Vitamin D for Inflammatory Bowel Disease

Vitamin D for Inflammatory Bowel Disease
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Vitamin D supplements were put to the test for Crohn’s disease.

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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.

“IBD is a chronic inflammatory condition of the intestine…that includes…Crohn’s disease and ulcerative colitis.” If you compare identical twins—even though they have the same genes—most of the time, if one twin has it, the other does not. So, there must be some important nongenetic “trigger factors.” What might they be?

Well, studies like these offered a clue. Why do those living in the southern United States have lower IBD rates than those living in the north?  Maybe it’s because those living in the south get more sun, which means more vitamin D, which may mean less inflammation.

So, do those with Crohn’s and ulcerative colitis with low vitamin D levels have worse disease? Apparently so; “increased risk of surgery and hospitalization,” and those that normalized their vitamin D levels appeared to reduce their risk of relapse. But, instead of better vitamin D leading to better Crohn’s, maybe the better Crohn’s led to better D; they felt so good, they went outside more. You can’t tell if it’s cause and effect, unless you put it to the test.

The first pilot study tried 1,000 units of vitamin D a day, and saw no change in the Crohn’s disease activity index—though at six weeks, there may have been a slight increase in the inflammatory bowel disease quality of life scores. But, even that disappeared by year’s end. Pretty disappointing results. Maybe they didn’t use enough.

How about 1,200 a day? The relapse rate appeared to be cut in half, though there were too few people in the study to reach statistical significance. How about 2,000 international units of vitamin D a day? Gut leakiness—so-called intestinal permeability—continued to worsen in the placebo group, but appeared to stabilize in the vitamin D group, though only those who reached blood levels over 75 nanomoles per liter appeared to have a significant drop in inflammation.

And indeed, if you start Crohn’s patients on 1,000, and then ramp it up until they reach a target blood level, you can get a significant boost in quality of life, accompanying a significant drop in disease activity. Disease scores under 150 are considered remission. So, “the majority of patients achieved remission,” with improvements in disease activity, in “all but one patient.”

This suggests that Crohn’s patients may want to take 5,000 international units of vitamin D a day. But, that’s nearly ten times the RDA. Why so much? Because that’s what it may take to get normal vitamin D levels—as in normal-for-our-species levels, the kind of levels one might get running around half-naked in Africa, as we did for millions of years.

Please consider volunteering to help out on the site.

Image credit: Meditations via pixabay. Image has been modified.

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.

“IBD is a chronic inflammatory condition of the intestine…that includes…Crohn’s disease and ulcerative colitis.” If you compare identical twins—even though they have the same genes—most of the time, if one twin has it, the other does not. So, there must be some important nongenetic “trigger factors.” What might they be?

Well, studies like these offered a clue. Why do those living in the southern United States have lower IBD rates than those living in the north?  Maybe it’s because those living in the south get more sun, which means more vitamin D, which may mean less inflammation.

So, do those with Crohn’s and ulcerative colitis with low vitamin D levels have worse disease? Apparently so; “increased risk of surgery and hospitalization,” and those that normalized their vitamin D levels appeared to reduce their risk of relapse. But, instead of better vitamin D leading to better Crohn’s, maybe the better Crohn’s led to better D; they felt so good, they went outside more. You can’t tell if it’s cause and effect, unless you put it to the test.

The first pilot study tried 1,000 units of vitamin D a day, and saw no change in the Crohn’s disease activity index—though at six weeks, there may have been a slight increase in the inflammatory bowel disease quality of life scores. But, even that disappeared by year’s end. Pretty disappointing results. Maybe they didn’t use enough.

How about 1,200 a day? The relapse rate appeared to be cut in half, though there were too few people in the study to reach statistical significance. How about 2,000 international units of vitamin D a day? Gut leakiness—so-called intestinal permeability—continued to worsen in the placebo group, but appeared to stabilize in the vitamin D group, though only those who reached blood levels over 75 nanomoles per liter appeared to have a significant drop in inflammation.

And indeed, if you start Crohn’s patients on 1,000, and then ramp it up until they reach a target blood level, you can get a significant boost in quality of life, accompanying a significant drop in disease activity. Disease scores under 150 are considered remission. So, “the majority of patients achieved remission,” with improvements in disease activity, in “all but one patient.”

This suggests that Crohn’s patients may want to take 5,000 international units of vitamin D a day. But, that’s nearly ten times the RDA. Why so much? Because that’s what it may take to get normal vitamin D levels—as in normal-for-our-species levels, the kind of levels one might get running around half-naked in Africa, as we did for millions of years.

Please consider volunteering to help out on the site.

Image credit: Meditations via pixabay. Image has been modified.

Doctor's Note

If Vitamin D helps with inflammation, what about childhood asthma? That was the topic of my last video, Vitamin D for Asthma.

More on the role diet can play in preventing and treating inflammatory bowel diseases in:

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

158 responses to “Vitamin D for Inflammatory Bowel Disease

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  1. what is the safety of aloe vera gel when ingested? I am asking about aloe vera gel inteneded for human consumption, not the stuff put on our skin. I have heard and read that aloe juice is not a good idea, and that the latex from the skin of the aloe plant is not healthy to ingest.

    Anyone know?




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      1. Tried this. There is no information that talks specifically about the “gel”, which is the interior of the plant. The exterior/skin and layer just under the skin have been found to be harmful when ingested, but the gel is reported by some to be both safe and healing, as well as nutritious. I don’t see Dr. G. making a distinction of which is safe and not safe, so I am hoping others could weigh in.




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      1. Are you saying that each part of the plant is not ok internally, or are you referencing the data that says just
        the outer leaf and skin is harmful if ingested internally?

        The research i have read says the inner gel is the safe part to eat, but that the skin is what contains the toxins that have been showed to hurt the liver and irritate the GI tract. The skin is
        what contains the chemical that is in senna that forces the bowels to open, but the inner gel is viewed as food/fruit.
        Sort of like how we can’t eat certain parts of plants due to toxins, but other parts of the same plant are safe to eat.




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        1. Uh oh. I really hope Dr. Greger replies about this. I just started taking Desert Harvest freeze dried aloe for interstitial cystitis and it seems like it’s helping – I don’t want to mess up my liver while I’m trying to fix my bladder :(

          It would be so awesome if anyone in the plant-based diet community would address interstitial cystitis and offer some hope or help for this troublesome condition …




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          1. Andrea,

            I recently saw a documentary created by a woman who healed her interstitial cystitis through medically supervised fasting at TrueNorth Health Center in Santa Rosa, CA. She suffered horribly from this painful condition for seven or so years before traveling from Ireland to California. Then she waited several years to put together the film. This should lead you to the TrueNorth website, where you can buy the documentary: http://www.healthpromoting.com. The film is Gabrielle’s Journey. Maybe you can find it on Youtube.

            You can call there and have a free consultation with Dr Goldhamer. He has done medically supervised fasting for over 30 years with amazing and excellent results. You can also find him on Youtube giving lots of talks.

            Before going there I had been reading about health and nutrition for 50 years and I’d never learned about the healing power of fasting. The staff is great, other patients friendly, the food, for those not fasting, or after coming off a fast, is whole food plant based with no sugar, oil, salt or gluten, and organic.




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            1. Hi Rebecca, thanks so much for taking the time to reply. I am breastfeeding a baby so I would not be a candidate for fasting right now but I’ll keep it in mind for the future and will check out the documentary.




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              1. Andrea, Wow! You’re caring for a young baby while living with all that pain and inconvenience. I’m so sorry. In that case, those suggestions for avoiding triggering foods sounds like the best course of action.

                As I understand it, IC is an autoimmune condition, so it makes sense to me that certain foods trigger the whole thing. Your body reacts to proteins that mimic or are similar to those of normal body proteins. So, by eliminating those proteins you can stop or minimize the attack on your own body tissues.

                I hope you’ll let us know how you progress.




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          2. Hello Andrea, I am a plant based dietitian from Scottsdale, Arizona. I help Dr. Greger with comments that come into NutritionFacts. This review article is interesting, and runs through the known approaches (including dietary modifications) that help with IC. The symptoms were reduced with the elimination, among others, of the following: alcoholic beverages, carbonated drinks, caffeine, spicy foods, tomatoes, citrus fruits, and vinegar. Arylalkylamine-containing foods (tryptophan, tyrosine, tyramine, and phenylalanine) have also been implicated as IC symptom exacerbate and include the following: bananas, beer, cheese, mayonnaise, aspartame, nuts, onions, raisins, sour cream, wine, and yogurt.

            Kind of a mixed dietary bag – but as a dietitian, I work with IC by encouraging clients to keep a detailed food diary, then eliminate the foods known to be triggers (see above list). If symptoms improve, we are on the right track – and can add back in items one by one and observe effects. Overall, I like the PubMed article and hope that you get some benefit from its suggestions.

            Remember one must have tremendous faith and patience when using a dietary approach, rather than taking medication. The answer may not always be obvious, but the journey can be interesting!

            Good luck!

            –Lisa




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            1. Thanks so much Lisa, that’s really helpful — there are a couple of things on the second list that you gave that I’ve still been eating, so I’ll try cutting out those and hope for the best. And I’ll go over the article you linked some more and try to follow your good advice.

              It looks like some people are saying that the compound Desert Harvest removes from their aloe product, which they remove because it causes diarrhea, is also the hepatotoxic compound. I don’t know how they can know that when there are 200+ compounds in the stuff but anyway, that’s what some people who sell aloe are saying. I think for myself I’d better not take it anyway. Such a shame though when it does seem to help interstitial cystitis :(

              I’ll try to stick it out with faith and patience and diet! Thanks again.




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          3. I am not a medical professional Andrea, but hope I can provide. Having suffered IC for decades, researched laboriously in a pre computer world, I did experiment with diet as per Lisa’s excellent suggestions and kept a journal. I could not eat chocolate, berries, fresh tomatoes and a host of other foods for years. 18 mos ago I went totally plant based , whole food for other reasons, having resigned myself to lifelong pain. I focussed on eliminating foods that caused inflammztion to my stomach.. stopped all artificial sweeteners (a biggie!), all dairy, processed foods, and vinegars/acid foods . My stomach healed, and so apparently has the IC.. Your trigger foods may be different, but I believe mine were actally allergies. Now I enjoy berries except strawberries. I hope this helps a bit. All the best to you in your healing journey!




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            1. Wow, that’s incredibly encouraging! I have been eating mostly plant-based for about six months since reading How Not to Die, but I have still been eating some dairy. Wouldn’t that be great if I cut dairy and my IC symptoms go away! Your story gives me the motivation to try it. So far it’s been too stressful to try to cut out the last bit of animal products at the same time that I’m also avoiding all fruit, all processed foods, all acidic foods. Maybe I just haven’t found my trigger yet. Thanks so much for sharing your great story!




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        2. Hi, can you share your citations with us? In a literature search through PubMed, I cannot find evidence that the inner gel is safe to eat.
          A secondary consideration are the lack of quality control standards used in the Wild Wild West of the supplement industry. As there are no regulatory or oversight activities of bioactive foods (supplements), we are often on our own when we venture into the non-scientifically tested world of Ancient Remedies.




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      2. I’m not surprised. The gel is amazing for burns, bites and other skin applications, so I have lots of it growing in my yard. I decided to taste the gel to see what all the hoopla was about, and it was disgusting! Nothing at all like the tasty beverages they sell, which really sets off alarm bells and raises suspicions when there is such a big discrepancy.




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    1. I have taken whole leaf aloe juice internally before and did not notice any bad side effects besides the terrible taste of the citric acid which is used in many of the products. The aloe plant is supposed to have many positive effects such as helping “leaky gut”, heartburn, and constipation. When I took it, I believe I noticed an improvement in bowel movements for certain. If I were you, I would take the aloe Vera juice with fruit juice such as grape because that does a lot to quench the unsavory taste.




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    2. This is a question that is important, and sheds a light on how little is known scientifically regarding the safety and efficacy of the myriad herbal products that are touted as remedies for all that ails us. I myself was prescribed ingested aloe gel as a remedy for IBS.
      I did a quick PubMed search to see what the science says. This review article is an interesting overview of liver toxicity and different herbal remedies. I find it interesting to read and review just how the liver works, and how little we know about what harms the liver. But if we do, it really is bad! Searching for research articles written since 2013 brings a variety of studies, mostly done with rats, that are likely not applicable to humans. This is an area where science does not support the ingestion of aloe juice or gel, in my humble opinion. It may actually be harmful.




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      1. Lisa: To access the review article you have linked signing up is necessary. Is there a way to access it without signing up? If not, can you please provide the full reference so that I could try to get it from a different source? Thank you Lisa.




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      2. Thank you Lisa for your explanation about the safety of herbal supplements. I could not read the review article as it asks for password. Could you share it through easyhprelinks.
        Thanks




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  2. I find these vit D videos very interesting … overall, my impression is that the suggested guidelines for daily intake have been set too low. But maybe too, we should be putting more effort into emmulating the lifestyle of the africans with high vit D serum levels than supplementing.

    My fav video of all time is this one http://nutritionfacts.org/video/how-to-regenerate-coenzyme-q10-coq10-naturally/ about the anti inflammatory action of dietary chlorophyll and sunlight. I cant help thinking that we are missing important pieces of the puzzle by staying out of the sun and/ or slathering on sunscreen.




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    1. I agree Susan. Being outside helps us get better quality air, connect socially with other people, with our community, and with plants or fungi in our garden or by foraging, improving the quality of what we can eat.
      John S




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    2. But then there’s the cold air, the rain, the snow, all of which keep us covered up when we are outside, and being further north than LA or Atlanta. Many of us must supplement most of the year.




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      1. Yes, of course Rebecca, and coming from ranch country in canada I know well what its like to stay totally covered until spring.. I caused a stampede once walking down to the cow pasture in my hiking shorts the first warm day of spring one year LOL. We are certainly lucky to have supplements to take , and that are effective. My point was only that I just have a hunch there is more to the miracle of our life interacting with the sun, environment and food than we currently know. Amazing stuff!




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        1. Oh, I’m sure you’re right about that. Our lives have become quite divorced from nature in so many ways. We’ll probably never know all that we’re missing because of our urban, electronically attached lifestyles.

          By the way, I’d love to have seen your stampeding cattle when they saw this lightly clad stranger in their midst!




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          1. Rebecca,

            Yes, we have gone soft.
            I deliberately rough up my life a little (walking barefoot, camping, DIY, periods of Spartan dieting et. c) and I’m also very fortunate to be living in the southern hemisphere and a regional town where I have quick access to some relatively pristine nature.
            It’s official … roughing it up is good for our health:

            [quote]

            NCBI-NIH database

            Influence of a 10-Day Mimic of Our Ancient Lifestyle on Anthropometrics and Parameters of Metabolism and Inflammation: The “Study of Origin”.
            Pruimboom L1, Ruiz-Núñez B2, Raison CL3, Muskiet FA2.
            Author information

            1Natura Foundation, 3281 NC Numansdorp, Netherlands; Laboratory Medicine, University Medical Center Groningen (UMCG) and University of Groningen, 9713 GZ Groningen, Netherlands.
            2Laboratory Medicine, University Medical Center Groningen (UMCG) and University of Groningen, 9713 GZ Groningen, Netherlands.
            3Department of Psychiatry, College of Medicine, John and Doris Norton School of Family and Consumer Sciences, Tucson, AZ 1075, USA.
            Abstract
            Chronic low-grade inflammation and insulin resistance are intimately related entities that are common to most, if not all, chronic diseases of affluence. We hypothesized that a short-term intervention based on “ancient stress factors” may improve anthropometrics and clinical chemical indices. We executed a pilot study of whether a 10-day mimic of a hunter-gatherer lifestyle favorably affects anthropometrics and clinical chemical indices. Fifty-five apparently healthy subjects, in 5 groups, engaged in a 10-day trip through the Pyrenees. They walked 14 km/day on average, carrying an 8-kilo backpack. Raw food was provided and self-prepared and water was obtained from waterholes. They slept outside in sleeping bags and were exposed to temperatures ranging from 12 to 42°C. Anthropometric data and fasting blood samples were collected at baseline and the study end. We found important significant changes in most outcomes favoring better metabolic functioning and improved anthropometrics. Coping with “ancient mild stress factors,” including physical exercise, thirst, hunger, and climate, may influence immune status and improve anthropometrics and metabolic indices in healthy subjects and possibly patients suffering from metabolic and immunological disorders.
            PMID: 27366752

            [unquote]

            It’s instinctive for us to like the soft life (this is why I keep hammering the point that ‘health is about more than just optimal nutrition – we also have to manage the psycho-spiritual aspect == social and environmental for the lay person):

            [quote]

            NCBI-NIH database

            J Hum Evol. 2008 Aug;55(2):340-8. doi: 10.1016/j.jhevol.2008.03.003. Epub 2008 May 16.
            Great apes prefer cooked food.
            Wobber V1, Hare B, Wrangham R.
            Author information

            1Department of Anthropology, Harvard University, Peabody Museum, Cambridge, MA 02138, USA. wobber@fas.harvard.edu
            Abstract
            The cooking hypothesis proposes that a diet of cooked food was responsible for diverse morphological and behavioral changes in human evolution. However, it does not predict whether a preference for cooked food evolved before or after the control of fire. This question is important because the greater the preference shown by a raw-food-eating hominid for the properties present in cooked food, the more easily cooking should have been adopted following the control of fire. Here we use great apes to model food preferences by Paleolithic hominids. We conducted preference tests with various plant and animal foods to determine whether great apes prefer food items raw or cooked. We found that several populations of captive apes tended to prefer their food cooked, though with important exceptions. These results suggest that Paleolithic hominids would likewise have spontaneously preferred cooked food to raw, exapting (exhibiting?) a pre-existing preference for high-quality, easily chewed foods onto these cooked items. The results, therefore, challenge the hypothesis that the control of fire preceded cooking by a significant period.
            PMID: 18486186

            [unquote]

            Of course the ‘captive’ apes, in the study ‘ know not what they do’.

            P.S I haven’t read these articles in detail ….. I’m just flagging the possibility that they point to some ideas worthy of our thoughts.




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            1. I guess I’m too old to worry about whether we came to like our food cooked or raw before or after we learned to control fire. Science now shows that both have value.

              You sound much more adventurous than me, so enjoy your “roughing it up”.




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            2. “It’s instinctive for us to like the soft life”…
              Makes me think of Doug Lisle’s great lectures about the “Pleasure Trap” and the motivational triad… As animals, we all seek pleasure, avoid pain, and conserve energy in our effort to survive.




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      2. Hi @rebeccacody:disqus I am a plant based dietitian and I help Dr Greger on the site. An important consideration with Vitamin D is that it is actually not a vitamin, but a steroid precursor hormone, with receptor sites throughout the body. Our hormone system is quite nuanced, and works together to self regulate. Our modern lifestyle of being indoors combined with slathering ourselves with sunblock may be some of the contributors to inadequate levels of Vitamin D. But measuring Vitamin D status is a modern development, and the big business of diagnosing Vitamin D deficiency and treatment was born. Apologize for the rambling, but for all of us who are concerned about just one hormone level, I advise working with a clinician who is skilled at treating hormone deficiencies (like Thyroid, as a primary one) as opposed to self diagnosing and dosing with large doses of Vitamin D. Excess Vitamin D is stored in the liver. There are some reports of calcification of the kidneys with too much supplemental Vitamin D.
        I may be a spoiler for Dr Greger, but Food sources of Vitamin D are mostly animal based, but fortified foods including plant based milks and alternatives as well as cereals can help.




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        1. I do keep track of my levels with testing, but even in summer I probably don’t spend enough time in the sun, so supplementing keeps my levels in the normal range.




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  3. Are there any benifits in taking a supplement which contains vitamin d3 and k2 mk7? Or would it be enough to just take 1000 ui of vitamin d daily?




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      1. Thank you for linking that seminar (:
        If I understood that correctly, at the moment there is no scientific evidance that supplementing vitamin k while taking vitamin d has any benifits apart from less artery calcification. And the intake of vitamin k from leafy green veggies should be sufficient.
        English is a foreign language to me so I better ask…




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  4. I had my blood tested for Vit D to reach a target of about 100. I determined I needed to take 50,000 units a week (10,000 x 5 days).




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    1. You are leaving off the units of your blood test. ln Dr Greger’s video he states that benefits came above a level of 75 nmol/l. This is equivalent to 30 ng/ml, another common test unit. Both units seem to be commonly used and can be easily converted between each other, but you should be aware of which you are reading off a test.




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      1. My target was 100 ng/mL. I did this with my doctor. Labcorp defines a normal range as 30.0 – 100.0 ng/mL.
        70,000 x 7 days put me slightly above 100, so we backed off to 10,000 x 5 days.




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            1. Take a look at https://www.vitamindcouncil.org/about-vitamin-d/testing-for-vitamin-d/

              They recommend taking about 5000 IU to reach a target of 50 ng/mL within an acceptable range of 40-80 ng/mL. . Dr. Fuhrman thinks around 45 ng/mL is the “sweet spot” and above 50 is too high. IOM cautions that levels over 50 ng/mL (actually a little lower, as I recall) have been associated with greater risk of adverse events and that risk rises with higher levels.




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      2. I’m glad you pointed that out. I had my level checked a couple years ago and it was 54. Based on this video I figured it wouldn’t hurt to ramp it up a bit. Then I checked the units and sure enough my results were in ng/ml. Using your conversion my level would be 135 nmol/l.




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  5. Thank you for making this wonderful video. Would you recommend taking three doses a day? As in 2000iu at breakfast, 2000iu at lunch, 1000iu at dinner; or would one dose of 5000iu suffice? Thank you in advance.




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      1. Dr. Bruce Hollis, a prominent vitamin-D researcher, disagrees. He claims that, to maintain bone health, it’s ok to take vitamin D less frequently than daily but for other benefits it must be taken daily. The reason given is that most of the active form of vitamin D (1, 25-dihydroxyvitamin D) other cells than intestinal cells use is made within the cells themselves from vitamin D directly, only a small amount from 25-hydroxyvitamin D received from the liver. Since the half life of vitamin D is about a day, cells require a frequent supply of vitamin D to maintain adequate 1, 25-dihydroxyvitamin D.




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        1. Hi George,

          I’m taking around 5000 iu/day (Dr’s orders).
          I believe it is beneficial and from the response of my body I agree that it is better drip feed (1 x 1000 iu per meal).




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    1. Hello Nasser, I am a volunteer and I help Dr Greger answer questions on NutritionFacts. I am also a dietitian based in Scottsdale, Arizona. It is RARE for Dr Greger to recommend supplementation. You can read what Dr Greger says about supplements HERE. You’ll note he references Vitamin D. He did not discuss dosing levels in today’s videos, so I would encourage you to check out the links I’ve added to this message for more precise information. Thanks for your comment!




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      1. Thank you for your reply, Lisa. I checked the links that you provided, but then found this video, which is the most up to date, as of now, and it debunks the u shaped curve that is explained in the links that you provided. It appears that the safe dose of vitamin D supplementation to get most of the population
        to the optimal level is 2,000 IU a day, but the elderly, and overweight,
        may need more. However, this still does not answer my original question; which is, would it be best to split the dosage to twice, or three times, a day? Or would a single dose be fine? http://nutritionfacts.org/video/how-much-vitamin-d-should-you-take/?utm_content=buffer6c7a7&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer




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  6. My ancestors were black monkeys swinging in the trees 4 millions years ago?? Does that sound at least a little racist? I like the data, but not the evo-speculation….




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    1. At the beginning of popular religions, there was no data. Science did not exist. It was all pure human opinion. Some founders did not even know how to write. But modern followers are in a data conflict and accuse science of ideological speculation. What can a book base religion say about science when science did not existed way back when the book was written?




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    2. You really stretched “running around naked in Africa” to your own offense there.

      Seek to be offended and ye shall find.

      There was no mention of colors,
      no mention of species,
      no mention of trees,
      no mention of swinging. Also the phrase was “For millions of years”, there was no mention of “four million years”.

      Criticism or offense should be based on accurate observations. Hope that helps.




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    3. Nope, . . .I didn’t see “black monkey’s” in the transcript or video either. Tell us, Steve, at what point you saw “black monkeys swinging in the trees 4 millions years ago” by giving us the minute and seconds.
      What I heard was that we were running around in African half naked for millions of years – not black monkeys running around 4 million years ago. Quite a difference.




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    4. To Thea(et al moderators):

      ‘To make NutritionFacts.org a place where people feel comfortable posting without feeling attacked, we have no tolerance for ad hominem attacks or comments that are racist, misogynist, homophobic, vulgar, or otherwise inappropriate.’




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      1. To Jeff and everyone in this conversation: I appreciate the restraint and logic that went into your replies to Steve. I think this is just one of those conversations that is best removed entirely. This is the first time that I can remember that I have deleted all posts in conversation like this. It’s not something I do lightly. It is not a comment on the appropriateness of your comment. It is just addressing a need for the site.
        .
        Steve Mulder: This is a science-based site. There are going to be references to “millions of years” and “evolution” not just in this video, but in future videos as well. This site is not the place to deny concepts that are so basic and accepted in science as to be as close to fact as we can get. Hopefully you can skip over the bits that conflict with your religion. Either way, you need to keep the religious based comments to yourself.




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  7. Well darn. Looks like sillyism is here to stay. I simply don’t know how this helps spread the word. It’s aggravating to me, VERY distracting. Like, here I am now writing about it rather than finishing the video. But then I was able to “ignore” the last several “incidents”. Hell, it’s aggravating even when I hear the audio change when only listening to the video.

    It’s weird and I hate it, and won’t share videos with it. I shall only cut/paste the transcripts only so long as green screen is involved, but it’s just a lot simpler for me to NOT SHARE.

    It’s just too difficult to get folks to take US seriously, and then “we” throw in extra SILLINESS. I cannot abide.

    BTW I just posted up about starting my second full years WFPB. I’m very happy the way I approach it. It now appears that I’ll have to lean on my words, my writings, my experiences, etc. and much less on NF.O to continue to promote Life and Longevity to my friends going forward.

    I am very thankful for all the great information and organization found here, but it’s time for me to let it rest for a while. I realize that my perspective is rarely that of “majority” or “normalcy”, so I shaddup now.




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    1. I have seen a previous post of yours complaining about Dr. G’s pop-ups in his video’s. The staff has already explained to you and the rest of us that these videos were pre-recorded in a batch. And until we have run them through we will see a few here and there. He has also explained that he got the message that we prefer not to see the popups and is not incorporating them into the videos in the future.
      So it would be a lovely thing for us all if you could be patient – like the rest of us.




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    2. Wade: This is video 26 out of 27 on volume 33. It is my understanding that the popups will stop at the end of this volume of videos. Hence, we have one more video.




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      1. Thanks. I knew there was a series, but had no idea how many videos that involved. A few more than I thought. Sorry I’m so vocal about my perception. Cheers.




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  8. Hello and Happy New 2017! Today I’m celebrating being with you today and helping moderate this discussion. I am a plant based dietitian located in Scottsdale, Arizona. I look forward to a robust discussion on today’s video!!




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  9. I have autoimmune gastritis and Sibo, my vitamin d levels are normal according to my blood test, I can’t digest foods with fiber and current taking rifaxamin for the Sibo with no success, I also have ibs-c. not sure why but I notice eating just oatmeal or bread with oatfiber and even with gluten helps with my condition a bit, even though I’m told to avoid gluten because it causes inflammation. I really want to go into remission, also I test my b12 and it is around 1000 and take b12 pill under the tongue. I will do anything to get into remission, I’m really just upset I have trouble digesting fiber, I get extremely bloated and wind in my stomach. I just want to be normal again. do you know of any studies where people actually went into remission, are there other autoimmune diseases associated with chronic constipation, it’s made worse 2 weeks before my menstral cycle. this might be tmi I know but I really want help… I have a good doctor now but I feel there’s more to my condition we still have to test more for.




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    1. Your symptoms made me wonder about your microbiome. Perhaps you can find an MD or naturopath who can do stool testing to see if you have an overgrowth of candida or other imbalances in your gut bacteria. This is just my guess, but if I had your symptoms that’s one direction of inquiry I’d look into.




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    2. Hi Rosanna,
      Unfortunately SIBO can be very difficult to treat and antibiotics like Rifaximin often take several courses before the bacterial overgrowth is gone. The reason for this is that unless the underlying cause for the SIBO is addressed the bacteria simply overgrow again after the antibiotic course is finished. That being the case you’ll need to look at what the likely contributing factors to SIBO are in your particular case and address those. This is a discussion you’ll have to have with your doctor since he/she knows your complete history but based on what you have told us here your chronic constipation is likely to be at least one of the contributing factors for you. When someone has chronic constipation or slow intestinal transit time, bacteria that normally live in the colon proliferate and migrate up into the small bowel. Slow transit of intestinal contents also shifts the PH in the intestines disrupting the homeostatic environment and encouraging the growth of bacteria in places like the small bowel where there would otherwise be minimal bacterial presence. You said that when you eat oat fiber it seems to help your condition. That makes sense because anything that increases your transit time will likely make you feel better. You also said that you can’t “digest” fiber because you become bloated gassy. It’s not the fiber that’s creating the gas it’s the overgrowth of bacteria that cause the gas.
      I would encourage you to adopt a whole foods plant based diet if you haven’t already. It will provide large amounts of phytonutrients which will help heal the inflammation in your gut while helping to decrease your intestinal transit time. If large amounts of raw vegetables create too much discomfort in the beginning (in terms of gas and bloating) you can try decreasing raw whole vegetables and doing 2-3 8oz servings of freshly extracted vegetable juice everyday. You’ll get the phytonutrient benefit without the fiber so your gut doesn’t have to work so hard to break it down and digest it. As you gut begins to heal you can gradually increase the whole fruits and vegetables as tolerated. It may be a slow process so be patient. The juice should be freshly extracted within 24 hrs and be raw. No commercially processed juices. You will likely have to address all of the things contributing to the SIBO simultaneously and for a substantial amount of time (weeks to months) in order to heal but it is possible if you have a knowledgable practitioner to work with and guide you.




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  10. Michael, et al,

    Just a heads up if you have not seen this. Nutritionfacts.org is officially declared Fake News!

    Amazing. “First they ignore you, then they ridicule you, then they fight you, then…they join you”. Won’t be long now…

    http://nymag.com/selectall/2016/11/fake-facebook-news-sites-to-avoid.html

    See link on that site to the list:

    https://docs.google.com/document/d/10eA5-mCZLSS4MQY5QGb5ewC3VAL6pLkT53V_81ZyitM/preview

    Jack,

    Cleveland Vegan Society

    John (Jack) McMillan

    jdmcm@windstream.net

    440.256.4020




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    1. Jack McMillan: NutritionFacts go erroneously put on one list. We got the site removed from that list, but it looks like other people had copied the list before the correction. So incredibly irresponsible that a site about fake news would itself be fake/spreading false information. I forwarded your post onto staff in the hopes that we could get this cleared up. Thanks for bringing this to our attention.




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  11. My husband was diagnosed with colitis but gets far fewer symptoms/flare ups since going vegan 12 years ago. I’ve been putting vegan D3 in his smoothies for several weeks and his symptoms – probably new job/heavy workload stress-induced – have subsided. I figured his desk job probably didn’t involve enough running around outside half naked… Good call!




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    1. Is he getting K-vitamin too? You should always get enough K-vitamin when taking D-vitamin since it helps regulate calcium in the blood (which vitamin D increases).




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  12. Off topic: I would like to gain muscle on a plant based diet so I bought protein powder made from organic peas and brown rice, but it has a high leucine content like 2100 mg and I’m upping my protein intake a lot aside from that…will this be detrimental to my health?




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    1. Hi Duvy – I’m a natural lifter (in my mid 30s) so I don’t think I’ll ever be Schwarzenegger :-) but I’ve had no trouble building similar amounts of muscle as Van Damme in Bloodsport without any protein powders or other fitness supplements over the last two years. (I don’t have any good recent photos, I’ll take one tomorrow if you want).

      I’ve been eating Dr.Greger’s Daily Dozen fairly strictly over the last year, and I think I’ve gained the most muscle during this time. (I incorporate the daily dozen ingredients in meals I pick from cookingwithplants.com and thevegancorner.com to keep the food delicious).

      A few tips I’ve picked out of Dr. G’s book:
      -Nutritional Yeast, helps recovery, as does water melon.
      -Fenugreek seed increases strength(buy powdered).
      Find some dishes which you can incorporate these into, nutritional yeast is great with anything that would normally have cheese – like red pasta sauce, or bean dips. These have done much more for me than any protein powder and creatine ever has, and are much much cheaper.

      Perhaps if you are getting into competitive levels of bodybuilding (which would require HGH/Steroids etc which of course not health promoting) then it’s possible the extra protein may be required to help the body push beyond the natural limits. But for natural, realistic, and maintainable amounts of muscle I would say protein powders are unnecessary.

      The reason I think for this is that, although you are breaking down muscle as you exercise, the body does a great job of reusing the protein from old muscle to build new muscle. There is a video on here that says something like 86% of the protein in the body is recycled. So the 60 grams or so of protein you get from just eating whole-foods each day is plenty to refill your body.




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      1. Hank Schkorio: Great post! We get lots of people asking about building muscle. I can tell them about vegans breaking weightlifting records, but I think comments from real every day people like yourself is more helpful.




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      2. Thanks so much! I really want to follow a certain workout program that does require me to eat a lot of protein and since I don’t eat any animal products it makes it harder to reach my protein goals so I got minimally processed protein powder, and I still really want to do this program but will eating a lot of protein like over 120g or more really make me age quicker and is it really a significant amount? Or maybe there’s something I can add to my diet as well that’s anti-aging to reverse the effects.




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        1. “I really want to follow a certain workout program that does require me to eat a lot of protein …”

          When I see a comment like that then I know nothing anyone says, evidence based or not, is going to alter the course of action whether the behavior is destructive or just a waste of money and time.

          But just to plant a seed of thought that may grow some day … How many grams of protein powder does a (98% vegan) gorilla need to build muscle mass? Why does human breast milk, the sole source of nourishment during our highest rate of growth, consist of 6% protein by calories?

          As far as adding something beneficial to the diet to attempt to offset something negative, does that really seem like a better idea than not consuming the potentially negative item in the first place?




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        2. Do you have a link to the program you are following? Just curious to see.

          120g a day is on the high end, but if you are young and healthy, then you’ll be OK with taking protein powder for a short time (I’m assuming the workout program only lasts a few months).

          But after you complete the program, try it all again (or the next program) without the protein powder too. I think you will notice just as many gains with a good whole foods diet.

          As for anti-aging, nothing beats a range of fruits, vegetables(green leafy ones too), beans and whole-grains :)




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    2. Forget the protein powders, eat beanpasta and other legumes and legume flours. Bean pasta has 45g protein per 100g (45% protein by weight).

      My favorite legume is red lentils. It only has 25g of protein per 100g, but its easy to eat alot of it. I also eat bean pasta, but its VERY powerful and i dont feel like eating much of it. In fact, i prefer to eat whole beans actually, taste great with some organic ketchup.

      You should be aiming at around 1.2g of protein per kg bodyweight. Thats a conservative figure. Remember, you will never grow unless you eat enough calories. EAT, get a little fatter if you have to for a while. Its easy to shed the fat.




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    3. Hi, Duvy Burston. I am Christine, a NF volunteer moderator. It looks like you have asked this question in more than one place on the site. As I stated in an earlier reply, I have several friends who are vegan bodybuilders, and they do not take protein powders and supplements. They build muscle on whole plant foods, and that is what I would recommend to you.
      These resources might be of interest:
      http://nutritionfacts.org/video/plant-based-bodybuilding/
      http://www.veganbodybuilding.com/?page=bio_robert
      http://www.veganmuscleandfitness.com/
      I hope that helps!




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    4. Terrible photo (I have no idea how to pose haha!) But hopefully it shows that size is definitely achievable without any supplements what so ever :)
      https://uploads.disquscdn.com/images/33ac110b05b84c153b748f88ad3d08c963f2b0f702785c507f3b9a29dc4fe6d0.jpg

      The fitness industry is obsessed with 3 macro nutrients (protein, carbs, fats), especially protein, when they should really be concerned with micro-nutrients instead. And they never mention fiber intake, which is a great indicator of health, and predictor of disease.




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        1. Where are you (roughly)? If not available locally then mail order is a possibility. Some online vendors provide free shipping if you buy a certain amount of goods, which isn’t hard to do if you buy more than 1 bottle of vitamins and load up on organic grains, vinegars, date sugar, etc.




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  13. This is off-topic but, if anybody is interested, the US National Academies have just made available the proceedings of a workshop on nutrition across the lifespan for healthy ageing. It is only 8 pages.
    https://www.nap.edu/catalog/24641/nutrition-across-the-lifespan-for-healthy-aging-proceedings-of-a?utm_source=NAP+Newsletter&utm_campaign=3497640db3-NAP_mail_new_2017-01-02&utm_medium=email&utm_term=0_96101de015-3497640db3-104108277&goal=0_96101de015-3497640db3-104108277&mc_cid=3497640db3&mc_eid=76a911133f




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    1. Thanks, Tom. It is an overview of the workshop and doesn’t say much. There are a few hopeful statements, but on the whole the focus is disappointing. Perhaps because:

      SPONSORS: This workshop was supported by National Institutes of Health, U.S. Department of Agriculture, U.S. Food
      and Drug Administration with additional support from Abbott Laboratories, Incorporated; Cargill, Inc., The Coca-Cola
      Company; ConAgra Foods, Inc., Dr. Pepper Snapple Group; General Mills, Inc., Kellogg Company; Kraft Heinz; Mars, Inc., Monsanto; Nestlé Nutrition; Ocean Spray Cranberries, Inc.; PepsiCo; Tate & Lyle; and Unilever.




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      1. Yes, it was pretty standard stuff with nothing really new for people who have been following the subject for a while.

        Nevertheless, I thought it was pretty brave of the sponsors to stump up for a conference like this. It was full of references to a healthy diet, fruit and vegetables, whole grains etc. I am an atheist but it brings to mind those sayings in the Bible “For those who have eyes to see, let them see, and for those who have ears to hear, let them hear.” Not a lot of comfort there really for food manufacturers and drug companies, I would say.

        However, to my mind, what the industry got out of it was two-fold:
        1. no explicit condemnations of processed foods; and
        2. a brief industry puff-piece (on page 6)




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    1. Yes. However, figuring out how much is enough is complicated. It depends on your skin type, the latitude, the time of year, the time of day, the amount of skin exposed, the cloud cover, the reflectance of the surface, the ozone layer, the altitude.

      Below is a link to the pdf file for an article that has more information than you probably want:
      Webb, A.R. and O. Engelsen (2006) Calculated Ultraviolet Exposure Levels for a Healthy Vitamin D Status. Photochemistry and Photobiology. 82(6), 1697-1703.
      http://www.nilu.no/Default.aspx?tabid=62&ctl=PublicationDetails&mid=764&publicationid=16084

      Or, see Dr Greger’s general recommendations for sun exposure at various latitudes.
      http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/
      It isn’t clear how much skin needs to be exposed for these recommendations.




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    2. It is possible… but it’s possible to get skin cancer… Moderate, careful sun exposure is great for D, but the problem is now we’re more concerned with longevity and our ancestors were primarily concerned with surviving to reproduction age and reproducing successfully so the species survived… So while we once got plenty of D from the sun, that doesn’t necessarily make it the ideal option today, especially if you live in a hot climate and have very pale skin, since many of us have migrated around the globe… I live in the tropics and subtropics, and my ancestors were from Inverness. Avoiding the sun is kind of important for ghostly pale folks in these regions, it’s too easy to burn to a crisp. I have had red shoulders in 5 minutes around midday… Something to keep in mind when choosing between D supplements and sun or a combination of them.




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    3. Hi, Hank Schkorio. I am Christine, a NF volunteer moderator. That is a surprisingly complex question, and the answer is that it depends. It depends on the color of your skin, where you live, how old you are, and what your nutritional status is like. The lighter the skin, the less sun exposure it takes to make enough vitamin D, but also the less protection you have against sunlight-induced skin damage. The farther you live from the equator, the longer the sun exposure required to produce vitamin D. Also, as we age, the ability to produce vitamin D in sun-exposed skin is diminished. Diet may also play a role in increasing or decreasing risks of sun exposure.
      We are always told to avoid the sun due to the risk of skin cancer. During my graduate courses in nutrition, I was surprised to read one study in which subjects with skin cancer were told to avoid the sun, and those who disregarded the advice had less recurrence of cancer than those who complied with it. There are some studies suggesting that vitamin D may help prevent some cancers, and we know that antioxidants from whole plant foods are protective. Certainly, you would not want to stay in the sun long enough to burn. It is my opinion that, in the absence of any elevated skin cancer risks, moderate sun exposure to produce vitamin D can be safe and effective for most people. If it is not sufficient, there are some good, lichen-derived vitamin D3 supplements on the market. I hope that helps!




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  14. (Just to be clear, I post this quote as a joke, but also so you can see how veganism is described by a psychologist in a 2015 course at the University of Toronto, and also to remind us that, against all temptations, we should do everything to prove prof Peterson wrong.)

    “They [vegans] are clueless religious, because what they have is ritual without philosophy.” – Jordan Peterson




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  15. Thanks to Dr Greger and the NF team for this video.
    I learnt a key fact about Vit D from it that I might otherwise have missed.

    When I was diagnosed with Intestinal Permeability IP (Leaky Gut) approx. 6 months ago I also registered low levels of Vit D.
    I was surprised about this because, while I generally don’t go out in the noonday sun without a shirt on, I am an active person and typically get a lot of sun exposure on my arms and legs (I live in a tropical climate with high UV levels and a lot of sunshine hours per year).
    I have been scratching my head over this one ever since.

    FTR my MD, who is experienced with IP, prescribed 5000 iu Vit D per day, so that is in-line with the upper levels recommended for IBS in the video.

    My tentative hypothesis, to date, is that IP and IBS are kissing cousins, with IP being the less severe form, or ‘little brother’ of IBS, so I assumed the etiology might have similarities. Further to that I assumed that for some reason I was either not metabolising Vit D normally, or that I was using greater than average amounts. My best guess is that the latter is the case and that many of us, in the modern world, are in a state of diet induced chronic low grade inflammation and that the body uses up Vit D to clear inflammation and/or toxins that we are exposed to in our food.

    Here is a 2013 study that strongly suggests that Vit D is catabolised, to produce toxin clearing enzymes, in the liver and the small intestine.
    As a result I would like to caution people that assumptions about how we got our Vit D, in the past, and how much we needed then, or how much we theoretically need today, might be wrong. In the modern world our requirements may well be much higher than anticipated, depending on our diet.

    [quote]

    NCBI-NIH database

    J Steroid Biochem Mol Biol. 2013 Jul;136:54-8. doi: 10.1016/j.jsbmb.2012.09.012. Epub 2012 Sep 15.
    Interplay between vitamin D and the drug metabolizing enzyme CYP3A4.
    Wang Z1, Schuetz EG, Xu Y, Thummel KE.
    Author information

    1Department of Pharmaceutics, University of Washington, Seattle, WA 98195,, United States.
    Abstract
    Cytochrome P450 3A4 (CYP3A4) is a multifunctional enzyme involved in both xenobiotic and endobiotic metabolism. This review focuses on two aspects: regulation of CYP3A4 expression by vitamin D and metabolism of vitamin D by CYP3A4. Enterohepatic circulation of vitamin D metabolites and their conjugates will be also discussed. The interplay between vitamin D and CYP3A4 provides new insights into our understanding of how enzyme induction can contribute to vitamin D deficiency. This article is part of a Special Issue entitled ‘Vitamin D Workshop’.
    Copyright © 2012 Elsevier Ltd. All rights reserved.
    PMID: 22985909

    [unquote]

    The full text is available for free from that the PubMed site.




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  16. People who take Vit D supplements need to constantly test their levels as excessive levels can be as harmful as low levels.
    Now there is another reason to carefully monitor Vit D supplementation; it is contra-indicated for some medications (exactly which ones and how many are implicated is not known at this time).

    [quote]

    NCBI-NIH database

    Photochem Photobiol Sci. 2012 Dec;11(12):1797-801. doi: 10.1039/c2pp25194a.
    Vitamin D and drug-metabolising enzymes.
    Lindh JD1, Björkhem-Bergman L, Eliasson E.
    Author information
    1Karolinska Institutet, Department of Laboratory Medicine, Clinical Pharmacology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Abstract
    Experimental studies on the molecular regulation of human drug metabolism have revealed that vitamin D up-regulates transcription of several key enzymes, such as CYP3A4, through the vitamin D receptor pathway in intestinal and hepatic cells. Recent data suggest that this results in seasonal changes with higher clearance of orally administered drugs during periods with high UV-B radiation and vitamin D levels. Taken together, vitamin D status might contribute to inter- and intraindividual differences in drug metabolism, but the therapeutic impact of these findings remains to be established.
    PMID: 22903070

    [unquote]

    The full text version is available for free here:

    http://dmd.aspetjournals.org/content/dmd/early/2011/02/24/dmd.111.038125.full.pdf

    It probably involves too much chemistry for general interest but the introduction does paint a clearer picture than the Pubmed abstract

    [quote]

    The most important enzyme in hepatic drug metabolism is cytochrome P450 (CYP) 3A4. Published in
    vitro-data indicate that vitamin D may up-regulate the expression of the CYP3A4 gene. Individual
    vitamin D-levels are highly dependent on sunlight exposure and show great seasonal variability in
    northern countries. The aim of the present study was to investigate whether plasma concentrations of
    CYP3A4 drug substrates exhibit seasonal changes compatible with a stimulatory effect of vitamin D
    on drug metabolism. Three immunosuppressants (tacrolimus, sirolimus, and cyclosporine) were
    analysed, as these CYP3A4 drug substrates are subject to long-term use and repeated concentration
    determinations. In addition, mycophenolic acid was included in the analysis as a control drug
    independent of CYP3A4 metabolism. Concentration-to-dose ratios were extracted from the Karolinska
    Therapeutic Drug Monitoring database, and compared between the three-month-periods of lowest and
    highest vitamin D levels. Sirolimus and tacrolimus levels showed seasonal variability highly
    consistent with changes in vitamin D; i.e. significantly lower drug concentrations in July-September
    than in January-March. As expected, no significant difference was evident for mycophenolic acid but
    this was also the case with cyclosporine, possibly due to cross-reactivity of CYP3A4-mediated
    metabolites with the immunoassay used for quantification. In conclusion, there is cyclic variation in
    blood levels of important immunosuppressants over the year that correlates with UV-light dependent
    changes in vitamin D levels. Even though a causal relationship remains to be established, it is
    suggested that individual differences in vitamin D may contribute to variability in drug metabolism
    and disposition.

    [unquote]




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  17. Sad, Dr. Greger. Seems you have moved your focus toward typical medicine. Risk of side effects of high doses of any vitamin is too great for a nutritional site like yours to be promoting it. What happened to the effects of fruits and vegetables on the gut? Mushrooms for the vitamin D effect? Perhaps you need to rethink your new writers.




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    1. Hi Marsha,

      I have taken a lot of interest, recently, in gut health.
      What do you mean when you say,” fruit and veges “, have an effect on the gut?
      I am aware that fibre effects the microbiome and that, depending on the fibre type, the products of fibre fermentation are claimed to be beneficial for the mucosal lining e.g. SCFA’s like butyrate ‘feeds’ the gut lining. but is there something else to it?
      (I believe NF has quite a bit of material on the above subjects).

      Also, what is the relationship between mushrooms and Vit D?




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      1. Vitamin D supplements are not a source of better health overall in the long run, especially high doses.
        Fruits and vegetables, nuts, seeds, beans, etc, whole plant foods have a tremendous effect on the gut. They not only feed the healthy gut flora which, in turn, will help to destroy the bad flora, but the phytonutrients provide the nutrition to the cells of the colon, as well as every other cell of the body, to rebuild and come back healthier and stronger. The symbiosis between the healthier cells which line the gut and the healthier gut flora helps to renew the mucous and return the gut to health.
        Mushrooms are the only plant source of vitamin D.




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        1. Marsha,

          I agree with your comments on the Microbiome.
          I think the current research and popularity of gut health is a very exciting development.
          I’m learning as much about it as I can, as fast as I can and I do eat appropriately for ‘gut health’.
          To be fair I couldn’t accuse Dr Greger of not doing his bit to promote the concept.

          I’m not certain about supplementation anymore though.
          I’ve been a long time adherent to the philosophy that I should strive to get all of my nutrition from food but I’m starting to wonder if this idealism is actually in my best interests e.g. I can obtain Natto, for the Vit K2, locally but it is imported from Asia and there isn’t a word of English on the packing, let alone certification as to the contents, or if indeed it actually contains any Natto.
          I dare say that there isn’t a company behind the importation who could be held to account for it.
          By comparison I can buy K2 supplements, from a reputable nationally registered company, with a specified dose per capsule.
          I also find it difficult to maintain the discipline of eating the Natto on a daily basis (I need to eat approx. 50g a day of Natto to get the RDI for K2) so all in all just taking one pill per day, of a known dose, does appeal to me.

          Looking at the mushrooms I have a similar issue.
          I found some research on the subject but it appears that the mushrooms have to be grown under UV lighting.
          Does that mean only ‘special’ mushrooms will meet our Vit D requirements or do all mushrooms contain some?
          I haven’t noticed any mushrooms, in my small-town supermarket or organic produce store, that are labelled as UV grown?
          Once again I also have issues with not knowing the dose contained in each mushroom and having to acquire and prepare them, on a daily basis, is going to put additional strain on my stretched resources and relationship (I do share a kitchen and meals with my wife and I like to strive for a harmonious household).
          I’m starting to think I should just accept the need for supplementation, in the modern world, and go with that.

          I am aware of opinion regarding the possible toxicity of vitamin supplements although I haven’t read anything on that lately.
          I believe over-dosing on the fat soluble vitamins is the key issue is it not?




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          1. A lot said, Rada. I don’t think “K2” or “vitamin D” or any other is the issue. I think it is a rabbit trail and there is no good end. It just sucks you back into how much is enough and where do you stop. I belong to a lab that reports what’s actually in supplements, the labels says… but then you find not that much, way too much, lead contamination, and many are what you would consider quality brands. The key is the wide variety of produce in the diet and as much locally grown as you can find. Local growers allow you to come look at the farm cause they have nothing to hide. The produce will keep you healthy and the produce will return you to health. Don’t get pulled back into supplements. That is why I made my original post. Dr. Greger stood for excellence in nutrition but has done a lot on supplements lately. It’s also why my only supplement is Juice Plus. It is merely produce and fills the gap between what I eat and what I should eat but what got my attention was the research. All the supplements on the shelves have very little in the way of primary research, meaning independent clinical research on their product. Juice Plus has 30 years of it. They carry a food label because of it.




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            1. Marsha,

              The discussion on ‘supplements’ (toxicity, functional foods versus pharmaceutical supps, risk factors et. c) is not a trivial discussion.
              I responded to your original post because of the relevance and to give you a chance to have your say.
              I previously promised the forum that I would be ‘open minded’ and I believe I am.
              In this case I am weighing both sides of the argument.
              I think that science has done a good job in this area and without science I wouldn’t know where to start e.g. my progressive M.D identified, through my bloodwork, that my ‘Vit D’ was low. Without science there would be no M.D, blood-panels or information on RDA’s, sources and the various types of Vit D, along with their efficacy and all of that information is , for one,something not to be sniffed at?

              On the other hand, I am aware of variable bioavailability and confounding factors, for some nutrients, ‘in vivo’.
              I understand that there may be holistic factors, or co-factors, in ‘functional foods’ that science is, as yet, not aware of.
              I now that Dr Brian Clements is one dissenter, who published a book claiming that Vit C was ‘toxic’ in high doses, although he is now in disgrace.
              I will accept your personal testimony but do you have any references to other resources that increase our knowledge on these subjects.

              I’m not picking on you, but once again giving you an opportunity to explain yourself:

              – do you think I need Vit K2 or not: If so how much, or doesn’t that matter? If I do need it where can I source it; supplement or food? If I eat animal products it is unlikely they will contain K2 these days although according to the USDA database chicken drumsticks are a good source, however the ‘organic’ chicken drumsticks I can obtain are not grass-feed but rather barn raised with acetic acid substituted for anti-biotics in their feed. I could eat Natto but it is, in effect, a supplement rather than a food and it also has producer risk (possible fraud, contaminants et. c) just like the pharma supplements. On top of that I don’t know how much Natto, if any is in the product I can get and, on top of that, I am faced with eating a portion of Natto every single day of my life? That wouldn’t be so bad if it was the only ‘functional food’ I had to work into my diet but it isn’t, there are others at the moment. As I busy person I cant trust myself to initiate, and sustain, all of the rituals I would need to ensure I keep eating these foods in the hope they are meeting my requirements? There are so many variables that I am juggling that at the end of the day, if I do, or don’t, feel better I cant be sure which one is working, or not, if I forget to eat one of the required foods or I don’t know the dose in the food?

              – ditto for Vit D. Do you think my M.D’s blood-panel and recommendations mean anything or not?
              If I need Vit D how will I know if I have enough and where should I get it? You didn’t answer my previous question about mushrooms. I don’t think there is enough in mushrooms to make a difference unless they are grown under UV light and I don’t know where I can get any that are certified as containing Vit D? Are you saying I should just eat a variety of foods and not worry about any of it?

              – have you experienced improved blood levels of Vit D from eating mushrooms or do you know of anyone who has (if so which type and how many?);

              – I do think there are a lot of questions to be asked about the RDA’s, and the assays that they are based, on but that is a massive subject and one I haven’t dug into so far e.g. it seems likely to me that our protein needs, as recommended by authorities, are over-stated and also the amount of protein contained in foods is not what the USDA database claims it is but that is just one example and the tip of the iceberg.

              To give you the context:

              – I am on a personal quest to cure arthritis and I have achieved significant remission without supplements (at various times I took heaps of supplements of all kinds but I didn’t feel that they worked for me);

              – I believe I improved my arthritis with diet alone and at that time my regime was very basic (supplement salt, eat one vege salad a day, raw muesli for breakfast alternated day about with fresh fruit, very low sugar, very low processed foods) and included meat, eggs and dairy. I have since been diagnosed with Leaky Gut and gone off all gluten containing foods, dairy and added a Leaky Gut supplement (mainly Glutamine);

              – I don’t believe in just sitting there and accepting the status quo so, for better or worse, I try things out.
              At the moment I am making further good progress with reducing joint pain et. c and I want to trial the Vit K2/Calcium/Magnesium combination as a supplement to see if that makes a difference (I am interested in Calcium because the ratio of Phosphorous to Calcium is very high in animal/nut/legume and grain foods and in the modern world it is hard to keep up a high volume intake of ‘green leafies’ to balance the phosphorous. I am taking the supps for a relatively short time. I am very sensitive to changes in my body and I think I would know if they are affecting me adversely. So far, so good.

              – I am currently taking Vit D 5000 IU/ day (doctors orders) – haven’t noticed any adverse effects there either.

              My current approach, for arthritis, is focused on eliminating ‘inflammatory’ foods.
              I am looking at everything from the science to holistic approaches and I am mainly using an elimination diet combined with observation of my ‘symptoms’ to estimate which foods I should or should not be eating.
              I believe I am getting results but my philosophy and protocols are going off the page (I am not in agreement with anyone else that I know off).

              As examples of the resources I am using:

              – I am looking at scientific approaches, like dietary inflammatory index (DII) by Shivappna et al
              Nitin Shivappa, holistic approaches, like Dr Koutchakoffs theory of Digestive Leukocytosis and everything in between.

              I believe that in the early stages the improvement in my arthritic symptoms is best explained by Digestive Leukocytosis but the conclusions reached by Koutchakoff are not based on any laws known to science.

              Full free text version of DII literature available at PubMed

              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925198/

              As you have frontline experience with treating inflammation, via diet and turmeric, it would be very helpful to me if you could share some examples or resources.

              I will post a link to Digestive Leukocytosis later today.

              [quote]

              Public Health Nutr. Author manuscript; available in PMC 2015 Aug 1.

              Published in final edited form as:
              Public Health Nutr. 2014 Aug; 17(8): 1689–1696.
              Published online 2013 Aug 14. doi: 10.1017/S1368980013002115
              PMCID: PMC3925198
              NIHMSID: NIHMS537023
              Designing and developing a literature-derived, population-based dietary inflammatory index
              Nitin Shivappa,1,2 Susan E Steck,1,2 Thomas G Hurley,1 James R Hussey,2 and James R Hébert1,2,*
              Author information ► Copyright and License information ►

              The publisher’s final edited version of this article is available at Public Health Nutr
              See other articles in PMC that cite the published article.

              Abstract
              Objective
              To design and develop a literature-derived, population-based dietary inflammatory index (DII) to compare diverse populations on the inflammatory potential of their diets.
              Design
              Peer-reviewed primary research articles published through December 2010 on the effect of diet on inflammation were screened for possible inclusion in the DII scoring algorithm. Qualifying articles were scored according to whether each dietary parameter increased (+1), decreased (−1) or had no (0) effect on six inflammatory biomarkers: IL-1β, IL-4, IL-6, IL-10, TNF-α and C-reactive protein.
              Setting
              The Dietary Inflammatory Index Development Study was conducted in the Cancer Prevention and Control Program of the University of South Carolina in Columbia, SC, USA from 2011 to 2012.
              Results
              A total of ≈6500 articles published through December 2010 on the effect of dietary parameters on the six inflammatory markers were screened for inclusion in the DII scoring algorithm. Eleven food consumption data sets from countries around the world were identified that allowed individuals’ intakes to be expressed relative to the range of intakes of the forty-five food parameters observed across these diverse populations. Qualifying articles (n 1943) were read and scored based on the forty-five pro- and anti-inflammatory food parameters identified in the search. When fit to this composite global database, the DII score of the maximally pro-inflammatory diet was +7·98, the maximally anti-inflammatory DII score was −8·87 and the median was +0·23.
              Conclusions
              The DII reflects both a robust literature base and standardization of individual intakes to global referent values. The success of this first-of-a-kind attempt at relating intakes of inflammation-modulating foods relative to global norms sets the stage for use of the DII in a wide variety of epidemiological and clinical studies.

              [unquote]




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              1. Would be interested in communicating off a public forum. You probably have email or facebook contact for me. The problem, rada, is the focus is all over the science, and eating is so much simpler, even eating to reverse disease. We have made it difficult. Contact me and we will talk.




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                1. Marsha,

                  I agree that most of the focus is on the science and while it is a very powerful tool that has provided many benefits to mankind, when used wisely, it is not the be all and the end all.

                  Thanks for your compassionate offer to help me off the board.

                  brian.brn002 [at] gmail.com

                  Keeping it simple and natural is my predilection.

                  For the benefit of others who might be reading along:

                  I recently completed a six month elimination diet (a hybrid version of AIP) which I was directed towards by my progressive M.D to help cure mild Leaky Gut.
                  At the end of that period I found my body/digestion has become very sensitised and rejects certain foods (either cooked foods or processed foods or both).
                  There is some science to suggest that elimination diets do lead to heightened auto-immune responses (this isn’t a bad thing for me as it serves as a warning system as to which foods I should avoid).
                  The only hypothesis I have come across, so far, that resembles an explanation of what I am experiencing is Digestive Leukocytosis by Dr P Koutchakoff.
                  While Koutchakoff appears to be a dedicated scientist, albeit one from a more primitive time (1930’s) his conclusions appear to go beyond science as we currently know it.

                  Here is a link to an approximate English translation of a paper he presented, in French, to a group of peers of the day.

                  (note that it is a temporary link that will cease to work after a short period of time)

                  http://www.filedropper.com/leukocytosiskoutchakoff2

                  I have posted this here before but this is a version with some additional minor correction and translation.




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          2. Over dosing on far soluble vitamins is certainly one of the issues but relying on supplementation with vitamins, itself, is the key issue. They are just like processed foods. You can’t take all the nutrition out and get something that’s healthy; it takes the whole gamut. Vitamin K comes from dark leafy greens that also provide EFA’s and lots of fiber as well as all the other nutrients that are too many to count. Flax seed oil comes from flax seed but with the seed you also get a whole plethora of nutrients that have been removed from the oil. AND, you have to ask, what toxins have been left behind?




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    2. Perhaps you need to check the vit D content in mushrooms before posting.
      Hint: they cannot deliver the required RDA thus the need for supplementation. B12 and D3 are two vitamins vegans cannot get enough of from their food sources.




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      1. You will never raise blood levels of anything through food like you can with supplements but thinking that blood levels need to be high is what got us in such an unhealthy state. The fact is that if we ate whole food plant based, we wouldn’t have unhealthy bowels to worry about, ineffective/overactive immune systems, heart disease, and the plethora of chronic degenerative disease. According to Cornell University, the 5.8 mg of vitamin C in one apple did as much work as 1500 mg vitamin C supplement. It doesn’t take quantity of one nutritient, it takes the interaction of a wide variety of nutrients. We don’t have vitamin deficiencies, we have whole food deficiencies.




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        1. The problem with vit D in particular is that we are not running half naked all day long like our distant ancestors did. You cannot eat enough mushrooms to counteract the “acquired” vit D deficiency caused by our modern mostly indoor lifestyles even when following WFPB diet so in the case of vit D, we have a “lifestyle deficiency” (to use your terminology), not a food one.




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          1. We will just have to agree to disagree. As a holistic nurse, I work with people with IBS and Chron’s and I don’t use vitamin supplements. I use Juice Plus (check it out http://www.marshacarter.com) and sometimes Turmeric for a month or so for quick reduction of inflammation and I teach them how to eat but even those who won’t change their lifestyle, the gut problems, and the other chronic diseases go away. I see blood work optimize when I don’t look at man’s appointed levels but at organ function and inflammation levels.




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            1. My point was on vit D levels in general, not specifically for IBS / Crohn’s.
              Can you give a numerical example for your last sentence? Which you consider “appointed” levels and which are non-appointed ones in a blood panel?




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            2. Juice Plus may be a good product, but it is damned expensive, and thus not sustainable for everyone. And a good, correct alimentation should be for everyone and not for the few. Does the body really need to conform every day to the RDA ? Are the RDA balanced ? A plant under water stress will do an effort and grow its roots deeper into the soil in order to find water. The wind will make it stronger by developping a bigger trunk. Is not the human body more evolved and complex than a plant ? Does its complexity make it weaker too than a plant to environmental conditions ? Under stress conditions, the body may also do an effort and develop better “defenses” the same way as do plants. Does it mean that supplementing vitamins in order to fulfill an optimum may make the body weaker ? Or, if the optimum can not be attained through food, a supplement is really necessary for optimum health ? That is a whole field of research that would benefit from further investigation.




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              1. Hi Aurelian,

                I am involved in further discussion with Marsha, off the board.
                It is a very interesting and important discussion.
                I think it is a primary axiom, of the health food movement, that if it is natural it must be better and if it is ‘Big Pharma’ or ‘Big Food’ but that isn’t always the case and IMO we should divest ourselves of that bias in order to arrive at the truth more quickly e.g. a natural anti-fungus may come with more variance, multiple effects (bio-actives), lack of trials and an unknown dose compared to a pharmaceutical anti-fungus.

                I agree the RDA’s are merely a guideline and, whilst not entirely accurate, they are the best we have and the only universal standard we have that enables us to talk to others from a common point of reference.

                You make some excellent points.
                We are not all the same from a holistic point of view (spiritual, mental, emotional, physical, financial, social, environmental and so on) and we have to cut the garment to suit the cloth e.g. a person of low education and finances may well be better off with a Calcium supplement than a juicer and a pile of Kale.
                There is quite a bit of good science around Calcium/Vit K2/Vit D and it isn’t easy to ignore the fact that the supplements do absorb and the participants in the trial do achieve measurable improvements in some bone structure, especially LumbarBoneMassDensity (LBMD).

                On the other hand I am using some techniques, with success, that are not in the science text books.
                I believe Marsha is similar to myself in that regard.

                The primary axiom of my health philosophy is that the body will strive to heal itself if we provide the right conditions.
                Determining what those conditions are is, IMO, what all of the debate is about.




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                1. Hi Rada,

                  The real issue with food may not be a question of whether one needs supplements or not, but perhaps is one of education about it. One is culturally conditioned to not eat healthily, and as a child, most of us do not receive a correct education about the importance of nutrition, and the great biodiversity of edible plants. Also knowledge about cooking play an important role. When one doesn’t know how to prepare and cook, how to create diversity into our meals, then it is difficult to not succomb to the sirens of the agro-industry with all their already prepared, processed and cooked foods. Those foods flatter the lazyness of our minds and we become addicted to eat unhealthily, by lack of time, energy and habit. So I do think that supplements are a partial solution somehow preventing us to think wholly about our alimentation and to make radical changes about it, towards more healthy products and more diversity. Sure it requires time and energy to cook and to learn about foods, but that may be worth well in terms of health and prevention of diseases.




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                  1. Aurelian,

                    You summed it all up beautifully in one paragraph.
                    You have a nice balance between philosophy and pragmatism which is needed for a balanced life.
                    I am experiencing it as a journey of discovery and transformation.
                    Some of the things I am discovering, about health and nutrition, are truly surprising.

                    I am not a supplement person but I have had a lot of success with a ‘trial and error’ approach so at the moment I am trying a supplement combination I haven’t tried before (Ca/Vit K2/Vit D) for a set time (3 months).
                    The literature is very positive for that combination and joint/bone issues.
                    I use an informal risk/reward model and I consider it is low risk.
                    Overall I don’t consider that elemental supplements of that kind are likely to have toxic side effects.
                    At worst they might just be harmless or a waste of money.
                    I don’t consider it is the ideal approach but rather a compromise.
                    The ideal environment doesn’t exist for me and I have to strive to create it and whilst making do with what I have; as you say it is a matter of learning and effort in order to reap the results.




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                    1. As we all have different biological backgrounds and conditions, I like to think that the modifications needed for each one particularly are related to individual diets within the domain of a plant-based diet. That is, depending on one’s biological background, particular foods should be privileged or emphasized, and some others should be diminished or restrained. Because of the great diversity of plants, such variations are possible and highly “customizable” according to each one. So foods are variables that one can adjust towards the resolving of the individual optimum health equation.




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                    2. I agree 100% and add that it goes beyond biology.
                      We know that the gut symbiotically influences our health and I have read research where the gut Micro-Biome in mice was altered when they were placed under stress so it seems likely that individuals will have different nutrient requirements depending on their social and environmental setting.

                      How to decide which foods are optimum for any individual is the interesting question: hair analysis, blood tests, trial and error or something else?

                      I assume you are a Vegan?
                      If so what do you do for Vit B12, Vit D and Vit K2?
                      Do you think Vit K2 is necessary?




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                    3. I’m not an expert in nutrition, so I’m to trust the scientific studies and Dr Greger concerning Vitamin B12 and D3, and hopefully there will also be non invasive tests in the future allowing doctors to suggest to their patients adequate foods to incorporate into their diet according to individual conditions. You’re quite right about the environmental conditions that should play a role in nutrients absorption and overall health equally. Concerning K2 and its relationship to calcium and vitamin D, it seems to me that the issue of supplementing K2 only appears when one has already started to supplement with calcium. So it is a by-product of supplementing calcium which may have its own detrimental effects like calcification favoring calcium deposits into the arteries. So if one rather considers to enhance one’s calcium absorption, when needed, with calcium rich foods and K2 rich foods, in order to have a calcium enriched food package, it may seem a safer approach than supplementing with individual supplements. But then, it all depends on individual conditions too, on a case-by-case basis. Some people for exemple have anticoagulant medications acting as antivitamins K, so the issue about calcium supplementation is different.




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                    4. Aurelian,

                      Re your statement,” :that the issue of supplementing K2 only appears when one has already started to supplement with calcium. So it is a by-product of supplementing calcium which may have its own detrimental effects like calcification favoring calcium deposits into the arteries.”

                      I don’t think tissue calcification, as a result of Vit D toxaemia, is limited to cases involving supplementation of Vit D and/or Calcium.
                      In his presentation to the Ancestral Health Symposium entitled,” Resolving The Vit D Paradox”, (available on YouTube) he cites a study of 45 Israeli lifeguards, who had approximately twenty times the incidence of kidney stones in the general population.

                      http://link.springer.com/chapter/10.1007%2F978-1-4615-9167-2_51

                      Increased Incidence of Nephrolithiasis (N) in Lifeguards (LG) in Israel
                      O. S. Better, M. Shabtai, S. Kedar, A. Melamud, J. Berenheim, C. Chaimovitz

                      [quote]

                      The data show that LifeGuards ( LG) have: a) enhanced incidence of Nephrolithiasis (N); b) increase in serum 25-HCC (Vit D), and decrease in serum iPTH, and c) hypercalciuria. It is postulated that excessive exposure to sunlight induced a state of hypervitaminosis D in LG. This led to hyperabsorption of calcium from the gut, which partially suppressed the parathyroid glands. Each of these factors contributed to the hypercalciuria and to the high incidence of N in LG. Relative oliguria in certain instances, and the low urinary Mg/Ca ratio, as well as the hyperuricemia were additional independent, potentially lithogenic factors in LG.

                      [unquote]

                      He went on to demonstrate that deposition of Calcium, in the soft tissues (Kidneys and arteries) is a result of under production of Vit K dependent proteins, that protect the soft tissues from Calcification, or an imbalance of Vit A/Vit D which brings about over production of deficient protective proteins (under carboxylated Matrix Gla protein versus carboxylated MGP).

                      This is explained in his video presentation, or a text based facsimile can be read here:

                      http://www.vitamindwiki.com/Masterjohn+on+Tufts+and+vitamin+A+D+and+K++April+2009

                      Note that in the Tufts mice trial Vit A and Vit D were administered as pharmacological metabolites (Retinoic Acid, Calcitriol?) and not as vitamin supplements.




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                    5. I do think that a well-balanced plant-based diet can give to the body adequate amount of vitamins so that their synergetic effects are not detrimental to the body. By beginning to supplement in many different vitamins, one moves away from the idea of a well-balanced diet, so it appears to me to be reductionist and distractive. At the fundamental level, it may help, to understand the effects of individual vitamins and molecules, but the adjustments and recommendations should be made within the context of the diet (eating more of this and less of that, or eating as much of this) and not by supplementing individual molecules, it seems to me. I adher more to a “whole” approach based on science, rather than on a reductionist approach based on partial evidences… That said I do not say that supplementation may not be useful in some marginal cases, but generally the adjustments within the diet should be, according to me, the way to practice a correct nutrition.




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                2. I have to disagree, rada. First, the RDA’s are based on science in response to processed foods. If you follow it all back, that is exactly where it all came from. The real problem is the subsidies we pay to get processed foods. Without the subsidies, food would be quite affordable for all and vitamin supplements and RDA’s would go away. As a holistic nurse, the only time I use vitamins is B12 for vegans and something like vitamin C for 2 or 3 days with upper respiratory stuff.




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              2. Interesting you think JP is expensive. I thought that once but what I realized was that for very little each day, less than a cup of Starbuck’s I could get a lot of what would build my health. I agree that good alimentation should be for everyone but we each get to choose how we spend our money. RDA’s? It’s not a vitamin so there is no RDA. It’s food; proven to be food; proven to do what good food does. I stand on my original premise, only food provides ALL of what a healthy body needs or an unhealthy needs to move back to health. I do not ever recommend vitamins because then, other deficiencies are created and off one goes down the trail of chasing vitamins instead of eating good food.




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                1. If JP is considered as a food, and is expensive in itself, then one may also consider to rather spend one’s money into real fresh and unprocessed food, because for the price of JP, one can get quite a lot of fruits, vegetables, beans, nuts and seeds as well… :)




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                  1. I don’t find it expensive, and yes, if we spent our money on unprocessed food that was a nutritious as JP there would be no need for JP or vitamin supplements




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                    1. Yes, of course, one meaned, expensive compared to unprocessed foods, but that is valid for any processed product. I do not think there is one, or two, or three supplements that would be optimum for everyone, because each individual have particular conditions and biological requirements. So to me, modifying the components of one’s diets may best achieved the conditions favoring one’s optimal health rather then taking a supplement that is more “normalized” and mass-fabricated…




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                    2. Obviously you haven’t looked at the research. From that I can make the statements I have. Across the board, age, gender, sex, health issues, location, people simply get healthier. It’s what I’ve seen in my family and in my clients. The truth is in the volume of research that has been done all around the world, repeated multiple times with the same results.




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                    3. I’m aware of the balance of scientific evidence showing that a whole-food plant based-diet is better for health: that is, eating more vegetables, fruits, nuts, seeds, whole grains, and reducing or eliminating animal products altogether. An eating fresh, unrefined, untransformed products make a lot of difference too. If you give fruits or vegetable powders to people who dot not eat healthy, that can affect a bit their health in a positive way, but not as effectively as actually changing their diet for the better, which is a whole-food fresh plant-based diet.




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  18. The target blood level (per the research cited) is 115 nmol/l or 46 ng/ml and for me to maintain that level requires 8000 iu/day! I no longer ever suggest an amount to take to people, only a target range blood level and tell them they must test to get it in their own body.




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  19. It has been more that 2 years for me – almost every day i’m taking 5000 IU and so far i see only positive effects.
    Vitamin D3 has the ability to recycle better(like may be any other vitamin) if we start eating organic food – any unnatural substances(even the polluted air we breath) are lowering our vitamin levels.




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  20. Random, but semi on topic or maybe not, but I don’t know where to go. I have been diagnosed (through endoscopy/colonoscopy) with Celiac, almost 12 years ago. Never mentioned colitis or crohns in any diagnosis. Been wfpbno gluten free for a long time yet, I cannot eat brown rice. I love the taste but it causes severe intestinal pain, for days. I can eat white jasmine or white basmati without issue. I can eat brown rice pasta or bread made from brown rice but not actual brown rice. The pains I get last for days, I am sometimes doubled over and lose the inability to go to the bathroom (which is usually a few times a day) for quite a few days until the rice visibly leaves my system. I often tell people, that I feel like this is what Crohns sufferers may feel, as it is that painful. While I know white rice like jasmine or basmati are not terrible for you, I’d like to eat brown rice with my family (no one else has this issue). Like I said, I do eat wfpbno and have for a while (20+ years). Is this just a fiber thing? An allergy/intolerance? My Vitamin D is fine as are all my other blood levels. I don’t really want to go in and get anymore colonoscopies done. I read How Not to Die – no unnecessary tests for me if it just means living without eating brown rice ya know? Any ideas or maybe something I can read on the topic would be greatly appreciated! Thank you!




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    1. Hi Trailmomma, it sounds like you may likely have a sensitivity or full blown allergy to rice bran. The bran is the part that is removed from white rice which is why the white rices don’t bother you. If you have true celiac (and it appears from what you’ve said you do) you may even have a genetic component at play that interferes with digestion of the rice bran much the same way you have with gluten. Since there are many other healthy grains you can eat and you enjoy a WFPBD I would say don’t sweat it, just pass on the brown rice.




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      1. Thank you for responding! That would make sense and kind of what I was thinking. I need to try wild rice and see if the same thing happens but I do appreciate your taking the time to respond!




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  21. Not sure where to go for info on this, so I’m throwing this out for feedback. In a recent colonoscopy I had they found a large carpet lesion with pre-cancerous cells. A carpet lesion is basically a very large area polyp. I’m being told it must be removed because it can quickly morph into cancer, and endoscopic surgery is recommended. The lesion is larger than endoscopic surgery normally tackles, however, covering 50% of the area. I will see another endoscopic surgeon this week, but the first specialist said if they cannot remove it endoscopically, then a total bowel resection (with colostomy) was recommended. I am willing to consider endoscopic surgery (minimally invasive), but will not consider the total bowel resection. I told them I believed it could be treated with a WFPB diet and they said they would have to ‘monitor’ the lesion by my having a colonoscopy every three months, if I chose the diet approach.
    I want to know if anyone else has dealt with a carpet lesion and treated it successfully with a WFPB diet? I’ve only been eating WFPB for a little over a year. I presume the lesion surfaced long before that. I don’t want to be ‘scared’ into unnecessary treatment; I also don’t wish to ignore something that could become cancer quickly (according to the doctors). Appropriate feedback appreciated.




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    1. You might find if you leave it a while, it might shrink and be easier to remove… but on the other hand, these things aren’t predictable. WFPB on average will help but you’ve only been on the diet for a year… But I’m optimistic – I would bet that by the time they go in for endoscopic surgery, it may well have shrunk enough already. And once removed you most likely won’t get a reoccurrence on WFPB… Can’t be sure about any of these sorts of things though! It’s difficult.




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  22. Good evening dr
    I just have a question please
    My weight was 120 KG and i loose 32 KG Now I’m 88 KG
    Iam an engineer and i working in project 12 hours daily and i register at univirsity to continu3e studying while working in the project actually every day when the winter season come i feel too much hungry and cant play workout every day and feeling hungry so i eating as before but with moving in work and university i dont need to get my previous weight so can you give me any advice i will be so many thanks




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    1. Sir, you are hungry because you spend a lot of energy, physically, mentally and intellectually, and the weather does not help in the process. 12 hours a day of work + how many hours a day of studying is a lot of activity, letting you very little time for workout or even for having a bit of leisure and rest. That is not sustainable on the long term. You are continuing studying because you are not satisfied with your present work, and you work because you have to pay your studies. So you are caught up in a process with little space for arrangement. That said, if you are on a B12 fortified plant-based diet you can eat a lot and feel more easily “filled” than with an omnivorous diet, and with lower calories, so you are not going to get too much weight by eating more vegetables and beans, compared to eating more meat and dairies.




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    2. Hi Alaa B Assi,

      Nutrition is like any other academic subject; it takes a lot of study and practical experience to become good at it.
      For your situation a short explanation, with some tips, can help get you started in the right direction.

      The fundamental principles of nutrition are correct:

      – we need to know what our approximate calorific intake is, on a daily basis;
      – if it is too high, for our needs, our weight (Body Mass Index BMI) goes up, and vice Versa;
      – we need to know what % of our calorific intake is due to carbohydrates, fat or protein;
      – scientific studies show that no matter what diet people are on they lose weight if they eat less and, over time, most people revert to approximately 40% of their total energy intake coming from carbohydrates;
      – fat contains more energy, per weight, than carbohydrates.

      When you are hungry you need to eat so change your diet and eat more foods that satisfy hunger whilst not tending to put on too much weight.
      Also, lack of nutrients also drives hunger so only eat nutrient dense foods and take a multi-vitamin with minerals included.

      You have to use trial and error to learn what works but try this to start:

      – eat 3 meals, plus 2 snacks a day, (maybe 3 snacks for you since you are working/studying long hours);
      – eat more vegetables, especially salad vegetables;
      – cut out all added vegetable oils except for 10-20 mls of olive oil on your salad;
      – reduce the amount of added fat (butter, ghee, milk, yoghurt et. c) in your diet and replace it with avocados;
      – substitute brown rice for white rice et. c;
      – cut out most bread, cakes, biscuits unless it is at a family or religious celebration;
      – if you are a vegetarian your meals should be legumes and salad or cooked vege;
      – if you are not a vegetarian substitute meat/fish/eggs in the above statement;
      – snack on dried fruit, fresh fruit, bananas;
      – if you get hungry between meals snack on 150 mls raw nuts eaten with 1 or 2 apples (mixed nuts or any kind except roasted. Rotate the type for variation;
      – do not drink sweet drinks like coconut water or cola.

      Most importantly stop eating any added sugar like table sugar, glucose, honey, maple syrup, artificial sweeteners et. c or any foods that contain them.
      Also do not drink any stimulating beverages like coffee or alcohol.
      sugar will cause wild swings in your insulin/blood sugar levels and when your blood sugar goes low you will feel hungry again.
      Eating carbohydrates, like fruit and brown rice, that contain fiber will even out your blood sugar levels.




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  23. Dr.Gregor, Along the lines of what is good for your gut, I have heard recently that Lectin is bad for your gut. Especially if you have gut issues (i.e.: Crohn’s, IBD, etc) this makes me very worried now that I have changed completely to a plant based diet 7 months ago and do eat beans, oats, etc. I have Crohn’s disease and have been in a flare for the last 6 months. I had hoped that being on this diet I would have been able to suppress my symptoms. Any advice would be greatly appreciated.




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    1. Coty: Not being an expert, I can’t comment on the Crohn’s disease part of your post. I do have some information on lectins which I share below. I hope it helps, though it is important to keep in mind that the information may not apply to your particular situation.

      *******************

      I found one blog post on NutritionFacts which talks about lectins. Here is a quote:
      .
      “Modern paleo advocates claim that these foods weren’t part of Paleolithic-era diets, but new research challenges that assumption.5 They also argue that lectins naturally present in these starchy foods are harmful to human health. Consuming too many lectins can cause significant gastrointestinal distress. However, because legumes and grains are almost always consumed in a cooked form—and lectins are destroyed during cooking—eating beans and grains doesn’t result in lectin overload. Sprouting also reduces lectin levels in plants, although not as effectively as cooking. Generally, pea sprouts, lentil sprouts, and mung bean sprouts are safe to consume, as are sprouted grains, which are naturally low in lectins. Most larger legumes contain higher amounts and should be cooked.” from: http://nutritionfacts.org/2014/09/23/will-the-real-paleo-diet-please-stand-up/
      .
      Since I eat my grains and legumes cooked, I consider the lectin brouhaha to be much ado about nothing.
      .
      In the past, Tom Goff has posted some additional helpful takes on the subject. Here are some quotes from Tom Goff’s previous posts.
      .
      “…problem with such claims is that people in the past ate huge amounts of (whole) grains (compared to modern-day Americans). Some people still do. There is no record of such people suffering abnormally high rates of toxicity or inflammation-related diseases. If anything, the exact opposite is the case eg
      .
      “This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes. These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.”
      http://www.bmj.com/content/353/bmj.i2716
      .
      Further, reviews of the health effects of grain lectins do not support the wild claims found on the internet or sensational mass market “health ” books
      .
      “We conclude that there are many unsubstantiated assumptions made. Current data about health effects of dietary lectins, as consumed in cooked, baked, or extruded foods do not support negative health effects in humans. In contrast, consumption of WGA containing foods, such as cereals and whole grain products, has been shown to be associated with significantly reduced risks of type 2 diabetes, cardiovascular disease, some types of cancer, as well as a more favourable long-term weight management.”
      http://www.sciencedirect.com/science/article/pii/S0733521014000228
      .
      Sure, it is possible to find toxic effects from grain lectins in the laboratory or in rat studies. You can find toxic effects from virtually anything if you design the study appropriately. Even water is toxic in high doses and specific circumstances. And you can turn such findings into sensational claims that garner a lot of publicity (and sales) – if you leave out all the evidence that does not suit your argument or book sales.”
      .
      And from another post:
      “The Paleo community attitude is certainly strange because there is evidence to show that humans in the Paleolithic period actually did eat legumes – and significant amounts at that – at least in certain locations and in the relevant season eg
      http://www.sciencedirect.com/science/article/pii/S0305440304001694
      .
      However, it seems that once an idea becomes established in the Paleo canon it becomes sacrosanct and no mere inconvenient fact is powerfu l enough to overturn it.
      .
      On lectins and health specifically, blogger has summarised the (Paleo) argument like this:
      “There is evidence that legumes provide health benefits. There is speculation that lectins cause diseases. Unfortunately, the autoimmune diseases some speculate are caused by legume lectins appear to occur more frequently in nations like the U.S., where legume consumption is rather low, than in Asian nations, where legume consumption is higher.”
      http://donmatesz.blogspot.com/2011/08/legumes-neolithic-or-not.html




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      1. Thea,

        Re: “lectins are destroyed during cooking”.

        Lectins are present in a lot of foods but most notably in beans.
        The attached paper reports on a multiple analyses of various bean types, typically consumed in Tunisia (not the beans that we are used to consuming in the west).
        Tests were conducted to find residual Lectin after a variety of cooking methods.

        J Med Food. 2015 Sep;18(9):1049-64. doi: 10.1089/jmf.2014.0120. Epub 2015 Mar 16.
        Toxicity Assessment of Common Beans (Phaseolus vulgaris L.) Widely Consumed by Tunisian Population.
        Authors: Nciri N et. al.
        PMID: 26355953
        (search by PubMed ID number to find the doc).

        [quote]

        ” ….. raw dry beans contained a considerable amount of proteins and PHAs (phytohemagglutinin == lectins). ELISA (the analytical method used) demonstrated that soaking, either in plain water or in alkaline solution, caused an increase in the concentration of PHA. A slight increase of PHA was produced equally by germination during 4 days in all bean varieties. Cooking or autoclaving (pressure cooking) of pre-soaked beans resulted in a complete disappearance of PHA. ELISA test also proved that both imported and local canned beans contained fingerprints of PHA. ……………………… In agar gel immunodiffusion using rabbit anti-PHA serum, raw, soaked, cooked unsoaked, and sprouted beans gave precipitin arc reactions, indicating that PHA existed in immunoreactive form in the tested seeds………………… This work revealed that the combination of soaking and cooking/autoclaving was the best way in reducing PHA content and its activity in all bean varieties when compared with germination.

        [unquote]

        While this science does not provide evidence for the effect of cooking on the many Lectin types found in a variety of foods, in the absence of further available evidence we can probably accept it as a generalised ‘rule of thumb’.

        Re: ” Asian populations have not displayed any adverse effects from grain/legume consumption”.

        I think we have to be careful about drawing inferences from observational studies in general and racial groups in particular as there are so many variables involved in peoples diets (did they report accurately, which beans and grains did they eat, how were they prepared and what else did they eat.

        There is also some quite good evidence available to show that genetic evolution has occurred in racial groups, exposed to ‘agricultural foods’, like grains and dairy, since the beginning of the Neolithic era e.g. a significant % of Europeans exposed to dairy have ‘adapted; to tolerate lactose within a few thousand years. Ditto for people of Mediterranean heritage exposed to grains (this excludes those of other European regions, like the United Kingdom, who were the forbears of many US citizens.

        That is a big topic though and I will have to save the discussion, and evidence, for another day.

        Rada.




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      2. Sorry; some oversights on my part.

        Some commentators claim that:

        – dry heat does not destroy Lectins (so things like baked goods might contain higher amounts than pressure cooked versions of the same food);

        – the Lectins in rice are contained in the germ so cooked white rice should contain negligible Lectins;

        – the main concern might be with those Lectins that are resistant to gastric and intestinal digestion e.g tomato lectin, navy bean lectin and wheatgerm agglutinin and possibly potatoes. If this is true it would rule out the relevance of observational studies of ‘Asian’ versus ‘European’ diets as presumably wheat is the only one, from that listing, that comprises a staple food source in any global community or communities.

        So far I haven’t finished my search for evidence to show how long ‘Asians’ have been eating white rice, in preference to brown, or what % of a typical ‘Asian’ diet is based on legumes versus rice.
        Ditto for the digestibility versus indigestibility of the various food Lectins, except for a passing reference, for the foods listed above, in this article from Cornell Uni:

        ‘PLANT LECTINS’ at Cornell University Dept of Animal Science.

        http://poisonousplants.ansci.cornell.edu/toxicagents/lectins.html




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    2. Hi Coty,

      Dr Greger doesn’t answer many questions personally. I think he is pretty busy these days.

      I think A.Z Donald has achieved remission from IBD after going on a WFPB diet. You might like to ask him for an opinion.

      I have checked some of the scientific literature for Crohns, in association with Lectins, but the answers aren’t compelling.
      If we consider it as an extreme manifestation of Gastro inflammation, and include IBD, Caeliac Disease, Intestinal Permeability et. c we do get some guidance:

      – lectins are found in man, or most, foods so it is impossible to avoid them all;
      – there are many types of Lectins and in some situations some perform vital roles or are helpful to our health;
      – the types, quantities and toxicity in all foods have not been identified or quantified;
      – generally we don’t know the amounts of ‘toxic’ Lectins that people consume on average nor the effect on their health, if any;
      – we do know that high pressure cooking destroys most, if not all of some Lectins, so as a rule of thumb Lectin containing foods should not have any adverse effects if pre-soaked, and pressure cooked;
      – some of the science indicates that some Lectins are not digested, with most of it passing through, while a significant % adheres to the villi that line the small intestine (there is some science that indicates this is not good for our health).
      Here is one example showing that wheat agglutinin (lectin) is indigestible (there are other examples for other lectins).

      [quote]

      J Nutr Sci Vitaminol (Tokyo). 1984 Aug;30(4):381-94.
      Susceptibility of Kintoki bean lectin to digestive enzymes in vitro and its behavior in the digestive organs of mouse in vivo.
      Hara T, Mukunoki Y, Tsukamoto I, Miyoshi M, Hasegawa K.
      Abstract
      The enzymatic digestion of a Kintoki bean lectin in vitro resulted in neither the extensive hydrolysis nor complete inactivation of the lectin. The majority of [3H]lectin administered to mice by stomach-intubation was found in the digestive tract at levels of 88.7%, 99.4%, 99.5% and 78.6%, after 0.5, 2, 5 and 24h of intubation, respectively. Twenty to forty percent of the administered radioactivity was found combined with the mucosa of the small intestine. After 24 h of intubation, part of the radioactivity was found in the feces. The recovery test of hemagglutinating activity and the molecular weight determination of the lectin administered to and recovered from mice revealed that more than 70% of the radioactivity detected in the digestive tract represented intact lectin. Therefore, it was concluded that most of the Kintoki bean lectin survived its passage through the gastrointestinal tract. The lectin-binding sites in the intestinal mucosa were traced with fluorescence microscopy using the lectin conjugated with fluorescein isothiocyanate. The fluorescent sites were found located at the top and upper sites of the villi, but not at the crypt.
      PMID: 6439840

      [unquote]

      In a review, published in the British Journal of Nutrition (2000), Cordain et. al do provide some information and the possible mechanisms of Lectins promoting intestinal inflammation although it is as an aside to a discussion of the role that gut inflammation plays in Rheumatoid Arthritis.

      “Modulation of immune function by dietary lectins in rheumatoid arthritis
      Loren Cordain*, L. Toohey, M. J. Smith and M. S. Hickey Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
      (Received 2 March 1999 – Revised 5 July 1999 – Accepted 30 August 1999)”

      available as a PDF download here )click on the PDF icon)

      https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/modulation-of-immune-function-by-dietary-lectins-in-rheumatoid-arthritis/64F4903A728BBA42F21F233D9C50C2EC

      At the other end of the spectrum, the alternative medicine, and self-help approach, is based around elimination diets of various kinds.
      Given the complexity of the issue and the lack of a clear direction elimination diets are an effective, if somewhat tedious method, to achieve some remission (note that people who are on medication and/or have chronic health issues should not attempt elimination diets unless under the supervision of a health professional).

      Fortunately there is one clinical trial that tested the efficacy of a Lection elimination diet on a large group, many of whom were associated with a history of autoimmune diseases.

      [quote]

      Abstract P354: Elevated Adiponectin And Tnf-alpha Levels Are Markers For Gluten And Lectin Sensitivity
      Steven R Gundry
      Circulation. 2014;129:AP354

      Abstract
      Adiponectin is a protein hormone secreted by adipose cells and is thought to be a precursor for the inflammatory cytokine TNF-alpha. Although low levels of Adiponectin are associated with visceral adiposity and high levels with weight loss, there is a strong association of elevated Adiponectin and TNF-alpha levels in thin women with dementia, osteopenia, and/or coronary artery disease. This paradox led us to consider that these biomarkers correlated to sensitivity to the plant defense proteins: gluten and other lectins.
      We studied serial Adiponectin and TNF-alpha levels every 3 months in 1,000 pts, M:F ratio 1:1 in response to a lectin and gluten elimination diet (The Matrix Diet). All samples were sent to a core lab (Singulex, Alameda, CA). The diet consisted of avoidance of grains, sprouted grains, pseudo-grains, beans and legumes, soy, peanuts, cashews, nightshades, melons and squashes, and non-Southern European cow milk products (Casein A1), and grain and/or bean fed animals.
      Eight hundred pts (80%) related some history of autoimmune disease (AID) personally or among family members, including Hashimotos thyroiditis, IBS, arthritis, RA, Lupus, Crohns, colitis, GERD, CAD, Type 1 DM.
      Adiponectin levels were elevated in all 800 pts with family hx or personal history of AID (16.6-83 ug/ml)(nl3.0 pg/mL). In contrast, Adiponectin was normal in 200 remaining pts without AID history (<16.5 ug/ml), while TNF-alpha was normal in 100/200 (50%) of pts without AID.
      When the lectin and gluten free diet was instituted, all TNF-alpha levels became normal in all 1,000 pts (<3.0 pg/mL), within 6 months and remained normal, if the diet was followed, for up to one year of study. However, despite normal TNF-alpha levels, Adiponectin levels remained elevated in 790/800 pts with AID hx. Late lack of adherence to the diet occurred in 56/1,000 pts (6%) (as determined by questionnaire) resulted in re-elevation of TNF-alpha in 56/56 pts (100%).
      We conclude that elevated Adiponectin is a marker for lectin and gluten sensitivity, while TNF-alpha can be used as a marker for gluten/lectin exposure in sensitive individuals. These findings probably explain the Adiponectin paradox. TNF-alpha levels appear to be useful as a marker of response to a lectin/gluten limited diet, and as a marker for degree of adherence to such a diet

      [unquote]

      Given that the Centre For Digestive Diseases has identified TNF-alpha as being highly correlated with Crohn's Disease it might be worth your while to find out some more about Lectin avoidance.

      http://www.cdd.com.au/pages/disease_info/crohns_disease.html

      [quote]

      Anti-TNF. Research has shown that cells affected by Crohn's Disease contain an inflammatory protein produced by the immune system called tumour necrosis factor (TNF). This cytokine may be responsible for the inflammation in Crohn's Disease. Anti-TNF (eg. infliximab and adalimumab) binds to TNF and inactivates it before it can cause inflammation in the intestine. In studies anti-TNF seems particularly helpful in closing fistulae. Unfortunately it is plagued by numerous side effects and has a fairly poor track record in inducing remission with progressive loss of activity. Complications can be quite severe including overwhelming infection, demyelination of brain tissue, and development of various cancers. The restricted drug, thalidomide, also has anti-TNF properties and is being carefully investigated as a possible treatment for severe Crohn's Disease.

      [unquote]

      I cant find anything on Dr Gundry's 'Matrix Diet'.
      I have read his book, 'Diet Evolution', and while I quite like it the focus is mainly orientated towards helping overweight people adjust from a SAD diet to something considerably more helpful.
      I believe he does communicate, with the public, via a Facebook page or a email list or the like.
      Here is a link to an interview of Dr Gundry, on autoimmine issues, that is hosted by the 'self-hacked' website.

      Note that the evidence, in several places, seems to be building behind the case that autoimmune/Lectin issues are correlated with a genetic pre-disposition so it is likely that not all people will have 'intolerance' issues with Lectins.




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  24. How best to treat a fistula in ano with nutrition and naturally based approaches?

    I am writing to ask the above in the subject line question; along with that, at the same time I came down with hemorrhoids. Digestive issues became bad and painful to eliminate. How best to treat a fistula in or near anal with nutrition and naturally based approaches? So I am just turned 65 this month have not been so messed up in many years. What do you suggest as the road to recover from these health issues? I am a missionary in Africa now since 1979. While up in the bush for 4 months I started feeling badly with one day having a fever and flush red cheeks the temperature was 99F then having night awakenings not able to sleep soundly. I had a three part blood test done for malaria, typhoid and brucellosis at the clinic in the nearest town. The results ‘some little malaria in your blood.’ Took another blood test for malaria in a kit that was negative. Took no medicines after weeks the pain intensified then draining of a sore. Was taking turmeric powder and garlic cloves, then found a black walnut with wormwood tincture brought to us by friend from a larger town. To which we later went to see a ND and then a MD the latter said I had the fistula in ano prescribed an antibiotic. Which I have not taken but followed up with those lists of vitamins, probiotics, and pellets that the ND listed. The whole issue is going on now about 8 weeks. I am vegan, sugar free, gluten free. I had a history of a mild IBS about 30 years ago. Have not taken any meds for about nine years and do not want to at all. Have just finished doing a 5 day fresh juice, tea/ liquids & few smoothies diet. I am going to do raw foods for awhile to see what happens unless you say otherwise. I researched my med books and online; now wonder if I have leaky gut syndrome. Have many allergies and in-tolerances to foods. What to do next from your views is appreciated? I think I have a leaky butt syndrome now.




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  25. Michael- I wonder if you are working with a doctor who is taking a comprehensive look at your whole health history and symptoms. I realize that may be difficult with your situation as a missionary and perhaps not close to a medical center. Still I’ve clarify your malaria status and review in detail symptoms you’re experiencing. Uness you are experiencing pain/bleeding with bowel movements isncreasing fiber in your diet should help with elimination. If raw food causes problems, you may consider cooking with gradual increase of raw food in your diet \P;ease review the following for more tips and best of health to you.
    http://nutritionfacts.org/?fwp_search=fistula&fwp_content_type=video
    http://nutritionfacts.org/video/should-you-sit-squat-or-lean-during-a-bowel-movement/




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  26. I know this video is regarding Vitamin D but I am curious about vitamin B12 supplementation for a person with Inflammatory Bowel Disease. I have seen may Vitamin B12 brands that contain sorbitol or mannitol and these sugar alcohols are often a concern in those with IBD. Is there an ideal way for those with IBD to get Vitamin B12 if they are plant-based?

    Also, a client with IBD that I am working with was told to drink distilled water related primarily to minimize chlorine intake from water. She was wondering if using a water filter instead (wants to get minerals from water and convenience factor) would be an okay alternative?

    Thank you.




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  27. Hi Emily, thanks for your question. I am one of the volunteers on the site. The plant based food rich in B12 are seaweed, soybean-fermented foods. However, there is a video by Dr Greger that I shall include that could help you with some more insight.
    Safest Source of B12




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