm of protein , not enough it seems as my husband and I are loosing muscle mass and bone mass and my stomach continually upset we need to stop this. We both do aerobic and resistance exercise , icludn hiit, three or four times per week. Weight loss is very slow indeed.

  26. Hi, Susan!
    It is unlikely that a person would be protein deficient on a whole food, plant-based diet such as one following the Daily Dozen https://nutritionfacts.org/video/dr-gregers-daily-dozen-checklist/. Depending on what is in your vegan protein shake, it could be the culprit in the issues you are describing, and the protein-enriched bread you eat for breakfast may not be helping much either. The best way to build bone and muscle is to exercise as much as you are able, and keep your diet alkaline and anti-inflammatory. With its emphasis on greens, berries, whole grains and legumes, the Daily Dozen will do that. Your digestive issues are likely due to your gut flora, which should adjust over time, if you stick with a healthy, whole food, plant-based diet.
    You may be interested in these videos, if you have not already seen them:
    https://nutritionfacts.org/video/increasing-protein-intake-age-65/
    https://nutritionfacts.org/topics/microbiome/
    I hope that helps!

    1. Dear Christine , thanks for your reply. The problem is at 65 we just cannot take in the Daily Dozen. I cannot eat that much in a day, and even if I could I cannot cook that frequently. The bread is the sukrin Chia bread, vegan full of seeds , vegetable fibre etc. I have to work from early morning so only have about 10 minutes for breakfast and this provides fibre, some protein peanut butter low sugar jam . Lunch is a full vegan lunch , whole grains , vegetables , tofu or legumes,and then fruit and granola and vegan yogurt. I then fast till the next morning but try to increase protein with the vegan shake in the evening which provides eg 20 gms of protein but few calories. To get that some other way I would need cups of legumes , or more tofu. The shake helps my stomach and lack of protein , definitely doesn’t harm it but is still not enough for my height or weight. The problem is at this age and needing to loose weight you need quite few calories and can’t eat much bulk. I can’t solve this problem of needing concentrated protein.

  27. Just saw a picture on face-palm-book… It was a native American man wearing a t-shirt saying Vegetarian: Old Indian word for Lousy Hunter. ‘-)

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