how not to diet
The Impacts of Plant-Based Diets on Breast Cancer and Prostate Cancer
"Impacts of Plant-Based Diets
on Breast Cancer and Prostate Cancer" There appears to be
a significant protective effect of a vegetarian diet for heart disease
and all cancers combined, particularly for those eating vegan,
but that’s for total cancer. What about breast cancer
and prostate cancer specifically? There’s been about a half dozen studies
on breast cancer risk and various plant-based dietary patterns,
and they all found lower risk, as expected. In some studies, vegetarians
had less than half the odds of breast cancer
compared to nonvegetarians, suggesting vegetarian diets
show a protective role against breast cancer risk. In another study, eating
a nonvegetarian diet was one of the important risk factors, nearly tripling the odds
of breast cancer. In the California Teachers Study, a more plant-based pattern was associated
with a significant reduction in breast cancer risk as well.
So, even trending in that direction
towards a greater consumption of, for example, fruits
and vegetables is associated with a reduced
breast cancer risk, particularly for the hardest
to treat tumors, which is interesting, offering a potential
avenue for prevention. Some of the reductions in risk
were only statistically significant if you included the weight loss benefits
of plant-based eating and associated lifestyle factors
and other reductions of risk, not statistically significant regardless. Lower risk but not significant. Lower risk but not significant,
meaning like in half of these studies, the lower risk may have just been
statistical flukes by chance.
Okay, but this, for example,
was for vegetarians. Do vegan women do any better? Vegetarian diets seem to offer
protection from cancers of the gastrointestinal tract;
whereas vegan diets seem to confer lower risk of all cancers
put together and female-specific cancers,
in particular, which included breast cancer
but also included cervical, endometrial, and ovarian cancer. After a few more years, they were able
to tease out the breast cancer data, and vegans showed consistently
lower risk estimates, but not statistically significantly. So, one study in India even suggested
that vegetarians who eat eggs have lower risk
than vegetarians who don’t.
But, put all the studies on egg intake
and breast cancer together, and eating like one egg a day—
five or more eggs a week— appears to increase
breast cancer risk compared to not eating
any eggs at all. An increase of five eggs
a week was also associated with a 47 percent increase
in fatal prostate cancer. In general, if you look
at the effect of plant- and animal-based foods
on prostate cancer risk, most studies showed that plant-based
foods are associated with either decreased
or neutral risk of prostate cancer, whereas animal-based foods,
particularly dairy products, are associated with either
increased or neutral risk. The dairy and eggs may be why all
three studies on prostate cancer in vegans found decreased risk, but half of the vegetarian
studies showed no change. It’s not just about avoiding
meat, though. Vegetables and beans specifically
were also associated with lower risk, and the same
with breast cancer. High intakes of vegetables and pulses,
like beans, lentils, and chickpeas, were associated with protection
against breast cancer. We’re talking about half
the odds of breast cancer eating four or more
vegetable dishes a day or a daily serving
of beans or lentils, regardless of whether you eat meat.
Note this is one of the studies
that only showed that non-statistically significant drop
in risk among vegetarians; so, it may be better
to be a meat-eater who eats lots of greens and beans
compared to a vegetarian who instead eats lots of junk. Now, diet recommendations should go
beyond just pushing a specific array of foods and really just
promote the overall benefits of eating more
whole plant foods in general. But what happens if you do
just push more veggies? You don’t know…until
you put it to the test: "Effect of a Behavioral Intervention
to Increase Vegetable Consumption on Cancer Progression Among Men
With Early-Stage Prostate Cancer." Oh, that’s exciting, trying
increased vegetable intake to not just prevent
but treat cancer. Men with biopsy-proven prostate cancer
were randomized to an encouragement to eat seven
or more servings of vegetables a day.
Nice! And the control group
was just given some generic dietary info. And…among men with early-stage
prostate cancer under active surveillance,
a behavioral intervention that increased vegetable consumption
did not significantly reduce the risk of prostate cancer progression. Bummer. But wait a second. The trial wasn’t testing
increased vegetable consumption, but the effect of advice
to eat more vegetables. Did they actually do it? The behavioral intervention
in this study produced robust, sustained increases in
vegetable intake for two years, the researchers wrote. But alas,
it still didn’t work. At the end of those two years,
they were eating two more servings. Wait, just two, not seven? And so, the difference
between the vegetable group and the control group
was less than two servings.
They were also supposed to get at least
two servings of tomatoes a day, and two servings of broccoli-
type cruciferous vegetables every day; yet, they ended up only eating
about an ounce of cruciferous, and less than a tenth
of a serving of tomatoes. So, with so little dietary change,
it’s no wonder there was so little change
in the cancer. Though it’s possible
you also have to cut down on animal foods. In this three-month study for men
who had prostate cancer come back after surgery
and radiation, they were able to boost plant foods,
restrict animal foods, actually eat some more tomatoes. And the average PSA
doubling time (meaning how fast
the tumor was growing) slowed from about 22 months
to 59 months. So, doubling in less than two years
to then taking nearly five years.
All just from a three-
month dietary intervention, whereas the control group
didn’t change. Now, slowing down
a tumor is nice, but how about reversing its growth
or shrinking it down? Are strict vegetarians protected
against prostate cancer? Yes, those eating strictly plant-
based diets have only a fraction of the risk of getting it
in the first place, but that’s not the half of it. Yes, the Ornish study. I’ve talked about this before, notable in my How Not
to Die from Cancer video. Randomize men with prostate cancer
to a diet packed with fruits, vegetables,
whole grains, and beans and tumors on average
appeared to shrink, as noted by PSA trending down, while the control group’s cancer
continued to grow. Drip some blood from the plant-
based group on some prostate cancer growing in a petri dish,
and the plant-based blood suppressed the cancer growth
almost eight times better.
And the more
they stuck to their diet, the more their bloodstream
suppressed the cancer growth..
Video Transcript – As found on YouTube
Plant-Based Protein: Are Pea and Soy Protein Isolates Harmful?
"Plant-Based Protein: Are Pea
and Soy Protein Isolates Harmful?" So, are these plant-based
burgers healthy or not? And the answer is…
compared to what? Eating is kind of a zero-sum game;
every food has an opportunity cost. I mean, every time we
put something in our mouth it’s a lost opportunity to put
something even healthier in our mouth. So, if you want to know
if something is healthy, you have to compare it to
what you’d be eating instead. So, for example,
are eggs healthy? Compared to a breakfast
link sausage? Yes! But compared to oatmeal?
Not even close. But look, sausage is considered
a group 1 carcinogen. In other words, we know consumption
of processed meat causes cancer. Each 50-gram serving a day,
that’s a single breakfast link, was linked to an 18% higher
risk of colorectal cancer. So, the risk of getting colorectal
cancer eating one link a day is about the same as the increased
risk of lung cancer you’d get breathing secondhand smoke all
day living with a smoking spouse.
So, compared to sausage,
eggs are healthy, but compared to oatmeal,
eggs are not. So, when it comes to Beyond Meat
and Impossible Burger, yeah, they may be better in
that they have less saturated fat, but, hey, you want
less saturated fat? Plant-based meat
alternatives are no match for unprocessed plant foods,
such as beans or lentils. And a bean burrito or lentil
soup could certainly fill the same culinary niche
as a lunchtime burger. But if you are going to
have some kind of burger, it’s easy to argue that the
plant-based versions are healthier. There is a sodium issue, and
it’s not that much, if any, lower, in saturated fat, since
they use coconut oil, which is basically just
as bad as animal fat; there’s not much
advantage on that front. Though the total protein is
similar across the board, does this matter? Or Is there any
advantage to eating plant protein over animal protein?
Let’s look at the association between animal and plant
protein intake and mortality.
In the twin Harvard cohorts,
following more than 100,000 men and women over decades, “…after
adjusting for other dietary and lifestyle factors, animal
protein intake was associated with a higher risk [of] mortality,
particularly [dying from cardiovascular disease], whereas
higher plant protein intake was associated with
[a] lower all-cause mortality”, meaning a lower risk of dying
from all causes put together. So, “replacing animal protein
of various origins with plant protein was associated
with lower mortality”, especially if you’re replacing
processed meat and egg protein, which were the worst. But when
it comes to living a longer life, plant protein sources beat out
each and every animal protein source. Not just better
than bacon and eggs, but better than burgers, chicken,
turkey, fish, and dairy protein. Together with other studies, these
“findings support the importance of protein sources for the
long-term health outcome and suggest plants constitute
a preferred protein source compared [to] animal foods.” Why? Well, unlike animal protein, plant
protein has not been associated with increased levels
of the cancer-promoting growth hormone IGF-1, for example.
Now, soy protein is similar
enough to animal protein that at high enough doses, like eating
two Impossible Burgers a day, you may bump your IGF-1. But the only reason we care
about IGF-1 is cancer risk, and if anything, higher soy
intake is associated with a decreased risk of cancer. For example, a recent systematic
review and meta-analysis found that soy protein intake was
associated with a decreased risk in breast cancer mortality;
we’re talking “a 12 percent reduction in breast cancer death
[associated with] each 5-gram-a-day increase in soy protein intake.” But the high soy groups
in these studies were on the order of
more than 16 grams a day, associated with a
whopping 62% lower risk of dying from breast cancer.
More than 10 grams of soy
protein a day may be good, associated with cutting
breast cancer mortality risk nearly in half, and getting
more than 16 grams a day may be better, which is like
one Impossible Burger a day. But we simply don’t know what happens at consumption levels far above that. Plant protein has also been
linked to lower blood pressure, reduced LDL cholesterol, and
improved insulin sensitivity. No wonder “substitution of
plant protein for animal protein has been related to a lower incidence of cardiovascular disease
and type 2 diabetes.” Indeed, 21 different studies following
nearly a half million people, and “high… animal protein
intakes [were] associated with an increased risk of [type 2 diabetes], whereas [even just] moderate
plant protein intake is associated with a decreased
risk of [type 2 diabetes].” OK, but these were just
observational studies. They all tried to control for other
dietary and lifestyle factors, but you can’t prove cause-and-effect,
until…you put it to the test.
The “Effect of Replacing Animal
Protein with Plant Protein on [blood sugar] Control in
Diabetes: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.” Even just switching out about
a third of your protein from animal to plant sources
yielded significant improvements in long-term blood sugar control,
and fasting blood sugars, and insulin. You can do the same thing
looking at cholesterol.
Here’s a systematic review and
meta-analysis of randomized controlled trials on the effect
of plant protein on blood fats. And indeed, swapping in plant
protein for animal protein decreases LDL cholesterol,
and this benefit occurs whether you start out at high
cholesterol or low cholesterol, whether you’re swapping out
dairy, or meat, and eggs, and whether you’re swapping in
soy or other plant proteins. We’ve known about the beneficial
effects of soy on cholesterol going back nearly 40 years, but
other sources of plant protein can do it as well. Yeah, but
we’re not swapping beans for beef. These products are mostly
just isolated plant proteins, mostly pea protein isolate
in the case of Beyond, and concentrated soy protein
in the case of Impossible.
If you just isolate out
the plant proteins themselves are you still going to get benefits? Yes, surprisingly. Check it out. Interestingly, the researchers
concluded, that they did not find a significant difference between
protein isolate products and whole food sources, “suggesting
that the cholesterol-lowering effects are at least, in part, attributable to the plant protein
itself rather than just the associated nutrients.” So, it’s not just because
plant protein travels with fiber or less saturated fat. Plant proteins break down
into a different distribution of amino acids; and so, it’s
like if you give people arginine, an amino acid found
more in plant foods, that alone can bring
down people’s cholesterol. And even plant protein concentrates
used in these products aren’t pure protein, retaining
a few active compounds such as phytosterols and antioxidants, which also can have beneficial effects..
Video Transcript – As found on YouTube
Can Alzheimer’s Disease Be Reversed with a Plant Based Diet?
"Can Alzheimer's Disease Be Reversed
with a Plant Based Diet?" Dr. Dean Ornish was
the first to show, in a randomized
controlled trial, that a plant-based diet
and lifestyle program could apparently reverse
the progression of our number one killer,
heart disease. Opening up arteries without
drugs, without surgery. Then, he showed the same
plant-based program could potentially
reverse the course of early-stage
prostate cancer and also elongate
telomeres, suggesting an anti-
aging effect as well. But when he told me
he was going to see if he could reverse the progression
of Alzheimer's disease, I was skeptical. Surely, he was biting off a little
more than he could chew. Dementia is the most
feared condition of later life. There’s a common
misconception that we have no control over whether we
develop dementia, but the good news is that although Alzheimer’s
may be incurable, at least it is preventable. There is an emerging consensus that “what’s good for our hearts
is also good for our heads,” because clogging of the
arteries inside the brain with atherosclerotic plaque
is thought to play a role in the development of
Alzheimer’s dementia.
This is what our cerebral
arteries should look like: open, clean, and
allowing blood to flow throughout our brain. This is what atherosclerosis
in our head looks like: clogged with cholesterol,
closing off our arteries, and clamping down
on blood flow. What kind of brain arteries do
you want in your head? Too much cholesterol
in our blood is unanimously recognized
to be a risk factor for the development
of Alzheimer’s disease. Those with a total cholesterol
of 225 mg/dL or more may have nearly
25 times the odds of ending up with amyloid
plaques in their brain 10 to 15 years later. After all, what is the
Alzheimer’s gene, APOE? It codes for the major cholesterol
carrier inside the brain. This may explain the
so-called Nigerian paradox: They have among the highest
rates of the Alzheimer’s gene but some of the lowest
rates of Alzheimer’s disease. How is that possible? Genes load the gun,
but lifestyle pulls the trigger. The paradox may be explained
by their low cholesterol levels, probably due to their
diets low in animal fat. So, in terms of dietary guidelines
for the prevention of Alzheimer’s, we should center our
diets around vegetables, legumes, fruits,
and whole grains.
In other words, the dietary
pillar of lifestyle medicine: whole food,
plant-based nutrition. Or, if that’s too complicated,
"plants, plants, and more plants." That may help explain
why vegetarians may be up to three times less likely
to become demented later in life. But it’s not all-or-nothing. Even just substituting 5%
of animal protein with plant protein appears to significantly reduce
the risk of dying from dementia. But prevention isn’t sexy. When prevention works,
nothing happens, but the same diet and lifestyle
that helps prevent heart disease was proven to
help reverse it. Until then, it was believed
that heart disease progression could only be slowed,
not stopped or reversed, similar to how Alzheimer’s
disease is viewed today. So, what if you put
people with Alzheimer’s on the same plant-
based program? You don’t know until
you put it to the test. A randomized,
controlled, phase 2 clinical trial to see if the progression
of Alzheimer’s disease may be slowed, stopped,
or perhaps even reversed.
They randomized about
50 men and women diagnosed with early-
stage Alzheimer’s to either make no lifestyle
changes for 20 weeks or eat a whole food,
plant-based diet (with supplements
like vitamin B12), moderate exercise (like walking half
an hour a day), stress management (like relaxing with
breathing exercises), and getting group
support (over Zoom). They measured
standard tests of cognition and function
before and after in each group, as well as objective
experimental biomarkers of disease progression. On the Clinical Dementia
Rating Global scale, which is used to stage
the severity of dementia, the control group
continued to get worse, but the diet and lifestyle
group started to get better. People diagnosed with
Alzheimer’s getting better? The same seemed to
happen when measured with the Alzheimer’s Disease
Assessment Scale, though this did not reach
statistical significance. Using what’s called the Clinical Dementia Rating
Sum of Boxes scoring, both groups
continued to deteriorate, but the decline was significantly
less in the healthy living group. Overall, using
what’s called the Clinical Global Impression
of Change scoring, most of the people in the
control group kept getting worse and none showed any improvement,
which is what you'd expect with Alzheimer's, whereas about 40% of those
in the diet and lifestyle group appeared to be getting
better within five months of eating and
living healthier.
Why did some get
better and others not? Well, the more they complied
with the recommendations, the greater the beneficial impact
on their cognition and function. This helps to
explain why studies of less-intensive
lifestyle interventions were not sufficient to
stop disease progression, let alone actually improve
cognition and function. The biggest limitation
of the study is that, unlike drug trials where
you can give people a disguised placebo
sugar pill, when a study involves major
diet and lifestyle changes, you can’t rule out
the placebo effect, especially for self-
reported, subjective “How’s your memory been?”
type-questions. But the researchers
also measured objective investigational biomarkers
of disease progression and saw the same
trajectory— improvements in the
interventional group and worsening in
the control group, with the same apparent
dose-response effect, meaning the more they improved
their diet and lifestyle, the more dramatic the effect.
Compare that to the
latest Alzheimer’s drugs, which may not
even work at all. All you may get
for your $56,000 is a one-in-three chance of
swelling or bleeding in your brain. When the U.S. Food
and Drug Administration approved the
drug anyway, the head of the American
Geriatrics Society replied, “My head just exploded.” The bottom line is
there is only one diet that's ever been shown to help
reverse our leading cause of death, heart disease,
in the majority of patients: a plant-based diet. If that’s all a plant-
based diet could do— reverse the number one
killer of men and women, then shouldn’t that be the default
diet until proven otherwise? And the fact that it
can also be so effective in preventing, arresting,
and reversing the progression of
other leading killers, like high blood pressure,
type 2 diabetes, and now maybe even early-
stage Alzheimer’s disease would seem to make the
case for plant-based eating simply overwhelming..
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
Type 1 Diabetes Treatment: A Plant-Based Diet
"Type 1 Diabetes Treatment:
A Plant-Based Diet" The brand-new International Journal
of Disease Reversal and Prevention had its share of typical plant-
based miraculous disease reversals. After having not one but two
heart attacks within two months, a whole food, plant-based diet
and no more chest pain, controlling his cholesterol,
blood pressure, and blood sugars while losing 50 pounds as
a neat little side-bonus. Yet the numbers don’t capture the
transformation, the resurrection from feeling like a “dead man walking”
to getting his life back. I already discussed the cases of
autoimmune inflammatory disease reversal, the psoriasis, the lupus,
nephritis (kidney inflammation); and speaking of autoimmune-
diseases-we-didn’t-think- we-could-do-anything-
about, type 1 diabetes.
In contrast to type 2 diabetes,
which is a lifestyle disease that can be prevented and reversed
with a healthy enough diet and lifestyle, type 1 diabetes is an autoimmune
disease in which your body attacks your own pancreas, killing off
your insulin-producing cells condemning you to a
life of insulin injections— unless, perhaps, you
catch it early enough. Maybe if we can switch people early
enough to a healthy enough diet, we can reverse the course by
blunting that autoimmune inflammation.
Now, we know patients with type 1
may be able to reduce insulin requirements and achieve better
blood sugar control with healthier diets. For example, randomize children
and teens to a nutritional intervention in which they boost the whole
plant food density of their diet, meaning eating more whole grains,
whole fruit, vegetables, legumes (which are beans, split peas, chickpeas,
and lentils), nuts, and seeds. And the more whole plant foods,
the better the blood sugar control. The fact that more whole
fruits was associated with better blood sugar control has
important clinical implications for nutrition education in
those struggling with type 1. We should be educating them
on the benefits of fruit intake and allaying “erroneous concerns that
fruit may adversely affect blood sugar". But this case series went beyond just
proposing better control of the symptom of diabetes—high blood sugars—but
better control of the disease itself, suggesting the anti-inflammatory
effects of whole healthy plant foods may slow or prevent further destruction
of the insulin-producing cells of the pancreas, if the dietary
intervention is initiated early enough.
Where are they getting this
from? Check it out. One patient who began a vegetable-
rich diet at age three immediately following diagnosis of type 1
diabetes, but three years later still has yet to require insulin
therapy, while experiencing a steady decline in autoantibody levels,
markers of insulin cell destruction. Another child, who didn’t start
eating healthier until several months after diagnosis, maintains a
low dose of insulin with good control. And even if the insulin-producing
cells have been utterly destroyed, type 1 diabetics can still enjoy
dramatically reduced insulin requirements and reduced inflammation and
reduced cardiovascular risk, which is the #1 cause of death for
type 1 diabetics over the age of 30.
Type 1’s have 11 to 14 times the risk
of death from cardiovascular disease compared to the general population,
and it’s already the #1 killer among the public, so it’s like
11 to 14 times more important for type 1 diabetics to be on
the only diet and lifestyle program ever proven to reverse heart
disease in the majority of patients— one centered around whole plant foods. And the fact that it may also
help control the disease itself is just sugar-free icing on the cake. All this exciting new research was
just from the first issue of the journal! As a bonus there’s a companion
publication called the Disease Reversal and Prevention Digest,
a companion publication to the International Journal of
Disease Reversal and Prevention for the lay public with the
belief I wholeheartedly share that everyone has a right
to understand the science that could impact their health. And so, you can go behind the
scenes and hear directly from the author of the lupus series,
with bonus interviews from luminaries like Dean Ornish, practical
tips from dietitians on making the transition towards a healthier
diet, complete with recipes. The second issue continued
to feature practical tips like how to eat plant-based on
a budget, what Dr.
Klaper is doing to educate medical students, what
Audrey Sanchez from Balanced is doing to help change school lunches,
and if you think that’s hard, Dr. Ostfeld got healthy foods
served in a hospital. What a concept! And, what magazine would be
complete without an article to improve your sex life. Now, while the journal itself is
free, downloadable at IJDRP.org, the companion digest, available
at diseasereversaldigest.com, carries a subscription fee, but I,
for one, am a proud subscriber..
Video Transcript – As found on YouTube
Improving VO2 Max: A Look at Vegetarian and Vegan Athletes
This is the first of a three
video series about exercise. Do plant based diets have an
impact on fitness? What are the best times
to workout? Watch the series to find out. "Improving VO2 Max: A Look
at Vegetarian and Vegan Athletes" In my video about comparing vegetarian
and vegan athletic performance, endurance, and strength, I discussed
a 2020 study that found that vegan athletes—even though
they were significantly older— had significantly superior
aerobic capacity and endurance, lasting 25 percent longer on a
time-to-exhaustion cycling test.
The question is why? One potential mechanism
that could explain the greater level of endurance performance
in vegans may be a higher amount of carbohydrate intake, which could
lead to better endurance performance through higher
muscle glycogen storage. Other potential mechanisms
that may explain the better endurance performance in vegans could
be due to the anti-oxidant and anti-inflammatory
profiles of their diet. Maybe it’s even their hearts. Yet another study showing superior
VO2 max in vegan athletes, meaning superior
aerobic capacity: this time they also
did echocardiograms, looking at their hearts
in real-time using ultrasound, and the lower relative
wall thickness and better main ventricle
systolic and diastolic function in the vegans are most
likely positive findings. Now wait a second. Given
the higher VO2 max reached by the vegan athletes, maybe
they were just better trained than the nonvegan athletes,
and that’s why their hearts looked like they
were working better. However, the weekly training
frequency and running distance were similar in both groups,
suggesting benefits even with the same
amount of training. So, it’s important to educate
healthcare professionals; so they don’t try
to discourage a vegan diet and may even want to consider
telling folks implementing an exercise training
program to give it a try.
But you don’t know if it
has the same kinds of effects in nonathletes, until
you…put it to the test. A vegetarian vs. conventional
calorie-restricted diet: the effect on physical fitness
in response to aerobic exercise in patients with
type 2 diabetes. Diabetics were randomized
to the same caloric restriction, the same exercise, but just
vegetarian versus nonvegetarian. They provided all the meals
so they could ensure compliance and closely monitored
the exercising. VO2 max increased by 12 percent
in the vegetarian group, significantly better than in
the non-vegetarian group who didn’t significantly
improve at all. Maximal performance increased
by 21 percent in the vegetarian group, again, significantly better than in
the non-vegetarian group who didn’t significantly
improve at all. In other words, the results indicated
that more plant-based diets led more effectively to
improvement in physical fitness than less plant-based diets, after the same aerobic
exercise program.
Here’s what the graphs look like: significantly better power
output and aerobic capacity in the group that was randomized
to a vegetarian diet. It seems that those eating vegetarian were able to better burn off carbohydrates compared
to nonvegetarians, and had better insulin sensitivity, both markers of improved
metabolic flexibility, meaning the ability
to switch back and forth between burning sugar and fat. Besides physiological
mechanisms, there may also be
psychological factors. They observed reduced hunger
and reduced feelings of depression in the vegetarian group
which may have given them a more positive attitude
towards exercise. Here’s the psychological data. Those randomized to eat vegetarian
had a greater improvement in quality of life and mood. They felt less constrained,
meaning the calorie restriction didn’t seem as burdensome; they had less disinhibition, meaning less tendency
to binge and overeat, along with maybe
less feelings of hunger.
Not to mention the superior effects
of a vegetarian diet on body weight, glycemic control,
blood lipids, insulin sensitivity,
and oxidative stress. Wait, better body weight? I thought they were given
the same number of calories. Yes, both diets were isocaloric,
the same calories, yet just eating meat-free led
to significantly more weight loss— about six pounds more;
more waist loss, a slimmer waist; lower cholesterol, of course;
and less superficial fat, meaning the external jiggly fat; and most importantly, significantly
more visceral fat loss, the most metabolically
dangerous deep belly fat.
Same calories, yet more
loss of body fat. And not surprisingly,
better control of their diabetes. All in addition to leading
more effectively to improvements
in physical fitness..
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
How to Lower Blood Pressure Naturally with Lifestyle Changes
"How to Lower Blood Pressure
Naturally with Lifestyle Changes" Fasting has been practiced
for thousands of years, but only recently have we
started to put it to the test. I did a previous video series
about the studies on using fasting for weight loss back in the ‘70s. Was it safe? Was it effective? But what about fasting for treating
and preventing other diseases? One of the side effects noticed
in the early weight loss studies was a consistent fall in blood pressure,
so much so you typically have to stop taking blood pressure
medications while fasting or else your pressures fall too low. Once you start eating again,
your pressures go back up, but remarkably, not as high
as they were before.
But, of course, it depends on
what you start eating again. For example, a case report
of a woman who used fasting to drive her rheumatoid
arthritis into remission. Systolic blood pressure
started up around 170 despite multiple blood
pressure medications was put on a whole food plant-
based diet for eight weeks. That dropped her down
from 170 down to 130, off of all medications
before starting the fast, and then normalizing down
to 110 after the fast. But is that just because
of all the weight loss? She lost 22 pounds on the fast,
and 27 pounds on the plant-based diet. So yeah, it’s extraordinary to drop
your pressures from 170 to 110, but that was after
losing about 50 pounds. We’ve known for decades
that any kind of weight loss can lower blood pressure. Even minor weight loss can lower
blood pressures in obese persons, even if they remain
significantly overweight. But most of the drop in blood pressures
with severe caloric restriction happens within the first two days,
before significant loss of body fat; so, it may also be a reduction in
the fight-or-flight stress hormones, like adrenaline and noradrenaline
both before… and after exercise, after just two weeks of just a
few hundred calories a day.
So, that may be one reason
why a very-low-calorie diets have been found useful in
lowering blood pressures even in those for whom blood
pressure medications fail: the changes in those hormones. But, low calorie diets also
tend to be more plant-based; so, there’s fiber and potassium-
rich foods, less saturated fat. Even just adding fruits and vegetables
to the diets of hypertensives can lower their systolic blood pressure—
the top number—by 7 points. That’s the kind of blood pressure
improvement you might get losing 10 pounds, just by eating
more fruits and vegetables.
And, if you combine that with
a drop in meat consumption, not only doubling fruit and
vegetable intake but combining that with trying to slash
saturated fat and cholesterol, you can cut pressures by 11 points. What else can we do? Restricting alcohol intake in regular
daily drinkers can drop you 5 points. So, let’s keep track here:
alcohol restriction can drop your systolic
blood pressure 5 points, losing ten pounds can drop you 7,
as can just eating the recommended 8 to 10 servings of
fruits and vegetables a day. Regular aerobic exercise for
at least 3 months can drop you 9…. So, let’s add that on to the chart. Combine the fruits and
vegetables with meat reduction and you can drop it 11. Blood pressure medications
can have side effects, but on their own can
drop pressures by 15 points.
What about cutting down on salt? Note in the other diet study they
kept the sodium levels the same. Cut sodium enough and it
can edge out drugs at 16: the drugs 15, sodium restriction 16. Is that the best we can do with diet? Put people on a purely plant-based
diet, even one moderate in sodium, and you can drop
hypertensives by 18 points even after 9 out of 10 reduced
their blood pressure medications or stopped them entirely,
all within just 7 days. That’s pretty impressive. Now, what if you took that
same diet, but added fasting? 37 points! We’ll review that study
and others like it, next..
Video Transcript – As found on YouTube
Plant-Based Protein: Are Pea and Soy Protein Isolates Harmful?
"Plant-Based Protein: Are Pea
and Soy Protein Isolates Harmful?" So, are these plant-based
burgers healthy or not? And the answer is…
compared to what? Eating is kind of a zero-sum game;
every food has an opportunity cost. I mean, every time we
put something in our mouth it’s a lost opportunity to put
something even healthier in our mouth. So, if you want to know
if something is healthy, you have to compare it to
what you’d be eating instead. So, for example,
are eggs healthy? Compared to a breakfast
link sausage? Yes! But compared to oatmeal?
Not even close. But look, sausage is considered
a group 1 carcinogen. In other words, we know consumption
of processed meat causes cancer. Each 50-gram serving a day,
that’s a single breakfast link, was linked to an 18% higher
risk of colorectal cancer. So, the risk of getting colorectal
cancer eating one link a day is about the same as the increased
risk of lung cancer you’d get breathing secondhand smoke all
day living with a smoking spouse. So, compared to sausage,
eggs are healthy, but compared to oatmeal,
eggs are not.
So, when it comes to Beyond Meat
and Impossible Burger, yeah, they may be better in
that they have less saturated fat, but, hey, you want
less saturated fat? Plant-based meat
alternatives are no match for unprocessed plant foods,
such as beans or lentils. And a bean burrito or lentil
soup could certainly fill the same culinary niche
as a lunchtime burger. But if you are going to
have some kind of burger, it’s easy to argue that the
plant-based versions are healthier. There is a sodium issue, and
it’s not that much, if any, lower, in saturated fat, since
they use coconut oil, which is basically just
as bad as animal fat; there’s not much
advantage on that front.
Though the total protein is
similar across the board, does this matter? Or Is there any
advantage to eating plant protein over animal protein?
Let’s look at the association between animal and plant
protein intake and mortality. In the twin Harvard cohorts,
following more than 100,000 men and women over decades, “…after
adjusting for other dietary and lifestyle factors, animal
protein intake was associated with a higher risk [of] mortality,
particularly [dying from cardiovascular disease], whereas
higher plant protein intake was associated with
[a] lower all-cause mortality”, meaning a lower risk of dying
from all causes put together. So, “replacing animal protein
of various origins with plant protein was associated
with lower mortality”, especially if you’re replacing
processed meat and egg protein, which were the worst. But when
it comes to living a longer life, plant protein sources beat out
each and every animal protein source. Not just better
than bacon and eggs, but better than burgers, chicken,
turkey, fish, and dairy protein. Together with other studies, these
“findings support the importance of protein sources for the
long-term health outcome and suggest plants constitute
a preferred protein source compared [to] animal foods.” Why? Well, unlike animal protein, plant
protein has not been associated with increased levels
of the cancer-promoting growth hormone IGF-1, for example.
Now, soy protein is similar
enough to animal protein that at high enough doses, like eating
two Impossible Burgers a day, you may bump your IGF-1. But the only reason we care
about IGF-1 is cancer risk, and if anything, higher soy
intake is associated with a decreased risk of cancer. For example, a recent systematic
review and meta-analysis found that soy protein intake was
associated with a decreased risk in breast cancer mortality;
we’re talking “a 12 percent reduction in breast cancer death
[associated with] each 5-gram-a-day increase in soy protein intake.” But the high soy groups
in these studies were on the order of
more than 16 grams a day, associated with a
whopping 62% lower risk of dying from breast cancer. More than 10 grams of soy
protein a day may be good, associated with cutting
breast cancer mortality risk nearly in half, and getting
more than 16 grams a day may be better, which is like
one Impossible Burger a day. But we simply don’t know what happens at consumption levels far above that.
Plant protein has also been
linked to lower blood pressure, reduced LDL cholesterol, and
improved insulin sensitivity. No wonder “substitution of
plant protein for animal protein has been related to a lower incidence of cardiovascular disease
and type 2 diabetes.” Indeed, 21 different studies following
nearly a half million people, and “high… animal protein
intakes [were] associated with an increased risk of [type 2 diabetes], whereas [even just] moderate
plant protein intake is associated with a decreased
risk of [type 2 diabetes].” OK, but these were just
observational studies. They all tried to control for other
dietary and lifestyle factors, but you can’t prove cause-and-effect,
until…you put it to the test. The “Effect of Replacing Animal
Protein with Plant Protein on [blood sugar] Control in
Diabetes: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.” Even just switching out about
a third of your protein from animal to plant sources
yielded significant improvements in long-term blood sugar control,
and fasting blood sugars, and insulin. You can do the same thing
looking at cholesterol. Here’s a systematic review and
meta-analysis of randomized controlled trials on the effect
of plant protein on blood fats.
And indeed, swapping in plant
protein for animal protein decreases LDL cholesterol,
and this benefit occurs whether you start out at high
cholesterol or low cholesterol, whether you’re swapping out
dairy, or meat, and eggs, and whether you’re swapping in
soy or other plant proteins. We’ve known about the beneficial
effects of soy on cholesterol going back nearly 40 years, but
other sources of plant protein can do it as well. Yeah, but
we’re not swapping beans for beef. These products are mostly
just isolated plant proteins, mostly pea protein isolate
in the case of Beyond, and concentrated soy protein
in the case of Impossible.
If you just isolate out
the plant proteins themselves are you still going to get benefits? Yes, surprisingly. Check it out. Interestingly, the researchers
concluded, that they did not find a significant difference between
protein isolate products and whole food sources, “suggesting
that the cholesterol-lowering effects are at least, in part, attributable to the plant protein
itself rather than just the associated nutrients.” So, it’s not just because
plant protein travels with fiber or less saturated fat. Plant proteins break down
into a different distribution of amino acids; and so, it’s
like if you give people arginine, an amino acid found
more in plant foods, that alone can bring
down people’s cholesterol. And even plant protein concentrates
used in these products aren’t pure protein, retaining
a few active compounds such as phytosterols and antioxidants, which also can have beneficial effects..
Video Transcript – As found on YouTube
