Reductionism & the Deficiency Mentality

Reductionism & the Deficiency Mentality
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How the food, drug, and supplement industries have taken advantage of the field of nutrition’s reductionist mindset

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Research in human nutrition over the past 40 years has led to numerous discoveries, and to a comprehensive understanding of the exact mechanisms behind how food nutrients affect our bodies. However, the epidemics of diet-related chronic diseases—obesity, type 2 diabetes, osteoporosis, heart disease, stroke, and cancers—dramatically increase worldwide, year after year.

Why hasn’t all this intricate knowledge translated into improvements in public health? Maybe it has to do with our entire philosophy of nutrition, called reductionism, where everything is broken down into its constituent parts, where food is reduced to a collection of single compounds with single effects. The reductionist approach has traditionally been, and continues today as, the dominant approach in nutrition research. For example, did you know that mechanistically, there’s a chemical in ginger root that down-regulates Phorbol Myristate Acetate (PMA)-induced phosphorylation of ERK1/2 and JNK MAP kinases? That’s actually pretty cool—but not while millions of people continue to die of diet-related disease.

We already know that three-quarters of chronic disease risk—diabetes, heart attacks, stroke, or cancer—can be eliminated if everyone follows four simple practices: not smoking, not being obese, half an hour of exercise a day, and eating a healthier diet—defined as more fruits, veggies, and whole grains, and less meat. Think what that would mean in terms of the human costs. We already know enough to save millions of lives. So, shouldn’t our efforts be spent implementing these changes before another dollar is spent figuring out whether there is some grape skin extract that can lower cholesterol in Zebrafishes, or even whole foods for that matter? Why spend taxpayer dollars clogging the arteries of striped minnows by feeding them a high cholesterol diet to see if hawthorn leaves and flowers have the potential to help? Even if they did, and even if it worked in people, too, wouldn’t it be better to just not clog your arteries in the first place?

This dramatic drop in risk, this increase in healthy life years through preventive nutrition, need not involve superfoods, or herbal extracts, or nutritional supplements—just healthier eating. When Hippocrates said something like, “Let food be your medicine and medicine be your food,” he didn’t mean that foods are drugs, but rather that the best way to remain in good health is to maintain a healthy diet.

Whereas, the historical attitude of the field of nutrition may be best summed up by the phrase, “Eat whatever you want after you have eaten what you should.” In other words, eat whatever you want, as long as you get your vitamins and minerals: a mindset epitomized by breakfast cereals, providing double-digit vitamins and minerals. But the road to health is not paved with Coke plus vitamins and minerals. This reductionistic attitude is good for the food industry, but not actually good for human health—because if food is just good for a few nutrients, then you can get away with selling vitamin-fortified Twinkies.

We need to shift from the concept of just getting adequate nutrition, to getting optimal nutrition: not just avoiding scurvy, but promoting health, and minimizing our risk of developing degenerative diseases.

Bringing things down to their molecular components works for drug development, discovering all the vitamins, and curing deficiency diseases. But in the field of nutrition, the reductionist approach is beginning to reach its limits. We discovered all the vitamins more than a half century ago. When’s the last time you heard of someone coming down with scurvy, pellagra, or kwashiorkor—the classic deficiency syndromes? What about the diseases of dietary excess: heart disease, diabetes, obesity, hypertension—ever heard of anyone with any of those? Yet, we continue to have this deficiency mindset when it comes to nutrition.

When someone tries to reduce their consumption of meat, the first question they get asked is “Where are you going to get your protein?” rather than “Wait a second, if you start eating like that, where are you going to get your heart disease from?” The same deficiency mindset led to the emergence of a multibillion dollar supplement industry. What about a daily multivitamin just as insurance against nutrient deficiency? Better insurance would be to just eat healthy food.

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.

Image thanks to KERBSTONE via Pixabay

Research in human nutrition over the past 40 years has led to numerous discoveries, and to a comprehensive understanding of the exact mechanisms behind how food nutrients affect our bodies. However, the epidemics of diet-related chronic diseases—obesity, type 2 diabetes, osteoporosis, heart disease, stroke, and cancers—dramatically increase worldwide, year after year.

Why hasn’t all this intricate knowledge translated into improvements in public health? Maybe it has to do with our entire philosophy of nutrition, called reductionism, where everything is broken down into its constituent parts, where food is reduced to a collection of single compounds with single effects. The reductionist approach has traditionally been, and continues today as, the dominant approach in nutrition research. For example, did you know that mechanistically, there’s a chemical in ginger root that down-regulates Phorbol Myristate Acetate (PMA)-induced phosphorylation of ERK1/2 and JNK MAP kinases? That’s actually pretty cool—but not while millions of people continue to die of diet-related disease.

We already know that three-quarters of chronic disease risk—diabetes, heart attacks, stroke, or cancer—can be eliminated if everyone follows four simple practices: not smoking, not being obese, half an hour of exercise a day, and eating a healthier diet—defined as more fruits, veggies, and whole grains, and less meat. Think what that would mean in terms of the human costs. We already know enough to save millions of lives. So, shouldn’t our efforts be spent implementing these changes before another dollar is spent figuring out whether there is some grape skin extract that can lower cholesterol in Zebrafishes, or even whole foods for that matter? Why spend taxpayer dollars clogging the arteries of striped minnows by feeding them a high cholesterol diet to see if hawthorn leaves and flowers have the potential to help? Even if they did, and even if it worked in people, too, wouldn’t it be better to just not clog your arteries in the first place?

This dramatic drop in risk, this increase in healthy life years through preventive nutrition, need not involve superfoods, or herbal extracts, or nutritional supplements—just healthier eating. When Hippocrates said something like, “Let food be your medicine and medicine be your food,” he didn’t mean that foods are drugs, but rather that the best way to remain in good health is to maintain a healthy diet.

Whereas, the historical attitude of the field of nutrition may be best summed up by the phrase, “Eat whatever you want after you have eaten what you should.” In other words, eat whatever you want, as long as you get your vitamins and minerals: a mindset epitomized by breakfast cereals, providing double-digit vitamins and minerals. But the road to health is not paved with Coke plus vitamins and minerals. This reductionistic attitude is good for the food industry, but not actually good for human health—because if food is just good for a few nutrients, then you can get away with selling vitamin-fortified Twinkies.

We need to shift from the concept of just getting adequate nutrition, to getting optimal nutrition: not just avoiding scurvy, but promoting health, and minimizing our risk of developing degenerative diseases.

Bringing things down to their molecular components works for drug development, discovering all the vitamins, and curing deficiency diseases. But in the field of nutrition, the reductionist approach is beginning to reach its limits. We discovered all the vitamins more than a half century ago. When’s the last time you heard of someone coming down with scurvy, pellagra, or kwashiorkor—the classic deficiency syndromes? What about the diseases of dietary excess: heart disease, diabetes, obesity, hypertension—ever heard of anyone with any of those? Yet, we continue to have this deficiency mindset when it comes to nutrition.

When someone tries to reduce their consumption of meat, the first question they get asked is “Where are you going to get your protein?” rather than “Wait a second, if you start eating like that, where are you going to get your heart disease from?” The same deficiency mindset led to the emergence of a multibillion dollar supplement industry. What about a daily multivitamin just as insurance against nutrient deficiency? Better insurance would be to just eat healthy food.

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.

Image thanks to KERBSTONE via Pixabay

Doctor's Note

This is an issue Professor Emeritus T. Colin Campbell wrote a Whole book about. I’m looking forward to doing many more videos on the topic.

Where do plant-eaters get protein from, though? Check out Do Vegetarians Get Enough Protein?

The concept of optimal, rather than just adequate, nutrition is illustrated well in this video about fiber: Lose Two Pounds in One Sitting: Taking the Mioscenic Route.

Previous videos on reductionism include:

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

120 responses to “Reductionism & the Deficiency Mentality

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    1. Tom: Thanks for this. The article has a great list of references, many of them with links to the full-text article. I’ve heard Dr. Ostfeld (last author) speak at a couple of conferences; he is wonderful.




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      1. Yes, the references are fabulous aren’t they? Even though this is a single case study, the references make this probably the best one-page summary of the potential benefits of a WFB diet that I have ever seen.

        Thanks for the comment about Dr Ostfeld – I immediately went to YouTube and found a number of videos featuring him. I am now working my way through them. They seem like good stuff.




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    2. I’m also a case study in the power of a wfpb diet to treat angina. I had microvascular angina and fatigue that was debilitating for about 18 months, and when I began eating whole plant foods I noticed a difference in one week. In 4 weeks I was off all my nitro patches and experienced no more chest pain. I had been at the maximum dose. After 6 weeks I was able to exercise again, which I now do for at least 90 minutes a day. I started only 6 months ago and I feel like a whole new person! (see what I did there?)




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    3. If only I’d known this before my Medical Professionals got their hooks into me!
      BTW/ You seem to have aged some Tom ; )




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      1. Yes, a sudden fit of honesty compelled me to update my Facebook profile picture. The old one was definitely better looking but, hey, I have to look in the mirror every day – why shouldn’t other people suffer also.




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    4. Oops, B12 is made by microbes in the soil and my vegetable food is too clean. I really need that supplement proven by blood test where MCV was too high fixed with B12….




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  1. In his book, “Whole”, Dr. Colin Campbell makes a similar point about reductionist research in nutrition. He says that here in the United States, only about 2 percent of the budget of the National Institutes of Health goes to research in nutrition, and most of that supports only studies in reductionist research. Much of the remainder of our nation’s health research dollars pays for development of new pills, instruments and procedures that treat disease. This is driven by the healthcare industry, which profits enormously from disease management. Fortunately, NutritionFacts.org does what the NIH fails to do: it summarizes in one place the world’s latest research on nutrition, both reductionist and not, from which everybody can benefit. Thanks to Dr. Greger for all your hard work in making this website possible!




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  2. Just this morning on NBC news , they were saying how 40.4 % of women and 35% of men in USA are now considered obese . The very next thing they said was that pop consumption was to blame for this increase of weight and they are ready to implement a tax on sugar to fight this obesity.Then they ended that report BTW pop consumption is at all time low, 40 year low was what I think they said. lol Their own report cast doubt on pop consumption was the main culprit . It’s the food ! Not enough whole foods and too many animal products in the diet.
    Since going on WFPB in sept 2015I have lost a modest amount of weight , my blood pressure went from 180/120 to yesterday 118/79 ,also had pre diabetic pain in my legs ,which is completely gone, actully I might be healthier now than at any other time in my life!
    People want to argue all the time, I just don’t bother anymore. I just tell them go to nutritionFacts.org and check out whatever question you have on their search function and if you can’t find it there, there is something wrong with your computer.
    They always comeback and say something like well dr so and so said I will die a horrible death without protein,lol
    I say and you found that on nutritionfacts? Well no.
    One thing for sure there is a lot of educational work to be done.
    cheers




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    1. Esben: Congratulations on your improved health! And yes, we all have so much educational work to do! I am a family physician, and have been trying to spread the word about a WFPBD in at least 75% of my patient encounters over the past 9 months — that is about the fraction of my patients who have serious health conditions including obesity, diabetes or pre-diabetes, hypertension, coronary artery disease, very high cholesterol or triglycerides, irritable bowel syndrome, breast/colon/prostate cancer, and erectile dysfunction. The evidence is clear to me that ALL of these conditions would be substantially improved with a WFPBD. I also refer all of them to NutitionFacts.org, plus the film Forks Over Knives, plus PCRM’s 21-Day Kickstart program.
      I have learned over many years of being a doctor to have a lot of compassion for people when they don’t follow my advice (which hasn’t always been the best advice in years past, believe me). There is so much conflicting information out there about diet, and people have to resist decades of indoctrination about the benefits of meat and dairy, and they are being given such bad advice by many physicians who should know better, including most cardiologists. And diet is such a personal and emotional thing: people get comfort from eating their junk food, and it is not at all easy to change one’s diet. When you love a juicy steak, and you have a group out there (Paleo) providing “evidence” that meat is good for you, it is very tempting to get sucked in, to get validation for what you are doing.
      So we all have a lot of work to do. NutritionFacts.org is a tremendous help. But we all need to spread the word, and we need to be compassionate, and non-judgmental, as much as possible.




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        1. I was about to agree with both of you, but then I remembered that those folks should be the first compassionate, towards all the forced guests at their tables. Billions and billions of sentinel beings, dismissed as “livestock” and all other euphemisms to pretend that are just animated objects, you cannot expect to do so much harm, and not expect karma hitting you back.

          (Karma, literally from Sanskrit, action).




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      1. My experience over the last 10 years of prescribing nutrition changes with my patients as a Family Medicine physician is most likely similar to yours. I gave up predicting which patients and their families would change. Once they get the concept they have moved from “not knowing” to “knowing”. After that each situation is different and needs to be tailored to specific skill level and environment of the individual. Supporting that change goes beyond the office visit and although classes are helpful they are usually more focused on getting patients to take medicine or follow more “mainstream” but less effective nutritional approaches. An example is the American Diabetic Association counting carbs diet. Clearly not the best approach once you understand about the importance of fats… both dietary and body stores.. to insulin resistance. Given limited time and trying to reeducate my patients who were going to classes providing substandard education I found Neal Barnard’s book on Reversing Diabetes to be an excellent “soup” to “nuts” approach with the appropriate precaution to avoid hypoglycemia by reducing oral medications. Dr. Jon… if you wish to contact me directly (donforr@gmail.com) and I will share some additional resources relating specifically to type two diabetes. Thanks for the post and keep up the good work.




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        1. I am VERY disillusioned with the ADA! After getting numerous phone calls and emails appealing for donations for a “cure”, I was pretty disgusted. Since they conveniently omit any channels for feedback, I went to their forum and after reading some of the incredibly wrong and outdated info being traded there, wrote a brief history of my own experience with T2 diabetes and the solution, and provided factual links as back-up so it wasn’t just random anecdotal BS. I expected resistance, but what I got was a hostile attack that was totally ridiculous! Ad hominem insults and name calling that I won’t even repeat! And not just a few, a whole slew! I was flabbergasted! In retrospect it seems to me the all out “defensive attack” could only be motivated by those with a pre determined agenda, if ya catch my drift, because there is no way your average human would have reacted with such venom.




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          1. Right there — if you still needed more proof — you saw them for what they are.

            The book Whole (Colin Campbell), deals exactly with all this. And I think he omits certain things because otherwise he would be sitting all day in court.

            But there you saw what is behind, it is an industry, and as any industry when they face obsolescence they resits with everything they have. There are many billions to be made, you cannot get a thing if T2 diabetes gets cured by a diet change. (People stop causing themselves diabetes).

            But to omit, and as you saw there actively hide this information to the public, it is clearly criminal.




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        2. I do like to hear about experiences with education on nutrition change and particularly the efficacy aspect. I am a financial planner and health issues turn out to be an extraordinarily important in my work.
          Two examples:
          One is a couple who have very different life expectancies. He has had several minor strokes while she may well have Methuselah genes. There finances will change dramatically on his death though not so much for him if he survivor. Well after setting things up so that either as survivor would likely never run out of income, I gave them a copy of How Not To Die. I also told them my experience with arthritis, cholesterol reduction and my family history with cancer.

          With the book they were like kids with a new toy. He will not forgo meat but he will eat better. She might give up animal products but that remains to be seen. But even with this limited success they might live longer just based on some of the recommendation crowding out the negatives of the SAD.

          Another client I saw two days ago has enought income so that the ACA will provide a subsidy that is inadequate. So she has a high deductable policy. Yes i did set her up so that she will likely never run out of income and will likely have increasing income. But health issues could change it all.

          She has IBS and can scarcely afford a colonoscopy and the meds they want to put her on are expensive. I told her about the recent posts on turmeric and it’s effacicy in treating inflammatory chronic disease. She was all over that like a duck on a June bug. She will read the reprint I will do for her and this will likely have a very salubrious effect.

          I could go on all day citing numerous examples with T2 diabetes, CAD, fibromyalgia, Parkinsons et al coming into the picture. If I get any response from the discussions we have I point them to information sources and hope for the best.




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          1. Nice work. Keeping exposing them to new information and hopefully they will continue to make progress on their diet. With GI symptoms such as IBS I would suggest they cut out all dairy products. Work on limiting the meat. If she is on medications she should work with her physicians as they often have to be modified especially with blood pressure and diabetic medications. Dr. John McDougall’s website has good information for patients and clinicians.




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      2. Hey Doc, don’t get discouraged and keep on spreading the good word on WFPB. Some of us do eventually listen (even if we are on the quick road to death before we finally do the right thing…some of us are thick that way…and no its never too late). Metabolic Syndrome, CKD, High Lipids, Obesity, Hypertention, Chondromalacia, Neuropathy, All those “muscular aches and pains of aging”, Periodontal disease, Sleep disorders, Anxieties, etc… are just no issue to a WFPB diet. If I can do it, anyone can…

        My results (including biomarkers over a years time): https://www.drmcdougall.com/forums/viewtopic.php?f=13&t=35090
        How I did it (a one year journal , reporting every day what I ate, did, thought, felt, etc…): https://www.drmcdougall.com/forums/viewtopic.php?f=21&t=27969

        Theres more data in those links then what most want to read, but I hope it will be of use to anyone that may have questions on does it really work and what it takes (which isn’t much more than eat the food and do a little walking for exercise).

        geos




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        1. WOW! Congratulations, Geos! What an amazing story! Very inspiring. I have also had some amazing success stories, already.




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        1. That’s such a funny thought! I know you were kidding, but actually, I would love to be able to carry that off. I think it would be awesome. My own real life musical as my life helping others…




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    2. Awesome. You are a great example. You can tell people that about 3% of the population does not get enough protein, whereas 95% do not get enough fiber, which happens to be much more correlated to long term health than protein.




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  3. What a GREAT video! I read T. Colin Campbell’s Whole several years back and loved it, and lately have been thinking a lot about this since listening to a couple brilliant podcasts with Ray Cronise. (The Rich Roll podcast and for a deeper dive into the science, Rhonda Patrick’s Found My Fitness podcast.) The reductionist approach has indeed begun to reach its limits–in fact, we could argue it did so long ago. Can’t wait until people start getting on board and we change this conversation!




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  4. Hear Hear! We don’t eat nutrients. We eat food. The shame of it is that the Facebook page of the nutritionist colleagues were I trained is all about, “What do I take for …?”




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  5. But Dr Greger himself focuses on the specific benefits of specific foods, often obscure ones at that. Amla berries? Is this not a form of reductionism? Anyway. He also covers global topics so at least he’s balanced. But I’m often curious if his reports of health benefits accrue to those who eat poorly or also to those who eat all plant non-processed diets. Could we be 99% good by not eating those things and limiting our diet to say 15-20 basic foods?




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    1. That’s a fair point, which is a cousin to what I was saying above. Besides, especially when it comes to specific classes of phytonutrients, the biology becomes incredibly individualized. I’ve been sequenced, routinely get my microbiome sequenced, get a lot of blood testing done, and so forth, and read dozens of journal articles a day. Even then, you have to complex that against any necessary medications and other factors. For almost anyone on any type of medication, green tea and grapefruit juice (and for that matter, most citrus) is off the table, and a lot of obscure fruits, vegetables, and especially herbs have CYP inhibitors and inducers that can change serum medication levels by an order of magnitude [not to mention that genetic testing is necessary to determine base CYP metabolic rates in the first place]. Ginger and curcumin can bind to certain medications and cause interactions. The takeaway is that it is VITAL to fully discuss diet with your doctor, pharmacist, and care team, and they have to be knowledgeable about the interactions that these more obscure fruits, vegetables, and herbs can have.




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        1. When I pointed out there was an interaction between Metformin and Bendrofluazide to my Dr. She said Hmmm, let me see…[googling]… its not that bad [of an interaction] keep taking it anyway. She didn’t know that it was on her to know about the interactions of the crap she was feeding me. I broke up with her and now date fruits and veg exclusively.




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      1. Okay, however I would never think of discussing diet in detail with my doctor. She is better than most I imagine. She is aware of “vegan diets” but I assure you that she does not take seriously diet-based health regimes. For example, she prescribes Statins to my father without informing him that he could fix his cholesterol levels w/o drugs. So, he goes on eating a lot of fatty SAD foods, I’m sure doing damage every day. In his situation, with neuropathy advancing, simply two weeks off statins and on a good diet could possibly begin a reversal of this serious nerve problem. Anyway. I personally don’t think doctors should concern themselves so much with diet. The basics yes, encourage vegan. But imagine how many times they would have to mention this to patients and how little they would listen. So, they have their domain. Modern Medicine. This represents a huge load for them already. It’s each individual who needs to stop fooling themselves, as bad eating is wilful ignorance at this point. Their only hope may be moderate to high risk standard medicine.




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        1. Tobias and Eric: I know somebody who had triple bypass surgery a few years ago, now takes statins to control them, but still eats the same crap he’s been eating for years, simply because his cardiologist hasn’t said to him anything about lowering and controlling cholesterol through diet. The universal problem is that the vast majority of people think that doctors know everything and his/her word is the last word.




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        2. It’s a chicken and egg problem. Most doctors don’t really want to open Pandora’s box, and most patients don’t want to do the work required for lifestyle interventions. [Of course, once you lose the weight and stop eating the crap and so forth, you won’t have that attitude, but getting people to go from A -> B, at best, difficult. Typically, only when people are REALLY and TRULY desperate are they willing to go to any lengths, and by then it’s much harder]




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          1. Eric Woods: I think you have a good point to a degree, but this situation is why I think Dr. Greger’s analogies (in other videos) about smoking are so important/helpful. There was a time when doctors smoked and doctors would tell their patients that smoking was healthful or at least not harmful. And doctors did not want to do the work of learning about the science concerning the cons of smoking. And they likely thought that even if they did, they would have no impact on their patients.

            People still smoke today, but it is an entirely different world. Doctors know that smoking is bad. Doctors tell their patients that smoking is bad even if the patients don’t want to hear it. And I believe that a lot less doctors smoke now than used to smoke. (I don’t have a study on that.) And at least in America, smoking in public places is severely limited. Well, if this kind of revolutionary change in culture happened in our recent past for smoking, there is no reason we can’t do it again for food.

            I don’t think it is helpful to think of the problem as a chicken or egg problem. Let me offer an alternative. I like to think of the problem as more like a giant, tightly packed pyramid display of oranges in a grocery store. Each every-day doctor who “wakes up” takes a random orange from the pile. Each public, outspoken doctor (like Dr. Greger, Dr. McDougall, the doctors on this forum, etc) who spreads the word takes a random orange from the pile. Every time a medical school or RD school makes a positive change in how the professionals are educated, removes one random orange from the pile. Every time a government institution takes another baby step in educating the public removes yet one more random orange from the pile. Every time there is a video that catches on, like Forks Over Knives, there goes another orange. And every time an every day person such as you and I chooses to eat healthy or spread the word, another orange gets eaten. This is a GIANT pile, so it is still there. But at some point, with all the little efforts working together, the pyramid is going to come crashing down. “Clean up on isle 3!!!”

            We are not responsible for fixing the whole world. We are just each responsible for our own little corner of it. And everyone doing a little bit makes a difference. That’s how I see it. That’s why I spend time moderating on NutritionFacts. I’m trying to remove my share of oranges from the pile.




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          2. Especially since if doctors are aware enough of the issues to inform patients, then they themselves would be put into the same position as their patients…making some drastic changes! Just so much more convenient to ignore the whole issue! Especially unfortunate though, considering most people think their doctor is the ultimate authority on health…as it should be, but…most aren’t. Happily there are notable exceptions, just not enough!




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        3. Which is where I think the new plant based nutritional degrees come into play. A busy doctor would of course still first need to be aware of the dramatic applications, comprehend the breadth of them and appreciate the science, but then he/she can delegate the actual implementation to PB specialists that could be employed or endorsed to spare him the time and effort, and free him to utilize his specialized knowledge where it’s necessary. As long as doctors chose to remain uninformed or ignore what is becoming progressively more obvious, they are shortchanging both themselves and their patients. I don’t know what THE answer is, but it NEEDS to change because in my personal experience I see too many doctors doing more harm than good. To the blessed ones who DO get it…thank you, you saved my life and many others, and equally important, made that life worth living. Prolonging death with pharmaceuticals is NOT the same as extending life!




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          1. I have a feeling that many people know the truth but they are dependent on others or others depend on them and this causes them to block out the good path and even make themselves believe that what they are eating is just fine. It’s pretty hard to tell your mate that the food they prepare for you is killing you, clogging your arteries. So, it comes down to some individual psychological and social factors.




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            1. Yep, it’s complicated, but I think if doctors could at least make the message unified and clear it would help out at least some. Most people I know think their doctors have the last word and know everything, and trust in whatever they say. Doctors may allude to diet being important, but since they have no formal nutritional training it’s probably mostly based on what they see as desirable, and that can vary a whole lot! I was always told to lose weight, yet not one offered an effective, workable, solution until WFPB! It was always a mimeographed handout about limitations, weighing and measuring, deprivation, willpower, and so on, and it just does not work, it feels like you are punishing yourself for naught and amplifies feelings of failure and saps your self worth. People at least need to know the truth beyond some vague concepts that just instills confusion, what they do with it is on them.




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  6. The good doctor doesn’t address the point that most people have chronic deficiencies of vitamins, minerals, and so forth, at levels that are below acute, classic clinical manifestation (e.g. we don’t see pellegra, scurvy, beri-beri, and the like). WFPB diets can address most of that, but not all, and most doctors don’t test for even the most common deficiencies (B12, D, B6, etc). Even Dr. Gregor recommends B12 supplements (assuming clinical levels are low, of course). Population studies suggest that there is a substantial portion of the population who have at least one vitamin / mineral absorption problem (I have IBS, I’m plagued by them, even though I’m a vegetarian, get >80g/day fiber from plant-based sources (not including fiber supplements), and follow the Daily Dozen). He makes excellent points, as usual. Reductionism does have its place, though. In an ideal world, a yearly physical would include testing about three dozen blood levels to ensure there aren’t deficiencies that are going unnoticed. I have to take choline supplements (and yes, I’ve listened to the videos about eggs and why they aren’t the best sources for choline (and I agree), but particularly in older individuals, optimized choline precursors can serve to enhance cognitive function and adjunctively slow cognitive decline). [Honestly, that should include phytonutrient levels as well; the recent video showcases recent results that chlorophyll in serum human blood serves to absorb NIR light to generate ubiquinol levels. Ditto for lycopene and so on.]




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  7. The reductionist approach is not limited to nutritional research. Thinking in the western world is generally not holistic. and so tends be be reductionist when dealing with any issue. Everything is broken down into component parts, which are then considered, analyzed and evaluated out of context to the larger whole. As an example consider the introduction of rabbits into Australia. A fast breeding non-native species, without natural predators, the rabbit population exploded, creating an emergency situation. Reductionist thinking at its most basic was responsible for creating the disaster. This is but one example among thousands of others across the globe. Likewise failure to see the global ecosystem as an interconnect web of life, coincidentally supporting all human life, is frequently the direct result of reductionist thinking. Permaculture on the other hand takes a systems view of nature and our place in it. All science, including medical science need to see the world from a permacultural paradigm. Everything is connected to everything, without exception. Only with such a view we come to grips with problems as antibiotic resistant bacteria or other such “superbugs”. It will only be through the application of permaculture thinking that we can stop killing the oceans, clear cutting rainforests or extinguishing entire species.




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  8. Reductionism sounds like a reactive style of thinking. It argues that there is a black and white world. Saying that what ever is not reductionist has to be good. However, that sounds like very simplistic argument to me. I think that reductionism has both good and bad sides. One of the mayor problems in health is culturally driven by economics and marketing combined with side effects of the agricultural revolution. But that idea sounds harder to sell to people that live inside a cultural cloud.




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  9. Good evening Mister Greger, you speak directly from my soul. Every day, when I talk to my patients I struggle with this topics reductionism. Is this vitamin good for my sickness or this, is this super food good to add or this… here in Germany for example, we used for centuries flaxseed, but now there is a super food available called chiaseed… of course I tell my patient, that’s really a super food but not for you, it’s a super food for the salesman, because the ingredients are similar to the flaxseed but the price is nearly four time more.

    I’m so tired and nearly frustrated by this talking. And you don’t will beliefe it – even Mr. Claus Leitzmann, the first speaker at the VegMed in Berlin answered after this Congress to a journalists question: Do you recommend a plant-based diet? Mr. Leitzmann answered: No!

    I’m speechless!




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    1. Hello Steffen.
      A few years ago Dr. Greger made a very short video comparing flax against chia. It’s very short, but might help you with what you want to konw. It follows on the heels of a previous video about prostate health. At the start of the video it mentions this, but then goes into the comparison, which is not prostate specific. So this video might help you provide information to your parents.
      http://nutritionfacts.org/video/flaxseeds-vs-chia-seeds/

      BTW, I love how the German people (generally) try to make so many improvements in society and the environment. I have a friend in a Ronheim, a very small village in Bavaria. I have visited him and his family there several times over the decades. I am always impressed by how Germans try to help each other, strengthen their communities, protect the environment and try to see the best in other people. I appreciate the German people’s contributions to our world.

      Cheers,
      Mark G (in California)




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      1. Hello Mark,
        thank you for your warm words. I don’t go so far to claim that chia isn’t a good food and at a special situation very helpful. But most of my patients konsum tonns of meat, eggs, fad, chocolate and more and then obesed and often confronted with diabetes the hear something about the miracle of chia. This was what I mean. Of course some Germans, like other people in other countries doing good thinks but also it’s true that Germany has only 1 % vegans, we have only about 5 % organic farms but the biggest player in pesticides “BAYER” who at the moment tries to take over monsanto. I gues his intention is not to cancel al this rubbish. And, let me say once more, speaking of oncologists, the still tell there patients that food has no or only very little influence to cancer – so I lost one of my best friends 2 years ago a mother of 4 beautiful kids. At the moment I try another friend to be a good health practitioner (Heilpraktiker) because he has brain cancer.
        Of course speaking generally or speaking generalize isn’t always good, I know this, but sometimes we have to make our self air (I don’t know if the sense of “making air” is the same in English like in German) otherwise I will stifle by what I see every day here. Sorry.
        I’m happy to read that you have made always good experiences when you visit your relatives here in Germany.
        Cheers Steffen




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        1. Hi Steffen
          Thanks for your reply. I understand what you’re saying and I agree with you. It’s the same here. I don’t know why more people don’t want to know about their health and make good choices.

          Your use of air is correct. Here, we would say, either “I have to make myself heard” or “I have to air it”. You could also say,
          Cheers,
          Mark




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    2. Steffen Jurisch: Keep up the good work. You may not affect everyone, but by being a leader, you will have an impact on those around you.

      I can understand the frustration. I know I would be frustrated! That’s one nice thing about this site. Doctors and other health care professionals can come here to get some moral support. Well, I’m not a doctor, but I applaud your efforts. Thank you for your work.




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  10. But Dear Doctor Greger, isn’t reductionism what you’re promoting when you give a report of the health benefits of some strange spice? Or of some specific fruit (like berries)? Or of any item on your list of the Daily Dozen? After all, the research on each of these spices and on each of the Daily Dozen components was an example of reductionism, right. After all, the most healthy group of people ever studied, the people of Okinawa (before the Standard American Diet crept into the island), got a whopping 70% of their calories from just one food, sweet potato, and the rest came from a limited number of other plant-based food (with about 1% coming from fish). They didn’t worry at all about a Daily Dozen. They just ate a whole-food, plant-based (WFPB) diet and left it at that. Another way of asking my question: Is there a study of people who are already eating a WFPB diet showing that they really need any particular item the Daily Dozen? Maybe just about any old WFPB diet would work just as well. What say ye?




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    1. The fact that some populations have done so well on rather limited diets (a point stressed by McDougall) makes me wonder about the RDAs, since I would think many of them would not be met on such diets. At least when I use cron-0-meter to track my nutrient intake, I find deficiencies here and there, and can only reach the RDA targets by pretty careful selections and amounts. I am wondering if others have found the same problem (reaching all RDAs).




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      1. David, you’re right. I track mine, and yes, it’s hard, particularly for potassium (depending on the recs, between 4-5.5g/day). Re: McDougall – My thoughts are that the phytonutrients in that Okinawan purple sweet potato may have second order effects – like modulating the microbiome – in ways that allow the bacteria (or us) to synthesize vitamins that we might not otherwise get. It’s also possible that their agricultural methods produced a high enough concentration of nutrients in those potatoes that RDAs got met anyway. Certainly the way that they prepared the soil and so forth is very different than how it is done today. Maybe rhizomal communities and other environmental components really created qualitative and quantitative differences in the potatoes.




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        1. We could drive ourselves crazy trying to control all the variables and I was starting to burn out assimilating all the specifics and trying to find a balance. Though I do love the science and all the specs, I had to simplify ( ala dr G’s daily dozen for ex.) knowing that plenty of populations of people actually often survive to a healthy old age who know nothing about diet…as long as they have access to even a minimal variety of fresh produce. Yes, optimal nutrition is better than adequate nutrition, but I think there are far too many variables to even guess where one ends and the other begins, unless there is an obvious symptom. And instead of treating symptoms as illness and just masking them with pills, we need to find their root cause and move to “appreciate” them as the helpful indicators the body provides to warn us something is out of balance and needs to be fixed.




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      2. We tend to forget the potential impact of trace elements in drinking water on achieving RDAs for minerals. However, I have no idea what the actual impact is except that it will obviously vary according to drinking water sources.
        http://www.bgs.ac.uk/research/groundwater/health/drinkingWaterTrace.html

        The effect of minerals in water on human health is nevertheless potentially important. I remember many years ago in the UK there was some research which found an association between heart disease death rates and the “hardness” of drinking water.
        http://www.ncbi.nlm.nih.gov/pubmed/4105042

        However, whether the association is actually causal is still not known I understand.
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1247198/




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    2. But Dear Doctor Greger, isn’t reductionism what you’re promoting when you give a report of the health benefits of some strange spice? Or of some specific fruit (like berries)? Or of any item on your list of the Daily Dozen?

      No Scott, it is the exact opposite of reductionist. It is optimizing. You can ping out a tune on a kazoo but whats a symphony without a kettle drum?




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    3. Saying why one particular food has particular benefits is not the same as reductionism. He isn’t saying blueberries are the answer. He is talking about how each one does particular useful things, so we should eat a wide variety of plants and he also mentions how there is probably synergy going on, which is the opposite of reductionism. The reason why Dr. Greger champions whole plant based diets is because we can’t reduce blueberries, to say one antioxidant. We don’t know what the secret chemical is in it, or that there is one secret chemical but they help in many different ways. That’s why he compares blueberries instead of vitamin C. Therefore, he champions whole food plant based diets, because he doesn’t reduce the value of the plants to one chemical, because reductionism doesn’t work in these scenarios.
      John S




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      1. John: Thank you for putting this into words. I’ll also add that every study and video on say blueberries or amla or etc helps put together the big picture about the whole topic of berries and fruit. We’ve also learned that not all food of a category are the same. For example, we have learned here on NutritionFacts that one type of cinnamon may help with diabetes while another type may not. If someone has diabetes and needs some extra help beyond a vanilla whole plant food diet, that type of distinction is vital information.

        NutritionFacts serves several purposes and those videos which focus on specific foods and even specific nutrients are as important as videos which cover the big picture. Both types of videos as well as both types of science are necessary for advancing human understanding of nutrition and health.




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      2. Thanks, John, for your explanation. You make a good point. But I’m still puzzled. If trying to sort out the chemicals responsible for the health benefits of a particular food is reductionism, then trying to sort out the particular plant foods responsible for the health benefits of a whole-food, plant-based (WFPB) diet is another type of reductionism, just at a different level. To put it in practical terms: If I eat a wide-variety of fruits, vegetables, tubers, legumes, grains, nuts, and/or seeds, does it really make a difference if I include or exclude blueberries? You have to use a reductionist-type research approach to answer that question. What if I eat a WFPB diet with almost the same level of variety but leave out (or mostly leave out)–to give another very paractical example–nuts and seeds, as Esselstyn and Ornish recommend. (Ornish now allows a small amount of nuts and seeds.) So Greger highly recommends nuts, because studies of people on non-WFPB diets (I presume) benefit from nuts. That’s reductionist thinking, isn’t it? Or at least faulty thinking. If you really want to know the benefits of nuts, you need to study only those who are already on a varied WFPB diet and then test for the benefits of adding or omitting nuts. I’m asking these questions not to be argumentative but rather because I really want to know. I’ve had serious heart disease, and as a scientist (professor emeritus of biochemistry), I want to be able to understand why, for example, I should follow the Daily Dozen vs just make sure I get a variety of plant-based, whole foods. I’d love to hear your or other’s responses.




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        1. Hi Scott,
          In the limit, to say that you refuse any type of analysis, you could say that no food is better than any other food. That is absurd, and goes completely against what science has taught us. The reason that Dr. Greger talks about whole foods is that the science on the benefits of eating whole foods is very solid. Some companies have tried to reduce the positive benefits of say, apples to quercetin, an antioxidant in it. The results have been very poor. What Dr. Greger is saying is that reductionism is a philosophical method for trying to understand the benefits, but it’s not the only way. In nutrition, it has mostly not worked very well or to a limit. Therefore, we need to look at other ways of understanding the problem. Dr. Greger has shown videos in which he has shown that reductionism of the benefit of the whole food to the isolated static chemical doesn’t work, so he hypothesizes why not? There does seem to be some evidence (not conclusive that I have seen) that some symbiosis is going on. I have seen this from other studies as well. One problem is that this way of understanding is harder to prove. Another problem is that no one will fund the double blind placebo controlled studies, because no one can patent the single medicine. IT’s nature, no one owns it, so everyone can use it freely. There seems to be something in whole foods that is really good for us, and the data on that is really clear, so we can back it up, even if we don’t know why apples are good for us exactly. We can’t say that it’s the isolated quercetin. Maybe it’s the way the peel combines with something else in the apple. Just because we don’t know why exactly apples are good for us doesn’t mean that we don’t know that apples are good for us. We have the studies. SO at that point, we stop reducing it, and just say that apples are good for us. That’s all we know right now, but we do know that.
          John S




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          1. Thanks, John, for your lengthy explanation. I agree with everything you said. I have read Dr. Greger’s “How Not to Die,” and all the other books in the standard WFPB-diet library by Esselstyn, McDougall, Cambell, Ornish, et al., so I am totally in agreement with the “Whole” philosophy, but I wanted to get your take on some of the details. Thank you again for taking the time to give me those details. Best wishes.




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        2. Scott: It is a reasonable question. Here’s my answer.

          The key, in my opinion, is this part of your statement: “…vs just make sure I get a variety of plant-based, whole foods.” To me, this no different than someone saying, “Just eat in moderation/a balanced diet.” Everyone has a different idea of what moderation and balance means. And everyone’s definition is meaningless without the context of science/evidence to tell us what actually is moderation/healthy.

          We had a poster once who bragged that he ate 50% meat and 50% veggies. And he actually said that it just doesn’t get more balanced/moderate than that. But the science tells us that moderate meat eating is more like 4% calories, if moderate means an amount that won’t contribute to disease promotion. (And there are some strong hints that eating 0% is the healthiest option, moderation be damned.)

          So, back to your point: “Just eat a variety of plant-based, whole foods” What does that really mean? Two points. Point 1) Based on your post, I think you have a very clear picture in your head about what that means. But you got that clear picture based on information you have learned from experts like Dr. Greger and others and from studies of particular foods and food groups. It’s not reductionist to try to figure out if nuts are overall health promoting or not. And it is not reductionist to find out how much nuts are too much. Those types of studies are the only way to get a sense of whether we should include nuts in our “variety of whole plant foods” diet, and if so how much to include. (You have to acknowledge that there can be too much of a good thing…)

          You make the point that if someone doesn’t do a study on people who eat exactly like you, then the study doesn’t count. I think that’s going too far. We do have evidence that people on a healthy diet have bodies which work differently. (In other words, I don’t think you are all wrong.) However, that doesn’t mean that we can’t use our heads and understanding of the mechanisms involved to make good guesses about which study results apply to people in general verses only people who eat a SAD diet. It is a place for honest disagreement, but I don’t think we are talking about reductionist or faulty thinking.

          Point 2) I can guarantee you that based only on your phrase as a dietary guide (“variety of plant-based, whole foods”), there would be a giant amount of interpretation/range from various people, including how much junk and animal products would be OK. The phrase is only meaningful in the context of the science which tells us what is healthy. What does “variety” mean? How much has to be whole plant foods? Dr. Greger’s Daily Dozen is an attempt to help people get a handle on what it means to “eat a variety of plant-based, whole foods”. You don’t have to follow Dr. Greger’s Daily Dozen to the letter, but at least you have something to compare your diet against. The Daily Dozen is Dr. Greger’s attempt at summing up what the science says about what eating healthy looks like. There are other models that also likely work well. But to really be helpful, a dietary model must a) be specific enough that everyone is on the same page, and b) be based on good evidence for what is healthy for the majority of people.

          In other words, I think you are taking the concept of “reductionism” and applying it at a level that does not work. Though I do understand your thinking and can see why you would think that way. It is good thinking. I just disagree.

          What do you think?




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    4. He reports what the science says. If the science wants to take a reductionist approach, then the videos will come off as that.




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  11. Regarding the video, it is refreshing to hear not the drug-oriented view of “magic” foods and their measured effects on specific diseases, but the broad view of simply eating good foods! YES!




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  12. Protein? Vegetable protein is great for Gorilla’s, strict herbivores strong as all get out. Leaves, fruits, shoots, … is perfect and they are 98% our DNA.
    Check Cornell nutritional biochemist prof T. Colin Campbell’s book “The China Study”. 10% calories vegetable protein is right – too much protein feeds cancer.
    Also, “A high ratio of vegetable to animal protein consumption was found to be impressively associated with a virtual disappearance of bone fractures.” Frassetto, LA et.al. J. Gerontology M55 (2000) M585-M592




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    1. A related thought… I’ve never seen mention of it so I wonder what I’m missing in regard to RDA’s of the big 3 nutrients… protein, fat and carbs. Human infants, whose rapid body and brain growth needs are higher than they ever will be again, get all the nutrients they need from the perfect food…human mother’s milk, which is just 3-5% fat, 1% protein, and around 7% carbs as lactose. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586783/ So how the heck did they come up with the totally skewed RDA’s for adults when I can’t imagine how a maintainance diet for a fully developed organism could possibly need more nutrients (calories maybe, based on size, but not % of nutrients) than an intensive growth diet? Any help would be appreciated because this just seems “too obvious”, so I feel I must be missing something!




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      1. I am not sure that I can offer an enlightening response but here are my thoughts:

        As your link makes clear, human milk contains a range of non-nutritive but bioactive factors which will necessarily reduce the percentage of milk represented by macronutrients. It is also a liquid food and 90% water. In other words, macronutrients are not the only factors needed for intensive growth diets so your question might simply be based on a false premise.

        As for how they come up with dietary reference intakes like RDAs, that is a bit of a can of worms. Settle in for a long read if you really want to know. You could start here:
        http://www.who.int/nutrition/topics/nutrecomm/en/

        Or for the US …………..
        “Data available for DRI development are often limited. As a result, study committees at times make decisions about reference values in the face of uncertainty and gaps in data. The effort to make a decision using available data is encouraged because, from the perspective of protecting public health, a study committee’s educated if imperfect input about an appropriate reference value—by way of scientific judgment—is preferable to deferring a decision until the database is more robust.”
        http://www.nationalacademies.org/hmd/~/media/Files/Activity%20Files/Nutrition/DRIs/New%20Material/11Bckgrd%20PaperFramework%20for%20DRI%20Devel.pdf




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        1. Thanks for the links and info Tom. Duh, I linked to the wrong article, this is the right one that the %’s came from… http://www.ncbi.nlm.nih.gov/pubmed/392766
          It just struck me that with what is known from Campbell’s casein studies (5% turned cancer off, 20% on) compared to RDA’s, that the composition of human milk kind of bears out that our needs are not near as high as we’ve been led to think, and obviously fat as well. I suck at math though!




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          1. Ah, thanks. Yes, I think the breast milk composition there is calculated by WEIGHT eg
            “Mature human milk contains 3%–5% fat, 0.8%–0.9% protein, 6.9%–7.2% carbohydrate calculated as lactose, and 0.2% mineral constituents expressed as ash.”
            By contrast, RDAs for fat etc for adults are calculated as a percentage of total calories. So you wouldn’t expect the ratios to be at all comparable.

            There is no doubt that high animal protein consumption is unhealthy but the science behind the RDAs is quite solid. I did check out the casein issue a year or two back and could not find good evidence for it being a key factor in human cancer. The only link I found was a study showing an association between casein consumption and fatal prostate cancer.




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  13. My myopic view, “Reductinism” is driven by Drug companies wanting to make a killing. No way I can think of boiling the Mediterranean Diet” down to a handful of chemicals. BTW, in a recent study, with the Mediterranean Diet the Type 2 diabetes risk was reduced 83% in a susceptible population. Just food, no drugs were involved.. http://www.bmj.com/content/336/7657/1348.
    The Mediterranean diet is much better but that does not mean it is “optimum”. We do a variety of plant foods plus occasional small portion of fish and a little Omega 3 from algae grown in drinking quality water (no ocean toxins). Algae is where the fish get omega 3 from anyway. Is that “reductionism”? Oh, I need B12 too proven with blood test.




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  14. The reductionist mindset resulted from the way clinical trials have been conducted for at least the last century. Two equal groups of subjects are selected and just one factor is changed in one of the groups and the results are compared. With the appropriate statistical tools, it can then be determined if this one factor, be it a pill, injection, surgical technique or a nutrient, has an effect on the subjects, while the lack if it does not. Multiple factors are seldom tested together because of the complexity of the experimental design. For example, if five factors are expected, all 5 would be tested together, along with the 5 possible combinations of four of these factors, the 10 possible combinations of 3 of theses factors, the 10 combinations of 2 of these factors and the five combinations of just one factor. That makes 31 different clinical trials. And it only gets worse from there. Usually researchers don’t have the time and means to do that many trials with their limited funds and subjects. Therefore, just one factor is tested at a time and the reductionist model is assumed. Although we are finding this model to be faulty, we have no real means of devising other tests. And yet, we can’t just throw up our hands and take the unscientific view that God knew what he was doing when he created natural whole plant foods. Good Heavens! (Pun intended) we can’t have scientists giving God credit for anything! Can we? On the other hand, acknowledging that the reductionist model is faulty is not justification for a rant against supplements. Yet this bias clearly comes through, not only in this posting but in previous ones. For example, not long ago Dr. Greger stated that eating foods rich in arginine might be helpful in promoting brown fat and thermogenesis. However when I checked the reference he cited, I found that he misrepresented it. In both it and other related studies, the researched used not foods but arginine supplements, between 5 and 9 grams a day, beyond the amount already found in the average protein-bloated American diet. That much would take a lot of beans to equal, and we can’t simply assume that arginine found in food behaves the same way that supplemental purified arginine does.




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    1. We could do the “10,000 foot reductionist study” and vary the whole eating pattern in fundamentally different ways and see how the different patterns stack up against each other. And in fact we have a ready made set of cohorts of dedicated subjects in those committed to following a WFPB diet, those eating a Paleo diet, the DASH diet, the ADA diabetes diet, and especially the Atkins/Wheat Belly/Grain Brain low-carb folks and follow them for say 5 years. The nice thing about dividing up the cohort this way is that you have a built-in recruiting tool in placed social media sites dedicated to the different eating patterns not to mention millions of potential subjects that passionate about following the eating plan and so compliance rates are likely to be very high.

      At the end it would be impossible to say which specific component of the a given eating plan resulted in an improvement or reduction in soft and hard markers of health. But does that matter because the ultimate goal of nutrition research is finding what to feed the human animal to maximize good health.

      Well if the different cohorts were large enough, researchers could look at the variations within each cohort to see if subvariations in the eating plan resulted in measurable differences. For example do Paleo eaters who focus on massive amounts of non-starchy vegetables and fruit with the amount of meat and eggs being limited to just supply needed calories (likely the True Paleo ™ diet was likely to have been) do better than those following Paleo who go full-caveman and really focus on the meat and eggs with a garnish of vegetable matter around the edges.

      Oh, and for any potential researchers out there reading this, please please include in the intake questionnaire a question asking why subjects switched to a given eating plan and what specific health issue if any they are trying to address. And include their initial health status and markers (cholesterol level, A1c, weight, BP, etc) when starting the diet as well as their current status and markers so as to avoid the dreaded reverse causation. This is likely why studies like EPIC Oxford “shows” that vegetarians don’t do any better than carnists, when in fact many people switched to vegetarianism because they were sick and so that population can have a unrepresentative number of people with serious health issues.

      And with the initial health status understood, you could get your reductionist groove on and even compare the effectiveness of different eating pattern on addressing specific preexisting health issues by extracting just those who say are obese, have high BP etc from each eating pattern and compare the outcomes. As a researcher myself (in a totally different field) I salivate at the number of journal articles I could publish not to mention how many PhDs students I could mentor from such a treasure trove of data.




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  15. There is strong evidence that disease can be cured with nutrition. Any unprocessed food from fertile ideal natural soils could possibly restore a person to health. Most food is highly processed. There is strong evidence that all disease can be cured with nutrition or minerals, according to Dr. Pauling. There is strong evidence that schizophrenia is just pellagra or a milk allergy. Many people have schizophrenia. There is even some evidence, in my opinion, that gingervitis is scurvy. It would probably take six to eleven servings of grain a day to prevent pellagra. I don’t think many people get that. Daily multivitamins add great length to teleomeres, perhaps the most powerful or only possible benefit. I believe that modern food is soaked, baked, milled, soured, and beaten. Most fertilizer has Nitrogen,Phosphorus, and Potassium in it. Perhaps N, P, K, and Sulfur, Silicon, Calcium, and Magnesium would be good for people to. You reported on deficiencies in the tomato effect. Truly great doctors would be able to understand deficiencies today.




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  16. Just wanted to give a shout out to something I thought was pretty awesome. I attended my first Plant Pure Pod meeting last night and just wanted to encourage people to join in a local chapter and spread the love. (from the movie “Plant Pure Nation”… about Nelson Campbell’s efforts to educate people about the importance of a WFPB diet) I was expecting a small group but was very pleased to see over a 100 people at a great program where a chef did a demo and shared with the crowd, and a local plant based doc did a talk on the microbiome! I met so many nice people and it was awesome to be surrounded for once by others who “get it”! It was such a nice switch to feel like a part of something great, instead of the weird outsider. (Not that that’s anything new for me, but , just sayin’ ;)




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  17. Reductionism vs Wholeism

    “To understand the Universe, one needs both a telescope and a microscope,

    and the brains to interpret what one sees in each” :-)

    —- Halthevegan, circa 2016




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    1. When the only tool you have is a hammer, every problem starts looking like a nail. Reductionism is a great tool, and we wouldn’t know nearly as much as we do about specific biochemical pathways as we do without it, but every problem requires the right tool/approach and reductionism isn’t the right tool for everything. So I might expand your quote a little

      “To understand the Universe, one needs both a telescope and a microscope and the brains to know which to use and how to interpret what one sees”




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  18. what about problems that don’t seem to be easily regulated with wfpb diets (and of course still being beneficial) like IBS, dysbiosis, yeast issues, anemia, hypothyroidism etc.




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    1. I can only speak for myself, but WFPB in combination with adding fermented foods totally resolved long standing severe IBS-d and a slew of other issues, major and minor, too long to list! Once you get the microbiome nurtured, so much will heal, but the more issues you have, the more stringent you need to be, especially early on.




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  19. The idea of the article is right, but the presentation is wrong.

    The idea is that we know very little about the components of food and its reactions in the human body.
    We know very little about how our guts work.
    But we do know that when people eat whole foods, plant based, health improves, and that when we eat junk, health suffers.

    In the long term, the reductionist appropach will win. IN THE LONG TERM.
    We will engineer and produce healthy food.

    Right now, we produce junk food, and our attempts to produce health by what we eat (pills) pales in comparison to natural whole foods.
    The reductionist approach has promised a lot and delivered very little.

    So, for now, its a mix between nature and pills, ignorance (or the wisdom of nature) and human knowlegde.
    However, nature is not evolving (at least not very fast) and human knowlegde is moving VERY fast.

    I eat WFPB, but I keep an eye on the reductionist approach, and I don’t forget to take my B12.
    I eat based on what I know, but keep an eye on what I don’t know.




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  20. The reference to breakfast cereals, had me thinking of breaking the fast, after sleeping – and than I find there is not a single reference on this site about the health benefits of intermittent fasting. There are a lot of published papers on the matter, especially their beneficial cortisol and growth hormone profiles.




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  21. I currently take Dr. Joel Furhman’s multivitamin and his Immune Biotect, as well as his algae oil, but I have often thought of switching to Dr. Greger’s recommendation of just B12, algae oil and Vitamin D. Furhman’s “Immune Biotect” has a lot of exotic mushroom extracts, a berry blend, elderberry fruit, glucans and Astragalus root. His multivitamin includes a bit of calcium, magnesium, zinc, Vitamin C, K 2, Thiamin, Riboflavin B6, B12, Biotin, Pantothenic Acid, Iodine, Chromium, Molybdenum, Vanadium, Polygonum cuspidatum, Maitake Mushroom, Taurine and Whole Food Fruit, Veggie and Greens blend. His has experience with thousands of patients and have seen many vegan deficiencies, so I’m reluctant to stop taking his vitamins. Any thoughts?




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    1. Thanks for your comment Joy.

      Dr Furhman is an excellent physician and whilst I think any recommendation for supplementation should be specific to individuals, there is some evidence to suggest the use of vitamin B12 & D, and algae oil in specific populations. Nevertheless, I highly recommend you to read this short summary on multivitamins.

      Hope this answer helps!




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      1. Thanks so much. It would be great if they could do studies on specific components of Dr. Furhman’s vitamins, since his avoid all the ones known to be unnecessary or to cause problems, such as Vitamin E, A, Beta Carotene, Lutein and Copper. Dr. Furhman feels the ideal weight for someone 5’6″ is 119, and to maintain this, I’ve found I don’t have as many grains as Dr. Greger recommends. But I know I can do it by cutting back on fruit. However, when he says ” a minimum of 9 fruits and veggies daily,” I could do better than that by cutting grains to one serving a day. Your thoughts are very helpful, as was the short summary. I think I’ll try going Dr. Greger’s way on supplements when I’m finished with my supply of Dr. Furhman vitamins.




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        1. >>> Dr. Furhman feels the ideal weight for someone 5’6″ is 119
          Is there somewhere he discusses ideal weight? Does this take frame size into account? I would think the ideal weight would have to take into consideration percent of body fat vs. muscle (and bone)…

          I also take a Dr. Fuhrman supplement (the one for men) and have wondered about the same issues you mention. But like you I cannot quite bring myself to quit, and for the same reasons.




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          1. He discusses ideal weight in his book “Eat to Live.” I’m sure in person he would take frame size and muscles into account, this is probably a rough guide. On the vitamin front, it seems to me now that if there can be a case made for one supplement or two or three (D, EPA and B12), then why couldn’t a case be made for a few more. Here’s what Dr. Furhman says about each one, which seems so convincing:

            Vitamin B12
            Vitamin B12 is required for important biological functions like red blood cell production, nervous system function, and DNA synthesis. Deficiency in B12 can cause a variety of health problems, including elevated homocysteine (a cardiovascular risk factor), anemia, depression, confusion, fatigue, digestive issues, and nerve damage.3Insufficient B12 levels are also associated with increased risk of Alzheimer’s disease.4

            Vitamin B12 is unique in that it is made only by microorganisms. Because our produce is washed and often transported much before we eat it (soil contains B12-producing microorganisms), most of us are unable to get sufficient B12 from plant foods alone.

            B12 deficiency is common, especially in vegans who don’t supplement and in the elderly. Our ability to absorb B12 decreases with age, and about 20 percent of adults over the age of 60 are either insufficient or deficient in vitamin B12.5 Supplementation with vitamin B12 is likely important for most people, and absolutely required for most vegans to achieve sufficient B12 levels.6

            Vitamin D
            Once thought to be important only for bone health, scientists have now found that Vitamin D has important actions in almost every cell in the human body.7 Consequently, insufficient vitamin D levels are associated with several cancers, diabetes, cardiovascular disease, depression, and autoimmune diseases.

            Insufficient vitamin D levels are also very common.8 Since many of us live in cool climates and work indoors, and because of the potential risks of skin damage and skin cancer, supplementing is the best choice for achieving adequate vitamin D levels. In my experience, 2000 IU has been an appropriate dose to bring most people into the favorable blood 25(OH)D range of 30-50 ng/ml (I also recommend getting a blood test to confirm adequate levels). For extra assurance, I’ve also utilized Vitamin D3 because of its high biological value, the most effective form for raising 25(OH)D levels.9

            Vitamin K2
            There are two forms of vitamin K, K1 and K2. Vitamin K2 seems to be more important to supplement – vitamin K1 is abundant in leafy green vegetables, so those on a healthful diet would not need to supplement with K1. Vitamin K2 is produced by microorganisms and is low in plant foods. Also, vitamin K2 supplementation may offer additional health benefits: Vitamin K2 supplementation has been shown to reduce the risk of fracture, reduce bone loss, and increase bone mineral density in women with osteoporosis.10

            In several studies, vitamin K2 intake was associated with reduced risk of heart disease or coronary artery calcification (an indicator of increased cardiovascular risk), whereas no such association was found for K1.11 The human body can synthesize some K2 from K1, and intestinal bacteria can produce some usable K2, but these are very small amounts.12 Therefore, it is likely important to supplement with K2.

            Iodine
            Iodine is required by the body to make thyroid hormones. A recent study of vegans estimated that only about 40 percent of the daily requirement for iodine was commonly met on a vegetarian or vegan diet.13 Another study concluded that 80 percent of vegans, 25 percent of vegetarians, and 9 percent of conventional eaters are iodine-deficient.14

            Most plant foods are low in iodine due to soil depletion. Kelp, a sea vegetable, is a good source of iodine, but is not commonly eaten on a regular basis and may actually provide excessive amounts of iodine. The chief source of iodine in the typical American diet is iodized salt. Since salt should be avoided for good health, it is important to supplement with iodine to maintain adequacy.

            Zinc
            Zinc is essential for immune function, growth, and reproduction, and supports hundreds of chemical reactions. Zinc is abundant in whole plant foods, but is not readily absorbed. Beans, whole grains, nuts, and seeds contain zinc, but also contain substances that inhibit zinc absorption.15 A recent study of vegetarians found a high prevalence of zinc deficiency, and zinc requirements for those on a completely plant-based diet are estimated to be about 50 percent higher than the U.S. RDI.16-18

            Zinc is especially important for men, because it is concentrated in the prostate and promotes death of cancer cells, possibly by suppressing the activity of inflammatory molecules. Long-term zinc supplementation is associated with reduced risk of advanced prostate cancer.19

            While most people can certainly benefit from a multivitamin, it is important to choose the right one. Just as it is important to avoid vitamin and mineral deficiencies, it is equally as important to avoid consuming excessively high levels of certain nutrients, and to steer clear of certain nutrients in supplement form.

            Don’t take multivitamins containing folic acid, vitamin A and beta carotene.
            The synthetic folic acid in supplements is not the same as natural folate, found in high concentrations in green vegetables. Taking supplemental folic acid may increase the risk of breast, prostate, and colorectal cancers.20

            Vitamin A and beta-carotene in supplement form have also been shown to increase the risk of cancers, possibly by interfering with the absorption of other carotenoids, and supplemental vitamin A, beta-carotene, and vitamin E are all associated with increased risk of death.21 These shocking scientific findings mean that most conventional multivitamins act as a double-edged sword, containing both helpful and harmful elements.




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  22. The magazine New Scientist took a report from a non-profit public health organization in the UK and picked out some of the findings and then reported them in a misleading way…they appear to be promoting the “eat all the dairy and meat fat you want” theory of weight loss and good health. It seems that they failed to note and to qualify the difference between refined carbs and whole foods, and the diff between processed veg oils and naturally occurring fats. What a mess. I would love to see some discussion on this. First, a link to the New Scientist article today:
    https://www.newscientist.com/article/mg23030771-600-carb-your-enthusiasm-are-bread-pasta-and-spuds-making-you-fat/?cmpid=EMP%7CNSNS%7C2016-0906-GLOBAL-Junewk2_fat_food%7Cplate&utm_medium=EMP&utm_source=NSNS&utm_campaign=Junewk2_fat_food&utm_content=
    Then the link to the UK report which was the source of the New Scientist article.
    https://phcuk.org/eat-fat-cut-the-carbs-and-avoid-snacking-to-reverse-obesity-and-type-2-diabetes-national-obesity-forum/
    I can just hear the bloggers now, trumpeting the importance of stuffing oneself with animal fat! Yuk!




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  23. The reductionist ideal of one change/one result can never be achieved in the field of nutrition because the addition of anything containing calories requires the remove of something else from the diet. So if there is a change in status you can’t know directly if it was due to the addition of the item being investigated or the subtraction of the item displaced. This even applies to “healthy” foods.

    So in a study say to investigate the health effects of complex carbohydrates by adding more whole starchy foods there would have to be a reduction in foods like meat, dairy and eggs that are high in protein and fat in order to stay isocaloric. If there was a change in health status (good or bad) the reductionist would never be able to tell whether that was do to the addition of foods high in starches or the remove of foods high in protein and fat.

    The good news for those whose actual concern is to simply be healthier the ultimate cause of a change in eating pattern is not anywhere near as important as the fact that it does result in a change in health. As such I think researchers trying to force fit a absolute reductionist approach (double blind, placebo controlled studies) on nutrition research just need to give it up as a lost cause.




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  24. What about the whole argument that the soil is depleted and foods aren’t as nutritious? For example I have YET to meet someone who has normal vitamin D levels, everybody seems low. Same for B-12 (although there seems to be variations there).

    Myself as an example, I used to eat plenty of B-12 rich foods (before I started cutting back) and my B-12 was still borderline low. If things like D and B-12 are low, who’s to say other things aren’t too? I suppose a blood test would answer that but doctors don’t seem to check for nutrients much.

    There’s also a whole slew of supplements that are not necessarily acting as food replacement, for example theanine or passionflower extract for stress relief. Both have been scientifically proven to work, but you can’t get quite enough through food (not even sure how you’d eat a passionflower..). Same for things like chromium for blood sugar control or coq10 for arterial health in older people.




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    1. Vitamin D does not come from plants and so deficiency has no relationship to soil nutrients. ,a href=”http://www.health.harvard.edu/mens-health/vitamin-d-and-your-health”>Vitamin D is made inside your skin from cholesterol when exposed to the sun. The pool of 7-dehydrocholesterol, the specific type of cholesterol converted to vitamin D, in the skin is limited and the body takes hours to recharge the pool. So once converted, additional sun exposure doesn’t make any further amounts of vitamin D. The best recommendation that I have seen is take the amount of time in the mid-day sun it takes to make your skin a little pink (if you are caucasian) and divide that in half to get the time skin without any sunscreen takes to exhaust its pool of 7-dehydrocholesterol. That can be a little as 10 minutes. More time is required when the sun is lower in the sky and some say that UV exposure is too low at anytime of the day during the winter at high latitudes (not to mention the chance of frost-bite). Darker skin tones require longer exposure to make the same amount of vitamin D. And the more skin exposed, the more vitamin D that is made, but not so much as to be arrested.




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  25. There is mention in this video about breakfast cereals, essentially the meal that breaks fast from sleeping – yet this site has ZERO about the health benefits from intermittent fasting. There seems to be a lot of papers on the topic and I would love to see nutrition.org take a stab at it.




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      1. Yes! I have written a few times suggesting an assessment of the 5:2 Dr. Mosely fasting BBC show and book. I wonder about the pros and cons. Dr. Greger now and then mentions that it is good to keep the nutrients and anti-oxidants flowing. Dr. Fuhrman wrote me that he personally would get too thin with intermittent fasting so does not do it. We did it for a couple of years. It is not fun, but if it is worth it, we would recommence. A doctor here in our town calculates that in about 17 hours of fasting we tip over to that state that leads to cell clean up and that by about 18 hours one could eat again. That is easy, but it is true? How long does one have to be in that state to have the clean up do its job? How often?




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        1. I feel like more and more research surrounding it will come out soon. I personally just spent six weeks as an intern at TrueNorth Health centre and saw first hand amazing patient results from fasting, however it’s much easier to see changes such as decreased BP, removal of joint pain and inflammation, reversal of T2DM… in those suffering ill health, and on extended water-only fasts. It is much harder to assess the long term say longevity benefit of skipping a few days or extra hours fasting, in the otherwise health WFPB devote! I find clinically those that do best on intermittent fasting are those that naturally tend that way, for example, if you don’t wake up hungry… don’t eat! If you feel ill and adverse to food… don’t eat! That kind of thing! I would definitely like to see more research in an already healthy, lean, fit, WFPB individual… probably wishful thinking though! I always felt a lot of the animal studies on longevity benefits were around caloric-restriction from birth leading to a smaller individual with associated longevity benefits, however the new research seems to suggest there is more to it than that, with metabolic changes, increased autophagy, and other beneficial physiological changes… Anyway I digress!

          In answer to your question I find it hard to believe it is a set number, it would be individually determined I feel based reserves, glycogen stores, metabolism, activity, muscle mass, diet etc… For example it takes between about 2-5 days for individuals to switch into ketosis completely… I feel intermittent fasting would too have similar variation windows…

          As for time frame, same thing… some of the ideas I learnt at TrueNorth include-
          1. For the sick, fast as long as safe to (in a medically supervised environment), usually 10-40 days, depending on the condition, OR until the problem resolves, whichever comes first.
          2. For the lean and healthy, a few days water or juice, a few times a year as a tune up can be good.
          3. For those more inclined to weight loss, juice fasting or IF with juice days is more effective than water other than as a kick start.
          4. IF for the curious as a try to see if it’s for you!




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          1. Dear Renea, Thank you for your thoughtful and detailed response! I only now have found it! I very much appreciate your answer and discussion. I am apparently a very healthy 67 -yo person and am so very grateful to Drs. Fuhrman and Greger, and Thea and the entire team which includes YOU!

            I live in Mill Valley, near San Francisco, with my WFPH husband, Kevin, We often have wished to experience (and drag our less-healthy friends with us to) True North. But being healthy and eating WFPB for 5 years, I have not been willing to spend the $$. I ice skate 2 x a week in Santa Rosa and would so love to participate in McDougall’s 10-day program too! And I would love to study the dreams of people in a residential program as they process the emotions of such a change as well as they go back home and manage their social problems associated with their new eating patterns. In 40 years of working with clients’ dreams, I have seen dreams that treat eating difficulties as they treat drug addiction and recovery. But I need more data. Most of my students choose to bring in dreams about relationships and work!

            I have suggested to my Kaiser Hosp. that they take advantage of their digitalized populations and study some healthy groups within their WFPB group to maximize understanding about how we can become even healthier. And I have suggested they keep records of those of us on their preferred diet (WFPB, see Phillip Tuso’s et. al article featured in one of Dr. G.’s videos on Kaiser Permanente’s choice of WFPB diet. (Phillip J Tuso, MD; Mohamed H Ismail, MD; Benjamin P Ha, MD; Carole Bartolotto, MA, RD
            Perm J 2013 Spring; 17(2):61-66 http://dx.doi.org/10.7812/TPP/12-085 ).
            Kaiser could do so much with their data— but our docs never ask about our diet, so must not about other patients unless they are in trouble.

            Thank you, too, for your “digression.” Very interesting: ” I find clinically those that do best on intermittent fasting are those that naturally tend that way, for example, if you don’t wake up hungry… don’t eat!” We have often wondered if we are missing important benefits by not eating before 3-5 in the day which is our preference! Dr. Greger has commented that by drinking his pink juice, he sends a good frequent flow of antioxidants to his body.

            Thank you for your moderating on this site!




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  26. This is the latest migraine medication that is still in trials. Wonder what the downside to this approach is.
    Erenumab, also known as AMG 334, is a fully human monoclonal antibody that targets the Calcitonin-Gene-Related-Petitide (CGRP) receptor.




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  27. This is my first comment here, but I am a longtime lurker. This may be the best video Dr. Greger has done. I am a plant scientist and I work on crop plants and am often asked about specific nutrients for health benefits in vegetables and crop plants from others. I always say the best thing is just to eat more unprocessed plant food from the source and our body will get all that it needs. I stopped by a dietary supplementary store and felt like I was walking into a snake oil selling quakary. Our gut is most obviously made to digest the whole fruit/vegetable/grain, not filtered by machines, animal flesh, or cooking. I do enjoy cooked food, but the best is whole, raw foods. I hope this video get shared a ton, because this is possibly the most important message that people can hear about taking care of their health.




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    1. Since you are a plant scientist, I thought I might ask you this. Does the depletion of the soil mean that some of the nutrients that normally appear in plant based foods no longer appear? Do fertilizers replenish this nutrients in the soil?




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  28. Interesting that this small study managed to reverse cognitive decline by using all interventions thought to have potential, including turmeric, D3 K2, blueberries, prebiotics, low glycemic diet (Table 1).

    Dale Bredesesn. 2014. Reversal of cognitive decline: A novel therapeutic program. Aging (Albany NY). 2014 Sep; 6(9): 707–717. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221920/




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  29. Does the depletion of the soil mean that some of the nutrients that normally appear in plant based foods no longer appear? Do fertilizers replenish this nutrients in the soil?




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    1. Greetings Richard Brian Kaziny! That is my understanding. While I do not have a link immediately at my fingertips, I do believe Dr. T. Colin Campbell explains that the nutrient composition of soil varies and therefore the nutrient composition of plants vary as well. While it is simply my humble opinion. I do not believe fertilizers can replenish the complexity of mother nature. Great question.




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