Welcome, guys, to episode 227 of Behind the Shield
podcast. My name's James Gearing, and I'm so
excited to bring to you this week Dr. Michael
Greger. Dr. Greger is the founder of nutritionfacts
.org. He is the author of the best -selling book,
How Not to Die. And most importantly to me, he
has put a huge amount of free content out there
to educate people on the healing and disease
-reversing properties of a plant -based diet.
So a really powerful conversation. You'll notice
it's a very short conversation compared to some
of my interviews, but I use a kind of rapid -fire
questioning to try and draw out as much as I
could, especially regarding heart disease and
cancer and some of these supposedly incurable
diseases to really illustrate how powerful a
plant -based diet can be. So as I always say
before we start the interview, please go to iTunes,
Stitcher, whichever one you use to listen to
this podcast. And just take a moment to subscribe,
leave feedback and a rating. Every rating that
we get on iTunes or in those apps make us more
visible to everyone else who's looking for this
project. And then most importantly, take your
social media, use it for good and share these
incredible podcasts. Every single one of these
men and women that's taken their time to tell
their story has so much information and content
that I know will benefit so many people that
need to hear it. So with that being said, I introduce
to you Dr. Michael Greger. Enjoy. Dr. Greger,
I want to start by saying welcome to the podcast
and thank you so much for taking the time. Happy
to help out. Let's do it. All right. So very
first question, where are we finding you on planet
Earth today? I am coming to you live from my
treadmill in Philadelphia, Pennsylvania. Excellent.
I love that. All right. So because we've got
30 minutes, I really want to kind of skip some
of the icebreakers and really get to the meat
and potatoes. But I think a great, interesting
story that really kind of starts everything is
your grandmother's illness. So if you wouldn't
mind just talking about that and how that influenced
not only her health, but then your introduction
to medicine. Sure. Straight to the kale and potatoes.
I was just a kid. when the doctor sent my grandma
home in a wheelchair to die. She was diagnosed
with end -stage heart disease, already had so
many bypass surgeries, basically run out of plumbing
at some point. So confined to a wheelchair, crushing
chest pain. Her life was over at age 65. Let's
hear about this guy, Nathan Pritikin, one of
our early lifestyle medicine pioneers. What happened
next is actually detailed in Pritikin's biography.
He talks about Francis Gregor, my grandmother.
They wheeled her in, and she walked out. She
was given a medical death sentence at age 65,
but thanks to a healthy diet, went on to live
another 31 years until age 96. Continue to enjoy
your six grandkids, including me. That's why
I went into medicine. That's why I started NutritionFacts
.org, why I wrote the book How Not to Die, why
100 % of the proceeds I get from my books are
all donated to charity. I just want to do for
everyone's family what Pritikin did for my family.
Brilliant. And that's the one point I really
want to start with as well. So you're not out
there, you know, making a fortune on all these
different DVD sets and books, kind of like this
podcast too, because I do this for free for everyone
listening as well. There's no real attachment
to any money whatsoever. I'm just a fireman trying
to be part of the solution. But I think that's
a very powerful point that you have all these
books and you're just trying to educate people.
So there is no ulterior motive that usually to
me shows someone who's driving from a very pure
place. Well, that's why all doctors should have
gone to medicine. I mean, I think generally,
you know, people go into the healthcare field.
You know, look, they wanted to just make money.
They would go to a stock market or something.
But people go into the healthcare field because
they want to take care of people. Now, often
that is kind of beaten out of them through medical
education or training. And they may end up kind
of demanding reparations and, you know, getting
their first BMW or something. But, I mean, I
think, you know, when you talk to medical students,
for example, there's a real kind of... youthful
idealism that draws people in as long as they
can hold on to that um i think they can do wonderful
things in the world absolutely now that's something
that i've seen again i'm not i'm a layman i do
have a degree in exercise physiology that's as
far as my training goes aside from being a paramedic
but all those kind of angles and views have showed
me now at age of 45 that yes the way that we
do many of our chronic disease management techniques
and the way that we're eating are categorically
hands down killing our people. So what was it
that on your road through medicine really made
you realize, apart from your grandmother's story,
of course, the sleep and the nutrition side was
going to be so much more powerful than a lot
of what the textbooks were teaching you? Well,
you know, so yeah, the reversal of our end stage
heart disease with this kind of plant based diet
and lifestyle program is really what inspired
me to go to med school. But once I got there,
I was shocked to find out this whole body of
evidence on reversing chronic disease with lifestyle
changes, you know, opening up arteries without
drugs, without surgery, was, you know, largely
ignored by mainstream medicine. So I figured,
wait, what are you saying? If the cure to a number
one killer could get lost down some rabbit hole
and ignored, you know, what else might there
be buried in the medical literature that could
help my patients? Well, I made it my life's mission
to find out. So that's what led me to start the
website. And so it's basically, I mean, so there's
basically this mountain of evidence it already
exists there's just no corporate budget driving
its promotion you know some new study on broccoli
comes out there's no press release there's no
like you know ads on tv or there's no i mean
there's just it just you know just exists and
it's just a matter of me you know digging through
the stacks and uh and you know bringing out what
we already know uh to the public right so i really
want to delve into your mind now and really explore
the world of food um so As an overall diet here
in America, in England where I'm from originally
and all the associated countries that eat the
way we do, what are the main culprits causing
the ill health in the first place? Well, so if
you look at the Goldberg Disease Study, for example,
the largest study of disease risk factors in
history funded by the Bill and Melinda Gates
Foundation, the number one – dietary cause of
death so the number one cause of death is diet
um um smoking is has been bumped to number two
uh and uh so uh so and what about our diet is
the worst well the five worst things they've
identified is number one is too much sodium uh
so i encourage people to stick to the american
heart association's recommendation of 1500 milligrams
of sodium a day which is basically eliminates
processed food from one's diet. So that's the
number one dietary risk factor for death on planet
Earth. And the other four is inadequate whole
grain consumption, inadequate vegetable consumption,
inadequate fruit consumption, and inadequate
nut and seed consumption. So it's interesting
that four out of the five is not something we
eat too much of, but actually something we're
not eating enough of, and that are these whole
plant foods. Yeah, that's an observation that
I've made is that, you know, we are overfed and
malnourished, which is a crazy contradiction
of terms. Right. I mean, so, yeah, we have a
billion people that are that are, you know, overweight.
We have a billion people who are not getting,
you know, who are food insecure. I mean, it's
really kind of a strange world we live in. But
it's a matter of, you know, I mean, but the science
is clear what we need to eat. We just need to
be able to, you know, make it happen in our day
to day lives. With the world of meat, I know
obviously now finally the processed meats are
getting some attention, all the chemicals that
are throwing in those. When it comes to the people
that advise occasional meat and it's grass -fed
and the most natural way that we can raise our
food, what is your perspective on a little meat
in a plant -based diet? Oh, well, look, it doesn't
matter what you eat on your birthdays, your holiday
special occasions. It's the day -to -day stuff
that really adds up. And on a day -to -day basis,
we really should indeed try to eat healthy. And
so, look, there are some meats that are less
harmful than others, absolutely. So there's a
famous study out of Australia, for example, found
that eating wild game, which is kangaroo in their
case, had led to significantly less bump in inflammation
compared to conventionally store -bought meat.
And so better, but certainly one could argue,
you know, why eat pro -inflammatory foods at
all? Why not eat foods that actually have an
anti -inflammatory effect like most whole plant
foods? So better, absolutely, step in the right
direction, sure. And, you know, by eating higher
quality meats, presumably they're more expensive,
so you're eating less of them. So I think that's
a real advantage. But, you know, I mean, ideally,
the more kind of whole plant foods we can stuff
into our diet, the better. Right. And then the
argument a lot of times is the evolution. We
have canines. We're omnivores. What is your view
on the diet of homo sapiens and the influence
of meat within that journey? Oh, so, yeah. So,
you know, I think it's useful to look back and
say, what is our biology designed to eat? Um,
and so, but it's interesting. So the kind of
the, the paleo diet advocates go back about 2
million years when we started into the paleolithic
period and we started using tools. Um, but you
know, we kind of split off from the last, uh,
great ape ancestor back in the Miocene era, about
20 million years ago. So for the first 90 % of
our evolution, um, before we started, you know,
we started to sharpening spears and certainly
boiling sugar cane or refining grains. um 90
of our evolution where all our digestive system
all our enzymes um put together was in the context
of even what the rest of our great ape cousins
eat which is almost exclusively plant -based
diet In fact, we even lost the ability to make
vitamin C. Most animals actually just make vitamin
C from scratch. We have the genes to do it, but
they were junked basically by our body because,
look, all we're doing is eating leaves and fruits
all day. We're getting all the vitamin C we need.
So we, guinea pigs, fruit bats, and a couple
other species just lost the ability to make vitamin
C. Why even care? Of course, now you can get
scurvy, but, you know, this was, you know, we
weren't. That was not a problem in kind of our
natural setting. So I do encourage people to
go back to our roots, no pun intended, by eating
the way our biology was designed. But instead
of just looking at the last 10%, really looking
at the foundational 90 % of our evolution, which
has really evolved around whole plant foods.
Yeah, and that makes perfect sense. I mean, if
we were hunter -gatherers, obviously the gathering
is a lot easier than the hunting. And without
weapons, if you go far enough back, we would
be pretty crap at catching fish and chasing.
most animals. Right. And it's all about, I mean,
you know, you obviously have to get more calories
in than you burn. And so, you know, that's why
we developed this taste for, you know, fat, starch,
sugar, because that's where the calories are.
Um, and of course we evolved in the context of
there wasn't enough, there weren't salt shakers
around. So we have this lust for, you know, calorie
dense foods, for sweet, starchy, fatty, salty
foods. And so what the processed food industry
has taken those natural biological, has hijacked
those natural biological drives, turned them
against us to make these hyper salty, hyper fatty,
hyper sweet foods that basically, you know, can,
can, you know, force us to just not eat one.
Um, and has led, uh, helped lead to this, you
know, epidemic. of obesity and type 2 diabetes
and something we're fighting with. A big part
of that is the industry, which has created this
kind of bliss point. where people just have these
almost like addictive relationships with some
of these processed foods. And ideally, we should
eat instead foods as grown and stay away particularly
from these ultra -processed foods. which are
very profitable but unfortunately may lead to
good shelf life but not good human life. Absolutely.
All right. Well, one area that I really want
to explore with you is cancer. As well as the
obesity, we're seeing a huge increase in what
it seems to be at least in… Cancer, not only
pediatric cancer, but obviously all the ones
in the adults, many of which through my layman
eyes appear to be also influenced through diet
and the environment. So what is your perspective
on the cancer causing agents and are they predominantly
from our diet? So, well, actually, the obesity
epidemic may indeed be part of. of the rising
cancer rates. So right now, the lifelong cancer
risk for men and women is about 40%, about a
40 % chance. And this, we're talking about invasive
cancers, about a 40 % chance any of us will get
an invasive cancer at some time of their life.
So we're not talking about something like a little
skin cancer that you just kind of cut off. And
so, and part of that... is because of the obesity
epidemic. You know, if you survey people, about
three -quarters of people are evidently unaware
of the link between obesity and cancer. But if
you look at, there's a comprehensive review of
more than a thousand studies, excess body fat
increases risk of most cancers, including esophageal
cancer, stomach cancer, colorectal cancer, liver,
gallbladder, pancreatic, breast, uterine, ovarian,
kidney, brain, thyroid, bone marrow cancer. And
so we think it's actually because of the chronic
inflammation associated with obesity or the high
insulin levels thanks to insulin resistance.
In women, it could be the excess estrogen. You
know, at menopause, you know, women's ovaries
shut down. And so fat actually takes over as
the principal site of estrogen production. That's
why obese women have about twice the estrogen
levels, you know, circulating in their bloodstream,
which may increase your risk of developing and
dying from breast cancer. And we know this is
not just kind of... We know this is cause and
effect because if you, for example, follow people
that have gotten gastric bypass surgery, for
example, you can see significant drops in cancer
risk, losing a significant amount of body weight.
So, I mean, that certainly is one way. Diet plays
into it. Alcohol certainly increases even light
drinking. For example, one, two glasses a day
of wine may increase breast cancer risk. You
know, processed meat consumption, group one carcinogens,
so bacon, ham, hot dogs, lunch meat, sausage.
We now know that we are as sure that they cause
cancer as asbestos cause cancer and cigarette
smoke and plutonium. They're group one carcinogens,
according to the IARC, the official kind of World
Health Organization body that determines what
is and is not cancer causing. And so, look, you
know, we try to not to smoke around our kids.
Why would we send them to school with a bologna
sandwich? And we know these foods cause cancer.
This is something I brought up to the Dietary
Guidelines Committee meeting a few weeks ago.
It's just outrageous that people don't know about
this. Absolutely. Now, on the flip side, so people
that have already discovered that they have cancer,
you have places where you can treat cancer purely
with nutrition in Portugal, in Mexico, and sadly,
they are always far forced outside of the UK
and the US. Have you in your career seen a great
success with people not doing chemo and radiation
but actually trying everything they can to put
their body back in homeostasis instead? Well,
I mean that's the beautiful thing about lifestyle
interventions like diet is that they can be done
in conjunction with whatever else. Your doctor
wants you to do radiation, chemotherapy, both,
surgery, anything. Whatever you and your doctor
choose. On top of that, you can also eat healthfully
to maximize your body's ability to fight off
the cancer, to withstand the... the sometimes
devastating effects of some of the treatments
that we have for it. And so it's not either or.
And, you know, depending on the cancer, one may
choose a, you know, a multiple, multi -pronged
strategy to attack it. But regardless of what
you choose, you can always eat healthier. Now,
what Ornish showed, Dr. Dean Ornish, after he
conquered our number one killer, heart disease
with his lifestyle heart trial. in 1990, he moved
on to killer number two, cancer. And he took
the same diet, this plant -based diet, and took
a group of men with early -stage prostate cancer,
randomized them, half of them to that plant -based
diet, and for the first time was able to show
in a randomized controlled trial a reversal of
the progression of cancer. The PSA levels actually
dropped compared to the control group that continued
to increase, suggesting a shrinkage of their
tumors. I mean you can take blood from – they
took blood from people eating plant -based diet
and showed that they're 70 % more better at killing
off cancer cells than a petri dish. We think
that's a down regulation of IGF -1, which is
a growth hormone, which is associated with increased
cancer growth. There's all sorts of ways in which
eating healthier can boost your body's ability
to fight off cancer, increasing the natural killer
cell activity. kind of front lines for so -called
immunosurveillance or cancer surveillance of
our immune system. There are case reports of
water -only fasting. There was a great case in
British Medical Journal case reports at True
North Clinic in California. where a woman with
stage 3 lymphoma had this remarkable reversal.
They just published their three -year update,
and she remains cancer -free. And so, I mean,
there's exciting things like that in the literature.
And, of course, after she fasted for two weeks,
they put her on a strictly no -added -salt -well
sugar plant -based diet, and she's doing remarkably
well. So, you know, these should all be. uh options
that are available to people um but if there's
good data to suggest that chemo is going to help
with your cancer radiation i would consider um
patients seriously consider it right yeah that's
the thing because from again from my perspective
like you said 40 percent of the population is
is going to get some sort of cancer and that's
directly related to you know the diet and the
other factors that you talked about and obviously
If you talk about our species, that has to be
an environmental input because we're pretty well
designed to survive. That's a horrible survival
rate when you look at it. So why not then reverse,
as you're saying? all the factors that have caused
it and see if that stops it. Adding more insult
to the immune system and destroying the body
even further to my layman brain doesn't seem
like the most intelligent way of trying to attack
something that you've done to yourself already.
Well, yeah, I mean, you know, we know that these
are environmental causes because you look around
the world and see cancer rates. There are common
cancers like breast, colon, prostate, very hundredfold
around the world. And we know that it's not just
some kind of, you know, genetic predisposition
because migration studies show that basically
your cancer risk is wherever you're living and
eating. And so, you know, Japanese men who have...
extremely low prostate cancer rates. And when
they move to California, for example, start eating
and living like California, their prostate...
uh cancer rates shoot through the roof whereas
the reverse happens in the other direction um
and uh and so and and now of course we have randomized
control trials we usually put people on their
diet and see um uh some of these improvements
and so you know that i mean when we look around
the world and say wait a second why is there
a hundredfold differences in lung cancer rates
we say wow there must be something that really
plays a role so we have control over lung cancer
if the rates were the same everywhere we'd assume
that it's just some kind of there's nothing we
can do about it but oh and then we discovered
oh tobacco smoking um is a is probably the primary
risk factor for lung cancer a number of other
cancers and similarly diet plays a major role
in many of our most common cancer right yeah
and i think that the china study and um forks
over knives and some of those you know those
documentaries and books that were delivered to
again us the layman It's kind of hard to refute
a lot of that data when you've got areas that
are, as you said, that have a very, very high
number of people in the hundreds and then all
of a sudden the lifestyle changes, food chains
come in or cigarette smoke comes in and all of
a sudden those numbers plummet then. Yeah, yeah.
And you can see within a generation. So like
you look at the Okinawa Japanese, some of the
– one of the longest living population on the
earth until we – they started opening up KFCs.
And now they're actually one of the unhealthiest
populations within Japan just because they so
westernized their diet. And so, yeah, I mean,
so it's really kind of sad what we've done. We've
kind of exported this diet and lifestyle around
the world. And now, you know, soon, I mean, the
leading cause of death are going to be these
chronic diseases, which is good in that we can
do something about them. And we can treat the
cause in reverse in many cases, but it's bad
when we're sticking with this kind of traditional
medical model. of just putting people on drugs
for the rest of their lives to treat their blood
pressure, cholesterol, when we really should
be treating the cause and eliminating the problem
in the first place. Absolutely. Now, an area
that I am convinced causes a huge amount of ill
health, mentally and physically, in first responders
is the shift work and the sleep deprivation.
So what is your view on sleep and sleep deprivation
and the causes of that in the body? Yeah, well,
I mean, you know, the biggest problem with shift
work is this, you know, you're interfering with
your circadian rhythms. There's this whole burgeoning
field of chronobiology, which suggests that even
if you get enough sleep, even without sleep deprivation,
when people do shift work, I don't call it, you
know, graveyard shift for nothing. When you do
shift work, you are at significantly increased
risk of all range of metabolic disease and a
significantly shortened lifespan. What you can
do, and part of that is actually eating. um at
night we should we really shouldn't be eating
when it's dark outside actually affects our bodies
in ways that are um that that that have all sorts
of negative effects and so we may not have control
over you know bright lights during night time
etc you know if you're working at night shift
but what we can do is try to reduce our caloric
intake um at at night and that can help um mediate
some of the damage that we get from that circadian
disruption Right. Now, speaking of the brain
itself, what about the effects of food choices
on mental health? Oh, yeah. Well, so there's
only been one diet ever been proven to actually
improve mood, for example, in a randomized controlled
trial. And that was this plant -based diet where
they took people, even kind of traditional American
diet, removed meat, including fish, as well as
eggs from their diet. So a significant improvement
in mood within just two weeks. Now, I think it's
this arachidonic acid, this long -chain inflammatory
omega -6 fatty acid found not only in chicken
and eggs, but throughout animal products. I think
it may be causing what's called neuroinflammatory
or brain inflammation but we can reduce that
inflammation with our brains in as short as two
weeks by removing you know chicken other meat
eggs from our diet and I mean that's that's we're
kind of speculating as why that's the case but
we did see that significant proven mood no other
diets been shown to do that now what that has
been done is a similar kind of study on people
with a major mental illness so these more people
with With major depression, for example, that
got better. These are people that felt okay and
then felt better after two weeks. And so that's
what these studies really need to be the next
phase. I think the only dietary studies have
on major mental illness are on anxiety disorder,
showing that, for example, for people with generalized
anxiety disorder. Giving people squash seeds
because of the high tryptophan, low protein combination
may actually improve anxiety disorder symptoms.
I have a video on that. butternut squash seeds
yeah okay and like you said earlier with the
sugar and the salt you know we really have created
this environment now where we have an emotional
attachment to our food so i think there's that
interrelation there versus you know if it was
just the clean plant base would that still be
the same would you would you You know, have a
bad day and then say, OK, I need to go eat a
zucchini now. Probably not. Right. People aren't
getting up in the middle of the night binging
on broccoli. That is very true. Right. I mean,
there's a reason, right, that people, you know,
we have these drives towards particularly these
fatty sugary combinations like, you know, chocolate
frosting, that kind of thing, where that seems
to be particularly potent. effect because out
in nature there really does there aren't natural
foods with both um with the exception of human
breast milk which may have been why we evolved
to have this real predilection for that combination
and of course the processed food industry is
more than happy to provide us with ice cream
and things like that which really tap into those
uh those kind of brain reward systems but unfortunately
at the expense of our health right so then the
last question before we go to where people can
find the websites So someone listening now, let's
say they've got type 2 diabetes, hypertension,
you know, all these diseases that we see, the
chronic diseases. They're eating the average
American diet. I know that's a broad term, but
what kind of advice would you give them to how
to begin to change their diet and what to kind
of remove initially? Oh, I mean, well, I would
tell them the tremendous good news, and that
is we have power over our health, destiny, and
longevity. The vast majority of premature death
and disability is preventable with a plant -based
diet and healthy lifestyle behaviors and high
blood pressure. And type 2 diabetes are not just
arrestable but reversible with a healthy enough
diet, and so I would encourage them. um to you
know go all in there's a wonderful program called
the 21 day kickstart program it's free uh it's
um put on by the physicians committee for responsible
medicine starts at the first of each month done
it's a bunch of different languages hundreds
of thousands of people have done it you do as
part of a social media group and you get like
daily recipes and inspiration um the hope is
you know after three weeks you'll just feel so
good that you'll have that internal motivation
to keep it up. And if you do have a chronic illness
like this, I encourage you to go get your labs
taken before and after just so you see the dramatic
difference in health indicators as well. And
so, you know, something like diabetes, number
one cause of lower limb amputations, blindness,
dialysis, kidney failure, but none of that is
inevitable. That's only if you continue to eat
the standard American diet where you'll die of
the standard American diseases. But there's no
reason to do that. And you really do have control
at the end of your fork. So that is the good
news. And if anyone's interested in learning
more, they can check out my website, nutritionfacts
.org. Brilliant. All right. And then I just want
to talk about the book as well. So the book is
called How Not to Die, which I think is one of
the best titles I've ever read. And then you
have a cookbook attached to that as well. Sure.
And then December of this year, How Not to Diet
on weight loss is coming out December 10th. Perfect.
All right. Well, I want to say thank you so much.
I mean, again, I want to underline to everyone
listening that, as you said, the proceeds go
to help the cause. You've got the websites, it's
all free information. And I think that's a big,
big thing. When people are doing this out of
the love of, you know, wanting to make change
in the world, I think that's very powerful. So
I urge everyone to go to nutritionfacts .org,
learn more. I never felt better than when I was
on the plant -based diet. I've got to be honest,
I had Rip Esselstyn on the show. He talks about
the same thing. So, you know, even if it's just
to reverse some issues for now, use that as a,
you know, as a goal. And then obviously, if you
carry it on, then even better. But yeah, I mean,
there's no question in my mind that I felt better.
And there's no question in my all the research
I've done that so many of these diseases are
reversible. And, you know, it puts the power
back in the individual instead of the industries.
Fantastic. Then our paramedics can leave more
relaxed lifestyles and get some sleep when they're
not getting calls all the time for people clutching
at their chests. Absolutely. Well, thank you
so much for taking the time and it's been a great
conversation. I really enjoyed it. Absolutely.
Thank you so much. Keep up the good work yourself.