Might animal protein-induced increases in the cancer-promoting grown hormone IGF-1 help promote brain artery integrity?
Vegetarians and Stroke Risk Factors—Animal Protein?
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.
In 2014, a study on dietary protein intake and stroke risk found that greater intake was associated with lower stroke risk, and furthermore it was the animal protein that appeared to be particularly protective. Might that help explain why vegetarians were recently found to have a higher stroke rate than meat-eaters?
Animal protein consumption increases the levels of a cancer-promoting growth hormone in the body known as IGF-1, insulin-like growth factor one, which can accelerate the progression of precancerous changes to invasive cancer. High blood concentrations are associated with an increased risk of breast, prostate, colorectal, and lung cancers, potentially explaining the association between dairy milk and prostate cancer risk, for example. But there are also IGF-1 receptors on blood vessels; so, maybe IGF-1 promotes cancer but also brain artery integrity.
People who have strokes appear to have lower blood levels of IGF-1, but it could just be a consequence of the stroke rather than the cause. There weren’t any prospective studies over time —until 2017, and indeed higher IGF-1 levels were linked to lower risk of stroke, but is it cause and effect? In mice the answer appears to be yes, and in a petri dish IGF-1 appears to boost production of elastin, a stretchy protein that helps keep our arteries elastic. Higher levels are associated with less artery stiffness, but acromegaly patients, like Andre the giant, those with excessive levels of growth hormones like IGF-1 do not appear to have lower stroke rates, and a more recent study of dietary protein intake and risk of stroke, looking at a dozen studies of more than a half million people, compared to only 7 studies with a quarter million in the previous analysis, found NO association between dietary protein intake and the risk of stroke. In fact, if anything dietary plant protein intake may actually decrease the risk of stroke.
However, those with high blood pressure who have low IGF-1 levels do appear to be at increased risk of developing atherosclerosis, thickening of the artery walls leading up to the brain, but no such association was found in people with normal blood pressure. So, there may be a cautionary lesson for vegans here. Yes, a whole food plant-based diet to down-regulate IGF-1 activity may slow the human aging process, not to mention reducing the risk of some of the common cancers that plaque the Western world. But, perhaps, the ‘take-home’ message should be that people who undertake to down-regulate IGF-1 activity by cutting down on animal protein intake as a pro-longevity measure should take particular care to control their blood pressure to preserve their cerebrovascular health, the health of their arteries in their brain. In particular, they should keep salt intake relatively low while ensuring an ample intake of potassium to keep their blood pressures down. So, that means avoiding processed foods and avoiding added salt, and in terms of potassium-rich foods, beans, sweet potatoes, and dark green leafy vegetables.
So, might this explain the higher stroke risk found among vegetarians? No. Why? Because dairy and egg whites are animal proteins too. Only vegans have lower IGF-1 levels in both men and women; so, low IGF-1 levels can’t explain why higher rates of stroke were found in vegetarians. So, what is it already? I think the best explanation for the mystery is something called homocysteine, which I’ll cover, next.
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- Zhang Z, Xu G, Yang F, Zhu W, Liu X. Quantitative analysis of dietary protein intake and stroke risk. Neurology. 2014;83(1):19-25.
- Tong TYN, Appleby PN, Bradbury KE, et al. Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study. BMJ. 2019;366:l4897.
- Kaaks R. Nutrition, insulin, IGF-1 metabolism and cancer risk: a summary of epidemiological evidence. Novartis Found Symp. 2004;262:247-60.
- Fürstenberger G, Senn HJ. Insulin-like growth factors and cancer. Lancet Oncol. 2002;3(5):298-302.
- Harrison S, Lennon R, Holly J, et al. Does milk intake promote prostate cancer initiation or progression via effects on insulin-like growth factors (IGFs)? A systematic review and meta-analysis. Cancer Causes Control. 2017;28(6):497-528.
- Delafontaine P, Song YH, Li Y. Expression, regulation, and function of IGF-1, IGF-1R, and IGF-1 binding proteins in blood vessels. Arterioscler Thromb Vasc Biol. 2004;24(3):435-44.
- Dong X, Chang G, Ji XF, Tao DB, Wang YX. The relationship between serum insulin-like growth factor I levels and ischemic stroke risk. PLoS ONE. 2014;9(4):e94845.
- Saber H, Himali JJ, Beiser AS, et al. Serum Insulin-Like Growth Factor 1 and the Risk of Ischemic Stroke: The Framingham Study. Stroke. 2017;48(7):1760-1765.
- Fulop GA, Ramirez-perez FI, Kiss T, et al. IGF-1 Deficiency Promotes Pathological Remodeling of Cerebral Arteries: A Potential Mechanism Contributing to the Pathogenesis of Intracerebral Hemorrhages in Aging. J Gerontol A Biol Sci Med Sci. 2019;74(4):446-454.
- Wolfe BL, Rich CB, Goud HD, et al. Insulin-like growth factor-I regulates transcription of the elastin gene. J Biol Chem. 1993;268(17):12418-26.
- Matsuda Y, Kawate H, Matsuzaki C, et al. Reduced arterial stiffness in patients with acromegaly: non-invasive assessment by the cardio-ankle vascular index (CAVI). Endocr J. 2013;60(1):29-36.
- Schöfl C, Petroff D, Tönjes A, et al. Incidence of myocardial infarction and stroke in acromegaly patients: results from the German Acromegaly Registry. Pituitary. 2017;20(6):635-642.
- Zhang XW, Yang Z, Li M, Li K, Deng YQ, Tang ZY. Association between dietary protein intake and risk of stroke: A meta-analysis of prospective studies. Int J Cardiol. 2016;223:548-551.
- Schut AF, Janssen JA, Deinum J, et al. Polymorphism in the promoter region of the insulin-like growth factor I gene is related to carotid intima-media thickness and aortic pulse wave velocity in subjects with hypertension. Stroke. 2003;34(7):1623-7.
- Mccarty MF. IGF-I activity may be a key determinant of stroke risk--a cautionary lesson for vegans. Med Hypotheses. 2003;61(3):323-34.
- Mccarty MF. A low-fat, whole-food vegan diet, as well as other strategies that down-regulate IGF-I activity, may slow the human aging process. Med Hypotheses. 2003;60(6):784-92.
- Potassium-rich foods linked to lower stroke risk. Harv Heart Lett. 2014;25(4):8.
- Allen NE, Appleby PN, Davey GK, Key TJ. Hormones and diet: low insulin-like growth factor-I but normal bioavailable androgens in vegan men. Br J Cancer. 2000;83(1):95-7.
- Allen NE, Appleby PN, Davey GK, Kaaks R, Rinaldi S, Key TJ. The associations of diet with serum insulin-like growth factor I and its main binding proteins in 292 women meat-eaters, vegetarians, and vegans. Cancer Epidemiol Biomarkers Prev. 2002;11(11):1441-8.
Video production by Glass Entertainment
Motion graphics by Avocado Video
- animal protein
- animal studies
- atherosclerosis
- beans
- brain health
- breast cancer
- cancer
- cardiovascular disease
- colon cancer
- colorectal cancer
- dairy
- eggs
- greens
- heart disease
- heart health
- homocysteine
- IGF-1
- junk food
- longevity
- lung cancer
- men's health
- milk
- mortality
- Plant-Based Diets
- potassium
- processed foods
- prostate cancer
- protein
- stroke
- sweet potatoes
- vegans
- vegetarians
- women's health
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.
In 2014, a study on dietary protein intake and stroke risk found that greater intake was associated with lower stroke risk, and furthermore it was the animal protein that appeared to be particularly protective. Might that help explain why vegetarians were recently found to have a higher stroke rate than meat-eaters?
Animal protein consumption increases the levels of a cancer-promoting growth hormone in the body known as IGF-1, insulin-like growth factor one, which can accelerate the progression of precancerous changes to invasive cancer. High blood concentrations are associated with an increased risk of breast, prostate, colorectal, and lung cancers, potentially explaining the association between dairy milk and prostate cancer risk, for example. But there are also IGF-1 receptors on blood vessels; so, maybe IGF-1 promotes cancer but also brain artery integrity.
People who have strokes appear to have lower blood levels of IGF-1, but it could just be a consequence of the stroke rather than the cause. There weren’t any prospective studies over time —until 2017, and indeed higher IGF-1 levels were linked to lower risk of stroke, but is it cause and effect? In mice the answer appears to be yes, and in a petri dish IGF-1 appears to boost production of elastin, a stretchy protein that helps keep our arteries elastic. Higher levels are associated with less artery stiffness, but acromegaly patients, like Andre the giant, those with excessive levels of growth hormones like IGF-1 do not appear to have lower stroke rates, and a more recent study of dietary protein intake and risk of stroke, looking at a dozen studies of more than a half million people, compared to only 7 studies with a quarter million in the previous analysis, found NO association between dietary protein intake and the risk of stroke. In fact, if anything dietary plant protein intake may actually decrease the risk of stroke.
However, those with high blood pressure who have low IGF-1 levels do appear to be at increased risk of developing atherosclerosis, thickening of the artery walls leading up to the brain, but no such association was found in people with normal blood pressure. So, there may be a cautionary lesson for vegans here. Yes, a whole food plant-based diet to down-regulate IGF-1 activity may slow the human aging process, not to mention reducing the risk of some of the common cancers that plaque the Western world. But, perhaps, the ‘take-home’ message should be that people who undertake to down-regulate IGF-1 activity by cutting down on animal protein intake as a pro-longevity measure should take particular care to control their blood pressure to preserve their cerebrovascular health, the health of their arteries in their brain. In particular, they should keep salt intake relatively low while ensuring an ample intake of potassium to keep their blood pressures down. So, that means avoiding processed foods and avoiding added salt, and in terms of potassium-rich foods, beans, sweet potatoes, and dark green leafy vegetables.
So, might this explain the higher stroke risk found among vegetarians? No. Why? Because dairy and egg whites are animal proteins too. Only vegans have lower IGF-1 levels in both men and women; so, low IGF-1 levels can’t explain why higher rates of stroke were found in vegetarians. So, what is it already? I think the best explanation for the mystery is something called homocysteine, which I’ll cover, next.
Please consider volunteering to help out on the site.
- Zhang Z, Xu G, Yang F, Zhu W, Liu X. Quantitative analysis of dietary protein intake and stroke risk. Neurology. 2014;83(1):19-25.
- Tong TYN, Appleby PN, Bradbury KE, et al. Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study. BMJ. 2019;366:l4897.
- Kaaks R. Nutrition, insulin, IGF-1 metabolism and cancer risk: a summary of epidemiological evidence. Novartis Found Symp. 2004;262:247-60.
- Fürstenberger G, Senn HJ. Insulin-like growth factors and cancer. Lancet Oncol. 2002;3(5):298-302.
- Harrison S, Lennon R, Holly J, et al. Does milk intake promote prostate cancer initiation or progression via effects on insulin-like growth factors (IGFs)? A systematic review and meta-analysis. Cancer Causes Control. 2017;28(6):497-528.
- Delafontaine P, Song YH, Li Y. Expression, regulation, and function of IGF-1, IGF-1R, and IGF-1 binding proteins in blood vessels. Arterioscler Thromb Vasc Biol. 2004;24(3):435-44.
- Dong X, Chang G, Ji XF, Tao DB, Wang YX. The relationship between serum insulin-like growth factor I levels and ischemic stroke risk. PLoS ONE. 2014;9(4):e94845.
- Saber H, Himali JJ, Beiser AS, et al. Serum Insulin-Like Growth Factor 1 and the Risk of Ischemic Stroke: The Framingham Study. Stroke. 2017;48(7):1760-1765.
- Fulop GA, Ramirez-perez FI, Kiss T, et al. IGF-1 Deficiency Promotes Pathological Remodeling of Cerebral Arteries: A Potential Mechanism Contributing to the Pathogenesis of Intracerebral Hemorrhages in Aging. J Gerontol A Biol Sci Med Sci. 2019;74(4):446-454.
- Wolfe BL, Rich CB, Goud HD, et al. Insulin-like growth factor-I regulates transcription of the elastin gene. J Biol Chem. 1993;268(17):12418-26.
- Matsuda Y, Kawate H, Matsuzaki C, et al. Reduced arterial stiffness in patients with acromegaly: non-invasive assessment by the cardio-ankle vascular index (CAVI). Endocr J. 2013;60(1):29-36.
- Schöfl C, Petroff D, Tönjes A, et al. Incidence of myocardial infarction and stroke in acromegaly patients: results from the German Acromegaly Registry. Pituitary. 2017;20(6):635-642.
- Zhang XW, Yang Z, Li M, Li K, Deng YQ, Tang ZY. Association between dietary protein intake and risk of stroke: A meta-analysis of prospective studies. Int J Cardiol. 2016;223:548-551.
- Schut AF, Janssen JA, Deinum J, et al. Polymorphism in the promoter region of the insulin-like growth factor I gene is related to carotid intima-media thickness and aortic pulse wave velocity in subjects with hypertension. Stroke. 2003;34(7):1623-7.
- Mccarty MF. IGF-I activity may be a key determinant of stroke risk--a cautionary lesson for vegans. Med Hypotheses. 2003;61(3):323-34.
- Mccarty MF. A low-fat, whole-food vegan diet, as well as other strategies that down-regulate IGF-I activity, may slow the human aging process. Med Hypotheses. 2003;60(6):784-92.
- Potassium-rich foods linked to lower stroke risk. Harv Heart Lett. 2014;25(4):8.
- Allen NE, Appleby PN, Davey GK, Key TJ. Hormones and diet: low insulin-like growth factor-I but normal bioavailable androgens in vegan men. Br J Cancer. 2000;83(1):95-7.
- Allen NE, Appleby PN, Davey GK, Kaaks R, Rinaldi S, Key TJ. The associations of diet with serum insulin-like growth factor I and its main binding proteins in 292 women meat-eaters, vegetarians, and vegans. Cancer Epidemiol Biomarkers Prev. 2002;11(11):1441-8.
Video production by Glass Entertainment
Motion graphics by Avocado Video
- animal protein
- animal studies
- atherosclerosis
- beans
- brain health
- breast cancer
- cancer
- cardiovascular disease
- colon cancer
- colorectal cancer
- dairy
- eggs
- greens
- heart disease
- heart health
- homocysteine
- IGF-1
- junk food
- longevity
- lung cancer
- men's health
- milk
- mortality
- Plant-Based Diets
- potassium
- processed foods
- prostate cancer
- protein
- stroke
- sweet potatoes
- vegans
- vegetarians
- women's health
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Vegetarians and Stroke Risk Factors—Animal Protein?
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
If you’re not familiar with IGF-1, a good primer is Animal Protein Compared to Cigarette Smoking or How Not to Die from Cancer.
How can we lower our blood pressures beyond just eating a plant-based diet? Check out the chapter of hypertension in my book How Not to Die at your local public library.
This is the 8th in a 12-part series on vegetarian stroke risk. If you missed any of the previous videos, check out:
- What to Eat for Stroke Prevention
- What Not to Eat for Stroke Prevention
- Do Vegetarians Really Have Higher Stroke Risk?
- Vegetarians and Stroke Risk Factors—Vitamin D?
- Vegetarians and Stroke Risk Factors—Omega 3s?
- Vegetarians and Stroke Risk Factors—Vegan Junk Food?
- Vegetarians and Stroke Risk Factors—Saturated Fat?
Coming up we turn to what I think is actually going on:
- Vegetarians and Stroke Risk Factors—Vitamin B12 & Homocysteine?
- How to Test for Functional Vitamin B12 Deficiency
- Should Vegetarians Take Creatine to Normalize Homocysteine?
- The Efficacy and Safety of Creatine for High Homocysteine
2023 Update: I recently put out a new video, Update on Vegetarian Stroke Risk.
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