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  1. 1. Recording begins Ari: Welcome to the Less Doing podcast. Today I have the pleasure, for the second time due to a technical error, of speaking with Dr. Michael Greger who is the founder of NutritionFacts.org. Hi, Dr. Greger. Dr. Greger: Hello, happy to help out. Ari: Thank you so much. First of all, I want to point out that if you can hear in the background, Dr. Greger is currently walking on a treadmill, right? Dr. Greger: Absolutely. All day, every day. Ari: So, you have a treadmill desk which I think standing at your desk is great. I think being able to walk on a treadmill at your desk is even more amazing. So how many miles do you think you are able to do each day just walking? Dr. Greger: I average about 17 miles a day at 2 ½ miles per hour. You can buy a fancy, expensive desk but I just went to a local thrift store and get a treadmill – a dime a dozen – and just stuck it under the table with some plastic shelving on top to bring up my monitor. And voila, I can actually exercise without any detriment in my workflow. Ari: I actually intended on focusing on nutrition but you bring up a really important point which I have spoken about before in my podcast and that’s, an active, is as good if not better in a lot of ways, than structured exercise. I think there's this idea that you can take no very good care of your body and go to the gym for an hour and everything is okay. But, that’s really not the case. Whereas, if you remain active and you sort of maintain this activity and you move like the body is meant to move, like running, walking, jumping, climbing, those kind of things, then you're really in a much better baseline, wouldn’t you say? Dr. Greger: Absolutely. In fact, that’s what the data clearly shows; we just weren’t meant to sit for long periods of time. The studies show an increased mortality rate, increased diabetes rate, etc...In those who have long sitting every day, this was – even after controlling [2:13] of it. so, even if people who they did after sitting all day go to the gym and work in an hour a day like [2:34] medicine recommends, they still had elevated mortality compared to those that, even that exercised less overall but just day in day out, weren’t sitting all day. We think that has to do with [2:36] activity in the muscles and the legs; we’re not quite sure. But that’s why, the kind of the standing desk, just your posture and your muscles just to keep you vertical, is actually enough to decrease some of these chronic disease risks. If you're going to be standing all day, might as well walk a little bit and burn off some energy.
  2. 2. Ari: Yeah, that’s wonderful. The flipside of that is I notice that if I do sit – and i don’t sit at my desk – but I notice that when I'm sitting for too long my leg starts to kind of shake. I have to like move that energy out of me somehow. Dr. Greger: Yeah. Your body is smart; it’s telling you what it needs and that’s great. So instead of ignoring it, we got to listen to it. Ari: Yeah, absolutely. Let’s switch gears and talk about diet now. So, tell me, in your opinion, what you think the optimal diet is? Dr. Greger: Well, I think the best available balance of it is so I suggest that a whole foods, plant based diet centered around whole plants, is the healthiest. We have about 2000 calories in the calorie bank everyday so we can pack it with junk, we can pack it calorically dense and nutrient dilute food or we can pack it in as much nutrition as possible. Like, anything you do for an hour there's an opportunity cause you choose to do something, you're choosing not to do a lot of things. So anytime you put anything in your stomach, there's an opportunity because you could be putting something else in your stomach. Just like the exercise; you can’t just keep eating crappy and then all of sudden eat a salad and think that you’ve undone the damage. We really do have to, at least on a kind of a day to day regular basis, eat as many healthy foods as possible and that will just kind of push it by adding more whole healthy plant foods to our diet, like fruits and vegetables. We just kind of push out some of the less healthy foods. Ari: So now to be clear, and I know that you have not eaten meat in you said I think 23 years, right? Dr. Greger: Yeah. As soon as Dr. G [4:56] study showing that our number one killer, heart disease, is not only preventable, not only can stop it in its tracks but actually reversible opening the arteries without surgery, without drugs; just with a healthy diet and lifestyle changes. So eating a plant based diet, subsequent research has also like [5:17] is a plant based diet, is the only diet shown to reverse heart disease in the majority people and as far as I was concerned when I read that in the Lansing’s – the most prestigious medical journal on the planet – 1990, I said well, shouldn’t that be the default diet until proven otherwise? In fact, that it also can prevent, stop, reverse diabetes and hypertension, obesity, some of the other chronic diseases, on down the list, well then was just overwhelming. As a physician, I couldn’t very well continue to be a hypocrite and not follow the recommendations that I tell my patients to follow. Ari: Well, but even on a plant based diet you still could, indulge is not the right word, but you could still partake in animal proteins, if they're high quality? Dr. Greger: Well, look, again it’s, look it doesn't matter what you do on your birthday or on a holiday or New Year’s, it’s the day to day stuff that adds up. You could smoke a cigarette on your birthday and your body heals. One of the most nomadic things I
  3. 3. learned in medical school was that in 8 years of smoking cessation, 8 years of stopping smoking, your lifelong lung cancer risk approaches that as a lifelong no smoker. Basically, it takes just 8 years – you never quite reach that level but you get very close – so that in 8 years your body and lungs can clear out all that tar and get rid of all that crap such that you're kind of almost back to where you started with. Of course, if you don’t get cancer before then. That just shows that your body wants to be healthy. Now, in fact, everyday your body wanted to be healthy but you kept pumping away and the same thing with diet. If you walk and you smack your shin against something, it hurts but it gets better. But what if you smack your shin three times a day? It would never get better. It would continue to be inflamed, it’d hurt and your body would try to heal but then you just injure it again. You go to your doctor and your doctor says, whoa, you have a swollen, painful shin; here's some painkillers. Instead of saying, maybe you should stop whacking your shin; and that’s what we do. We stab ourselves with a fork three times a day and our body just tries to heal, tries to clear out our arteries, tries to maintain homeostasis but if we keep working against it… If we eat cotton candy at a country fair every year, our pancreas might not be happy but it gets back to baseline and it can undo the damage. So again, day to day stuff that adds up, that’s what I'm really most concerned about. Not the kind of outline of foods that one might get into ones diet. Ari: So you are basically saying that meat is akin to either physically injuring yourself or sort of going against our body’s natural homeostasis, right? So, what's so bad about meat? Dr. Greger: For example, we have the sense that eating meat a couple of decades down the road might increase our risk of heart disease or something but, no. There’s internal damage that happens within hours of consumption. For example when we talked before about this endotoxemia. Basically now for about 15 years now that the average consumption meals containing animal product we get this spike of inflammation in our bloodstream. Basically, we cut our ability of our arteries to react in half within hours and then 4 or 5 or 6 hours later, there's kind of this crippling of the arteries starts to calm down but then lunchtime we whack our arteries with another load of meat and dairy. So many of us are stuck in this chronic low grade state of inflammation, increasing our risk of inflammatory diseases like heart disease and certain cancers, diabetes, one meal at a time. Same thing with our lungs. We actually get inflammation in our lungs from drinking tea, again, within hours of consumption. View these tests with arterial activity. There's saturated fats that do damage to our arteries within hours of consumption although it turns out it’s not the saturated fat we originally thought it was but these so called endotoxins, these bacterial toxins present. The endotoxin is bacterial latent that the bacterial toxins in those cell walls of these bacteria which is [10:05] with that saturated fat and cause this kind of immediate inflammation within hours of consumption. That’s just one little piece but there's all sorts of other things like oxidized
  4. 4. cholesterol and things that cannot explain why those eating plant based diets have lower rates of these chronic diseases which are laying waste to our society. Ari: Okay, that’s fair enough. I was talking with my wife about this interview because she reminded me that the way I found out about you originally was about 5 years ago when she was doing her original yoga teacher training and nutritional counseling certification and you had come into her group to speak. Believe it or not, you actually you were the emphasis for me going completely vegan for a month and then vegetarian for a significant amount of time once I started to working on healing my gut and working on anti-inflammation. However, I then did start to introduce high quality fish and eventually some meat, so am I doing myself a disturbance because I feel better than ever? Dr. Greger: The best results and relapse prevention for Crohn’s disease ever described was a somewhat vegetarian diet described in a video done in Japan. The fact that the diet was not strictly plant based could still see its remarkable. So, 2 years out but in the first year 90% still in remission, 2 years out – I forget – but still the majority; even drugs can’t typically do that. That was just a remarkable finding and all they did was put people on a somewhat vegetarian diet. I think they eat like meat once every two weeks, or something like that. But it shows, it’s not all black and white; there's a spectrum. Whether or not if they'd done better with less animal protein is an unanswered question but certainly that’s a direction one may want to go for Crohn’s disease, specifically. Ari: If it works for Crohn’s disease, it should have some sort of effects in inflammatory conditions, I would imagine, like rheumatoid arthritis and maybe some others. Dr. Greger: Yeah. I've got a lot of videos on rheumatoid arthritis; very successful in treating. In fact, a variety of plant based diets. There's been studies on raw plant food diet, raw plant based diets, even this kind of Mediterranean style more kind of plant centered but not necessarily vegetarian diet. Ari, again, some of the most successful interventions in these inflammatory arthritis. Ari: And sort of, I mean a little bit of what I'm taken from this too is that you can include some of these other things in your diet but what seems to be an issue is that a lot of people might have meat or fish at the expense of having some of those really important fruits and vegetables that they do need and those leafy greens. I mean, that’s probably fair to say. Dr. Greger: Your body, unconsciously, your body kind of knows how many calories to eat. And you say, obviously not we have an obesity epidemic. Before, daily caloric intake was all consistently in one direction, 10% every day. Just 10%. I mean like 6,000 pounds. It’s remarkable how our body can regulate caloric intake and to get it pretty close. And so, you know if you add a handful of nuts to one’s diet, for example, which are very
  5. 5. calorically dense, what we see in studies is that even given no other instructions, people don’t tend to gain weight. You say, well, wait a second. You just added over weeks, thousands of calories to people’s diet, why didn’t they gain weight? Well, it’s primarily because of the dietary compensation. Basically, nuts are so filling that they just without thinking, eat less of other foods throughout the day so that they arrive at the same kind of caloric intake by the end of the day. So you add one food to your diet, you're almost by definition, decreasing in other food so that’s why we should strive to eat the healthiest foods we can. Look, there's some fruits and vegetables that are healthier than others: berries are better than bananas, kale is better than cucumbers. It’s not just….i guess as long as you are eating plants you're okay. There's obviously a lot of plant based junk food. But even in the whole plant, they're better foods, there's less good food and we just strive to get the most nutrition we can. Ari: I think that’s a very good approach. One of the questions I have then about that is, there are some nutrients, micronutrients that are difficult or impossible to get from a plant based diet. I'm thinking of vitamin b12, vitamin d, iron so what are your ways of dealing with that? Dr. Greger: There's only two. Ari: Well, actually, iron I guess you can get from leafy greens, right? Dr. Greger: In fact, people they find that they get a lot more iron but it’s non-heme iron but non- heme iron is preferable because your body can regulate its absorption. So, whereas heme iron, the blood based iron found in animal products, can actually kind of slip through the gut wall, even if you have too much iron and some men have what's called hemochromatosis. It’s an iron overload disease so for them, in particular, heme iron is, you know… Our body, if you’re eating plant iron can say, well, nope, we’re fine on iron but unfortunately heme iron just kind of slips right through and iron is kind of double [16:03] as a pro-oxygen capacity. So, basically we want to have as low as iron storage without hurting our blood count, without becoming anemic. That’s probably actually the ideal state in terms of iron status because iron is associated with diabetes and sorts of cancers, and all sorts of things. But people eating plant based diets, vegetarians, do not have higher rates of iron deficiency anemia than meat eaters; and of course that’s not saying much. But 1 in 20 menstruating women have iron deficiency anemia which is very serious. So even though it’s not higher in vegans than it is in meat eaters, still, it’s something that needs to be treated if it’s found. It’s a wide [16:56] of women of childbearing age to include vitamin c rich foods with their meals like citrus and tropical fruit and bell peppers and broccoli, that kind of thing, to boost absorption of the iron that they do get in their diet. So, iron’s not an issue, it’s really only two things one can’t get from plants. One is vitamin d which is made by animals such as ourselves when we walk outside and get some midday sun at the right latitude. If, however, we’re stuck inside all day or we live up in Canada or for a variety of reasons you need to get vitamin
  6. 6. d, and this is for everybody regardless of what they eat, you can get it from a diet supplement center. And finally, b12; that’s not made by plants or animals either, it’s made by little microbes that blanket the earth and we probably got all the b12 we needed from drinking out of the mountain stream or well water but now we chlorinate our water supply to kill off any bacteria. We don’t get a lot of b12 in our water anymore but we don’t get a lot of cholera; that’s a good thing because of the way we live in our sanitized world need to get b12 from some place. So people eating healthy diets shouldn’t show a regular reliable source of b12 says because supplements or b12 fortified foods, probably the easiest way is one 5,000 microgram catalyst of vitamin b12 once a week can’t get too much. Costs about 5 bucks a year and you are set for vitamin b12. In fact, the video from today, October 23rd , I have just looked at I think 12,000 people, people eating meat, people not eating meat and just looking at their nutrient intake and almost to that accession, those not eating meat had higher intakes of nutrients across the board which is what you'd expect since that’s where nutrition comes from, essentially. Out of the ground. And then there's just further costs from the animals. Ari: It’s interesting to look at animals at sort of a…obviously, I think most people can agree – well, I would hope most people would agree, that avoiding processed food is a good thing and you're looking at animals as sort of another level of processing, which I think is kind of an interesting way to frame this stuff. But, that also brings up a really important point which is how can people kind of maintain the diet you're talking about without spending a lot of money? Because you're really talking about a lot of fresh foods and sort of whole foods, are basically expensive, and you're not storing them necessarily, so? Dr. Greger: Actually, the healthiest foods are some of the cheapest foods. A can of beans, for example, legumes, chick peas, lentils; these are some of the cheapest foods in the store. Sweet potato; in terms of cost per nutrition, right? Kind of bang for your buck in terms of nutrition, the healthiest foods like purple cabbage, these are the cheapest foods. Recording ends [20:00]