Should Women Get Mammograms Starting at Age 40?

Should Women Get Mammograms Starting at Age 40?
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Various health organizations offer clashing mammogram recommendations that range from annual mammograms starting at age 40 to eliminating routine mammograms altogether. Who should you trust?

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

“Various [health] organizations offer clashing [mammogram] recommendations” that range from annual “mammograms start[ing] at age 40,” to eliminating routine mammograms “altogether.” It’s hard to know who to trust, given all the various conflicts of interest, but a good place to start is the USPSTF, the U.S. Preventive Services Task Force, whose 2009 recommendations “ignited a firestorm” of controversy by recommending pushing back routine mammograms from age 40 to 50, and doing them every other year, instead of annually. This evoked “a swift and decidedly passionate condemnation from members of the public, the media, and [medicine].”

Most people have never even heard of the USPSTF, but it’s “considered the leading independent panel of [nongovernmental] experts” when it comes to prevention—considered the “gold standard for preventative care,” since they have a reputation of sticking more with the science, for example, “recommending against” teaching women to do breast self-exams. Why? Because it doesn’t appear to work. It was put to the test—hundreds of thousands of women randomized to do self-exams or not, and no benefit—in fact, only harms: doubling the number of women who had to get biopsies taken, but not actually shown to decrease the risk of getting breast cancer, or dying from breast cancer. It didn’t catch tumors in earlier stages.

Now, to be clear, they didn’t come out against breast self-examination, but “against teaching” women how to do them; reminding them to do them only appears to cause harm with no benefit. If you do discover an abnormality, then definitely tell your doctor, but telling women to get into the practice of looking seems to do more harm than good. Yet, most doctors continue to teach women to perform self-exams. But wait; it’s not been shown to help, and in fact, has been shown to harm, so why do doctors keep doing it? Because that’s just what we’ve been telling women forever. So, there’s this medical inertia that may trump women’s health—even without a multibillion-dollar industry pushing for the practice to continue. Even without Big Business tipping the scales.

Now, consider mammograms. Billions of dollars of revenue every year from sticking with the status quo. Maybe the $7.8 billion spent annually on mammograms “might be better spent on something else.” Of course, “[o]ne person’s cost is another person’s income.” These billions of extra dollars from the status quo may “best explain the organized resistance to the…USPSTF panel [conclusions].” For example, breast radiologists denounced the panel, “implying that the panel members were guilty of a callous disregard for the life and well-being of women,” all while the American College of Radiology is receiving millions of dollars of donations from mammogram machine manufacturers.

Yeah, but in the case of self-exams, it was put to the test, and the science was clear. It’s a no-brainer that harms outweigh the benefits, when apparently there are no benefits. And, the same appears to be the case with starting mammograms at age 40. It was put to the test to specifically address “the population-wide efficacy of mammography screening starting at..age…40…,” and it started out looking like it might help, but ultimately failed to show any benefit in terms of lowering one’s risk of dying from breast cancer. Instead, they just found harms, so-called “overdiagnosis”—all the chemo, radiation, and surgery from the detections of what looked like cancer, but may have never caused any problems had they never been picked up.

So, it may have just resulted in like unnecessary mastectomies. Yet, when the USPSTF tried to explain that again in their 2016 recommendations, the firestorm was reignited, with full-page ads taken out in major papers asking, “Which of our mothers, wives, daughters, and sisters would it be OK to lose?” But, that misrepresents the science—disrespecting women, rather than saving their lives. It’s time to “douse the flames,” “clear the smoke so that we can clearly see what the evidence shows…”

Evidence, schmevidence, said Congress, who snuck in some language to interpret any reference to “current” USPSTF breast cancer-screening recommendations to mean those issued “’before 2009’—in other words, its 2002 recommendations” that recommended annual mammograms starting age 40. “Essentially, Congress is requiring health insurers to ignore modern scientific assessments, and instead use [a 15]-year-old guidance.” “Although many women’s health advocates applauded the congressional mandate, it [could be viewed as undermining] women’s rights to make informed decisions based on the best scientific evidence.”

The same thing happened 20 years ago, when “a National Cancer Institute…consensus panel arrived at [the same conclusion],” but the Senate voted unanimously “to ignore” them. The number one killer of women is heart disease. Why not focus our billions on more effective interventions? “Since health care dollars are limited,” maybe we could be doing more for women’s health.

But hey, it could have been worse. The original bill “would have denied funding for any future USPSTF mammography recommendation[s],” period. And “[s]ome members of Congress [even proposed] to alter the Task Force’s composition to include ‘stakeholders from the [mammogram machine manufacturers],” so they can play a more direct role in influencing policy.

Please consider volunteering to help out on the site.

Image credit: Colin Charles via flickr. Image has been modified.

Motion graphics by Avocado Video

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

“Various [health] organizations offer clashing [mammogram] recommendations” that range from annual “mammograms start[ing] at age 40,” to eliminating routine mammograms “altogether.” It’s hard to know who to trust, given all the various conflicts of interest, but a good place to start is the USPSTF, the U.S. Preventive Services Task Force, whose 2009 recommendations “ignited a firestorm” of controversy by recommending pushing back routine mammograms from age 40 to 50, and doing them every other year, instead of annually. This evoked “a swift and decidedly passionate condemnation from members of the public, the media, and [medicine].”

Most people have never even heard of the USPSTF, but it’s “considered the leading independent panel of [nongovernmental] experts” when it comes to prevention—considered the “gold standard for preventative care,” since they have a reputation of sticking more with the science, for example, “recommending against” teaching women to do breast self-exams. Why? Because it doesn’t appear to work. It was put to the test—hundreds of thousands of women randomized to do self-exams or not, and no benefit—in fact, only harms: doubling the number of women who had to get biopsies taken, but not actually shown to decrease the risk of getting breast cancer, or dying from breast cancer. It didn’t catch tumors in earlier stages.

Now, to be clear, they didn’t come out against breast self-examination, but “against teaching” women how to do them; reminding them to do them only appears to cause harm with no benefit. If you do discover an abnormality, then definitely tell your doctor, but telling women to get into the practice of looking seems to do more harm than good. Yet, most doctors continue to teach women to perform self-exams. But wait; it’s not been shown to help, and in fact, has been shown to harm, so why do doctors keep doing it? Because that’s just what we’ve been telling women forever. So, there’s this medical inertia that may trump women’s health—even without a multibillion-dollar industry pushing for the practice to continue. Even without Big Business tipping the scales.

Now, consider mammograms. Billions of dollars of revenue every year from sticking with the status quo. Maybe the $7.8 billion spent annually on mammograms “might be better spent on something else.” Of course, “[o]ne person’s cost is another person’s income.” These billions of extra dollars from the status quo may “best explain the organized resistance to the…USPSTF panel [conclusions].” For example, breast radiologists denounced the panel, “implying that the panel members were guilty of a callous disregard for the life and well-being of women,” all while the American College of Radiology is receiving millions of dollars of donations from mammogram machine manufacturers.

Yeah, but in the case of self-exams, it was put to the test, and the science was clear. It’s a no-brainer that harms outweigh the benefits, when apparently there are no benefits. And, the same appears to be the case with starting mammograms at age 40. It was put to the test to specifically address “the population-wide efficacy of mammography screening starting at..age…40…,” and it started out looking like it might help, but ultimately failed to show any benefit in terms of lowering one’s risk of dying from breast cancer. Instead, they just found harms, so-called “overdiagnosis”—all the chemo, radiation, and surgery from the detections of what looked like cancer, but may have never caused any problems had they never been picked up.

So, it may have just resulted in like unnecessary mastectomies. Yet, when the USPSTF tried to explain that again in their 2016 recommendations, the firestorm was reignited, with full-page ads taken out in major papers asking, “Which of our mothers, wives, daughters, and sisters would it be OK to lose?” But, that misrepresents the science—disrespecting women, rather than saving their lives. It’s time to “douse the flames,” “clear the smoke so that we can clearly see what the evidence shows…”

Evidence, schmevidence, said Congress, who snuck in some language to interpret any reference to “current” USPSTF breast cancer-screening recommendations to mean those issued “’before 2009’—in other words, its 2002 recommendations” that recommended annual mammograms starting age 40. “Essentially, Congress is requiring health insurers to ignore modern scientific assessments, and instead use [a 15]-year-old guidance.” “Although many women’s health advocates applauded the congressional mandate, it [could be viewed as undermining] women’s rights to make informed decisions based on the best scientific evidence.”

The same thing happened 20 years ago, when “a National Cancer Institute…consensus panel arrived at [the same conclusion],” but the Senate voted unanimously “to ignore” them. The number one killer of women is heart disease. Why not focus our billions on more effective interventions? “Since health care dollars are limited,” maybe we could be doing more for women’s health.

But hey, it could have been worse. The original bill “would have denied funding for any future USPSTF mammography recommendation[s],” period. And “[s]ome members of Congress [even proposed] to alter the Task Force’s composition to include ‘stakeholders from the [mammogram machine manufacturers],” so they can play a more direct role in influencing policy.

Please consider volunteering to help out on the site.

Image credit: Colin Charles via flickr. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

Wasn’t that self-exam thing wild? It’s counter-intuitive results like that which should be a good cautionary tale in terms of ideally putting everything to the test.

You can check out my Doc Note under the first video in this series to get a sense why I chose to spend so much time on this topic. This is the third video in a 14-part series. If you missed the first two, watch them here: 9 out of 10 Women Misinformed about Mammograms and Mammogram Recommendations: Why the Conflicting Guidelines?

Interspersed with videos on other topics, stay tuned for:

If you can’t wait and want to watch the entire series right now you can stream it for a donation to NutritionFacts.org by going here.

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

120 responses to “Should Women Get Mammograms Starting at Age 40?

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  1. This reminds me so much of the hoo hoe over hypertension as a result of the JNC8 recommendations to back off of aggressive drug therapy. A breakaway group formed and not only redefined hypertension, they recommended greatly increased drug therapy. They relied on a huge PHRMA-backed SPRINT drug trial. SPRINT was conveniently ended a couple of years early so that side effects wouldn’t be counted in their results — no inconvenient all cause mortality figures to interfere with the brute-force method of hypertension lowering pharmaceuticals.




    7
    1. Perhaps

      However, the “breakaway group” you refer to appears to be the American College of Cardiology and the American Heart Association which issued new hypertension guidelines in 2017 (the JNC8 recommendations were published in 2014) Is that correct?

      The updated guidelines clearly state that nonpharmacological interventions are recommended for people with hypertension or elevated BP.

      Drugs are recommended for people with clinical cardiovascular disease (CVD) or who are at high risk of CVD.

      However, they do also recommend that people without CVD and who are not otherwise at high risk risk but who have Stage 2 hypertension (>140/90) should be prescribed blood lowering medication. This is the big difference, I understand.

      That said, it is not as if there isn’t evidence apart from SPRINT that elevated BP – even mildly elevated BP – is associated with increased mortality risk. For example, this Japanese study which was funded by the Japanese Government and published 15 years ago.
      https://www.nature.com/articles/1001602

      Drugs are always a second best option compared to diet and lifestyle changes of course just as walking is always a better option than sitting on our backside and driving somewhere. However, urgency and practicality sometimes dictate that drugs and driving need to be employed in some circumstances. Principle and practicality don’t always coincide. if you have CVD or stage 2 hypertension then perhaps a quick drug fix so to speak while waiting for diet and lifestyle changes to kick in, might well be the prudent option. The evidence suggests this

      https://nutritionfacts.org/video/how-to-prevent-high-blood-pressure-with-diet/
      https://nutritionfacts.org/video/how-to-treat-high-blood-pressure-with-diet/




      8
    2. I know people given these meds who have collapsed in the street only for their doctor to then decide that hey, maybe they did not need these meds in the first place. Or when some one goes to the doctor with a batch of worrisome symptoms the doctor suggests dropping the meds and said patient walks away wondering if it is so OK to just stop them why he/she was put on the wretched things for so long. Sadly though stopping the meds only comes after the patient is trawled through every available variation on the theme. Many people in the uk on the meds got on them by chance having visited the doctor for a bunion or some such but it is routine to check blood pressure even though the patient is not complaining of any associated symptoms. In the atmosphere of dread in the surgery guess what- BP often registers high. Hey presto… prescription time. Big pharma loves these meds because people can be put on them for life. They wreck the metabolic pathways (sodium potassium balance in particular) so often require various counter meds. What a happy of flourishing of prescriptions!

      Finally, they interfere with the natural healing response of the body to infection and so have been implicated in some of the cases in the recent spiral of deaths and serious illness from sepsis.




      5
      1. OTOH, my doctor prudently prescribed BP meds after years of discussing my self-monitoring, doing diagnostics, and giving dietary therapy a chance to resolve the issue (I have had a healthy plant-based diet for 14 years). Recently, an electrocardiogram showed that my aorta had increased in size, probably from years of high blood pressure. The prudent course of action was to take BP pills. Of course I know the risks. Granted, dying prematurely because of an aneurism is also a risk. It’s not always a case of doctors being rash, or patients falling prey to an off-the-cuff suggestion. Though they may be over-prescribed, sometimes drugs can save lives.

        Since starting the meds, I’ve found a cardiologist who is a fan of plant-based diets, though he does not recommend stopping the meds at this point. I’ve also intensified my dietary interventions. My GP says my lifestyle is far better than most of his patients, and some of them have perfect BP (as does my wife, who eats essentially the same diet I do). He says it just may be my vasculature.




        0
  2. Dr G. You just make too much sense!

    I feel like congress is like Jack Nicholson in A Few Good Men, “You can’t handle the truth!”

    It like the insurance companies telling me the physician what drug and how many and how I can use them. Of course that decision is made by non-physicians, and who have never examined the pt in question. Ludicrous!

    This is not fake news everybody.




    34
      1. People all to often select their doctor blindly because of their address ( vicinity to home and or work. THEY DON’T INTERVIEW THE DOCTOR! WE DON’T HAVE REVIEWS of doctors. Nor do we INTERVIEW our doctors for the kind of jobs treatments philosophy they have to determine if they are consistent with our own. We do. DR GREGOR…. TEACH US THAT… TIMING IS IMPORTANT… teach us that. I told my female doctor that I believe in Hippocrates who said let thy food be they medicine and and thy medicines be they food.




        3
          1. I can’t stand my doctor and she pretty much can’t stand me because I push back when she feeds me a line of bull. I would love to find a doctor like Dr. Gregor however this area is a repressed area that does nothing to draw the good doctors here. The drive thru line at McDs is always long day or night around here. There are very few places to even get healthy foods. Basically a whole lot of fat, pasty and unhealthy people that just want to take a pill to solve everything. Unless I move I would have to drive over an hour or more to see a decent doctor :(




            6
              1. Katey Harris, I don’t have the stats you asked about, but I do know that there is a long list of adverse effects, up to and including death, for breast cancer treatments. Both radiation therapy and chemotherapy increase the risk of heart problems as well as leukemia, to name just two. Since these treatment only help a small percent of women who undergo them, all women treated are at increased risk of adverse effects — most for no benefit. The problem is that at the moment we can’t distinguish between who would be helped and who would not be helped by these treatments — nor among those who would be harmed and those who wouldn’t. So get this: Once you’re treated for breast cancer, you are then monitored not only for recurrence but ALSO for occurrence of any of these adverse effects! And you have more to worry about! YAY!!!




                5
                1. On the other hand

                  “Background
                  The impact of adjuvant chemotherapy on breast cancer prognosis has been demonstrated in randomized trials, but its impact is unknown in real-world populations. The aim of this study was to evaluate the effect of adjuvant chemotherapy on the survival of breast cancer patients in an unselected population.

                  Methods
                  This prospective cohort study included 32,502 women treated at the Institut Curie between 1981 and 2008 for a first invasive breast cancer without metastasis. The patients were matched based on their propensity score to receive adjuvant chemotherapy.

                  Results
                  The matching generated a subsample of 9,180 patients with an overlapping propensity score. In the group without chemotherapy, the overall survival (OS) rates at 5 and 10 years of follow-up were 87.6% (95% CI [86.7–88.6]) and 75.0% (95% CI [73.6–76.5]), respectively, versus 92.1% (95% CI [91.3–92.9]) and 81.9% (95% CI [80.6–83.2]), respectively, in the chemotherapy group. Distant disease-free survival (DDFS) was significantly improved in the five first years (absolute benefit of 3.5%). In a multivariate analysis, adjuvant chemotherapy was associated with better OS (HR = 0.75, 95% CI [0.69–0.83], p<0.0001) and DDFS (HR = 0.82, 95% CI [0.75–0.90], p<0.0001).

                  Conclusion
                  Adjuvant chemotherapy significantly improves OS and DDFS rates in an unselected population, in accordance with previous results reported by randomized trials."
                  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516355/




                  0
              2. Hi I’m a Health Support Volunteer. That is great, but very specific, question. Dr. Greger has not done any videos on that specifically. Dr. Greger recommends you go to pubmed.gov if you are looking for peer reviewed research on topics he has not covered.
                Dr. McDougall, another partner in promoting the whole food plant based lifestyle and mentor to Dr. Greger, has a lot of information on breast cancer and unnecessary screenings you might like.
                https://www.drmcdougall.com/health/education/health-science/hot-topics/medical-topics/breast-cancer/

                His early detection webinar is long, but has a lot of good information. I watched it on my spin bike one day and the time flew by.
                All the best,
                NurseKelly
                Health Support Volunteer.




                0
            1. If you are reasonably healthy chances are you don’t really need a doctor? Between eating a healthy diet and taking a few targeted supplements…you should be able to create your own HEALTHY ZONE?

              Check out some of the available health newsletters for some decent advice?

              You should probably avoid the SAD people and create a sane space of your own…

              Alternative doctors are few and far between.




              1
    1. ReL Just imagine a world where Dr. Greger is Surgeon General of the United States…

      Especially when he spreads the 70 year old theory and makes it into law.




      3
      1. Jerry Lewis,

        Why do you keep bringing up the “70 year-old theory” about cholesterol? The length of time a theory has been in existence has nothing to do with it’s truth. People thought the earth was flat for thousands of years, then only after scientific experiments proved it was a sphere did people change their minds and that was several hundred years ago. It was scientific evidence that changed people’s thinking, not length of time!

        And people thought that eating meat, eggs, and dairy was perfectly OK for centuries until scientific evidence showed otherwise. It’s scientific evidence that makes or breaks a theory, not length of time.




        31
      2. Yes Jerry. And there are even older scientific theories still blighting the landscape – relativity, evolution, gravity for example. We have to get rid of those too.

        They must be wrong. We know this for sure because there are videos on YouTube by crackpots and charlatans saying that they are wrong, just like there are videos on YouTube saying diet heart theory is wrong.




        13
      3. Oh, Jerry. I am not American but I think that your understanding of the US Constitution and the powers of the US Surgeon General is just as faulty as your understanding of nutrition and health, if your last sentence is anything to go by.




        11
  3. Too sad. The majority of women think that by obeying medical orthodoxy they will be spared death from cancer.

    In my circle, one had an implant ruptured by mammography and another had to endure an invasive false-positive.
    One found her tumor herself.

    No one I have ever heard of benefited from early detection.
    Once found by mammography, it was already at a later stage for one acquaintance who battled unsuccessfully.




    7
    1. I benefitted from early detection. I had my first mammogram at age 45. They detected a stage zero breast cancer. It had not yet formed a mass big enough to be detected by self exam or palpitation. Because it was stage zero, I had a lumpectomy (this does not cause disfigurement – just a small scar that can be hidden by a bathing suit), and radiation. I got to skip chemo because it was detected early. If it was detected at a later stage, I would have needed chemo, which is much nastier than radiation, and my chances of a full recovery would have been lower. I am very glad that I got a mammogram when I did, and got that ticking time bomb removed.




      9
  4. Imagine how many lives would be saved and fewer breast cancer victims if Dairy simply wasn’t consumed? People just cannot put down the damn Cheese. The addiction is worse than smoking. It’s a shame.




    29
      1. Jerry,

        You forgot about T. Colin Campbell’s work with casein. He could turn cancer on and off by the amt of casein fed.

        OH, WAIT–you didn’t read that book yet….




        9
      2. I checked out that paper, since the idea that nuts cause breast cancer is rather alarming. They say that processed foods, including “nut mixes” contribute to the risk of breast cancer. I suspect that they mean something like trail mix, with nuts that are highly salted and cooked in oil. If that is the case, one doesn’t know if the nuts or the processing cause the problem.




        9
        1. I have to say that I HATE that they used the words “nut mix” with “processed foods” and didn’t differentiate, because I read it and had the same thought that I am not sure what it means.

          Is it trail mix or is it something in a jar of mixed nuts?

          I have been eating walnuts, pecans and pistachios and sometimes peanuts, and once a month Brazil nuts out of the nuts videos, but that study even putting “processed” and “nuts” in the same category is useless information, unless they say what it means.




          3
          1. Many nut mixes are roasted and added oil is used in the roasting process. I don’t know what oils would be used in a commercial roasting process. Presumably the cheapest available. I would not be surprised if these resulted in a worse fatty acid profile. Additionally, some mixes are salted which adds a further confounding variable.

            However, Jerry’s link does raise an interesting point about the role of dietary fats in breast cancer risk. This 2016 study found

            “Breast cancer risk was positively associated with %PPL SFA and the ratio of dietary n-6 to n-3 PUFA and inversely associated with dietary long-chain n-3 PUFA intake. Some associations between fatty acids and breast cancer varied by age and tumor phenotype defined by hormone receptor status. Increased intake of fish and other foods rich in long-chain n-3 PUFAs and reduced n-6 PUFA intake might reduce breast cancer risk.”
            https://link.springer.com/article/10.1007%2Fs10552-016-0753-2

            dairy is high in staurated fat of course which might explain the link there. Of course, we don’t need to eat fish to obtain omega 3 PUFAs. Many of us already take algal oil supplements and there are other good vegetarian sources which many of us regularly consume
            https://plenteousveg.com/vegan-sources-omega-3/

            Jack Norris has a useful article on omega 3s, omega 3:6 ratios and vegetarian diets
            http://www.veganhealth.org/articles/omega3

            I hate to say it but Jerry does occasionally raise an interesting point, even if only by accident.




            7
              1. Jerry

                I am neither a US citizen nor a US resident. Nor have I ever been employed there or by the US Government anywhere (or by a US company for that matter).

                This is typical of you. You just make up your own facts

                And at least the US CDC cleaned its own house. How many of your sources make money from the advice they peddle, or have an otherwise major conflict of interest? What? Virtually of them? Yet here you are expressing phoney indignation at the news that the CDC rightly tossed out a board member with a financial conflict of interest. If your crowd had to lose every guru with a financial conflict of interest, you could hold your next conference in a telephone box.




                8
        2. Diana, I mainly want to point out that any food, be it plant food or animal food, can cause cancer or heart disease if consumed excessively or processed incorrectly. I do that to counter the kool aid post above that dairy consumption is the cause of cancer, and the reverse is if you eat plant foods then it must be always OK.

          OK so nut and seed by itself contain Omega 6 PUFA fat and if you eat it excessively without consuming also Omega 3 fat then it will cause inflammation and all kind of diseases including breast cancer.

          Now added to the danger of processed food even if you eat plant foods, is that you cannot tell what kind of oil do they use to cook, and how old is the food, how they heat it, and any kind of addictive that they add.

          The best way is to prepare your own nut from raw nut, or if you have to buy then buy from some store that you can trust such as Trader Joe.

          Even if it is homemade, it does not give you the license to eat nut as much as you want.




          1
          1. Nobody here is talking about excessively consuming Sugar or Omega 6’s. That’s your problem. You don’t realize how educated this crowd is… and smaller amounts of Casein turn on and off cancer.

            Trader Joe has had so many recalls and issues it’s laughable you’d consider them a good source of food.




            4
              1. How’s this for measurement?

                It is likely that the vegetable and high fiber content of a vegan diet reduces CRP in the presences of obesity. Neither the quantity of exercise nor the length of stay was significant predictors of CRP reduction. Additionally, those participants who had a vegan diet prior to the intervention had the lowest CRP risk coming into the program.

                C-reactive protein response to a vegan lifestyle intervention https://www.ncbi.nlm.nih.gov/m/pubmed/25637150/




                4
                1. Good copy and paste, Casper.

                  If vegans compare themselves to SAD eaters then they are 1000 times better. That makes them as proud as a 20 year old who compares his physique with a 5 year old kid.

                  And every since I talked about CRP then all in a sudden vegans talk about it too. Previously they only taked about cholesterol and thought that CRP stands for Cholesterol Reducing Produce.




                  1
                  1. Dude, you’re a piece of work. CRP in the Vegan community is well-known and a non-issue. You wouldn’t know that bc you’re new to our community. I’ll give you another acronym that we’ll never hear come out of your mouth – TMAO. It’s the perfect compliment to drive your excessive cholesterol into your arteries walls.

                    I included the journal along with an excerpt from it to illustrate yet another example of vegans having superior CRP levels. And those are just “vegans” not even whole plant-based vegans.

                    So again, just stop it man. It’s tiring bro. Go over to that dude’s Forum who created the “Pegan” diet.




                    3
                    1. Re: CRP in the Vegan community is well-known and a non-issue.

                      Ahem, I think this is true for vegans if CRP stands for Cholesterol Reduction Protocol because i see the word cholesterol mentioned about 1000 times everyday on this forum. If CRP is a non issue for vegans then they should all live until 130 but in reality, I heard that there is currently only one 7 Day Adventist man who live past 101 and is still alive (but he looks very frail)

                      In the meantime, meat eaters are dying young.

                      http://guardianlv.com/2013/11/spain-lives-longest-in-europe-spanish-style-mediterranean-diet-explored/

                      https://www.expatica.com/es/news/country-news/OP-Spain-has-second-highest-life-expectancy-in-the-world-new-figures-show_895677.html




                      0
                    2. Jerry,

                      You sound silly bro. Why would Vegans with low CRP be expected to live until 130?

                      I simply provided some quick evidence about CRP since you seem to think YOU have enlightened this crowd on CRP. So I showed you a study where Vegans who participated in the trial “started with” lower levels of CRP than non-Vegans.

                      So again, just accept that: Plants reduce inflammation Animals cause inflammation




                      0
                    3. Jerry

                      You do have a sense of humour!

                      You wrote “i see the word cholesterol mentioned about 1000 times everyday on this forum.” That’s mainly because you make your crackpot claims about cholesterol and saturated fat here every day! Nice one. But given your short term memory probles, here’s a reminder for you

                      “We assessed whether the association between LDL and ASCVD fulfils the criteria for causality by evaluating the totality of evidence from genetic studies, prospective epidemiologic cohort studies, Mendelian randomization studies, and randomized trials of LDL-lowering therapies. In clinical studies, plasma LDL burden is usually estimated by determination of plasma LDL cholesterol level (LDL-C). Rare genetic mutations that cause reduced LDL receptor function lead to markedly higher LDL-C and a dose-dependent increase in the risk of ASCVD, whereas rare variants leading to lower LDL-C are associated with a correspondingly lower risk of ASCVD. Separate meta-analyses of over 200 prospective cohort studies, Mendelian randomization studies, and randomized trials including more than 2 million participants with over 20 million person-years of follow-up and over 150 000 cardiovascular events demonstrate a remarkably consistent dose-dependent log-linear association between the absolute magnitude of exposure of the vasculature to LDL-C and the risk of ASCVD; and this effect appears to increase with increasing duration of exposure to LDL-C. Both the naturally randomized genetic studies and the randomized intervention trials consistently demonstrate that any mechanism of lowering plasma LDL particle concentration should reduce the risk of ASCVD events proportional to the absolute reduction in LDL-C and the cumulative duration of exposure to lower LDL-C, provided that the achieved reduction in LDL-C is concordant with the reduction in LDL particle number and that there are no competing deleterious off-target effects.”
                      https://academic.oup.com/eurheartj/article/38/32/2459/3745109

                      As for the Spanish Mediterranean diet, they emphasise unstaurated fats not saturated fats
                      “Use good fats, such as unsaturated fatty acids (olive oil), omega-6 (sunflower oil and soya oil) and omega-3 (nuts and soya oil and fatty fish).”
                      and they don’t say anything about animal protein or bone broth. In fact they say
                      “Prefer carbohydrates and fibre-rich foods.”
                      http://www.fao.org/nutrition/education/food-based-dietary-guidelines/regions/countries/spain/en/




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          2. Jerry, I thought the same thing about Trader Joe’s nuts/seeds. Turns out they’re pasteurized, not truly raw. I wrote to the company and asked. They refunded me for the “raw” sunflower seeds I purchased, that’s how I know. I now buy truly raw products from Terrasoul.com (brand), which does not pasteurize their products.




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  5. Self exam is how my mammogram nightmare began when I was 24 back in the mid 80s.

    What is the sound of a mammogram in the healthcare industry? Kah-CHING




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  6. The metrics by which organizations make decisions are self serving. No organization would do otherwise because it would mean its end. They are only going to find things that makes them bigger because bigger is good (success). More is better. The higher the number of people they treat is success to them. All they have to do is tweak the opinions of decision makers to seed the ground and fulfill their interest.




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  7. I seriously have to have a discussion with my general practitioner. He is a great person so I look forward to some good critical thinking.

    A proud and healthy monthly supporter of Nutritionfacts.org




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  8. Thank you for this important series on breast cancer.

    I am very dismayed to see that we have institutions stating self-exam of the breasts as not being beneficial. Four years ago, through self-exam, I found a lump, which tested positive for breast cancer …and, I was regularly getting mammograms, as recommended (sadly, this seems to often change as to when you should get them). The lump was on left side of my breast, which could have potentially be missed during a mammogram.

    I now tell many ladies to “get to know the girls” and don’t solely rely on mammogram (although rarer, men also get breast cancer and they’ve attended some of the many classes and support groups, so they should also take precautions too). And, for those that don’t get mammograms…self-exam could save your life.

    Lastly, Dr. Greger, your website and talks are part of my daily arsenal, so thanks for all you do …I look forward to the email that arrives daily to my in-box and have your “How Not to Die” books and DVD’s (i.e., From Table to Able), as well. Btw, I thoroughly enjoyed your YouTube video, “Dr. Greger in the Kitchen: My New Favorite Beverage”, on making the vegetable smoothie, so a hearty thumbs-up from me for making more of these videos!

    Good health all!




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  9. I found a lump through self breast exam that was not detectable on a diagnostic mammogram or ultrasound. So thankful I was taught to do self exams and that I had a biopsy when the lump was suspicuous. It was stage 3 invasive ductal carcinoma. I van barely comprehend this article and find it upsetting and obviously noy written from the perspective of someone who has expwrience with cancer.




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    1. Stefanie Mayer, I am so sorry for your diagnosis. I have been diagnosed with breast cancer (one of many in my family), and I have been living with it’s specter since my mother was first diagnosed with it almost 60 years ago. As a result (and because I was a research scientist by training), I haven done a fair bit of reading and research on the topic. And this video is spot on. The question is a balance of risks and benefits, and the data shows that there are no benefits overall from teaching self exams. Some people do benefit, such as yourself, but many more are harmed by unnecessary treatment, so overall the harms are about the same if not greater than the benefits. The outcome for the population at large is not improved by teaching self exams.




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  10. I am looking forward to some research on the effectiveness of thermography since I have read mixed opinions and my doctors feel that it has not been sufficiently authenticated. Did Dr. Greger weigh in on 3-D mammograms?




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    1. This 2016 study tested their effectiveness. It was done in Iran so speculation about industry/ FDA.CDC tampering with the results would be hard to justify.

      “Results
      132 patients were included. The median age of all patients was 49.5 ± 10.3 years (range 24-75 years). The sensitivity, specificity, PPV, NPV, and accuracy for mammography were 80.5%, 73.3%, 85.4%, 66.0%, and 76.9%, respectively, whereas for thermography the figures were 81.6%, 57.8%, 78.9%, 61.9%, and 69.7%, respectively.

      Conclusion
      Our study confirms that, at the present time, thermography cannot substitute for mammography for the early diagnosis of breast cancer.”

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040931/




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  11. Wow, I find this so interesting and yet so typical of our government. Thank you Dr. G for your research.

    Putting corporate hacks in charge of policy is the worst decision ever. Let the fox gaurd the hen house, brilliant. Sadly stuff like this is happens to often in Government fat to often.




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  12. Sorry for going off topic, but I found no general contact form on the site:

    There are some imperial/metric measurement discrepancies in the print version of the How Not To Die Cookbook. For example the three-bean chili recipe ingredients list includes “1 ¼-inch/5mm piece fresh turmeric, grated”. I trust that is an error and not Dr. Greger not wanting non-US readers to have less turmeric. The same turmeric error repeats in some other recipes. And there are similar other errors.

    Which brings me to the question: is there an errata (sheet of corrections) for the book put online somewhere?

    If there isn’t an errata yet, can someone reading help pass on the above information to someone on the Greger team?




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  13. I found a lump in 1986, biopsy showed it was nothing but my mammograms were hard to read due to fibrocystic changes in breast. But now drs were worried that they wouldn’t be able to see cancer if it occurred. I had 5-6 biopsies over the next 5 years, all benign with the last one carcinoma insitu. After much pressure from doctors I had a double mastectomy. I was never happy about caving into pressure. I wish I had never found the first lump.




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  14. If I relied on BSE to detect breast cancer there’s a pretty good chance I’d be diagnosed with advanced stages of breast cancer later on in my life. All three of the areas of concern were undectable by self examination. Including the cancerous spot. The mammogram saved my life and hopefully is sparing me from having to go through Chemotherapy.




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    1. Glad it worked out for you. That side of the equation needs to be stated as loudly as the other side, because women need to make choices.

      I had cancer symptoms and pondered a mammogram, but was not willing to do medical even if it was Cancer, and I had three people who got rid of Cancer through things like juicing, so I started researching everything possible on PubMed and watching every YouTube testimony of people reversing Cancer and I went organic and gave up acid drinks and foods and started eating and drinking every high antioxidant food and juice and tea I could find – and learned about angiogenesis and apoptosis and watched every Ted Talk and Chris Beats Cancer and I spent almost a year reading every PubMed study and trying everything possible until the symptoms went away and after the symptoms were gone, I found Dr. Greger on YouTube and over the course of the past few months went vegan.

      What I know about Cancer is that people tend to either think more like the medical model and if they do, they probably should get early mammograms for making decisions and those of us who won’t do medical, probably should get thermograms, so we know we need to up our vegan nutritient army.




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      1. There’s a lot of information in the report; you have to page down to do “page find” of DBT to read it all. The following is just one part. I think it’s notable that it doubles radiation exposure. I am glad now that my insurance does not cover it. Unfortunately, I’ve already had it twice.

        Primary Screening With DBT Currently, DBT is most frequently performed in combination with conventional digital mammography; this practice essentially doubles the resulting radiation exposure to the patient. The U.S. Food and Drug Administration has approved a method to generate synthetic reconstructions of 2-dimensional images from 3-dimensional views, which reduces the total radiation dose emitted. However, study data on the performance of DBT in isolation (that is, with synthetic reconstruction of 2-dimensional views) is limited to 1 mammography reading study that compared sensitivity and specificity and 1 prospective clinical trial,42 and the method is not yet thought to be in widespread clinical use.
        Limited evidence suggests that DBT may slightly increase the risk for breast biopsy compared with conventional digital mammography. In 4 U.S. studies of DBT that reported breast biopsy rates, 3 noted higher rates in the combined DBT and conventional digital mammography group compared with conventional digital mammography alone (median difference, 0.2% [range, −0.1% to 0.4%]).13

        Sent from Mail for Windows 10




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  15. Thankfully, I found this website and Dr. Greger!!! Back in 2004 when I was 39 I had my first mammogram. They found a benign fibro adenoma which they recommended I had removed. I did not know any better. I had surgery and follow ups where they found more things ‘suspect’ with more mammograms and then I had a radio static breast biopsy which was a horrible experience, turned out to be nothing. I was grossly overweight, had a terrible fatty diet and was going through a very stressful time in my life watching my mother die from cancer. Long story short, not one doctor, not one told me to change my diet, lose weight etc. Flash forward to 2017, I thought I was eating healthy but I was so wrong. Ended up getting clostridium difficile (C-Diff) from antibiotics from dental work and had to diagnose myself from doing research on the internet because my ‘doctor’ is pathetic. I took the very expensive medication vancomycin but as soon as I finished it I spiked a fever and the c-diff came back. I also had blood work done and found out that my triglycerides were bad among a lot of other things and my A1C was 7.3. Did more research. My overweight bad attitude doctor wanted to put me on metformin, I said no. From my research for all of my different issues like trying to heal my colon and reverse the Type 2 diabetes I felt that I just had to go whole foods plant based. I started that at the end of June 2017. I started out gluten free and no fresh fruits or veggies because of the c-diff but I gradually added those in. I’ve lost 60 lbs in a few months and would have lost more but then I broke my ankle in October walking my dog. I have not gained any weight back and now am getting back into the swing of things albeit cautiously due to it being Winter here. I would like to lose 40 more lbs and completely get rid of the Type 2 diabetes. I was limiting my carbs to 50-60 per meal but have been checking out the videos from Dr. Greger on insulin resistance and also Dr. McDougall and Mastering Diabetes with Cyrus Khambatta & Robby Barbaro. I am a little afraid to increase my carb intake for fear of sugar spikes and drops but I’m going to give it a try. I do very much though want to thank Dr. Greger for his dedication to educate us on How Not to Die. Your website has been a huge source of information for me and I thank you so very much!!!




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    1. I do want to add that my mother died at age 65 of lung cancer. She never smoked. She was however a breast cancer ‘survivor’. She had the lump removed and then had radiation. The lung cancer that developed years later I am 99.99% positive was caused by the radiation used to ‘cure’ the breast cancer. All of her doctors poo-poohed this and said that just wasn’t possible. The tumor in her lung was just behind the breast that had cancer. We want to spend all of our time and money trying to detect cancers but why don’t we spend all of our time and money eating the right foods and reducing our risk so that maybe we don’t get cancer in the first place. It’s been said that certain kinds of cancers are hereditary but maybe what’s hereditary is bad diets that we pass on from generation to generation that cause the cancers and maybe not so much our genes.




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    2. Wow, what a journey you have gone through. Sounds like you are doing great.

      I suspect it is okay to wait as long as you want before going back up on carbs. I have been watching so many vegan doctors on this issue and think the ones like Dr Barnard and others who are specifically doing vegan to reverse Diabetes might be the ones you should be listening to until you are sure that your pancreas has started functioning again.

      I know that Dr. Greger did a video recently that there was a study on the positive effects of low carb (I think the gist of it was that it was okay to both be vegan AND low carb, particularly while you are reversing Diabetes.)

      God bless you is what I want to say. Keep up the good work.




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  16. In the UK we have had a massive surge in screening of just about every cancer you can think of. And it’s not just free, but all but imposed (a bit like vaccinations). Why, eh?….. an NHS so strapped for cash you can fade away in A & E waiting for some sort of attention and it can be over a month before you can get to see a doctor in his surgery if you are actually sick, while there is this massive trawl of the well to discover treatable conditions they did not even know they had.

    So here’s the thing- We happen to be missing targets for cancer survival rates (a meaningless statistic if there ever was one). The solution- diagnosis shed loads of stuff as cancer that would probably have gone away of its own accord or never caused a treatable problem, and declare medical success!- assuming that is you do not kill of your patients with the treatments- but these are by and large fit people who will probably survive the assault. You could not make it up and I am not. That is where we are now in the UK. No one is interested in the customers already on board absorbing massive amounts of public funds for their treatments. It is all about getting in new business and creating an illusion of just how successful modern medicine is.




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    1. On the other hand, you could argue that early detection and treatment is far preferable to late detection and treatment.

      The earlier you detect cancer, the greater the chance of survival for the patient and the lower the total cost of care. That is the conventional view anyway. On the face of it, it sounds like a very sensible use of resources.although we would need to see the analyses by health economists and other specialists to be sure.




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      1. Bu that assumption is precisely the orthodoxy Dr G is challenging here- with the science. And he is flagging the essential conflict of interests involved. So long as we continue to swallow the idea that it is the medical profession that can enable us to live longer healthier lives so long as we deliver ourselves cradle to the grave into its care- prophylactically, of course, (no good just coming along when we are already sick!!! hell, no)- we will continue to be its victims.




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        1. Gillian

          What assumption? I wrote “we would need to see the analyses by health economists and other specialists to be sure.”

          Also Dr Greger is challenging it specifically in the context of mammograms. I have seen (and been convinced by) similar arguments about colonoscopies and PSA tests… But just because some screening tests or some vaccines are ineffective or do more harm than good, it does not automatically follow that all them are equally bad. Also, of course, it is not just Dr Greger saying this – he is merely reporting what the evidence shows and what the USPSTF concluded.

          I am old enough to remember the UK TB X-ray screening campaigns and the polio vaccination programmes. They were very successful and saved many lives. It is entirely possible that some targeted cancer screening programmes may also be effective. We have to see the evidence before coming to a judgement.




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          1. ? Those dreadful street chest X ray trawls were abandoned Tom, because of the terrible harm they did. I too have a memory. To say screening programs work because of the number of cases they pick up begs the question.




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            1. That’s not my recollection, Gillian The mass X ray campaigns came to an end because TB rates dropped dramatically and because more technologically advanced X-ray machines became available in hospitals and these exposed patients to much less radiation than the mobile units.
              They certainly found a lot of new cases though and TB death rates fell significantly.by the end of the campaign

              But yes you are right, screening may pick up new cases but if there is no good treatment what is the point? However, I think there were effective new TB drugs coming through in the 1950s and 1960s.

              So, I suppose the point I am trying to makes is that whether or not a particular screening programme is worthwhile can only be judged on a case by case basis. I don’t think people do them for fun or to make a profit – certainly not in the case of the UK’s mass X-ray campaign where the Government paid for it all, UK governments notoriously keep a very tight rein on expenditure and don’t embark on this sort of thing unless they believe it will be cost effective.




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              1. I don’t know about the effectiveness of chest x-rays in detecting TB and improving overall mortality, but I was told by my mother that she and her sister ended up living in a TB sanitarium when they were adolescents (my grandfather was there with TB, but they did not have it), and were subjected to weekly x-ray screenings. Each developed breast cancer in their mid 30s, and my siblings and I wondered if those chest x-rays could have been a cause or contributing factor.




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                1. Wow, that is tragic. I suspect that those weekly x rays would have been a significant contributing factor especially since the earlier machines exposed patients to very high levels of radiation.
                  https://www.sciencedaily.com/releases/2006/06/060627105051.htm

                  But nothing is entirely black and white. TB was a big killer and active TB is infectious. In the first half of the 20th century, tens of thousands of people died every year from TB. Perhaps active surveillance was beneficial on balance but I suspect that they didn’t fully appreciate the risks of X ray exposure back then
                  https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/363056/Tuberculosis_mortality_and_mortality_rate.pdf




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      2. TG, there is a wonderful book by Dr. Gilbert Welch, “Should I Be Tested for Cancer? Maybe Not, and Here’s Why.” The original paradigm that early cancer detection by screening leads to decreased mortality is changing. For some cancers, that may be true But others detected by screening will never cause a problem in a patient’s life because they are slow growing and the patient would die with it, not of it; these patients are over treated and suffer harms. And for still others by the time cancer is detected by routine screening it is too late, because the cancer is so fast growing it has already spread. And all of these scenarios apply to breast cancers, as well as other types of cancers. As far as I know, at this point the different kinds of cancer (indolent, effectively treatable, highly aggressive) can’t be distinguished from each other, though genomic testing is moving in that direction. I highly recommend this book to the followers of Nutrition Facts, as well as anything else written by Dr. Welch.




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        1. Thank you. Dr J.

          I remain wary of cancer screening overall because of the risks of false positives/negatives and over servicing, and of course the issues you describe. However, i am reluctant to condemn any particular screening programme without first viewing the evidence. That would be prejudging the issue and prejudice here as anywhere else is not usually helpful.




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  17. There is a blood test in work that can detect a number of cancers, including breast cancer, I think. But it is still far from prime time as the success rate is only 40%. I think that if you treat it like a biomarker like the lousy cholesterol test then it’s OK.

    The best way to detect cancer is symptom check, provided that you are healthy and not in constant pain and then you cannot tell any abnormality anymore.

    https://www.technologyreview.com/s/610008/a-cheap-and-easy-blood-test-could-catch-cancer-early/

    https://www.npr.org/sections/health-shots/2018/01/18/578620342/scientists-edge-closer-to-a-blood-test-to-detect-cancers

    There are currently several blood tests to detect cancer biomarker but they are not precise and can lead to false diagnostics.

    https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-diagnosis/art-20046459




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  18. ELI5

    It is time to seriously dumb these things down. Please allow me to do the dirty work and give you the ELI5 version. I will give you the exact questions you should ask yourself to make a good decision. Here it goes.

    Are you eating a whole food plant-based diet and are you getting the recommended daily physical activity? YES or NO.

    If YES you are, congratulations, you are getting the best preventative medicine in the world, the N°1 standard that money can not buy. Your odds of developing whatever form of cancer is nihil! Stay away from doctors and medical screenings they can only make you worse. Limit yourself to some routine blood work.

    If NO you are not, we are sorry to tell you that your body does not guarantee sustained health because it is not generating the biochemical ideal conditions. You have a risk of cancer developement that is comparable or greater than the averages that one sees in the developed world. Because you are having average risk you should follow the average people’s recommendations; so get your cancer screenings and your doctor visits and inspect your body for signs of cancer. You are not getting the N°1 in preventative medicine but it is “better than nothing” and even this is debatable.

    CONCLUSION
    For someone eating and moving average one can expect average cancer risk, this makes medical screenings “preventative medicine”, check your cancer, I mean body.

    For someone doing wfpb+exercise, all bets are off, you are getting the best of the best regarding prevention from disease; for you medical screenings are mere diagnostic tools (that also happen to be a bit radioactive) in hospitals far far away. Don’t bother, if it ain’t broke, don’t fix it.




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    1. Spot on, EL15. But there are many people on this board constantly checking their pulse, blood sugar, blood pressure, heart rate….. white blood count not to mention fat levels in the blood- all the different types, markers for inflammation…… What body can survive this level scrutiny I have no idea. It verges on certifiable. It also raises the question of the observer effect in quantum physics (The cat in the box). We will all die sometime, of something.




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    2. EL15, I agree with what you just said.

      If you are eating organic whole food plant based and not exposing yourself to toxins left and right, these tests might seriously be dangerous, because you might get false positives.

      If you are eating junk food and food with pesticides and lots of meat and lots of processed foods and lots of dairy and eggs and almost zero nutrition, like my whole family is, then, early detection may be better, because, they will deal with things with chemo and surgery and radiation and the sooner the better if that is the path you are on.




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      1. You make yourself sick by your diet obviously if let thy food be they medicine is the prescription and it has all those effects… then we should change our food our medicine to a non toxic medicine a non poison or toxic medicine… we should all have a garden. And go to Starbucks for water.
        They have got a plan to take you out of this world. You decide if you want to stay in it and when you want to go. We all go to the market for foods to prepare. Why don’t we go to our backyards and windowsills. Take the power from those who have prove to abuse it!
        Grow herbs upstairs and downstairs. When you take them outside and you have a balcony…set them up there… other wise meditate while watering the garden. It is very relaxing and good ideas come to you mind! Organic seeds only & from organic foods you purchase or a good fiends organic garden are preferable.
        Just do it and feel good




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      2. What?…. let us not criisize. We get up in the morning and say “Good morning how do you feel this morning?.” The answer we gets usually fine and You? We are not aware of cancer until the pain persist when it persist then we know something is wrong and must be address the proplem. When it doesn’t go away…we go to the doctor.when our for gives us his diagnosis… we go to home contemplate our next move. I hear Hippocrates voice saying let thy food be thy medicine and research my next steps including my diet…keep faith and prayer alive and and your new diet on point tweeking everyday … saying this is my new diet… and mighty tasty veggies fruit and water.commercial juices today as not up to par so make your own.




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  19. You know, I can’t help but ask myself why doctors like Colin Campbell, Kim Williams, Fuhrman and Esselstyn are speaking at a conference where at the same time several speakers are featured alongside their names that come to spread dissinformation about vaccinations and GMO’s.

    I know they have to operate a bit outside from the conventional medical establishement but do they really have to sink so low as to affiliate with these movements that are not evidence based? In doing so they are giving credibilty to the whole thing.

    People like Campbell who are so old and respected and accomplished, why disrespect your own work just to get 60 minute talk at such a dubious conference. Make your own conference Dr. Campbell with nothing but evidence based scientists so that people like me can continue to respect your work.

    Some wfpb doctors like Joel Khan are already leaning towards this alternative anti vaccination thing without any credible evidence by posting links to dubious websites and articles spreading “evidenceless based doubt” about vaccination. Put up or shut up.




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    1. I completely agree.

      Unfortunately, in my view, Dr Greger has also spoken at some dubious events in the company of people and organisations I have little respect for. The Hippocrates Institute being one of them. I think this gives those other players an unwonted credibility and tarnishes Dr Greger’s reputation in the mainstream medical community




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  20. The funny thing about diets and health, is that the onus is on non-Plant based dieter community to PROVE that their blend of food sources is superior to a plant based diet, if they want to make outlandish health-based claims. It’s not the other way around.

    Yet, we in the Vegan community always go out of our way to do THEM a big favor and convince them that their health will improve if they simply follow a plant based diet. I’m still not sure why we waist our time.




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    1. The issue is the availability of evidence. There is plenty of fairly good quality evidence about eg Menditerranean diets but very little about plant based diets as such. That’s why, I think, mainstream advice tends to emphasise such diets and not plant diets. Plus the fact that unsupplemented plant diets may be deficient in eg b12, zinc, iodine etc. And let’s not forget the human factor. Most people providing such advice are themselves meat/dairy/fish eaters and may have an unconscious bias towards justifying their consumption.

      As the recent US AHA presidential advisory statement on dietary fats commented
      “Finally, we note that a trial has never been conducted to test the effect on CHD outcomes of a low-fat diet that increases intake of healthful nutrient-dense carbohydrates and fiber-rich foods such as whole grains, vegetables, fruits, and legumes that are now recommended in dietary guidelines.”
      http://circ.ahajournals.org/content/early/2017/06/15/CIR.0000000000000510

      Still less of WFPB diets. The Esselstyn and Ornish studies suffer from methodological problems such as small size, no control group or too may intervention variables which do not allow the effect of diet alone to be measured.

      The non plant commuity can point to good quality, methodologically rigorous (more or less) trials to support their case. We can’t




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      1. Great points, Tom. Although Esselstyn’s 2nd trial was 10x the size, it’s still peanuts compared to these larger trial. However, you and I know that in order to get a TBC of 150, without meds, you’d have to be consuming mostly or all plants.

        The other side of the coin is, even if the Mediterranean diet is considered the next best thing to Plant-based diets, it includes a considerable amount of fish and dairy. This means the inclusion of toxins, IGF-1 promoters, etc. And, although PB-vegans must take a B12 supplement, that to me pales in comparison to the deficiencies among pretty much all other diets. Take the famous WD Wheat Belly plan… it’s dangerously deficient in Fiber, Resistant Starch, Magnesium, Potassium, variety of phytonutrients, etc.

        So regarding deficiencies, I think again that the onus is on the non-plant based communities to explain and prove how they could be healthy on 15g of Fiber daily when the preponderance of evidence suggests exceptional Gut Health relies upon lots of fiber and resistant starch…. and how deficiencies in Potassium and Magnesium (which is rarely talked about in Mainstream) are contributors of Thyroid issues among other disorders.

        As Greger, et al, have said so many times, food is a package deal. Plant sources are always superior and beneficial to the human body.




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  21. Because I was recently diagnosed with breast cancer as I mentioned above I have decided to give vegenisim a try. I want to know I am doing everything I possibly can to prevent this from ever happening to me again. As a former Atkins/low carb fanatic I have to wonder if this was the cause of my breast cancer. I just don’t know how realistic it is for me a meat eater, dairy lover, sugar lover to spend the rest of my life from depriving myself of these things. I am not sure it’s worth it and no one even knows for sure a vegan lifestyle guarantees that you will be cancer/disease free for life. So my question is, how about “cheat” days. Does that negate everything you’ve been trying to accomplish by being vegan or does it just up your risk for health issues a little more. If anyone could shed light on this for me that would be great. Thank you.




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    1. Kristen, Sorry to hear about your diagnoses. Genuinely sorry. So many people have it.

      I think that I am going to say that I had cancer symptoms and didn’t want to go vegan either, but after watching video after video after video about the gut and the contribution of meat and chicken and eggs and dairy to getting cancer and heart disease and diabetes, I started losing my appetite.

      The process of watching the videos – which I have watched one or two every day and eventually, it is that I don’t want my food to harm me and I don’t want to empower the bad guys in my microbiome to kill me.

      When I was young, I might have not had my mind renewed by those concepts, but I have had so many people in my communities recently have strokes and cancer and heart attacks and I feel like the trauma from those things eventually changed me.

      My friend’s father, who was diabetic, never could kick the food and died recently and none of my family members even want to try to change their eating, but watching even one video a day might change your brain.

      I laugh, because I can’t fully tell if it was just the videos, because I read a study in Pub Med that stimulating the vagal nerve could change the emotional attachment to food and change food attraction, so I bought a device, called a MicroPulse ICES and have been using it to kick the dairy habit. It has worked beyond my wildest dreams, but my step-mother having a stroke already did help to motivate me.




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    2. The other thing I was going to say is that Dr. Amen in talking about food, which damages the brain said something like it has to become a process as if you were romantically attracted to an abusive person. He is a different diet, which I am not agreeing with, but the concept itself of not romanticizing something that is abusive to you, is the first mental step to take.




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    3. I was a meat/dairy/sugar lover as well. I tried going plant based for 8 weeks and felt better lost weight, cholesterol went from 230to 160 and I thought I could do it most of the time. So, I went out and had a cheeseburger!! Got kind of sick. For the nest year and a half, I would “cheat “ and every time it would make me feel bad so I finally decided it wasn’t worth it and I quit. I continued to eat cheese occasionally, but then it got to where that made me feel bad. I still do occasional seafood, but now my body is becoming sensitive to that. When you remove the inflammation from your body and eat something that is inflammatory, you can feel it. I never feel deprived, and I continue to watch the science unfold which continues to motivate me.




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    4. Kristen…
      You are feeling sad about going vegan. Diet and eating are complicated because demons try to psych you out…turn off that evil voice. Tell your self the truth. Which is: vegan food will taste good and is nutritious and that is why we should be eating. Not because Gladys makes the best cakes… and ice cream. But to get nutrition for our bodies to thrive… we need to eat vegetables and fruit and that needs to be balanced also…There is plenty information about being vegan. I allowed myself to be 295lbs before I started going down and I am less than 200 now … Remind yourself daily that your body would get nutrients from the foods that you eat. This internet has plenty of information on nutrition on it. Get info from books at the library or better yet good friends that are vegan.
      IAmZ1Greatest@Gmail.com. Get Dr. Michael Gregor’s book “How not to die! He played it out for you very gently.




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      1. I am not mad about going vegan at all. I just don’t realistically how I can keep it up. I do have the book “How Not To Die”, that’s why I’m eating vegan now. I also gained weight in the few days I’ve been on the “diet”. I’m not used to eating beans,oatmeal, chick peas , sweet potatoes, whole grain bread every day. And mammogram saved my life!! End of story.




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  22. I’m confused– if neither mammograms nor self-exams are good for detecting breast cancer, what is a woman supposed to do? Have I missed something? After a very stressful couple of years, I found a lump in my breast last year. It didn’t even show up in a subsequent mammogram (dense breast tissue-how many women have heard that?), but after a biopsy I was told it was an invasive stage 1 carcinoma. So would it have been better if I never found it?




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  23. Kath,

    I think an important point is being missed. Absolutely do breast self exams as you did. Is it still a controversy… however regardless, changes in any body tissue is an indication that should be evaluated.

    Dr. Greger’s take is based on the relative risk and results of mammography radiation that apparently may be more causal of the problem vs appropriate for diagnostics.

    Dense breast tissue is not unusual and is fairly common. It will often mask or result in a radiological report that essentially says that they are unable to discern the tissue results. There are a number of new testing techniques that are becoming available for breast imaging, especially when dense tissue is present. Please see the use of serum (blood) markers for dense breast patients such as: Breast density does not impact the ability of Videssa® Breast to detect breast cancer in women under age 50 or more conventionally, with radiation… molecular evaluations.

    Trust this will have you evaluating and addressing your situation with more information.

    Dr. Alan Kadish Health Support Volunteer
    for Dr. Greger




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    1. I think I may not have made myself clear. I just listened to Dr. Gregor’s video again. He repeatedly states that mammograms may not be helpful ( somethings I agree with because it didn’t show my tumor even after I could feel it) and he also states repeatedly that breast self exams can cause more harm than good. So what, exactly, does he recommend that women do to detect breast cancer in its early stages?

      Kathy Weber




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      1. Kath: according to what I’ve been reading over the years I’m sorry to say that there IS NO WAY TO DETECT BREAST CANCER IN IT’S EARLY STAGES. Dr. John McDougall has an excellent article on his web site in the archives. Sorry, don’t know the exact title, but if you go to his web site and do a search you’ll probably find it. Anyway he says cancer cells double every 90 days. Sounds like a lot but it really isn’t. And by the time all those BILLIONS of cells are large enough to be detected by a mammogram guess what? YOU’VE HAD THEM IN YOUR BODY FOR OVER 8 YEARS!! Apparently, cancer cells are too small to be detected by a mammogram until they’re the size of an eraser on a pencil.As Dr. McDougall says all doctor’s know this but they don’t tell you. So early detection by a mammogram is a lie and a myth. This is the progression of cancer cells in your body:

        90 days–2 cancer cells
        1 year–76 cancer cells
        2 years 256 cancer cells—at this stage cancer cells can be detected by a test called thermography. (don’t hold me to the spelling.) Most places
        WON’T perform this, and few know how to do it or read the results anyway.
        3 years–4,896 cancer cells
        4 years-65,536 cancer cells
        5 years–1,048,576 cancer cells
        6 years–16,777,216 cancer cells
        7 years–568,435,456
        8 years–4,294,967,296–now your cancer cells can be detected by a mammogram.

        The best thing to do is to prevent yourself from getting cancer in the first place! Eat right. Eliminate entirely or cut way back, and I mean way back on your consumption of meat and dairy. This included beef, chicken, pork, fish (fish isn’t meat, but is loaded with mercury) milk, cheese, eggs, and all oils. Oil is 100% fat with little nutritional value at all, and yes, that includes olive oil! Also eliminate processed foods, and junk.
        These foods have been proven to promote cancer. Way back we ate these foods, but not in the HUGE quantities we do now. So is it any wonder cancer is on the rise? No. Make the produce aisle in the grocery store your best friend! Load up on vegetables, whole grains, legumes, beans, starches, etc. There are tons and tons of recipes out there for those who want to do this.
        And if you HAVE cancer visit the web site chrisbeatcancer.com. It’s a site by Chris Wark who had stage 3 colon cancer back in 2004-05 I believe.He got healed by alternative therapies in his own home. He refused the chemo and radiation. Purchase his “square one” program. I’ve seen it, and it’s good. But AVOID MAMMOGRAMS!! I stated in an earlier comment that one chest ex-ray has about 8 millirems of radiation. But a mammogram with 4 pictures delivers 1,200 millirems of radiation to that part of your body. And as Dr. Ben Johnson author of No Mammograms says “What’s the problem with all that radiation? RADIATION IS A KNOWN CAUSE OF CANCER.” Don’t believe me, read his book titled No Mammograms.




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        1. It seems its a bad idea to wait for cancer show and praying that it doesnt best thing to do is get our diets in order now! Then perhaps it is very likely cancer will be a no show… The three matriachs befor me all died of cancer: My great grandma uterine cancer 70yo  my grandma fallopian tube @71yo and my mom breast cancer at 48yr… my mom was the youngest of the three. Get the mammogram.  Most importantly watch and improve your diets… i am 61 or 62yo. THATS WHAT I BELIEVE.   Take car of yourself on a Vegan Diet! Put your whole family on it because you love them. No junk food you know what that consist of.




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        2. Wendy- thanks so much! I’ve spent most of the last two hours watching and reading stuff on Chris beat cancer. Really helpful information. Much appreciated.




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  24. I’ve had many questionable mammograms, and currently I’m on a 6 month schedule for another diagnostic mammogram after an unclear finding a year ago, and a history of multiple biopsies. I have a diagnosis/pathology of LCIS (one step before DCIS) with raloxifene (generic for Evista) prescribed.

    I was not aware of the Videssa blood test would love the opportunity to take it, but I suspect it is not something that insurance will not cover. Has anyone had any experience with this test? Are conventional doctors aware of it?




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  25. Many years ago I was fortunate to read articles by Dr. John McDougall telling women NOT to get mammograms. And he gave some very important facts. He said that by the time a mammogram can detect cancer cells in a woman’s breast, you’ve had that cancer slowly growing for over 8 years!! And the cancer cells are only the size of an eraser on a pencil. In that eraser are BILLIONS of cancer cells. So early detection is a lie and a myth. Eight years is NOT early detection.
    Secondly, I read a book by Dr. Ben Johnson titled No Mammograms. He said that a single ex-ray delivers 8 millirems of radiation. But a mammogram with 4 pictures, 2 per side can deliver 1,200 millirems of radiation!!! And if you don’t get a good picture the first time, you can double that amount. What’s the problem with all that radiation? RADIATION IS A KNOWN CAUSE OF CANCER!!
    Thankfully I eat right, and haven’t had a mammogram in well over 10 years. Last year I needed to get some blood work done, because I MIGHT have low thyroid, but thankfully I didn’t. Well, when the doctor learned I hadn’t had some standard tests done in over 10 years he was ready to schedule them for me. I politely declined them all. I’m so glad I did.




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    1. Just curious, Wendy. Do you see a doctor for routine GYN exams and if so, what do you tell them about not getting a mammogram? They usually ask about the mammogram at that time.




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  26. In the video Dr. G endorses US Preventative Services Task Force as THE most trusted source for medical guidelines. Here are the USPSTF current final recommendations for breast screening on their website:

    • For women who are at average risk for breast cancer, most of the benefit of mammography results from biennial screening during ages 50 to 74 years. Of all of the age groups, women aged 60 to 69 years are most likely to avoid breast cancer death through mammography screening.

    • The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years.

    I love Dr. G’s nutrition videos, bought “How to Die”, etc. so know that I’m a fan, but I feel a little let down after watching this video and glancing at the titles of the videos to come. It’s clear this series presents a strong anti-screening view point without, at least so far, pointing out the potential benefits to certain age groups (60-69 in particular). A WFPL diet and physical activity is a good defense but it’s not bullet-proof.




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    1. I agree, Lisa. I wish we had more definitive information, even on the alternative tests that were mentioned in the discussion. My guess is that most insurance companies do not cover them and out of pocket costs are pretty high. I have a history of a high-risk non-cancerous breast condition, and I’m still on the fence. I wish I never started getting mammograms so young, but we didn’t have these guidelines back then.




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