b12 deficiency
Update on Vegetarian Stroke Risk
"Update on Vegetarian Stroke Risk" Healthy plant-based diets
have been associated with lower all-cause mortality,
up to a 34 percent lower risk of death from any cause over an average
of an eight-year period, just being in the top
versus bottom quarter of healthy plant-based consumption. If sustained, that could translate
into more than four extra years of life. A meta-analysis of a dozen studies
prospectively following more than a half a million people
for up to 25 years similarly found significantly lower
heart disease and overall death rates among those eating more plant-based.
No surprise,
a systematic review concluded since plant-based diets
may arrest or even reverse our number one killer—
cardiovascular disease. Those eating wholly plant-based
tend to be significantly slimmer with lower LDL cholesterol, triglycerides,
blood sugars, blood pressures, significantly less inflammation,
and less carotid artery wall thickening (a sign of atherosclerosis measured
via ultrasound in the neck), as good as what you see
in endurance athletes who’ve run an average of 50,000 miles,
which is like twice around the globe. And changes in risk factors
can happen fast, as evidenced by results
from one to three-week ad libitum (eat-all-you-want)
plant-based “kickstart” programs. For example, the results from the first
few hundred participants of the at-home
15-day Jumpstart program created by the nonprofit Rochester
Lifestyle Medicine Institute were recently published. On a whole food plant-based diet,
obese patients lost an average of 7 pounds without controlling portions
or counting calories or carbs.
Diabetics saw their fasting blood sugars
drop 28 points. Those with LDL cholesterol
over 100 experienced a 33-point drop (comparable to some statin drugs), and hypertensive individuals
experienced a 17-point drop in systolic blood pressure,
which is better than drugs, and all within just two weeks! Studies dating back nearly 40 years
show those eating meat-free diets also have improved blood “rheology,”
meaning fluidity or flowability, which may play a role
in cardiovascular protection. Subsequent interventional studies putting
the cross-sectional findings to the test, show that switching people
to a plant-based diet can improve rheology measurements
within three to six weeks. But might the blood of vegetarians flow
a bit too well, though? In 2019, a study of thousands
of British vegetarians called EPIC-Oxford found that they were at higher risk
of hemorrhagic (bleeding) stroke. They had such a lower risk
of heart disease that they still had less
cardiovascular disease overall (and a half dozen studies show no overall
increased risk of stroke mortality), but why the greater stroke incidence? I suggested it might be vitamin B12
deficiency, which can lead to excessive levels
of a stroke- associated metabolite called homocysteine
which is normally detoxified by B12. This is thought to be the reason
why vitamin B12 supplementation can improve artery function
of vegetarians.
Vitamin B12 supplements
or fortified foods are critical for anyone eating plant-based,
but my 12-part video series on vegetarians and stroke risk
triggered by the 2019 publication was all in vain. It turns out vegetarians don’t appear
to have higher stroke risk after all. In response to the EPIC-Oxford results,
researchers around the world scrambled to see if the findings
were merely a fluke. In 2020, UK Biobank, a massive study
following more than 400,000 volunteers, confirmed that vegetarians
had lower cardiovascular disease rates and importantly,
no increased incidence of stroke. And two studies from Taiwan
found vegetarians had significantly
lower risk of stroke. Following tens of thousands
of vegetarians for up to ten years, they only had about half the stroke risk
compared to nonvegetarians (including a 64 percent lower risk
specifically of hemorrhagic stroke). By 2021, Harvard researchers
had finished and published their analyses of the 200,000+ participants
of the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals
Follow-Up Study. They too found no increased stroke risk
for vegetarians and indeed a decreased risk of stroke among those eating
healthy plant-based diets.
A meta-analysis putting all the studies
together found that indeed the EPIC-Oxford data appeared
to be a fluke after all, finding, if anything, a lower risk
of stroke in a subgroup analysis. A 2022 systematic review
concluded that vegetarian and low-animal product diets are associated with a significantly
lower risk of bleeding strokes, a significantly lower risk
of clotting strokes, and a significantly lower risk
of total strokes across the board..
Video Transcript – As found on YouTube
Update on Vegetarian Stroke Risk
"Update on Vegetarian Stroke Risk" Healthy plant-based diets
have been associated with lower all-cause mortality,
up to a 34 percent lower risk of death from any cause over an average
of an eight-year period, just being in the top
versus bottom quarter of healthy plant-based consumption. If sustained, that could translate
into more than four extra years of life. A meta-analysis of a dozen studies
prospectively following more than a half a million people
for up to 25 years similarly found significantly lower
heart disease and overall death rates among those eating more plant-based.
No surprise,
a systematic review concluded since plant-based diets
may arrest or even reverse our number one killer—
cardiovascular disease. Those eating wholly plant-based
tend to be significantly slimmer with lower LDL cholesterol, triglycerides,
blood sugars, blood pressures, significantly less inflammation,
and less carotid artery wall thickening (a sign of atherosclerosis measured
via ultrasound in the neck), as good as what you see
in endurance athletes who’ve run an average of 50,000 miles,
which is like twice around the globe. And changes in risk factors
can happen fast, as evidenced by results
from one to three-week ad libitum (eat-all-you-want)
plant-based “kickstart” programs.
For example, the results from the first
few hundred participants of the at-home
15-day Jumpstart program created by the nonprofit Rochester
Lifestyle Medicine Institute were recently published. On a whole food plant-based diet,
obese patients lost an average of 7 pounds without controlling portions
or counting calories or carbs. Diabetics saw their fasting blood sugars
drop 28 points. Those with LDL cholesterol
over 100 experienced a 33-point drop (comparable to some statin drugs), and hypertensive individuals
experienced a 17-point drop in systolic blood pressure,
which is better than drugs, and all within just two weeks! Studies dating back nearly 40 years
show those eating meat-free diets also have improved blood “rheology,”
meaning fluidity or flowability, which may play a role
in cardiovascular protection. Subsequent interventional studies putting
the cross-sectional findings to the test, show that switching people
to a plant-based diet can improve rheology measurements
within three to six weeks.
But might the blood of vegetarians flow
a bit too well, though? In 2019, a study of thousands
of British vegetarians called EPIC-Oxford found that they were at higher risk
of hemorrhagic (bleeding) stroke. They had such a lower risk
of heart disease that they still had less
cardiovascular disease overall (and a half dozen studies show no overall
increased risk of stroke mortality), but why the greater stroke incidence? I suggested it might be vitamin B12
deficiency, which can lead to excessive levels
of a stroke- associated metabolite called homocysteine
which is normally detoxified by B12.
This is thought to be the reason
why vitamin B12 supplementation can improve artery function
of vegetarians. Vitamin B12 supplements
or fortified foods are critical for anyone eating plant-based,
but my 12-part video series on vegetarians and stroke risk
triggered by the 2019 publication was all in vain. It turns out vegetarians don’t appear
to have higher stroke risk after all. In response to the EPIC-Oxford results,
researchers around the world scrambled to see if the findings
were merely a fluke. In 2020, UK Biobank, a massive study
following more than 400,000 volunteers, confirmed that vegetarians
had lower cardiovascular disease rates and importantly,
no increased incidence of stroke.
And two studies from Taiwan
found vegetarians had significantly
lower risk of stroke. Following tens of thousands
of vegetarians for up to ten years, they only had about half the stroke risk
compared to nonvegetarians (including a 64 percent lower risk
specifically of hemorrhagic stroke). By 2021, Harvard researchers
had finished and published their analyses of the 200,000+ participants
of the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals
Follow-Up Study. They too found no increased stroke risk
for vegetarians and indeed a decreased risk of stroke among those eating
healthy plant-based diets.
A meta-analysis putting all the studies
together found that indeed the EPIC-Oxford data appeared
to be a fluke after all, finding, if anything, a lower risk
of stroke in a subgroup analysis. A 2022 systematic review
concluded that vegetarian and low-animal product diets are associated with a significantly
lower risk of bleeding strokes, a significantly lower risk
of clotting strokes, and a significantly lower risk
of total strokes across the board..
Video Transcript – As found on YouTube
The Efficacy and Safety of Creatine for High Homocysteine
"The Efficacy and Safety of Creatine
for High Homocysteine" The average blood levels
of homocysteine in men is about one and a half points
higher than in women. Maybe that's one of the reasons
why men tend to be at higher risk for cardiovascular disease. Women don't need to make
as much creatine as men since they tend to have
less muscle mass, and that may help explain the
gender gap in homocysteine levels. If you remember from my last video,
in the process of making creatine, your body produces homocysteine
as a by-product. So maybe for people with stubbornly high homocysteine
levels that don't sufficiently respond to B vitamins, perhaps creatine
supplementation may represent a practical strategy to draw homocysteine
levels down into the normal range.
It seemed to work in rats, but in humans,
it worked in one study, this one, but didn't seem to work in another
study, this one, or this one, and in this study homocysteine
levels were even driven up. So this whole suggestion that
taking creatine supplements would lower homocysteine
was called into question. But all those studies were done
in non-vegetarians, so they were effectively already supplementing
with creatine every day in the form of muscle meat, so they were basically just testing
higher versus lower supplementation. Those eating strictly plant-based
make all their creatine from scratch, so may be more sensitive
to an added creatine source, but there were never any studies
on creatine supplementation in vegans for homocysteine
lowering until now.
They took a bunch of vegans
who were not supplementing their diets with vitamin B12,
so some of their homocysteine levels were through the roof,
a few as high as 50 when the ideal is more like under 10,
but after taking some creatine for a few weeks all of their homocysteine
levels normalized. Before… …and after. Now they didn't really normalize,
which would have been under 10, but that's presumably because
they weren't taking any B12. Give vegetarians and vegans
vitamin B12 supplements, either daily dosing or once a week,
and their levels really normalize in a matter of months, but the
fact that even without B12, that you could bring down homocysteine
levels with creatine alone suggests— to me at least—that if your homocysteine
is elevated on a plant-based diet, meaning above 10, despite
taking B12 supplements, and eating greens and beans to get
enough folate, well then it may be worth experimenting with
supplementing with a gram of creatine for a few weeks and see if your
homocysteine levels come down.
Why one gram? That's approximately
how much nonvegetarians are not having to make themselves; that's how much
erased vegetarian discrepancies in blood and muscle, and how much has
been shown to be safe in the longer-term. How safe exactly is it? Well, one
can take a bit of comfort in the fact that it's one of the world's
best-selling dietary supplements, with literally billions of servings taken,
and the only consistently reported side effect has been weight gain,
presumed to be from water retention. The only serious side effects
appear to be among those with pre-existing kidney diseases taking
whopping doses like 20 grams a day. A concern was raised that creatine
could potentially form a carcinogen, known as N-nitrososarcosine,
when it hits the acid bath of the stomach, but when actually put to the test this
does not appear to be a problem. Bottomline, doses of up 3 grams
a day are unlikely to pose any risk provided high purity creatine is used, and as we all know dietary supplements
are not regulated by the FDA and may contain contaminants or not
actually contain what's on the label, contaminants generated during
the industrial production.
When researchers looked at 33
samples of creatine supplements made in the U.S. and Europe, they all did
actually contain creatine, which is nice, but about half exceeded the
maximum level recommended by food safety authorities
for at least one contaminant. The researchers recommend that
consumers give their preference to products obtained by producers
that ensure the highest quality control. Easier said than done. Because of the potential risks
I don't think people should be taking creatine supplements willy-nilly,
but the potential benefits may exceed the potential risks, if again, you're
on a healthy plant-based diet, taking B12 and your homocysteine
levels are still not under 10, I would suggest giving a gram a day of
creatine a try to see if it brings it down.
The reason I did this whole video
series all goes back to this study, which found that although the
overall cardiovascular disease risk is lower in vegetarians
and vegans combined, they appeared to be at slightly
higher stroke risk. I went through a list of potential causes, arrived
at elevated homocysteine, and the solution? A regular,
reliable source of vitamin B12. The cheapest, easiest method
that I personally use is one 2500 mcg chewable
tablet of cyanocobalamin. In fact you can just use
2000 mcg once a week, and cyanocobalamin is the
most stable source of B12.
Take that once a week. And then as I detailed in this video,
a back-up plan for those doing that and still having elevated
homocysteine, is an empirical trial of one gram a day of
creatine supplementation, which has been shown to improve
at least capillary blood flow in those who started out with
high homocysteine levels. The bottom line is that plant-based
diets appear to markedly reduce our risk of multiple
leading killer diseases— heart disease, type 2 diabetes, and
many common types of cancer— but an increased risk of stroke
may represent an Achilles heel. Nonetheless, they have the potential to
achieve a truly exceptional health span if they face this problem forthrightly
by restricting salt intake and taking other practical measures
that promote brain artery health.
Nonetheless, these considerations
do not justify nutritional nihilism. On balance, even strictly plant-based
diets offer such versatile protection to long-term health that they
remain highly recommendable. Most likely, the optimum strategy
is to eat plant-based, along with going out of the way
to eat particularly protective foods as I talked about before,
regular aerobic exercise, and most importantly
taking your vitamin B12. Oh, and try not to huff whipped
cream charged in canister gas..
Video Transcript – As found on YouTube
Update on Vegetarian Stroke Risk
"Update on Vegetarian Stroke Risk" Healthy plant-based diets
have been associated with lower all-cause mortality,
up to a 34 percent lower risk of death from any cause over an average
of an eight-year period, just being in the top
versus bottom quarter of healthy plant-based consumption. If sustained, that could translate
into more than four extra years of life. A meta-analysis of a dozen studies
prospectively following more than a half a million people
for up to 25 years similarly found significantly lower
heart disease and overall death rates among those eating more plant-based. No surprise,
a systematic review concluded since plant-based diets
may arrest or even reverse our number one killer—
cardiovascular disease. Those eating wholly plant-based
tend to be significantly slimmer with lower LDL cholesterol, triglycerides,
blood sugars, blood pressures, significantly less inflammation,
and less carotid artery wall thickening (a sign of atherosclerosis measured
via ultrasound in the neck), as good as what you see
in endurance athletes who’ve run an average of 50,000 miles,
which is like twice around the globe. And changes in risk factors
can happen fast, as evidenced by results
from one to three-week ad libitum (eat-all-you-want)
plant-based “kickstart” programs.
For example, the results from the first
few hundred participants of the at-home
15-day Jumpstart program created by the nonprofit Rochester
Lifestyle Medicine Institute were recently published. On a whole food plant-based diet,
obese patients lost an average of 7 pounds without controlling portions
or counting calories or carbs. Diabetics saw their fasting blood sugars
drop 28 points. Those with LDL cholesterol
over 100 experienced a 33-point drop (comparable to some statin drugs), and hypertensive individuals
experienced a 17-point drop in systolic blood pressure,
which is better than drugs, and all within just two weeks! Studies dating back nearly 40 years
show those eating meat-free diets also have improved blood “rheology,”
meaning fluidity or flowability, which may play a role
in cardiovascular protection.
Subsequent interventional studies putting
the cross-sectional findings to the test, show that switching people
to a plant-based diet can improve rheology measurements
within three to six weeks. But might the blood of vegetarians flow
a bit too well, though? In 2019, a study of thousands
of British vegetarians called EPIC-Oxford found that they were at higher risk
of hemorrhagic (bleeding) stroke. They had such a lower risk
of heart disease that they still had less
cardiovascular disease overall (and a half dozen studies show no overall
increased risk of stroke mortality), but why the greater stroke incidence? I suggested it might be vitamin B12
deficiency, which can lead to excessive levels
of a stroke- associated metabolite called homocysteine
which is normally detoxified by B12.
This is thought to be the reason
why vitamin B12 supplementation can improve artery function
of vegetarians. Vitamin B12 supplements
or fortified foods are critical for anyone eating plant-based,
but my 12-part video series on vegetarians and stroke risk
triggered by the 2019 publication was all in vain. It turns out vegetarians don’t appear
to have higher stroke risk after all. In response to the EPIC-Oxford results,
researchers around the world scrambled to see if the findings
were merely a fluke. In 2020, UK Biobank, a massive study
following more than 400,000 volunteers, confirmed that vegetarians
had lower cardiovascular disease rates and importantly,
no increased incidence of stroke.
And two studies from Taiwan
found vegetarians had significantly
lower risk of stroke. Following tens of thousands
of vegetarians for up to ten years, they only had about half the stroke risk
compared to nonvegetarians (including a 64 percent lower risk
specifically of hemorrhagic stroke). By 2021, Harvard researchers
had finished and published their analyses of the 200,000+ participants
of the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals
Follow-Up Study. They too found no increased stroke risk
for vegetarians and indeed a decreased risk of stroke among those eating
healthy plant-based diets. A meta-analysis putting all the studies
together found that indeed the EPIC-Oxford data appeared
to be a fluke after all, finding, if anything, a lower risk
of stroke in a subgroup analysis. A 2022 systematic review
concluded that vegetarian and low-animal product diets are associated with a significantly
lower risk of bleeding strokes, a significantly lower risk
of clotting strokes, and a significantly lower risk
of total strokes across the board..
Video Transcript – As found on YouTube
Update on Vegetarian Stroke Risk
"Update on Vegetarian Stroke Risk" Healthy plant-based diets
have been associated with lower all-cause mortality,
up to a 34 percent lower risk of death from any cause over an average
of an eight-year period, just being in the top
versus bottom quarter of healthy plant-based consumption. If sustained, that could translate
into more than four extra years of life. A meta-analysis of a dozen studies
prospectively following more than a half a million people
for up to 25 years similarly found significantly lower
heart disease and overall death rates among those eating more plant-based. No surprise,
a systematic review concluded since plant-based diets
may arrest or even reverse our number one killer—
cardiovascular disease. Those eating wholly plant-based
tend to be significantly slimmer with lower LDL cholesterol, triglycerides,
blood sugars, blood pressures, significantly less inflammation,
and less carotid artery wall thickening (a sign of atherosclerosis measured
via ultrasound in the neck), as good as what you see
in endurance athletes who’ve run an average of 50,000 miles,
which is like twice around the globe.
And changes in risk factors
can happen fast, as evidenced by results
from one to three-week ad libitum (eat-all-you-want)
plant-based “kickstart” programs. For example, the results from the first
few hundred participants of the at-home
15-day Jumpstart program created by the nonprofit Rochester
Lifestyle Medicine Institute were recently published. On a whole food plant-based diet,
obese patients lost an average of 7 pounds without controlling portions
or counting calories or carbs. Diabetics saw their fasting blood sugars
drop 28 points. Those with LDL cholesterol
over 100 experienced a 33-point drop (comparable to some statin drugs), and hypertensive individuals
experienced a 17-point drop in systolic blood pressure,
which is better than drugs, and all within just two weeks! Studies dating back nearly 40 years
show those eating meat-free diets also have improved blood “rheology,”
meaning fluidity or flowability, which may play a role
in cardiovascular protection. Subsequent interventional studies putting
the cross-sectional findings to the test, show that switching people
to a plant-based diet can improve rheology measurements
within three to six weeks. But might the blood of vegetarians flow
a bit too well, though? In 2019, a study of thousands
of British vegetarians called EPIC-Oxford found that they were at higher risk
of hemorrhagic (bleeding) stroke.
They had such a lower risk
of heart disease that they still had less
cardiovascular disease overall (and a half dozen studies show no overall
increased risk of stroke mortality), but why the greater stroke incidence? I suggested it might be vitamin B12
deficiency, which can lead to excessive levels
of a stroke- associated metabolite called homocysteine
which is normally detoxified by B12. This is thought to be the reason
why vitamin B12 supplementation can improve artery function
of vegetarians. Vitamin B12 supplements
or fortified foods are critical for anyone eating plant-based,
but my 12-part video series on vegetarians and stroke risk
triggered by the 2019 publication was all in vain. It turns out vegetarians don’t appear
to have higher stroke risk after all.
In response to the EPIC-Oxford results,
researchers around the world scrambled to see if the findings
were merely a fluke. In 2020, UK Biobank, a massive study
following more than 400,000 volunteers, confirmed that vegetarians
had lower cardiovascular disease rates and importantly,
no increased incidence of stroke. And two studies from Taiwan
found vegetarians had significantly
lower risk of stroke. Following tens of thousands
of vegetarians for up to ten years, they only had about half the stroke risk
compared to nonvegetarians (including a 64 percent lower risk
specifically of hemorrhagic stroke). By 2021, Harvard researchers
had finished and published their analyses of the 200,000+ participants
of the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals
Follow-Up Study. They too found no increased stroke risk
for vegetarians and indeed a decreased risk of stroke among those eating
healthy plant-based diets.
A meta-analysis putting all the studies
together found that indeed the EPIC-Oxford data appeared
to be a fluke after all, finding, if anything, a lower risk
of stroke in a subgroup analysis. A 2022 systematic review
concluded that vegetarian and low-animal product diets are associated with a significantly
lower risk of bleeding strokes, a significantly lower risk
of clotting strokes, and a significantly lower risk
of total strokes across the board..
Video Transcript – As found on YouTube
Should Vegetarians Take Creatine to Normalize Homocysteine?
"Should Vegetarians Take Creatine
to Normalize Homocysteine?" Almost universally, research findings
show a poor vitamin B12 status among vegetarians because they're
not taking vitamin B12 supplements like they should. And this results in
an elevation of homocysteine levels that may explain why vegetarians
were recently found to have higher rates of stroke. Of course, plant-based eating is just
one of many ways to get B12 deficient. I mean, even laughing gas can
do it, in as short as two days, thanks to the recreational use
of whipped cream canister gas. That's something new I learned today.
Anyways, if you do eat plant-based, giving vegetarians and vegans
even as little as 50 micrograms once a day of cyanocobalamin, the
recommended, most stable form of vitamin B12 supplement,
and their homocysteine levels start up in the elevated
zone, and within 1 to 2 months their homocysteines normalize right
down into the safe zone under 10.
Or just 2000 micrograms of
cyanocobalamin once a week, and you get the same beautiful
result, but not always. In this study even 500 micrograms
a day, either as a sublingual chewable or swallowable regular B12 supplement, didn't normalize homocysteine
within a month. Now, presumably if they had kept it up, their levels
would have continued to fall like in the other study. But if you're
plant-based and have been taking your B12 and your homocysteine levels
are still too high, meaning above 10, is there anything else you can do? Now, inadequate folate intake
can also increase homocysteine, but folate comes from
the same root as foliage. It's found in leaves, concentrated
in greens, as well as beans. But if you're eating beans and
greens, taking your B12, and your homocysteine level is still
too high, then I'd suggest trying, as an experiment, taking
one gram of creatine a day and getting your homocysteine levels
retested in a month to see if it helped.
Creatine is a compound formed
naturally in the human body that is primarily involved in energy
production in our muscles and brain. It's also naturally formed in the
bodies of many animals we eat. And so when we eat their
muscles, we also can take in some creatine through our diet. We need about two grams a day,
so those who eat meat may get like one gram from their diet, and
their body makes the rest from scratch. There are rare birth defects where
you're born without the ability to make it, in which case you have to get it
from your diet, but otherwise our bodies make as
much as we need to maintain normal
concentrations in our muscles. When you cut out meat, the
amount of creatine floating around in your bloodstream goes down, but the
amount in your brain remains the same, showing dietary creatine doesn't
influence the levels of brain creatine, because your brain just makes
all the creatine you need. The level in vegetarian muscles is
lower, but that doesn't seem to affect performance, as both vegetarians
and meat-eaters respond to creatine supplementation with similar
increases in muscle power output.
And if vegetarian muscle
creatine was insufficient, then presumably they would
have seen an even bigger boost. So basically, all that happens
when you eat meat is that your body just doesn't
have to make as much. What does this all have
to do with homocysteine? Okay, in the process of making creatine,
your body produces homocysteine as a waste product. Now
normally this isn't a problem because your body
has two ways to detoxify it using vitamin B6 or using a
combination of vitamins B12 and folate. Now B6 is found in both plant and
animal foods; it's rare to be deficient. But B12 is mainly in animal
foods, and so can be too low in those eating plant-based who don't
supplement or eat B12 fortified foods. And folate is concentrated in plant
foods, so can be low in those who don't regularly eat greens or
beans or folic-acid fortified grains, and without that escape valve
homocysteine levels can get too high.
If, however, you're eating a healthy
plant-based diet and taking your B12 supplement, your homocysteine levels
should be fine, but what if they're not? One might predict that if you started
taking creatine supplements, the level of homocysteine might go
down since you're not going to have to be making so much of it from scratch,
producing homocysteine as a by-product. But you don't know until you put it
to the test, which we'll cover next.
Video Transcript – As found on YouTube
Update on Vegetarian Stroke Risk
"Update on Vegetarian Stroke Risk" Healthy plant-based diets
have been associated with lower all-cause mortality,
up to a 34 percent lower risk of death from any cause over an average
of an eight-year period, just being in the top
versus bottom quarter of healthy plant-based consumption. If sustained, that could translate
into more than four extra years of life. A meta-analysis of a dozen studies
prospectively following more than a half a million people
for up to 25 years similarly found significantly lower
heart disease and overall death rates among those eating more plant-based. No surprise,
a systematic review concluded since plant-based diets
may arrest or even reverse our number one killer—
cardiovascular disease. Those eating wholly plant-based
tend to be significantly slimmer with lower LDL cholesterol, triglycerides,
blood sugars, blood pressures, significantly less inflammation,
and less carotid artery wall thickening (a sign of atherosclerosis measured
via ultrasound in the neck), as good as what you see
in endurance athletes who’ve run an average of 50,000 miles,
which is like twice around the globe.
And changes in risk factors
can happen fast, as evidenced by results
from one to three-week ad libitum (eat-all-you-want)
plant-based “kickstart” programs. For example, the results from the first
few hundred participants of the at-home
15-day Jumpstart program created by the nonprofit Rochester
Lifestyle Medicine Institute were recently published. On a whole food plant-based diet,
obese patients lost an average of 7 pounds without controlling portions
or counting calories or carbs. Diabetics saw their fasting blood sugars
drop 28 points. Those with LDL cholesterol
over 100 experienced a 33-point drop (comparable to some statin drugs), and hypertensive individuals
experienced a 17-point drop in systolic blood pressure,
which is better than drugs, and all within just two weeks! Studies dating back nearly 40 years
show those eating meat-free diets also have improved blood “rheology,”
meaning fluidity or flowability, which may play a role
in cardiovascular protection. Subsequent interventional studies putting
the cross-sectional findings to the test, show that switching people
to a plant-based diet can improve rheology measurements
within three to six weeks.
But might the blood of vegetarians flow
a bit too well, though? In 2019, a study of thousands
of British vegetarians called EPIC-Oxford found that they were at higher risk
of hemorrhagic (bleeding) stroke. They had such a lower risk
of heart disease that they still had less
cardiovascular disease overall (and a half dozen studies show no overall
increased risk of stroke mortality), but why the greater stroke incidence? I suggested it might be vitamin B12
deficiency, which can lead to excessive levels
of a stroke- associated metabolite called homocysteine
which is normally detoxified by B12. This is thought to be the reason
why vitamin B12 supplementation can improve artery function
of vegetarians. Vitamin B12 supplements
or fortified foods are critical for anyone eating plant-based,
but my 12-part video series on vegetarians and stroke risk
triggered by the 2019 publication was all in vain.
It turns out vegetarians don’t appear
to have higher stroke risk after all. In response to the EPIC-Oxford results,
researchers around the world scrambled to see if the findings
were merely a fluke. In 2020, UK Biobank, a massive study
following more than 400,000 volunteers, confirmed that vegetarians
had lower cardiovascular disease rates and importantly,
no increased incidence of stroke. And two studies from Taiwan
found vegetarians had significantly
lower risk of stroke. Following tens of thousands
of vegetarians for up to ten years, they only had about half the stroke risk
compared to nonvegetarians (including a 64 percent lower risk
specifically of hemorrhagic stroke). By 2021, Harvard researchers
had finished and published their analyses of the 200,000+ participants
of the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals
Follow-Up Study. They too found no increased stroke risk
for vegetarians and indeed a decreased risk of stroke among those eating
healthy plant-based diets.
A meta-analysis putting all the studies
together found that indeed the EPIC-Oxford data appeared
to be a fluke after all, finding, if anything, a lower risk
of stroke in a subgroup analysis. A 2022 systematic review
concluded that vegetarian and low-animal product diets are associated with a significantly
lower risk of bleeding strokes, a significantly lower risk
of clotting strokes, and a significantly lower risk
of total strokes across the board..
Video Transcript – As found on YouTube
Update on Vegetarian Stroke Risk
"Update on Vegetarian Stroke Risk" Healthy plant-based diets
have been associated with lower all-cause mortality,
up to a 34 percent lower risk of death from any cause over an average
of an eight-year period, just being in the top
versus bottom quarter of healthy plant-based consumption. If sustained, that could translate
into more than four extra years of life. A meta-analysis of a dozen studies
prospectively following more than a half a million people
for up to 25 years similarly found significantly lower
heart disease and overall death rates among those eating more plant-based. No surprise,
a systematic review concluded since plant-based diets
may arrest or even reverse our number one killer—
cardiovascular disease. Those eating wholly plant-based
tend to be significantly slimmer with lower LDL cholesterol, triglycerides,
blood sugars, blood pressures, significantly less inflammation,
and less carotid artery wall thickening (a sign of atherosclerosis measured
via ultrasound in the neck), as good as what you see
in endurance athletes who’ve run an average of 50,000 miles,
which is like twice around the globe. And changes in risk factors
can happen fast, as evidenced by results
from one to three-week ad libitum (eat-all-you-want)
plant-based “kickstart” programs.
For example, the results from the first
few hundred participants of the at-home
15-day Jumpstart program created by the nonprofit Rochester
Lifestyle Medicine Institute were recently published. On a whole food plant-based diet,
obese patients lost an average of 7 pounds without controlling portions
or counting calories or carbs. Diabetics saw their fasting blood sugars
drop 28 points. Those with LDL cholesterol
over 100 experienced a 33-point drop (comparable to some statin drugs), and hypertensive individuals
experienced a 17-point drop in systolic blood pressure,
which is better than drugs, and all within just two weeks! Studies dating back nearly 40 years
show those eating meat-free diets also have improved blood “rheology,”
meaning fluidity or flowability, which may play a role
in cardiovascular protection. Subsequent interventional studies putting
the cross-sectional findings to the test, show that switching people
to a plant-based diet can improve rheology measurements
within three to six weeks. But might the blood of vegetarians flow
a bit too well, though? In 2019, a study of thousands
of British vegetarians called EPIC-Oxford found that they were at higher risk
of hemorrhagic (bleeding) stroke.
They had such a lower risk
of heart disease that they still had less
cardiovascular disease overall (and a half dozen studies show no overall
increased risk of stroke mortality), but why the greater stroke incidence? I suggested it might be vitamin B12
deficiency, which can lead to excessive levels
of a stroke- associated metabolite called homocysteine
which is normally detoxified by B12. This is thought to be the reason
why vitamin B12 supplementation can improve artery function
of vegetarians.
Vitamin B12 supplements
or fortified foods are critical for anyone eating plant-based,
but my 12-part video series on vegetarians and stroke risk
triggered by the 2019 publication was all in vain. It turns out vegetarians don’t appear
to have higher stroke risk after all. In response to the EPIC-Oxford results,
researchers around the world scrambled to see if the findings
were merely a fluke. In 2020, UK Biobank, a massive study
following more than 400,000 volunteers, confirmed that vegetarians
had lower cardiovascular disease rates and importantly,
no increased incidence of stroke. And two studies from Taiwan
found vegetarians had significantly
lower risk of stroke. Following tens of thousands
of vegetarians for up to ten years, they only had about half the stroke risk
compared to nonvegetarians (including a 64 percent lower risk
specifically of hemorrhagic stroke).
By 2021, Harvard researchers
had finished and published their analyses of the 200,000+ participants
of the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals
Follow-Up Study. They too found no increased stroke risk
for vegetarians and indeed a decreased risk of stroke among those eating
healthy plant-based diets. A meta-analysis putting all the studies
together found that indeed the EPIC-Oxford data appeared
to be a fluke after all, finding, if anything, a lower risk
of stroke in a subgroup analysis. A 2022 systematic review
concluded that vegetarian and low-animal product diets are associated with a significantly
lower risk of bleeding strokes, a significantly lower risk
of clotting strokes, and a significantly lower risk
of total strokes across the board..
Video Transcript – As found on YouTube
Should Vegetarians Take Creatine to Normalize Homocysteine?
"Should Vegetarians Take Creatine
to Normalize Homocysteine?" Almost universally, research findings
show a poor vitamin B12 status among vegetarians because they're
not taking vitamin B12 supplements like they should. And this results in
an elevation of homocysteine levels that may explain why vegetarians
were recently found to have higher rates of stroke. Of course, plant-based eating is just
one of many ways to get B12 deficient. I mean, even laughing gas can
do it, in as short as two days, thanks to the recreational use
of whipped cream canister gas.
That's something new I learned today.
Anyways, if you do eat plant-based, giving vegetarians and vegans
even as little as 50 micrograms once a day of cyanocobalamin, the
recommended, most stable form of vitamin B12 supplement,
and their homocysteine levels start up in the elevated
zone, and within 1 to 2 months their homocysteines normalize right
down into the safe zone under 10. Or just 2000 micrograms of
cyanocobalamin once a week, and you get the same beautiful
result, but not always. In this study even 500 micrograms
a day, either as a sublingual chewable or swallowable regular B12 supplement, didn't normalize homocysteine
within a month. Now, presumably if they had kept it up, their levels
would have continued to fall like in the other study. But if you're
plant-based and have been taking your B12 and your homocysteine levels
are still too high, meaning above 10, is there anything else you can do? Now, inadequate folate intake
can also increase homocysteine, but folate comes from
the same root as foliage.
It's found in leaves, concentrated
in greens, as well as beans. But if you're eating beans and
greens, taking your B12, and your homocysteine level is still
too high, then I'd suggest trying, as an experiment, taking
one gram of creatine a day and getting your homocysteine levels
retested in a month to see if it helped. Creatine is a compound formed
naturally in the human body that is primarily involved in energy
production in our muscles and brain. It's also naturally formed in the
bodies of many animals we eat. And so when we eat their
muscles, we also can take in some creatine through our diet. We need about two grams a day,
so those who eat meat may get like one gram from their diet, and
their body makes the rest from scratch. There are rare birth defects where
you're born without the ability to make it, in which case you have to get it
from your diet, but otherwise our bodies make as
much as we need to maintain normal
concentrations in our muscles. When you cut out meat, the
amount of creatine floating around in your bloodstream goes down, but the
amount in your brain remains the same, showing dietary creatine doesn't
influence the levels of brain creatine, because your brain just makes
all the creatine you need.
The level in vegetarian muscles is
lower, but that doesn't seem to affect performance, as both vegetarians
and meat-eaters respond to creatine supplementation with similar
increases in muscle power output. And if vegetarian muscle
creatine was insufficient, then presumably they would
have seen an even bigger boost. So basically, all that happens
when you eat meat is that your body just doesn't
have to make as much. What does this all have
to do with homocysteine? Okay, in the process of making creatine,
your body produces homocysteine as a waste product. Now
normally this isn't a problem because your body
has two ways to detoxify it using vitamin B6 or using a
combination of vitamins B12 and folate. Now B6 is found in both plant and
animal foods; it's rare to be deficient. But B12 is mainly in animal
foods, and so can be too low in those eating plant-based who don't
supplement or eat B12 fortified foods.
And folate is concentrated in plant
foods, so can be low in those who don't regularly eat greens or
beans or folic-acid fortified grains, and without that escape valve
homocysteine levels can get too high. If, however, you're eating a healthy
plant-based diet and taking your B12 supplement, your homocysteine levels
should be fine, but what if they're not? One might predict that if you started
taking creatine supplements, the level of homocysteine might go
down since you're not going to have to be making so much of it from scratch,
producing homocysteine as a by-product.
But you don't know until you put it
to the test, which we'll cover next..
Video Transcript – As found on YouTube
Update on Vegetarian Stroke Risk
"Update on Vegetarian Stroke Risk" Healthy plant-based diets
have been associated with lower all-cause mortality,
up to a 34 percent lower risk of death from any cause over an average
of an eight-year period, just being in the top
versus bottom quarter of healthy plant-based consumption. If sustained, that could translate
into more than four extra years of life. A meta-analysis of a dozen studies
prospectively following more than a half a million people
for up to 25 years similarly found significantly lower
heart disease and overall death rates among those eating more plant-based.
No surprise,
a systematic review concluded since plant-based diets
may arrest or even reverse our number one killer—
cardiovascular disease. Those eating wholly plant-based
tend to be significantly slimmer with lower LDL cholesterol, triglycerides,
blood sugars, blood pressures, significantly less inflammation,
and less carotid artery wall thickening (a sign of atherosclerosis measured
via ultrasound in the neck), as good as what you see
in endurance athletes who’ve run an average of 50,000 miles,
which is like twice around the globe. And changes in risk factors
can happen fast, as evidenced by results
from one to three-week ad libitum (eat-all-you-want)
plant-based “kickstart” programs. For example, the results from the first
few hundred participants of the at-home
15-day Jumpstart program created by the nonprofit Rochester
Lifestyle Medicine Institute were recently published.
On a whole food plant-based diet,
obese patients lost an average of 7 pounds without controlling portions
or counting calories or carbs. Diabetics saw their fasting blood sugars
drop 28 points. Those with LDL cholesterol
over 100 experienced a 33-point drop (comparable to some statin drugs), and hypertensive individuals
experienced a 17-point drop in systolic blood pressure,
which is better than drugs, and all within just two weeks! Studies dating back nearly 40 years
show those eating meat-free diets also have improved blood “rheology,”
meaning fluidity or flowability, which may play a role
in cardiovascular protection.
Subsequent interventional studies putting
the cross-sectional findings to the test, show that switching people
to a plant-based diet can improve rheology measurements
within three to six weeks. But might the blood of vegetarians flow
a bit too well, though? In 2019, a study of thousands
of British vegetarians called EPIC-Oxford found that they were at higher risk
of hemorrhagic (bleeding) stroke. They had such a lower risk
of heart disease that they still had less
cardiovascular disease overall (and a half dozen studies show no overall
increased risk of stroke mortality), but why the greater stroke incidence? I suggested it might be vitamin B12
deficiency, which can lead to excessive levels
of a stroke- associated metabolite called homocysteine
which is normally detoxified by B12. This is thought to be the reason
why vitamin B12 supplementation can improve artery function
of vegetarians. Vitamin B12 supplements
or fortified foods are critical for anyone eating plant-based,
but my 12-part video series on vegetarians and stroke risk
triggered by the 2019 publication was all in vain.
It turns out vegetarians don’t appear
to have higher stroke risk after all. In response to the EPIC-Oxford results,
researchers around the world scrambled to see if the findings
were merely a fluke. In 2020, UK Biobank, a massive study
following more than 400,000 volunteers, confirmed that vegetarians
had lower cardiovascular disease rates and importantly,
no increased incidence of stroke. And two studies from Taiwan
found vegetarians had significantly
lower risk of stroke. Following tens of thousands
of vegetarians for up to ten years, they only had about half the stroke risk
compared to nonvegetarians (including a 64 percent lower risk
specifically of hemorrhagic stroke). By 2021, Harvard researchers
had finished and published their analyses of the 200,000+ participants
of the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals
Follow-Up Study. They too found no increased stroke risk
for vegetarians and indeed a decreased risk of stroke among those eating
healthy plant-based diets.
A meta-analysis putting all the studies
together found that indeed the EPIC-Oxford data appeared
to be a fluke after all, finding, if anything, a lower risk
of stroke in a subgroup analysis. A 2022 systematic review
concluded that vegetarian and low-animal product diets are associated with a significantly
lower risk of bleeding strokes, a significantly lower risk
of clotting strokes, and a significantly lower risk
of total strokes across the board..
Video Transcript – As found on YouTube
