Why Patients Aren’t Informed About Mammograms

Why Patients Aren’t Informed About Mammograms
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If doctors don’t understand health statistics how can they possibly counsel patients properly?

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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.

“In the…mammography wars, rational thinking can be easily lost.” Yes, mammograms are big business, bringing in about seven billion dollars a year. But, “[i]t would be [a bit] too…cynical to believe that [the pushback from mammogram critics] stems only from [the] self-interest of radiologists [and breast] surgeons,…whose daily bread depends on the continuation of [routine mammogram] screening. It just makes intuitive sense that mammograms should work. But, that’s why we have science—so we can put things to the test. “We owe it to [our patient]s to be ‘evidence-based’ rather than ‘faith-based.'” “[They] deserve [an] objective analysis of the data.”

“[W]e have done a dismal job of accurately informing the public,” and the question is: why? Well, one reason is that the doctors themselves aren’t informed. “For example, a survey of…radiologists found that 96% overestimated a [middle-aged] woman’s risk of breast cancer.” In one sneaky study, researchers called up gynecologists, and pretended to be a concerned family member asking for a phone consultation about the benefits and harms of mammograms. “Although all [the] gynecologists appeared motivated and concerned with sufficiently answering our questions, they [simply appeared to lack the] information as well as knowledge of how to communicate information on medical risk.”

“When Doctors Meet Numbers.” “We cannot take for granted the ability of physicians to understand and interpret [data and…] use it to the best advantage of the patient.” “[A]n educational blind spot” for physicians, identified more than 80 years ago. In this study, for example, 151 practicing physicians were asked a series of multiple choice and true-and-false questions to gauge their practical understanding of some key concepts. And, they failed miserably: only got 55% correct, only about 20% more than they would have gotten just randomly guessing.

If doctors don’t understand health statistics, how can they possibly counsel patients properly? There was a famous study in which a hundred physicians were asked what the chances were of a woman actually having breast cancer if her mammogram came back positive. They gave them all the numbers so they could do the math, and 95 out of 100 not only got it wrong, but spectacularly wrong: off by a thousand percent.

Even doctors at Harvard had a problem. “…[F]aculty, staff, and students at Harvard Medical School” were asked a simple question, and 82% got it wrong. That was a few decades ago, though. In an updated survey in Boston, only 77% got it wrong, an average of about 3,000% off, demonstrating medicine’s continued discomfort with math.

“Only 12% of [thousands of OB-GYN] residents were able to correctly answer 2 simple questions on medical statistics.” “What will the uninformed 88% of these residents say when their first patient asks about her chance of truly having breast cancer given a positive mammogram?” And, what’s particularly frightening is that in some studies, “those [doctors] most confident in their estimates were furthest away from the correct response.” So, they didn’t even know that they didn’t know. “All of these studies document the same phenomenon: A considerable number of physicians are statistically illiterate, that is, they do not understand the statistics of their own discipline.”

So, when physicians say they don’t have time to fully inform patients about the benefits and harms of a test, maybe that’s a good thing—if they don’t know what they’re talking about! Instead, they may just talk about the benefits, and skip the whole harms part. And so, we shouldn’t be surprised when nine out of 10 women say, “Harms from mammograms? What harms?” while often greatly overestimating the benefits—whereas, “[i]n fact, the benefits and harms [may be] so evenly balanced that maybe we should just inform women, and let them make up their own minds. But, that’s not what you hear from ad campaigns. They just tell women to do it, overstating the benefits, sometimes ignoring harms altogether, using persuasion instead of education—”fear, guilt,” whatever it takes.

“[I]t is easy to ‘sell’ screening: just magnify the benefit, minimize the [harms],…keep the actual numbers [under wraps].” I mean, studies have randomized hundreds of thousands of women to get mammograms, or not to put it to the test. What’s the point if we’re not going to share the results? “We spend billions on [these] clinical studies, but fail to ensure that patients and physicians are communicated the results [in a] transparent…[manner]. Maybe women should “tear up the pink ribbons and campaign for honest information.” How else can women “make informed decisions”?

Instead, we get hospitals putting on like mammogram parties. Maybe, in addition to the appetizers, they should serve women “balanced information…to chew on” as well.

Please consider volunteering to help out on the site.

Image credit: Jean-François Chénier via flickr. Image has been modified.

Motion graphics by Avocado Video

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

“In the…mammography wars, rational thinking can be easily lost.” Yes, mammograms are big business, bringing in about seven billion dollars a year. But, “[i]t would be [a bit] too…cynical to believe that [the pushback from mammogram critics] stems only from [the] self-interest of radiologists [and breast] surgeons,…whose daily bread depends on the continuation of [routine mammogram] screening. It just makes intuitive sense that mammograms should work. But, that’s why we have science—so we can put things to the test. “We owe it to [our patient]s to be ‘evidence-based’ rather than ‘faith-based.'” “[They] deserve [an] objective analysis of the data.”

“[W]e have done a dismal job of accurately informing the public,” and the question is: why? Well, one reason is that the doctors themselves aren’t informed. “For example, a survey of…radiologists found that 96% overestimated a [middle-aged] woman’s risk of breast cancer.” In one sneaky study, researchers called up gynecologists, and pretended to be a concerned family member asking for a phone consultation about the benefits and harms of mammograms. “Although all [the] gynecologists appeared motivated and concerned with sufficiently answering our questions, they [simply appeared to lack the] information as well as knowledge of how to communicate information on medical risk.”

“When Doctors Meet Numbers.” “We cannot take for granted the ability of physicians to understand and interpret [data and…] use it to the best advantage of the patient.” “[A]n educational blind spot” for physicians, identified more than 80 years ago. In this study, for example, 151 practicing physicians were asked a series of multiple choice and true-and-false questions to gauge their practical understanding of some key concepts. And, they failed miserably: only got 55% correct, only about 20% more than they would have gotten just randomly guessing.

If doctors don’t understand health statistics, how can they possibly counsel patients properly? There was a famous study in which a hundred physicians were asked what the chances were of a woman actually having breast cancer if her mammogram came back positive. They gave them all the numbers so they could do the math, and 95 out of 100 not only got it wrong, but spectacularly wrong: off by a thousand percent.

Even doctors at Harvard had a problem. “…[F]aculty, staff, and students at Harvard Medical School” were asked a simple question, and 82% got it wrong. That was a few decades ago, though. In an updated survey in Boston, only 77% got it wrong, an average of about 3,000% off, demonstrating medicine’s continued discomfort with math.

“Only 12% of [thousands of OB-GYN] residents were able to correctly answer 2 simple questions on medical statistics.” “What will the uninformed 88% of these residents say when their first patient asks about her chance of truly having breast cancer given a positive mammogram?” And, what’s particularly frightening is that in some studies, “those [doctors] most confident in their estimates were furthest away from the correct response.” So, they didn’t even know that they didn’t know. “All of these studies document the same phenomenon: A considerable number of physicians are statistically illiterate, that is, they do not understand the statistics of their own discipline.”

So, when physicians say they don’t have time to fully inform patients about the benefits and harms of a test, maybe that’s a good thing—if they don’t know what they’re talking about! Instead, they may just talk about the benefits, and skip the whole harms part. And so, we shouldn’t be surprised when nine out of 10 women say, “Harms from mammograms? What harms?” while often greatly overestimating the benefits—whereas, “[i]n fact, the benefits and harms [may be] so evenly balanced that maybe we should just inform women, and let them make up their own minds. But, that’s not what you hear from ad campaigns. They just tell women to do it, overstating the benefits, sometimes ignoring harms altogether, using persuasion instead of education—”fear, guilt,” whatever it takes.

“[I]t is easy to ‘sell’ screening: just magnify the benefit, minimize the [harms],…keep the actual numbers [under wraps].” I mean, studies have randomized hundreds of thousands of women to get mammograms, or not to put it to the test. What’s the point if we’re not going to share the results? “We spend billions on [these] clinical studies, but fail to ensure that patients and physicians are communicated the results [in a] transparent…[manner]. Maybe women should “tear up the pink ribbons and campaign for honest information.” How else can women “make informed decisions”?

Instead, we get hospitals putting on like mammogram parties. Maybe, in addition to the appetizers, they should serve women “balanced information…to chew on” as well.

Please consider volunteering to help out on the site.

Image credit: Jean-François Chénier via flickr. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

Many doctors display a similar ignorance about nutrition. See, for example, Physicians May Be Missing their Most Important Tool.

There’s just one more mammogram video to help you decide: The Pros & Cons of Mammograms.

In case you missed any of the first dozen, check them out:

And if you want this whole series in one place, you can get it on DVD or streaming for a donation to NutritionFacts.org by going here.

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

97 responses to “Why Patients Aren’t Informed About Mammograms

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    1. Yeah, we gals feel the same about his deep dives into prostate cancer. Maybe my interest has to do with having had breasts mashed painfully flat between giant cold panini presses and zapped with radiation every one or two years. That REALLY gets old. (And I’m done, thanks to this series.)

    2. this is a very important topic and affects so many women! I personally APPRECIATE EACH and every video he puts out there to educate us. All of us have family or friends that have been affected so please care and stop complaining.

      1. Breast cancer also affects men albeit less frequently. An old high school friend of mine had both breast cancer and prostate cancer. He is now in the clear though.

        So mammograms may not be relevant to men but breast cancer is.

      2. I wasn’t belittling the videos or women’s suffering: it’s a VERY important subject. I would have understood 13 videos in a row on breast cancer prevention/treatment in general not ONLY on the single topic of mammograms…. It just seems a bit unbalanced to me.

        1. I think this video is largely about the reliability of statistics coming from your doctor. That viewpoint is crucial for all of us. My wife “had breast cancer”. I continually wonder if she ever really had it, or if it was just the most profitable decision for the hospital. We need to understand the statistics if most of our doctors can’t.

  1. Being a mathematician, I love this particular video. I think I’ll give one of those statistical tests to my doctor and see how well he does on it :-)

    Then maybe change doctors until I find one who can “pass the test ” !!!

    1. Doctors also fail miserably to understand risk-harm of drugs. They seem to believe what the reps tell them.
      And of course, the drug companies hire statisticians to try to make the drugs look better than they are.
      So apply the playing with numbers game that Dr, Gregor, to his credit, shows here to drugs also.

      1. Doctors are taught by a system run largely by the drug industry. So their approach is usually somewhat tainted.
        The good doctors, like Dr. Greger, manage to rise far above that mess. But so many doctors do not.

        And the doctors that do rise above don’t always fare that well. The industry doesn’t take kindly to doctors that don’t support their mission. Go too far astray and they’ll take strong action, like taking away your license.

        What Dr. Greger does is courageous, and potentially troublesome for him. We need to be sure to support him in his wonderful mission.

    1. Thanks for the link!
      “The NNT that we calculate here is designed to be a tool for those attempting to make decisions about health care interventions, and in aggregate the best available evidence suggests there is no overall benefit to screening mammography. This should not be taken to mean that some individuals are not saved—it is likely that they are—however an equal number of individuals appear to lose their lives due to mammography, and there is no way to know which group one will eventually fall into.”

      This sums up my discomfort with this type of “screening.” What happened to “first do no harm”?

      1. “do no harm” doesn’t even exist in the cancer biz.

        Cancer doctors get direct kickbacks for prescribing drugs like chemo, etc. And they act like it.
        Total conflict of interest. But it keeps the drug industry in the green, big time.

        Health care needs to become non-profit. It’s the only way that makes sense.

    2. Thanks Linda –

      As far as informed consent goes, I think that doctors should provide patients with the NNT – number needed to treat for one person to benefit, AND the NNH – number needed to treat before one patient suffers harm – for any procedure or treatment they recommend..

      And considering that any exposure to unnecessary radiation increases the chance of getting cancer later down the road proportional to the dose received, even the small amount of radiation exposure for a mammogram exposure will increase the likelihood of someone getting cancer, even if only by a very small amount, in effect brings the NNH up to 1.

      Still, the NNT/NNH benefit/risk imbalance for mammograms unfortunately does not seem the exception but the rule for many medical treatments, including for example the top ten best selling pharmaceutical drugs.

      Check out this paper in Nature News article (I’d rate Nature as one of the premier scientific journals in the world):

      http://www.nature.com/news/personalized-medicine-time-for-one-person-trials-1.17411

      “Personalized medicine: Time for one-person trials” and especially its “Imprecision Medicine” chart, that graphically represents the NNT (Number Needed to Treat to help one patient), which I found particularly illuminating and depressing. It states, “The top ten highest-grossing drugs in the United States help between 1 in 25 and 1 in 4 of the people who take them. For some drugs, such as statins, routinely used to lower cholesterol. as few as 1 in 50 may benefit.”

      The chart does seem a bit of an eye-opener. I wish every patient received a copy of this, as well as of the NNT’s and NNH’s of the drugs their doctors prescribe for them so they could make better informed decisions about whether to take them or not. (And if doctor’s had NNT’s and NNH’s, easily to hand, even the most mathematically incompetent doctor could make more informed and ethical choices about whether to prescribe them or not . . . )

      And as far as informed consent goes, it seems fair that doctors tell their patients of the likelihood of a particular drug helping them, by giving them the NNT, while also giving them information on the NNH and the likelihood of a drug harming them – and in what ways – so they can make an informed choice.

      And given that doctors now have NNT and NNH data freely available, one would hope that this would have become standard practice. That it has not should indeed make one wonder what happened to the Hippocratic oath and to its prescription to “first of all do no harm.”

    3. I checked out that site a year or two ago. To be honest, it didn’t seem entirely reliable or trustworthy to me.

      Specifically, I looked at a review of statins for heart disease which stated that 1 in 10 people were harmed with muscle damage.
      http://www.thennt.com/nnt/statins-for-heart-disease-prevention-with-known-heart-disease/

      In fact, “There has been considerable controversy about the prevalence of muscle-related statin intolerance because large randomized trials have reported low rates of muscle symptoms, while observational studies have suggested that 5 to 20 percent of patients experience muscle symptoms when taking statins.”
      https://www.sciencedaily.com/releases/2016/04/160403200142.htm

      and at least one blinded RCT has found that the percentage of people reporting muscle damage was actually similar for people taking statins and people taking a placebo who thought they were taking statins …. this suggesting there may be a nocebo effect at work (however, this was funded by drug companies so I am a bit cautious about its findings)
      https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-05-03-statins-side-effects-have-been-overstated-says-study/

      My impression therefore was that the NNT team have chosen to use data from observational studies and to ignore data from large, randomised trials. I can’t think why they would, because RCTs are usually regarded as providing better quality evidence than observational studies.

      Consequently, I don’t have a lot of confidence in the analyses on that site.

      1. TG, to each his own of course, but I posted the website since I was advised by a physician to start my research there when checking any drug that was suggested I take. Best doctor I ever had, but unfortunately was only filling in during staff holidays. He also recommended this site, TG, which you may find useful http://www.ti.ubc.ca/about-us/working-groups/drug-assessment-working-group/
        btw, I found other respectable references of interest under the ‘Further References’ tab at the nnt site.

          1. Thanks Linda.

            I was prescribed statins a long time ago but experienced liver problems, hence my interest in this particular topic. However, I believe that there is also a lot of knee-jerk anti-statin propaganda around to counteract the industry hype. Consequently, it is difficult to know where to go to get reliable assessments.

            The sites you linked to are certainly interesting but I am just not sure how reliable they are. Often, any given analysis methodology will deliver quite different results depending on the evidence/studies the authors decide to examine or not examine. I like the independent Cochrane Reviews by and large and they also are fairly sceptical. However, some commentators think that these sceptical reviews throw the baby out with the bathwater.
            https://sciencebasedmedicine.org/statins-the-cochrane-review/

            My concern here I suppose is that these types of concerns may also be relevant to discussion of the mammogram issue. GIGO.

            That is why I think that it is also important to read the more conventional analyses such as the US Preventive Services Task Force reviews which c
            also deal with these issues – and whose members are arguably better qualified to assess the evidence.
            https://www.ncbi.nlm.nih.gov/books/NBK343819/

  2. I LOVED this video series — THANK YOU SO MUCH!! And I say this as a woman diagnosed with breast cancer, and in whose family breast cancer runs rampant, sometimes with fatal results.

    And I knew that doctors and math are like oil and water; I worked in a research lab in a medical school, where some of the principal investigators (heads of labs) were MDs — and they were abysmal researchers!! I worked for one: Harvard undergrad and MD. His only saving grace as surrounding himself with very smart talented scientists.

  3. one thing i don’t understand. If lesions are found on mammograms after they are 21 years extant, how can they also be self-limited? am i to conclude that the progress for 21 or more years, and then regress?????????????????

    1. Cancer kills by growing into healthy adjacent tissues with cells of this primary tumor breaking loose into the lymph/blood to seed other distant areas of the body (metastases) that then grow and also invade adjacent tissues. If a tumor grows slowly, does not metastasize and does not invade adjacent tissue, then it acts like a benign lesion, is “self-limited” and causes no significant problem.

      Dr. Ben

  4. Such a scary and confusing topic for women. I have had a few false positives and surgery to remove hyperplasia tissue. Research shows this puts me at a higher risk for future breast cancer. How do I screen for it if not mammograms? I’m scared not to.

    1. WFBP-Hal shared a link on Wednesday to Dr. McDougall’s website on some cancer topics. I ended up finding this story: https://www.drmcdougall.com/health/education/health-science/stars/stars-video/jessica-bowen/
      Life is full of pitfalls and cancer is a scary word. If you are very anxiety driven, maybe you can find some comfort in Jessica Bowen’s story, or if you have the funds, spend time with Dr. McDougall. Ever since I saw Dr. Gregor’s video on how we ALL have cancer cells in our body and that our body works to destroy them, I’ve been comforted knowing that with fresh air, exercise, a nutritious diet, I (ME) am taking my health into my own hands and giving my body the tools it needs to repair itself, and IT WILL do the work.

      1. Loved the video, Jessica!

        Listening to what she went through pre-going low fat WFPB, that is what struck me when I used to listen to Chris Beat Cancer interviews. It wasn’t that the people were rejecting medicine, they had come to the end of any benefits of the medical approach and had very little hope that anything else the medical community was offering would end in life.

        Jessica Bowen had the same glowing, energetic, happy, vibrant, healthy-appearing look that Chris’ Stage 4 survivors have.

        Chris’ people usually had already been there tried that and were sent home to die before they did the whole change their diet thing and I respect that they wanted to try everything possible. They wanted the laetrile, they wanted the blood root, they wanted to try the juices and coffee enemas and hyperthermia and vitamin C IV’s and vaccines and every, every, every possible thing and with numbers like the real ones being unmasked in these videos, can anyone possibly blame them?

    2. Michele, I think the first thing should be the examining of what are you doing, which might cause Cancer and dealing with those things, rather than just testing.

      Making the dietary changes and getting rid of the chemicals and toxins and not spending hours with your cell phone up against your head, test your water, move if you life too close to power lines, etc.

      Feels like, watching the videos on the people who survived Stage 3 and Stage 4 Cancers, they aren’t constantly checking for Cancer. They genuinely are empowered. You can see it in their faces. They are doing what it takes to not have it grow.

      The women who are afraid of it in my life are the ones who are living in ways, which they know there are risks. They are drinking the soda and junk food and they don’t even know the animal products risks and they shut out the revelation, before I could give it to them.

      They are afraid, because they should be. If that eventually gets them to change something, then that would be good, but their focus will be on testing rather than diet and it is a focus, which isn’t very fun.

    3. Hello Michele,
      I’m a family doctor and also a Health Support Volunteer for this website. Thank you for your very excellent comment/question, which really goes to the crux of the issue.

      You have already received some excellent responses, below — from Jessica, Deb, Alef1, and Blair. I can only add that you need to understand as much as you can about this issue, by looking at the whole series of videos that Dr. G. has done on the topic of mammograms. The issues he raises, of “lead-time bias”, false positives, the number of mammograms needed to save one life (vs. the number needed to harm one person) — these issues are not easy to explain nor understand. I have a master’s degree in epidemiology, and I think Dr. G does a nice job of explaining these concepts.

      I recommend that you look at this Dr. G video, if you haven’t already:
      https://nutritionfacts.org/video/do-mammograms-save-lives/?utm_source=NutritionFacts.org&utm_campaign=2c7ddbf07f-RSS_VIDEO_MONTHLY&utm_medium=email&utm_term=0_40f9e497d1-2c7ddbf07f-23843473&mc_cid=2c7ddbf07f&mc_eid=8486225ff4

      The bottom line is that we doctors do not have a good screening test for breast cancer. It’s a difficult conversation to have with a worried patient, that, for example: chest X-rays are not a good screening test for lung cancer, EKGs are nearly worthless for detecting coronary artery disease, PSA is not a good screening test for prostate cancer, etc.

      From the doctor’s standpoint, one big problem we face is that for a patient to make a truly informed decision about whether or not to have a mammogram, or a PSA test, would take 30-60 minutes of explaining. And we rarely can take that much time. So we just end up by either recommending or not recommending a test. AND, if a patient is really insistent on having a test we think is questionable at best, we often will acquiesce, because it’s just not worth the time it would take to try to convince a person like that.

      If you look at the history of medicine, it is FILLED with crazy, harmful advice and tests and surgeries we doctors have performed, and we mostly have had the patient’s best interests in mind — although in a fee-for-service medical system like ours, there have been LOTS of instances of conflicts of interest: like when the doctor owns the EKG machine or the X-ray machine, (s)he will be more likely to order an unnecessary test.

      I hope this has helped somewhat.
      Dr. Jon
      PhysicianAssistedWellness.com
      Health Support Volunteer for NutritionFacts.org

  5. ” . . . [i]n fact, the benefits and harms [may be] so evenly balanced that maybe we should just inform women, and let them make up their own minds.”

    Evenly balanced? Not even close.

    For those who have not watched the earlier videos in this series, documenting the harms, this statement gives the unfortunate impression that the benefits of doing mammograms and the harms seem about equally balanced. Like flipping a coin.

    For those who don’t have time to go through the whole series, I suggest that you at least watch https://nutritionfacts.org/video/understanding-the-mammogram-paradox/ (7 minutes) or his https://nutritionfacts.org/video/women-deserve-to-know-the-truth-about-mammograms/

    From the last videos transcript: ““Still, [women] who have had a cancer detected and then removed are likely to feel their life was saved.” But perhaps 10 times more likely their lives were actually seriously harmed, not saved. Ten times more likely you were told you had a cancer that could kill you, but you really didn’t, corralled into the operating room for surgery you didn’t need. Every doctor’s appointment, every sleepless night, all completely unnecessary—yet, you come out as mammograms’ greatest advocate; it saved your life. ”

    I see these as two of Dr. Greger’s best videos, looking at the dangers of over-diagnosis and over treatment, focusing on current research on routine mammograms in the U.S.(now an 8 billion dollar a year industry) as a particularly bad example. For the majority of women, getting routine mammograms seems a gamble with the odds stacked against them at over 10 to 1. For every woman saved, in the U.S. apparently at least one other dies, from over-diagnosis and over-treatment, with 10 healthy women having the quality of their lives severely impacted and shortened by years through undergoing a nightmare of unnecessary and grossly harmful treatments – having their breasts removed, their bodies damaged by radiation and poisoned by chemotherapy, and their bank accounts emptied.

    And even those lucky ones who do not get false positives but simply have routine mammograms do not get off scot free. As Dr. John Gofman ( https://ratical.org/radiation/inetSeries/nwJWG.html ), formerly a Professor Emeritus at the University of California, Berkeley (Ph.D. in nuclear-physical chemistry and an M.D.) who was the first Director of the Biomedical Research Division of the Lawrence Livermore Laboratory from 1963-65 and one of nine Associate Directors at the Lab from 1963-1969. put it, “the evidence on radiation-producing cancer is beyond doubt. I’ve worked fifteen years on it [as of 1982], and so have many others. It is not a question any more: [b] radiation produces cancer, and the evidence is good all the way down to the lowest doses.”[/b] And that includes the radiation from mammograms.

    1. Agree. Throughout this series, people keep asking in the comments whether they should get mammograms. Everything I’m taking away from these videos is that the answer is no. Can a mammogram save your life? Yes. But you have to ask yourself if you’re feeling lucky. Am I missing something here? (Also, see the NNT link provided above.)

  6. Thank You Thank You Thank You! Dr Greger, what would we do without you? this series on Mammograms was one of your best ever! Sending to all the women i know who are constantly pushing the mammogram mantra that more and constant screening is better. It’s an epidemic! I appreciate your moving slightly into a different topical realm- as in not specifically “nutrition” – to bring us this critical information, because our health care is so horrendous i wouldn’t trust my current doctor with understanding the flu, let alone giving me real info on mammogram risks.

  7. My personal experience treating and reversing severe ulcerative colitis using WFPB diet is that, with respect to the field of Gastroenterology, the following statement from Upton Sinclair is alive and well in the medical establishment:
    “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”

    And the experience others have shared with their “specialist” is similar. IMO mainstream medicine is not just uninformed, they are willfully ignorant.

    1. “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”

      I’d never hear that Upton Sinclair quote before – thanks for sharing!

      And along the same lines, two excerpts from George Bernard Shaw’s “Preface on Doctors” written in 1909(!) for his play, The Doctor’s Dilemma shows. In my opinion no one has written a more devastating, accurate – and funny! – critique of this problem in health care before or since. Shaw’s preface begins:

      “It is not the fault of our doctors that the medical service of the community, as at present provided for, is a murderous absurdity. That any sane nation, having observed that you could provide for the supply of bread by giving baker’s a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity. But that is precisely what we have done. And the more appalling the mutilation, the more the mutilator is paid. He who corrects the ingrowing toe-nail receives a few shillings: he who cuts your inside out receives hundreds of guineas, except when he does it to a poor person for practice. …”

      And as far as medical diagnostics goes:

      : “As to the humor and conscience of doctors, they have as much as any other class of men, no more and no less. And what other men dare pretend to be impartial where they have a strong pecuniary interest on one side? Nobody supposes that doctors are less virtuous than judges; but a judge whose salary and reputation depended on whether the verdict was for plaintiff or defendant, prosecutor or prisoner, would be as little trusted as a general in the pay of the enemy. To offer me a doctor as my judge, and then weight his decision with a bribe of a large sum of money and a virtual guarantee that if he makes a mistake it can never be proved against him, is to go wildly beyond the ascertained strain which human nature will bear. It is simply unscientific to allege or believe that doctors do not under existing circumstances perform unnecessary operations and manufacture and prolong lucrative illnesses. . . . ”

      http://www.gutenberg.org/files/5069/5069-h/5069-h.htm

  8. Not sure where else to post this link since I don’t do social media and I can’t find any email addresses to send directly to the NF.org staff. Check out this photo in an article about Al Sharpton that is currently posted on the “New York Times” website (under news from N.Y. Region). The photo was taken in his car and check out the book next to him: “How Not to Die!!”

    Al Sharpton with “How Not to Die”

  9. The mammogram videos have been interesting and thought provoking, but will there also be similar in-depth coverage on the benefits of thermograms?

    1. Thank you for your question Natalie. We shall all wait and see for the new series and topic by Dr Greger. However meanwhile I searched for your question and there was a study in the literature that had compared the two modality that I shall refer you to it. It explained that, Thermography was introduced by Lawson in 1957 as a new tool in the investigation of breast lesions, a non-invasive means of breast imaging, [3]. This entity was considered rather extensively in the 1970s and 1980s [4], and was approved by the US Food and Drug Administration (FDA) as an adjunctive tool for the diagnosis of breast cancer, but not as a useful screening or diagnostic tool for breast malignancy, due to its low sensitivity and specificity [5,6]. In this study they found that thermography cannot substitute for mammography for the early diagnosis of breast cancer.

      Comparison of the Accuracy of Thermography and Mammography in the Detection of Breast Cancer

  10. Sounds like we all could benefit from a “plain language” video series on understanding statistics. I had two semesters in graduate school some years ago, but I’m not sure I understand how the medical community works these statistics. I could use a refresher myself!

    1. Hi Cindy and all –

      Actually, if you want to understand how the medical industry uses statistics, going to a standard scientific textbook won’t do the job.

      Instead, I suggest you have a look at Darrell Huff’s masterpiece, How To Lie With Statistics, which not only informs, but entertains:

      A number of websites offer free downloads of the book, just Gooogle search: How To Lie With Statistics Huff pdf

      Some reviews:

      “A hilarious exploration of mathematical mendacity…. Every time you pick it up, what happens? Bang goes another illusion!”
      – The New York Times

      “In one short take after another, Huff picks apart the ways in which marketers use statistics, charts, graphics and other ways of presenting numbers to baffle and trick the public. The chapter “How to Talk Back to a Statistic” is a brilliant step-by-step guide to figuring out how someone is trying to deceive you with data.”
      – Wall Street Journal

      “Illustrator and author pool their considerable talents to provide light lively reading and cartoon far which will entertain, really inform, and take the wind out of many an overblown statistical sail.”
      – Library Journal

      “A pleasantly subversive little book, guaranteed to undermine your faith in the almighty statistic.”
      – Atlantic

      1. Good point, Aleph1. That book is an absolute classic.

        But if people prefer videos, they can go to YouTube and type “medical statistics” in the search box. Like everything else on YouTube though, it’s best to select the videos that come from credible/reliable sources.

  11. Not at all surprised by this.

    Sounds like Doctors need some software company to design a computer program to do the math for them.

    Or a Doctor’s homework hotline?

    I remember when doctors didn’t like the whole symptoms being analyzed by computers process and the person talking gave the average grade for physicians in classes, which they had taken years ago and brought up the fact that many of them crammed for a test, rather than having genuine understanding of the subject.

    This just says to me that they need help and it can’t be another doctor.

    They need the math and statistics department to step up and they probably need to take those courses again every once in a while, like teachers need to take courses to keep up with their field.

  12. In my dealings with doctors, the most obvious thing is that they weren’t open to research in the first place.

    They HATED that people who come to sites like this and try to learn things for themselves.

    They genuinely tell people, “Whatever you do, don’t go to these television or internet doctors” and they mean it.

    It also seems like the Cancer process is the most arrogant one.

    I have learned a lot from this series, but feel like I am already in the category, which wouldn’t have the Tamoxifen slight bump of improvement, and I would need someone who understands statistics to do the pre and post menopausal women mortality statistics to have me want to do any of the medical process at all. I already leaned in that direction, but now I am all the way over to not wanting any of it.

    1. That’s because most people get their opinions from Dr Oz, Dr Mercola, Dr Hyman and various others cut from the same cloth.

      And indeed, people should stay away from drs like those.

      Doctors seem a little more open-minded about this sort of thing if you take along print-outs of studies from the professional journals but I am not surprised that they throw up their hands in despair when people begin eg “Dr Mercola says …….”

  13. I want to see the charts with the Stage 0 removed and I want it done by age of the women.

    Feels like we should be able to get that.

  14. Someone on the radio was talking about how places like 23 and me are going to be allowed to tell women their risks for Cancer.

    Big brother is going to let us know our risks?

    Wondering how much of the confusion about mammogram is related to the money in the system.

    Doctors putting their heads in the sand and not wanting to do the math and being arrogant, even when wrong, because of the money?

    I have some relatives with personalities who can’t figure out things when money is involved, because part of their mathematical process is how to get more money, so they skew logic left and skew logic right and tell themselves sentences, which help them feel better about it.

  15. Prop up Mammogram and Prop up maybe a system, which doesn’t show much benefit in the area of mortality, because “Women can’t handle the truth” or “Because doctor can’t handle losing the money if they opt out” and once you are in trying to manipulate someone into doing something, because of your benefit, you can’t process information clearly.

    THAT is true politics.

  16. You can flip the coin. Instead of being a recipient or customer of an advertising campaign (mammograms), you can become the active agent and drive the boat of your actions. In order to do that, you need to use psychology and learn the advertising techniques they use. Only then you will have a chance to be free of manipulation.

  17. My concern is that articles like this and advise given by vegan doctors like McDougall are scaring people away from seeing their doctors. The thinking seems to be that a plant based diet alone is enough to cure disease like breast cancer, and that you’ll end up with unnecessary procedures that might harm or kill you. Examples of this behavior is Dr. McDougall’s decision to not go to the emergency room after fainting in his bedroom and fracturing two of his vertebrae, his hip and a spiral fracture of his upper leg bone. Why? Out of fear that they’d stent his heart before treating his fractures. His advise for breast cancer is to forget lump removal, and chemo relying exclusively on a plant based diet to cure you. The fracture nonsense was written up extensively in his May 2016 newsletter and he’s repeated his breast cancer advise for years. I’ve noticed an increasing number of this type of article over the years from vegan doctors. It’s disturbing. The smart move is to combine a plant based diet with modern medicine, not to rely on one or the other exclusively.

    1. I don’t see it that way but understand your view. Instead, instead these videos show that going the doctor for a mammogram is like taking a haunted house ride and then making an important decision but while being uninformed and unprepared.

    2. Michael Parish – I looked up the McDougall newsletter that you mentioned. Here it is in case anyone else wants to read it. https://www.drmcdougall.com/misc/2016nl/may/heartsurgeons.htm

      I think it’s important to understand why McDougall recommended no angioplasty for him and why he didn’t want to go to the hospital. If one reads his newsletter one will understand. And it isn’t because he thinks a WFPB vegan diet cures all. His reason for not wanting to go to the hospital was because he would be automatically stented because of “accepted practice”. He also knew that angioplasty could show no value as a preventative strategy (as opposed to someone who is in an acute active heart attack phase). Here is a quote from one of his references:

      “Following these consistent research findings of the failure of angioplasty to save lives, cardiologists were advised in 2007 by the American College of Cardiology and the American Heart Association to change their practice behaviors. In 2011 studies published in the Archives of Internal Medicine and the Journal of the American medical Association, however, showed that cardiologists were still doing business as usual, with no reduction in unnecessary angioplasties. In an editorial accompanying the Archives of Internal Medicine article, an expert wrote about these ghastly findings: “In addition, in a fee-for-service health system and in an environment in which more and more physicians are being compensated on the basis of relative value unit productivity, it remains to be determined whether personal financial gain might play a role in continuing old practices and in performing procedures shown to be of no benefit.”

      This, also, from the same newsletter: “This knowledge is universally accepted in the medical business. Research showing the failure of angioplasty to save lives has been extended to 15 years after treatment. Even successfully treating completely blocked coronary arteries does not save lives.”

      After reading Dr. McDougall’s newsletter I completely understood why he chose not to go to the hospital and enter into the medical system. It had mostly to do with his particular set of circumstances and he explained why. He shared his story to educate all of us. But I did not read anywhere in his article to never go. He is rightfully wary. And he was sharing with all of us that this procedure – preventative angioplasty – is an unnecessary procedure that is showing to be of no benefit – agreed to by the medical community itself. Wow!

      1. Dr. McDougall wouldn’t have been stented. The premise is nonsense. My doctors (GP who is head his department at the University of Chicago hospital and my Heart specialist at the same hospital) laughed when I told them his story and had a hard time believing an actual physician made let alone printed something like this. You can refuse any procedure. And the idea that the first thing a hospital would do is to do an angiogram when you’re coming in with broken bones is pure nonsense. Written permission from him or from his wife would have been required for any invasive procedure. I’ll give you a good guess as to why he didn’t want to go to a hospital. The one test that would have been required before treating him for broken bones would have been x-rays. And those x-ray would have pointed out how poor his bone health was. It would have spoke of terrible osteoporosis for a man of 67 at that time to have suffered so much damage by fainting in his own bedroom. Many people have access to your health records at a hospital. I’m sure he remembers well what happened when Dr. Atkins of low carb fame died and his hospital records were leaked to the public. The vegan doctors had a field day publishing how overweight he was at the time of his death. If Dr. McDougall’s records would have leaked the fact that he has terrible osteoporosis after following his own program for forty years would have ended his career and he would have suffered a crash in his income. Who is going to follow a program that can’t keep its author healthy? What Dr. McDougall does with this article is to encourage people to follow his example and not trust doctors and hospitals when you have a major medical crisis, and to sit at home instead. And his other articles are telling women not to have mammograms, not to have cancerous lumps removed because it will disfigure them, and not to have chemo or radiation because it won’t extend you life one minute is pure fear mongering. The only conclusion you can draw is that if a plant based diet won’t help your cancer nothing done by science will so just sit at home and die. I’ve been following his program for six years and reading his newsletters and watching his videos. As time has passed he has printed more and more articles encouraging his followers not to trust a profession he’s been a part of for almost fifty years. For me it’s been a disturbing trend.

        1. Michael Parish, I agree .. when the incident first happened, his explanation of events did not appear honest to me. Of course, none of us were there, so it makes no difference what our opinion is. However, I thought it very odd, since I can fall (and have.. on ice, down stairs, on trails) and barely suffer a bruise or two, and I am 66. Also, he has mentioned often in the past that if a person has an accident, acute care is what modern medical care excels at, but yet he himself avoided receiving that care.

        2. Michael Parish, Lots of people in this country have low bone density: “The 44 million people with either osteoporosis or low bone mass represent 55 percent of the people aged 50 and older in the United States” (https://www.iofbonehealth.org/facts-statistics) I’m going to guess that most of them do not eat a whole foods, plant based diet. Is that diet 100% protective or curative? Of course not. But then, neither is what most people in this country eat, apparently. However, the evidence appears to show that a whole foods, plant based diet improves your odds of avoiding many chronic illnesses and conditions, including heart disease, diabetes, and obesity. But the risk never goes to zero.

  18. Maybe, a less sinister concept.

    Maybe doctors can’t even handle the statistics.

    That means they have to say, “There is nothing I can actually do for you” and they feel powerless and discouraged watching one patient after another die?

  19. I don’t remember the names of the doctors.

    Gonzales maybe, the enzyme guy, was treating cancer patients with enzymes and he said that his friend was treating patients with Keto on the theory that he could starve it by getting rid of the sugar, but he got so discouraged that he left practice.

    Cancer doctor has to be a very high burn out rate.

    I have relatives who were psych nurses and they couldn’t handle it for more than ten years. After a certain point, they went into denial to keep their sanity and eventually left the work. I know an ex-lawyer who did the same thing.

  20. Okay, I love what you do, Dr. Greger.

    But you have still been trained as a doctor, and thus suffer from similar problems yourself. Like eschewing supplements in a world were our food is lacking in nutrients. And following the RDA in ways that simply doesn’t follow what we really know.

    Here’s a test: research the writings and history of Dr. Frederick Klenner. Some heavily suppressed breakthroughs there. Sometimes double-blind studies aren’t necessary. But they’re the medical industry’s excuse for staying away from inexpensive (and safer) cures.

    Thanks again, Dr. Greger. You’re a peach!

    1. Uncritically believing claims about alleged “inexpensive (and safer) cures” may not be the wisest course. Where’s the hard evidence for these, apart from wild claims on quack websites?

      Professor Gorski has some sober comments on Klenner’s claims and alleged cures
      https://respectfulinsolence.com/2014/09/05/high-dose-vitamin-c-can-cure-ebola-virus-disease-not-so-fast/

      As for vitamin C, it has its uses (I take a vitamin C supplement myself), and I like the Linus Pauling Institute’s assessment of the evidence on its utility
      http://lpi.oregonstate.edu/mic/vitamins/vitamin-C

  21. I have just found Nutrition Facts and Dr. Greger after doing countless hours of online research concerning the reversal of Disbetes 2 through diet, exercise, and intermittent fasting. These videos and the written information seem to be the most balanced material I have found anywhere–replete with loads of references to the “academic” literature ! I can’t believe how so many of the so-called “gurus” are so
    completely one-sided in their recommendations, esp. re nutrition : like one has to eat either completely low or non-carb, or totally non-fats, and bulk up with pastas ! And no mention of need for B-12. Duh ! So either avoid heart disease or diabetes …….take your choice !? Dr. Greger & Co seem to give excellent subtle facts and persuasive arguments for vegan/vegetarian eating. Other doc who has a pretty good take on health is Joel Furhman, M.D. , but he gives the public far less info than NF videos do ! And his diet requires a big lifetime jump to only micronutrients.

    I can’t believe what I have just read about Dr. MacDougall avoiding traditional medical help after serious orthopedic injuries ! He needs to have more trust in some aspects of “trad” medicine. Some years ago, I considered shelling out a lot of $$ for his residential program. Glad I didn’t.

    1. Hi Carolyn, I agree that I have been overwhelmed with the amount of analysis Dr. Greger is doing on some of these topics, all using studies and statistics. So many of his videos, he has spent reading exact wording from studies and I get to read it at the same time to make sure he isn’t skipping something.

      I am going to say that I have spent time on Dr. Furhman’s site and Ornish’s site and Barnard’s site and McDougall’s site and this site and they all have seriously useful information.

      I have seen testimony videos of people whose life was changed by diets from every one of those doctors. I think most of the people here like Dr. McDougall, and all of them.

      Dr. Greger gives me the studies in a way, which I can learn so much and be entertained and I like this format very, very, very much, but I clicked on the link above to one of Dr. McDougall’s patients and they were glowing with happiness and vitality, so I think he is doing something right.

      I do think it comes down to the subtleties of the programs and which suits your personality.

      I have “added in” the foods Dr. Greger talks about, but I find Barnard’s just eat anything, except animal products and don’t use oils to be my fall back, simpler thinking process than I tend to have. McDougall is helping me get past my fear of starches and carbs. I haven’t bought his cookbooks yet so I can see how he does mashed potatoes and gravy, but I will do that someday. Right now, I just had someone give me a years worth of rice, so I am learning about rice and bean dishes.

    2. If you watch enough Dr. Greger longer talks on-line, you will find out that he speaks at McDougall Conferences and the men respect each other highly.

      I don’t see any competition between the vegan doctors.

      I watched a panel where McDougall and Furhman and other doctors were “debating” which vegan diet was better and it was such a friendly debate and all of the people had good points.

      McDougall is one of the doctors doing the research and getting the message out and saving lives, so that is something to celebrate.

      Not trying to contradict you, I just feel like you might not know how many people here, including Dr. Greger like Dr. McDougall and I don’t want you to be taken by surprise.

      1. Ruth, could Dr. McDougall just have refused certain tests and procedures? I thought that patients always had to right to say ‘No.” Having suffered a few broken bones that I had medically treated, and 1 or 2 injuries that I didn’t, I now regret those for which I didn’t seek medical care — they didn’t heal well, and are now giving me grief. The other healed fractures are pretty much well behaved. (I did all physical therapy religiously)

        I know people who have refused treatment for cancer, and lived the remainder of their lives on their own terms. In most if not all cases, I think they had better lives than if they had agreed to treatment. I strongly doubt that anyone can force another person to accept medical tests or treatments, and certainly wrt CVD tests and treatments.

    1. Carolyn, I know you are new to this process, so I don’t want you to feel like I was calling you out.

      We live in a society where all these diet doctors compete to sell products. Dr. Greger and Barnard are doing non-profit. Not sure about the rest.

      Dr Esselstyn is another of the doctors who are doing Whole Food Plant Based to reverse diseases.

      I don’t feel like you have to look at it competitively. You can do Dr. Greger’s Daily 12 AND any of the others at the same time.

      You can use all of their cookbooks and all of their research and gain so much from listening to their different teachings and testimonies.

      You can start of with Dr. Fuhrman and if that is too hard, you can back up to Dr. Barnard and if that is too hard, Dr. McDougall has a few versions of his eating plan and if you need things specifically for Diabetes, you can listen to Dr. Barnard’s videos or walk through with someone like Dr. McDougall and you can use all of them and still watch Dr. Greger’s videos.

      For recipes, it might even make sense to look at all of them and Forks Over Knives would be another site.

      Don’t know if this helps or not. I just know that I am a newbie, too, but have been here for a few months.

  22. Diese Beiträge über Mammographie und Brustkrebs führen bei mir zu noch mehr Fragen zu den Grundlagen:
    Alle drei Jahre erneuert sich Dank intensiver Forschung das Wissen über die Behandlung von Brustkrebs.
    Ich denke an die Verbesserung des Überlebens von her2neu positivem Brustkrebs dank des Wirkstoffs Herceptin,
    das vor 10 Jahren eingeführt wurde. Was ist mit dem Mittel Pertuzumap, das vor 5 Jahren in Studien für her2neu positivem
    Brustkrebs in der Erstlinientherapie zugänglich gemacht wurde. Warum bilden sich diese kleinen medizinischen Revolutionen in
    der Brustkrebsbehandlung nicht in der Überlebensrate ab?

    1. Went to free internet translation site to translate this post from German to English:
      These posts on mammography and breast cancer will cause me to even more questions about the foundations: every three years to renew itself thanks to intensive research the knowledge about the treatment of breast cancer. I am thinking of the improvement in the survival of HER2positive breast cancer Herceptin, thanks to the new active substance was introduced 10 years ago. What is with the Middle Pertuzumap, the 5 years ago in studies for HER2positive breast cancer again in the first-line therapy was made available. Why are these small medical revolutions in the treatment of breast cancer is not in the survival rate?

  23. A fascinating and valuable video. Thanks, Dr. Gregor, for addressing this important topic of statistical illiteracy in the medical field

  24. Saw that there is going to be a movie with Dr. Greger and Dean Ornish, Neal Barnard, Caldwell Esselstyn, Jr., Joel Fuhrman, John McDougall & T. Colin Campbell

    Eating You Alive IN THEATERS APR 5.

    It is helping me not wanting to go back watching all the videos.

    I actually bought cook books tonight. (I had bought, How Not to Die, but immediately gave it to a friend who has health issues.)

    Tonight, I bought books for me.

  25. Actually, if you want to understand how the medical industry uses statistics, going to a standard scientific textbook won’t do the job.

    Instead, I suggest you have a look at Darrell Huff’s masterpiece, How To Lie With Statistics, which not only informs, but entertains:

    Some reviews:

    “A hilarious exploration of mathematical mendacity…. Every time you pick it up, what happens? Bang goes another illusion!”
    – The New York Times

    “In one short take after another, Huff picks apart the ways in which marketers use statistics, charts, graphics and other ways of presenting numbers to baffle and trick the public. The chapter “How to Talk Back to a Statistic” is a brilliant step-by-step guide to figuring out how someone is trying to deceive you with data.”
    – Wall Street Journal

    “Illustrator and author pool their considerable talents to provide light lively reading and cartoon far which will entertain, really inform, and take the wind out of many an overblown statistical sail.”
    – Library Journal

    “A pleasantly subversive little book, guaranteed to undermine your faith in the almighty statistic.”
    – Atlantic

    1. You can get this book as a free download – just do a google search for How To Lie With Statistics Huff pdf.

      For some reason this board won’t allow me to post the link.

    2. I would say it that is more appropriate to use “Selling with statistics” instead of “Lying with statistics.”

      Lying conveys intention (deceiving) whereas selling does not. When selling, it sounds like a customer is doing the conscious choice so it is easy to pass the radar and not sound the alarm. They both achieve the same purpose but selling is harder to prosecute. Selling is a better choice all around except if you are the customer. Think about the bottom line. If both methods provide the same result, which is is best?

  26. Perhaps NutritionFacts has addressed the issue of false negatives, which happened to me and I am not alone. This is a much more difficult issue to deal with, not only because it gives a false sense of security.

  27. I have a topic I was wondering if Doc could investigate and talk about a bit. I have been eating all plant based for probably 6 or 7 months not and like it but am always looking for ways to make it even better. I saw an interesting TedX done by Dr Eran Segal who is developing something he refers to as personalized nutrition using computational biology. He doesn’t think there is a one size fits all diet. I am pretty convinced plant based eating is an optimal option for me but I don’t think he would necessarily agree that all plant based eating is the best solution for all people. I was wondering what you thought of his theories and if any of his work could be applied to plant based eating to make it more individually tailored. Thoughts on this?

    1. There are too many “experts” to keep track of. While it’s tempting to buy into the latest expert-of-the-week that will give us good news about our bad habits, the only logical conclusion is to focus on the unbiased, peer-reviewed published clinical research. Read it yourself and come to your own conclusions. This real evidence will always override anyone’s opinions or theories. You’re playing with your life here, so it’s best to play it safe. As Dr. G says, we’re up to 4000 published studies in support of WFPB. I dare any of these talking head authorities to provide any compelling research to refute these 4000 studies. Experience, testimonials and youtube videos don’t count as evidence.

      Dr. Ben

      1. I was hoping for a bit more of a substantive response. I am in no way saying anything bad about a WFPB diet. It is the best approach. But dismissing a Tedx talk as “talking heads” before you investigate it seems a little bit closed minded. I hope others don’t view Dr Gregor that way when he does Tedx talks. That said I will investigate it more myself but I would suggest you do the same.

        1. I’m speaking in generalities, not about talk that you referenced.
          Unfortunately, we don’t have time to review them all all the opinions out there. We focus on published studies since that has a much higher probability of yielding useful information as it has already been at least partially vetted. If the speaker you’re referring to has cited published peer-reviewed research, I’d be happy to evaluate it if you post the citation here, as this has a much higher probability of representing real evidence that warrants a closer look.

          Dr. Ben

          1. Ben, Go to pubmed.gov and enter Eran Segal. He is list as co author of 146 related studies. Many are of interest in this area. One specific study is: Towards utilization of the human genome and microbiome for personalized nutrition. This is the type of thing I am referring to. Are the ways to tailor a diet to a specific individual rather than simply rely on larger populations studies that do not seem to account for how individual microbiomes etc might derail a mainstream whole food plant based diet. It seems a complex topic but probably one worth keeping an eye on.

            1. You’ll likely get a quicker response from the volunteers here if you paste a link.
              I found the paper you’re talking about. Did you see the journal? It has the word “opinion” in it. That’s a red flag. Its a very interesting concept but this is at the hypothesis stage. No actual clinical research was done in the publication of that paper. It might be true, or it might not, it needs to be “put to the test” as Dr. G says. If you can find clinical research publications, and paste links, we can point out the strength of the evidence if you’d like.

              Dr. Ben

        2. Dr. Greger has talked about gut microbiome and variety, which is one of the things, this doctor is dealing with.

          The part where he is showing individually which foods affect blood sugar is interesting.

          And it is really, really cool that they can show you your gut microbiome.

          My concern with that particular site is that he is showing one picture where meat products as an A+ and says that the recommendations they give are based on wanting enough variety in gut microbiome.

          Variety is good is what Dr. Greger has said, but variety from a wide variety of organic plant products. (Dr. Greger said that non organic plant products have different contributors to our gut microbiome, which we don’t know if those are good or bad.)

          I think my point is we want variety of the good guys only.

          We don’t want the bad guys.

          My warning flag is that the doctor is talking about variety and showing meat and isn’t talking about getting rid of the bad gut microbiome.

          His focus is on blood sugar and my friends are Keto and point blood sugar lowering, but the videos Dr. Greger showed the arteries to the heart being negatively impacted, even though the blood sugar part is “good news” and the bad gut microbiome cause Cancer would be another “oops” if you start micromanaging what you eat solely based on variety and its effect on blood sugar, without wisdom.

          If you haven’t watched the gut microbiome series on this site, do that, before using that man’s test.

          It would be cool to find out what is in your gut microbiome, but I wouldn’t trust him about what to eat.

  28. Scott, I hope you could understand my sentences. I have brain issues and I feel like I know what I want to say, but it comes out complicated.

    My advice is if you want a microbiome gut test, then cool, get one.

    But don’t let the bad bugs in for the sake of variety.

    And don’t just look at one factor like blood sugar, because even Keto can lower blood sugar and if that Doctor has a Keto mindset, he might make “variety” errors in recommendations for the diet.

    The whole diet could be riddled with wrong thinking if he doesn’t have his bearings set before analyzing data.

    I say it, because my friends are Keto and they don’t know about the gut microbiome and cancer or about the arterial flow medial dilation. (Is that the words? LOL! I am trying to reverse early onset Alzheimer’s symptoms and tonight hasn’t been as good, but I think that my thoughts about it have some sort of logic.)

  29. Scott, I was just reading reviews about all of the Microbiome companies and was reading MIT and Consumer Reports position on it and MIT and Consumer Reports said that the field isn’t ready for this type of testing yet.

    The reviews from people said that they felt fleeced by it.

    Many of them spoke of getting a list of fruits and vegetables to eat or a list of bacteria, but having no idea, which bacteria is which. Just a list of names.

    They felt like they spent a lot of money to be told to eat their vegetables, when their mothers had already told them that for years.

  30. More than that, the companies which tell you what your gut bacteria like to eat to keep your blood sugar low…. don’t take into account that you are trying to change your gut microbiome in the first place.

    One reviewer said:

    “About two months after I sent my sample, my iPhone lit up with my results in a handy app that gave me a personalized rating for most common foods, graded from A+ to C-. In my case, whole grain breads all rate C-. Slightly better are pasta and oatmeal, each ranked C+. Even “healthy” quinoa — a favorite of gluten-free diets — was a mere B-. Why? DayTwo’s algorithm can’t say precisely, but among the hundreds of thousands of gut microbe and meal combinations it was trained on, it finds that my microbiome doesn’t work well with these grains. They make my blood sugar rise too high. So what kinds of bread are good for me? How about a butter croissant (B+) or cheese ravioli (A-)? The ultimate bread winner for me: French toast with challah bread (A). I was also pleased to learn that a Starbucks double chocolate brownie is an A- for me, while a 100-calorie pack of Snyder’s of Hanover pretzels gets a C-. That might go against general diet advice, but an algorithm determined that the thousands of bacterial species inside me tend to metabolize fatty foods in a way that results in healthier blood sugar levels than what I get from high-carb foods.”

    As a dear friend of mine used to say, “Run away!”

    This company is trying to get you to feed the gut bacteria, which are there the foods they like and I am trying to starve the bad guys out.

    The reviewer, who got this food advice liked it and has not thought about the concept of CHANGING the gut microbiome and neither have any of the researchers, but I watched Dr. Greger’s videos and the fact that you CHANGE your gut microbiome, then go ahead and do the pain in the neck process of collecting the stool and other samples, but after they start telling you to eat cheese ravioli, take that advice with a grain of salt and see if you can eat the quinoa with Dr. Barnard for a while and THEN do the pain in the neck test again and better yet, test your blood sugar instead of believing your gut microbiome, because my feeling is the gut bad guys might be big fat liars when they are hungry.

  31. My thought is that you can deal with the blood sugar the way they are doing it or you can deal with it by something like Keto

    OR

    You can follow a whole food plant based program and get the fat out of your pancreas and then blood sugar won’t be a problem.

    Seems like that logic is simpler than feeling okay about eating Starbucks double chocolate brownies all the time.

  32. Honestly, I am thinking that the whole Microbiome “industry” versus the research is so far off that the implications of people changing how they eat based on how these researchers are telling people is frightening.

    You pay $100 to $200 and pick your poop out of your toilet and they do something worse than a pseudoscience based on a new science and that happens all the time, but who is getting their “wisdom”

    They are aiming this at Diabetics and Parkinson’s and Gut problem patients and they are getting them to stop eating grains and eat cheese ravioli and double chocolate brownies?

    Who plugged Starbucks double chocolate brownies in and gave it the A+ as something good to be eating?

    The thing is, I go back to the Christian concept of renewing the mind and this App is going to tell you what to eat and 65% of the people who obey authority figures are gonna start doing it and it might not occur to them that they are replacing the wisdom of everybody else and that maybe it is less costly to just do a good Diabetic diet program. Dr. Barnard has a free 21 day Jumpstart or you can get more support with the $25 version.

    Hey, you can save $200 and not mess up your mind about what foods are good for your body.

    It really is a war for your thinking and it has already been made so complicated by all of the experts out there all thinking in opposite directions and all having their own opposite wisdom.

    Scott, those Apps aren’t going to improve your way of eating, they are going to confuse you.

    (I already have a brain condition, which confuses me enough without their help.)

  33. The thing, which dismays me is that the reviewers don’t have a sophisticated enough logic process to actually analyze the gut microbiome industry.

    They do the test and are pleasantly surprised that double chocolate brownies are better for their health than pretzels and that cheese ravioli is better for their blood sugar than quinoa.

    People are going to walk around saying, “I have analyzed my gut microbiome and I can’t eat grains.” Rather than analyzing the advice of that App.

    If the reviewers aren’t capable of doing that process, how can we expect the average person to do it?

    Americans are SOOOOOOOOOOOOOOO RRRRRRRRIDICULOUSLY confused about Nutrition already and, YES, there’s an App for that.

  34. Another thing about the gut microbiome testing industry.

    Some of them compare your gut microbiome to everybody else’s gut microbiome.

    People who are peer pressure oriented are going to be trying to get the most popular gut microbiome and people who are far off from normal might get worried and try to “Fix” themselves.

    The technology has already fallen into the hands of various people with various belief systems and one literally will tell you to eat Paleo – people are getting a list like eat low carb and one has told people that cheese ravioli and French toast is better for their blood sugar than whole grain bread.

    If you haven’t waded through all the conflicting data and aren’t using those apps from a solid belief system…..

    To quote John Cougar Mellencamp’s song lyric, “If you don’t stand for something, you’re going to fall for anything.”

    And we have a society, which is going to see that you don’t have a belief system and you are going to be the one with the target on your back and people are intentionally going to steal your money while they are going to try to control your brain.

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