[First, Dr. McDougall's introduction of Dr. Greger. Captions of Dr. Greger's talk start shortly.]
All right, welcome back.
We have what I consider the McDougall team, which is a group of associates,
actually friends that I've had for 20, 30 years.
And our next presenter
is one of those men who's worked with us, worked in conjunction
with the things that we've done, supported each other, had similar crowds.
And one thing really distinct about our next presenter is his ability to communicate.
I understand—I was just shocked that he's given over a thousand lectures,
and sometimes he's given four lectures a day— amazing, what a dedicated person.
So he also finally came out with his first book.
It's "How Not to Die"— what a title—
and it has put him on the New York Times Best Selling list for the last seven weeks.
So because of our long-time friendship and my great respect for him,
he's been a speaker for at least one presentation every year
for who knows how far back it goes,
and I know you're going to enjoy Dr. Michael Greger.
"How Not To Die:
The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers"
I have taken so many great ideas from Dr. John McDougall
that it's only fair that he take my beard.
Allow me to begin on a personal note.
This is a picture of me,
right around the time that my grandma was diagnosed with end-stage heart disease
and sent home to die.
She had already had so many bypass operations—
basically run out of plumbing at some point—
confined to a wheelchair, crushing chest pain.
Nothing more they could do.
Her life was over at age 65.
But then she heard about this guy, Nathan Pritikin,
one of our early lifestyle medicine pioneers.
And what happened next is chronicled in Pritikin's biography.
My grandma was one of the "death's door" people.
Frances Greger arrived in one of Pritikin's early sessions
in a wheelchair.
"Mrs. Greger had heart disease, angina, claudication;
her condition was so bad she could no longer walk
without great pain in her chest and legs.
Within three weeks though, she was not only out of her wheelchair
but was walking ten miles a day."
This is my grandma at her grandson's wedding
15 years after she was given her medical death sentence,
and thanks to a healthy diet, she was able to live another 31 years
on this earth until 96, to enjoy her six grandkids, including me.
That is why I went into medicine.
When Dr. Ornish published his Lifestyle Heart trial years later,
proving with quantitative angiography
that coronary heart disease could be reversed—
arteries opened up without drugs, without surgery, just a plant-based diet
and other healthy lifestyle changes, I assumed it was going to be the game changer.
I mean, my family had seen it with their own eyes,
but here it was in black and white,
in some of the most prestigious medical journals on the planet.
But nothing happened, leaving me to wonder if effectively
the cure to our number 1 killer could get lost down some rabbit hole and ignored,
what else was there in the medical literature that could help my patients?
I've made it my life's mission to find out.
For those of you unfamiliar with my work, every year I read through every issue
of every English-language nutrition journal in the world,
so busy folks like you don't have to.
I then compile all the most interesting, the most groundbreaking,
the most practical findings,
new videos and articles I upload every day to my nonprofit site, NutritionFacts.org.
Everything on the website is free.
There are no ads, no corporate sponsorships.
It's strictly noncommercial, not selling anything.
Just put it up as a public service, as a labor of love.
New videos and articles every day on the latest in evidence-based nutrition.
What a concept!
Where did Pritikin get his evidence from?
Well, a network of missionary hospitals set up throughout Sub-Saharan Africa
uncovered what may be the most important advance in health, according to
one of the most famous medical figures of the 20th century, Dr. Denis Burkitt.
The fact that many of our most common and major Western diseases
were universally rare, like heart disease.
"In the African population of Uganda,
coronary heart disease is almost non-existent."
Wait a second.
Our number 1 cause of death almost nonexistent?
What were they eating?
They were eating a lot of starchy vegetables, starchy grains, and greens,
and their protein almost exclusively from plant sources,
and they had the cholesterol levels to prove it.
Actually very similar to what You see down here in the corner
of those eating modern-day plant-based diets.
I said, wait a second.
Maybe the Africans were just dying early from some other kind of disease,
never lived long enough to get heart disease.
No.
Here's age-matched heart attack rates in Uganda versus St. Louis.
Out of 632 autopsies in Uganda, only one myocardial infarction.
Out of 632 age and gender matched autopsies in Missouri, 136 myocardial infarctions:
more than 100 times the rate of our #1 killer.
They were so blown away they went back, did another 800 autopsies in Uganda,
and still just that one small healed infarct, meaning it wasn't even the cause of death,
out of 1,427 patients—less than 1 in a thousand—
whereas here heart disease is an epidemic.
This is a list of diseases commonly found here in places
that eat and live like the US,
but were rare or even nonexistent in populations
centering their diets around whole plant foods.
These are among our most common diseases, like obesity, for example,
or hiatal hernia: one of the most common stomach problems.
Varicose veins and hemorrhoids, two of the most common venous problems,
colorectal cancer, a leading cause of cancer-related death,
diverticulitis, the #1 disease of the intestine,
appendicitis, the #1 cause of emergency abdominal surgery,
gallbladder disease, the #1 cause for non-emergency abdominal surgery,
as well as ischemic heart disease, our commonest cause of death here,
but a rarity among plant-based populations.
And so this suggests that heart disease may be a choice, like cavities.
If you look at the teeth of people who lived over 10,000 years before
the invention of the toothbrush, pretty much no cavities.
Didn't brush a day in their lives, no flossing, yet no cavities.
Why?
Because candy bars hadn't been invented yet.
So why do people continue to get cavities
when we know they're preventable through diet?
Easy.
Probably because, you know, the pleasure of dessert
basically outweighs the cost and discomfort of the dentist chair for many people.
Look, that's fine.
As long as people understand the consequences
of their actions, as a physician what more can I do?
If you think the benefits outweigh the risks for you and your family, then go for it.
I certainly enjoy the occasional indulgence.
I've got a good dental plan.
But what if instead of the plaque in our teeth,
we're talking about the plaque building up inside of our arteries?
All right, this is another disease that can be prevented by changing our diet.
Now what are the consequences for you and your family?
Now we're not just talking about scraping tarter anymore.
Now we're talking life and death.
The most likely reason that most of our loved ones will die is because of heart disease.
So being at a McDougall event is the best Valentine's Day present ever.
It's still up to each of us to make our own decisions as to what to eat and how to live,
but we should make these choices consciously,
educating ourselves about the predictable consequences of our actions.
Coronary heart disease, atherosclerosis, hardening of the arteries
begins in childhood.
By age 10, the arteries of nearly all kids raised on the standard American diet
already have fatty streaks, the first stage of the disease.
And then these plaques start forming in our 20s, in our 30s,
and then can start killing us off.
In our hearts, it's called a heart attack;
in our brains, the same disease is called a stroke.
If there is anyone here in the room today older than age 10,
then the question isn't whether or not to eat healthy to prevent heart disease;
it's whether you want to reverse the heart disease that you already have.
Is that even possible?
When researchers took people with heart disease, put them on the kind of diet
followed by populations that did not get heart disease,
their hope was to slow the disease down, maybe even stop it,
but instead something miraculous happened.
The disease started to reverse, to get better.
As soon as patients stopped eating an artery-clogging diet,
their arteries started opening up.
Their bodies were able to start dissolving some of that plaque away,
without drugs, without surgery.
Even some cases severe triple-vessel heart disease, arteries opening up,
suggesting that their bodies wanted to be healthy all along,
but were just never given the chance.
This improvement in blood flow on the left you see up here, if you can see,
this is after just three weeks of eating healthy.
Let me share with you what's been called the best kept secret in medicine.
The best kept secret in medicine is that sometimes, given the right conditions,
our body can heal itself.
If you whack your shin really hard on a coffee table,
it can get all red, hot, swollen, inflamed, right?
But will heal naturally if you just stand back
and let your body's magic take its place.
But what if you kept whacking your shin in the same place every day,
in fact, three times a day: breakfast, lunch, and dinner?
It'd never heal.
You'd go to your doctor and you'd be like, "Oh, my shin hurts so bad."
They'd be like, "No problem,"
whip out their pad and write you a prescription for painkillers.
You're still whacking your shin three times a day,
"Oh, it's still really bad—but feels so much better with those pain pills on board.
Oh, yeah."
Thank heavens for modern medicine.
It's like taking nitroglycerine for crushing chest pain:
tremendous relief, but you're not actually treating the underlying cause of the disease.
Our body wants to come back to health, if we let it.
But if we keep re-injuring it three times a day, it may never heal.
It's like smoking.
One of the most amazing things I learned in all of my medical training
was that within 15 years of stopping smoking,
your lung cancer risk approaches that of a lifelong nonsmoker.
Isn't that amazing?
Your lungs can clear out all that tar,
and eventually it's almost as if you never started smoking at all.
And every morning of our smoking life, that healing process started until wham,
our first cigarette of the day, reinjuring our lungs with every puff,
just like we can reinjure our arteries with every bite, when all we had to do,
the miracle cure, is to just stand back, get out of the way,
and let our bodies natural healing processes bring us back towards health.
Now sure, you could choose moderation, and hit yourself with a smaller hammer,
but why beat yourself up at all?
We've known about this for decades.
American Heart Journal, 1977: cases like Mr. F.W. here.
Such severe angina, couldn't even make it to the mailbox,
then started eating healthier, and a few months later: climbing mountains, no pain.
Now there are some fancy new anti-angina drugs on the market now,
costs thousands of dollars a year.
But at the highest dose, they can successfully prolong exercise duration
as long as 33 and a half seconds, ladies and gentlemen.
It does not look like those choosing the drug route
will be climbing mountains anytime soon.
See, plant-based diets aren't just safer and cheaper, but can work better.
Heart disease is our number 1 killer.
Killer number 2 is cancer.
What happens if you put cancer on a plant-based diet?
Dr. Dean Ornish and colleagues found that the progression of prostate cancer
could be reversed with a plant-based diet and other healthy lifestyle behaviors,
and no wonder.
If you drip the blood of those eating the standard American diet onto cancer cells
growing in a Petri dish, cancer growth is cut down about 9%.
But put people on a plant-based diet for a year, though, and their blood can do this.
The blood circulating throughout the bodies of those eating plant-based diets
has nearly 8 times the stopping power when it comes to cancer cell growth.
Now this was for prostate cancer, the leading cancer killer specific to men.
In women, it's breast cancer.
So they wanted to repeat this study using women and breast cancer cells instead.
But look, they didn't want to wait a whole year to get the results.
So they said, well, let's see what a plant-based diet can do in just two weeks,
against three lines of human breast cancer cells.
Here's the before: cancer cell growth powering away at 100%.
Here's after just two weeks, eating healthy.
Here's kind of a before picture: this is a photograph taken under a microscope.
What they did is they laid down a confluent layer,
like a carpet of human breast cancer cells,
and then they dripped the blood of women
eating the standard American diet onto those cells,
and as you can see, it kind of breaks up the cancer,
in these kind of cancer continents here.
So even women eating crappy diets aren't totally defenseless.
But then they take these same women, put them on a plant-based diet.
Two weeks later, so they act as their own controls.
Same women, two weeks later after a plant-based diet.
They laid down another layer of breast cancer, and then they dripped the blood
of the same women two weeks later, and their blood can do this.
Just a few individual cancer cells left, with their bodies cleaned up.
Before and after, just two weeks eating healthy.
Their blood became that much more hostile to cancer.
Slowing down the growth of cancer cells is nice; getting rid of it is even better.
This is what's called apoptosis, programmed cell death.
Their bodies were able to somehow kind of reprogram the cancer cells,
forcing them into early retirement.
This is what's called TUNEL imaging, measuring DNA fragmentation or cell death.
So dying cancer cells show up as little white spots.
So as you can see in that little corner there, there's a dying cancer cell.
Again, this is after you drip the blood of women
eating the standard American diet onto them.
Then you take these same women, two weeks later eating healthier,
drip their blood again on cancer and you see this.
It's like you're an entirely different person inside.
The same blood now coursing through these women's bodies
gained the power to significantly slow down and stop breast cancer growth,
within just two weeks of eating a plant-based diet.
What kind of blood do we want in our body?
What kind of immune system?
Do we want blood that just kind of rolls over when new cancer cells pop up,
or do we want blood circulating to every nook and cranny in our body
with the power to slow down and stop it?
Now, this dramatic strengthening of cancer defenses was after 14 days
of a plant-based diet and exercise.
They had these women out walking 30 to 60 minutes a day.
So, well, wait a second.
If you do two things, I mean, how do you know what role the diet played?
So the researchers decided to put it to the test.
So this is measuring cancer cell clearance.
This is what we saw before, the effect of blood taken
from those eating a plant-based diet, in this case for an average 14 years
along with mild exercise, like just out walking every day.
Plant-based diet and walking, that's the kind of cancer cell clearance you get.
Compare that to the cancer stopping power of your average sedentary meat-eater—
you see a little burger in there;
I don't know if you can see that— which is basically nonexistent.
Now but this middle group is interesting.
Instead of 14 years on a plant-based diet, 14 years of a standard American diet,
but 14 years of daily, strenuous, hour-long exercise, like calisthenics.
They wanted to know if you exercise long enough, if you exercise hard enough,
can you rival some strolling plant-eaters over here?
And the answer is exercise helped, no question,
but literally 5,000 hours in the gym was no match for a plant-based diet.
Same thing as we saw before, even if you are a couch potato eating fried potatoes,
you're not totally defenseless.
You can kill off a few cancer cells.
If you exercise for 5,000 hours, you can knock off cancer cells left and right.
But nothing appears to kick more cancer tush than a plant-based diet.
We think it's because of the animal proteins—meat, egg white,
and dairy proteins—increasing the level of IGF-1 in our bodies;
insulin-like growth factor-1, a cancer-promoting growth hormone
involved in the acquisition and progression of malignant tumors.
But if we lower animal protein intake,
if you put people on a plant-based diet, their IGF-1 levels drop.
This is the graph on the left.
And if you put people on a plant-based diet for years, it drops even further.
And their IGF-1 binding protein levels go up.
IGF-1 binding protein, it's like our body's emergency brake.
It's one of the ways our body protects itself from excessive growth.
Sure, within two weeks, you can drop your liver's production of IGF-1,
but wait a second.
What about all the IGF-1 you have circulating in your body
from the bacon and eggs you had three weeks ago?
Well, your body releases this snatch squad
of binding proteins into the blood stream
to tie up any excess IGF-1,
As you can see, binding protein levels go up within weeks,
continue to get better the longer one eats healthy.
Here's the experiment that really nailed IGF-1 as the villain.
Same as last time.
Go on a plant-based diet, cancer cell growth drops, cancer cell death shoots up.
But then here's the interesting column here.
What if you add back to the cancer just the amount of IGF-1 banished from your system
because you were eating healthy for two weeks?
What happens?
You erase the diet and exercise effect.
It's almost as if you never started eating healthy at all.
So the reason the largest prospective study on diet and cancer ever
found that the incidence of all cancers combined was lower
among those eating vegetarian than those eating meat,
maybe because they're eating less animal protein,
so end up with less IGF-1, and so end up with less cancer growth.
How much less cancer are we talking about?
Middle-aged men and women with high protein intakes:
75% increase in total mortality, 4-fold increase in the risk of dying from cancer.
But not all proteins.
Specifically animal protein, which makes sense, of course,
given the higher IGF-1 levels.
The academic institution sent out a press release with a memorable opening line.
"That chicken wing you're eating could be as deadly as a cigarette,"
explaining that eating a diet rich in animal proteins during middle age
makes you four times more likely to die from cancer,
which is comparable to what you see with smoking.
So what was the response to this revelation that diets
high in meat, eggs and dairy could be as harmful to health as smoking?
Well, one nutrition scientist replied that it was potentially dangerous
to compare the effects of smoking to the effects of meat and cheese.
Why?
Because a smoker might think: "Well, wait a second.
Why bother quitting smoking if my ham and cheese sandwich is just as bad for me?"
So we can't tell anyone about this meat and cheese thing.
Shh...
This reminds me of a famous Philip Morris cigarette ad
which tried to downplay the risks by saying,
"You think second-hand smoke is bad, increasing the risk of lung cancer 19%,
drinking 1 or 2 glasses of milk may be three times worse,
62% increased risk of lung cancer."
Or doubling the risk by frequently cooking with oil,
or tripling your risk of heart disease by eating by non-vegetarian,
or multiplying your risk 6-fold by eating lots of meat and dairy.
So, they conclude, "Let's keep some perspective here."
The risk of lung cancer from second-hand smoke,
is well below the risk of other everyday activities.
So breathe deep.
That's like saying: "Yeah, don't worry about getting stabbed,
because getting shot is so much worse."
How about neither?
Two risks don't make a right.
Of course, you'll note Philip Morris stopped throwing dairy under the bus
once they purchased Kraft Foods.
Just saying—
All right, what about the other 13 leading causes of death?
Let's do it.
The top three killers used to be heart disease, cancer, and stroke.
Oh, that is so 2007.
Now it's heart disease,
cancer, and COPD—chronic obstructive pulmonary diseases like emphysema.
Thankfully, COPD can be prevented with the help of a plant-based diet,
and even treated with plants, improving lung function over time.
Of course, the tobacco industry viewed these landmark findings a little differently.
If adding plants to one's diet can help one's lung function,
I mean wouldn't it be easier to just add plants to cigarettes?
And indeed, oh, let's go back.
The addition of acai berries to cigarettes evidently has a protective effect
against emphysema in smoking mice.
Who would have thunk it?
Next, they're going to start putting berries in meat.
And indeed, I couldn't make this stuff up, ladies and gentlemen.
The addition of fruit extracts to burger patties was not without its glitches.
For example, the blackberries dyed burger patties with a distinct purplish color,
kind of turned people off a little.
Evidently you can improve the tenderness of lamb carcasses
by infusing them before rigor mortis sets in with kiwifruit juice.
You can even improve the nutritional profile of frankfurters
by adding powdered grape seeds.
Though there were complaints that grape seed particles
became visible in the final product,
And, look, I mean if there's one thing we know about hot dog eaters,
it's that they're picky about what goes in their food.
Pig anus? OK
But grape seeds? Ew!
Strokes are killer number 4.
Preventing strokes may be all about eating potassium rich foods,
yet most Americans don't even reach the recommended minimum daily intake,
and by most, I mean more than 98%.
98% of us eat potassium deficient diets,
because 98% of us don't eat enough plants.
Potassium comes from the words pot ash.
You take any plant, put it in a pot, reduce it to ash, and you're left with pot-ash-ium,
potassium, the so-called vegetable alkali.
True story.
But who can name me one plant food in particular high in potassium?
Bananas, right?
I don't know why; it's like the one thing everybody knows about nutrition.
I think like Chiquita must have had this great PR firm or something.
But it turns out that bananas don't even make the top 50 sources, coming in,
let me see, coming in at number 86, right after fast food vanilla milk shakes.
It goes fast food vanilla milk shakes, and then bananas.
You know, it's funny. When I was writing the book,
I wanted to go back and make sure that they didn't update their list, and they had.
It turns out now bananas don't even make the top 1,000 sources,
coming in at 1,611, right after Reese's Pieces.
I kid you not.
The most concentrated whole food sources of potassium in the American diet
are beans and greens and dates, of all three things.
But bananas don't even make the top thousand.
In fact, if you look at the next leading cause of death (unintentional injuries),
bananas could be downright dangerous.
Alzheimer's disease, our sixth leading killer,
now striking a staggering 4 million Americans affected.
Now 20 years ago it wasn't even in the top 10.
According to the latest dietary guidelines for the prevention of Alzheimer's,
the two most important things we can do: cut down our consumption
of meat, dairy, and junk,
and replace those with vegetables, beans, fruits, and whole grains.
This is based, in part, on data going back 20 years now.
Those who eat meat—red meat, white meat, it doesn't matter—
between two to three times of the risk of becoming demented later in life,
And the longer one eats healthy, the lower the risk of dementia drops.
Next on the list is type 2 diabetes, which we can prevent, arrest, and reverse
with a plant-based diet—something we've known since back in the 1930s.
Within five years, about a quarter of the diabetics were able to get off insulin.
But, you know, plant-based diets are relatively low calorie diets.
Look, maybe their diabetes just got better because they lost so much weight.
To tease that out, what one would have to do is design a study
where you put people on a healthy diet, but force them to eat so much food
that they wouldn't lose weight despite eating healthier.
Then we could see if a plant-based diet had particular benefits,
unique benefits beyond just all the weight loss.
Well, we'd have to wait 44 years, but here it is.
Subjects were weighed every day
and if they started losing weight, they were made to eat more food.
In fact, so much food some of the participants had problems eating it all.
They're like "Oh, no, not another tostada.
Oh, not another salad."
But they eventually adapted.
So no significant alterations in body weight
despite restricting meat, dairy, eggs, and junk.
So with zero weight loss did a plant-based diet still help?
Well, overall, insulin requirements were cut about 60%,
and half were able to get off insulin altogether despite no change in weight.
How many years did this take?
No, 16 days!
So we're talking diabetics who've had diabetes as long as 20 years,
injecting 20 units of insulin a day, and then as few as 13 days later,
off all insulin altogether, thanks to less than two weeks on a plant-based diet.
Diabetes for 20 years, off all insulin in 2 weeks.
Diabetes for 20 years because no one had told them about a plant-based diet.
Here's patient 15.
32 units of insulin on the control diet, and then, 18 days later on none.
Lower blood sugars on 32 units less insulin.
That's the power of plants.
And as a bonus, their cholesterol dropped like a rock to under 150, in just 16 days.
Just like moderate changes in diet, you only get moderate changes in cholesterol.
How moderate do you want your diabetes?
Everything in moderation is a truer statement than many people realize.
Moderate changes in diet can leave diabetics with moderate vision loss,
moderate kidney failure,
moderate amputations—maybe just a few toes or something.
Moderation in all things is not necessarily a good thing.
You know that study that purported to show that diets
high in meat, eggs, and dairy could be as harmful to health as smoking,
supposedly suggested that people who eat lots of animal protein
are four times more likely to die from cancer or diabetes.
But if you look at the actual study, you'll see that's not true.
Those eating lots of animal protein
didn't have 4 times more likely risk of dying from diabetes.
They had 73 times higher risk of dying from diabetes.
Now those who chose moderation, eating a moderate amount of animal protein,
they only had 23 times the risk of death from diabetes.
Killer number 8 is kidney failure, which can be both prevented and treated
with a plant-based diet, and no surprise.
Kidneys are highly vascular organs.
Harvard researchers found three dietary risk factors for declining kidney function.
Number one, animal protein; number two, animal fat;
and number three, cholesterol — all of course only found in one kind of food.
Animal fat can alter the actual structure of our kidneys,
based on studies like this showing plugs of fat
literally clogging up the works in autopsied kidneys.
And the animal protein can have a profound effect on normal kidney function,
inducing what's called hyperfiltration, increasing the workload on the kidney,
but not plant protein.
Eat some tuna fish and you can see increased pressure on the kidneys:
1, 2, and 3 hours after the meal, shoots right up.
But, if instead of having a tuna salad sandwich though,
you had a tofu salad sandwich with the exact same amount of protein: no effect.
Kidneys can deal with plant protein without even batting an eyelash.
So wait a second.
Why does animal protein cause that overload reaction, but not plant protein?
It appears to be due to the inflammation triggered by the animal protein.
How do we know that? It's because if you give
a powerful anti-inflammatory drug along with the tuna fish,
you can actually abolish that hyperfiltration effect,
that protein leakage effect in response to meat ingestion.
Then, of course, there's the acid load.
Animal protein induces the formation of acid within the kidney,
which can then lead to what's called tubular toxicity:
damage to the delicate urine-making tubes within the kidney.
Animal foods tend to be acid forming, whereas plant foods
tend to either be neutral or actually alkaline,
actually base forming to counteract some of that acid.
So the solution to stopping the progression of chronic kidney disease
may lie in the produce market, produce aisle rather than the pharmacy aisle.
No wonder plant-based diets have been used to treat kidney failure for decades now.
Here's protein leakage on the traditional low sodium diet
that physicians would normally put these patients on,
switched to a supplemented vegan diet,
a conventional, plant-based, conventional, plant-based,
turning on and off kidney dysfunction like a light switch
based on what's going into their mouths.
Killer number 9 is respiratory infections.
What possible role could diet play?
Well, you obviously haven't seen my video "Kale and the Immune System,"
talking about the immunostimulatory effects of kale.
Is there anything kale cannot do?
Boosting antibody production 7-fold, but this is in a Petri dish.
What about in people?
Well, if you take two groups, older men and women, split them up.
Half continue to eat their regular diet;
the other half, add just a few servings of fruits and vegetables to their diet.
After getting their pneumonia vaccination, their Pneumovax vaccination,
and you can see a significant improvement
in the protective antibody immune response
to just adding a few servings of fruits and vegetables to their diet.
That wasn't cutting out meat;
just adding fruits and vegetables can significantly improve immune function.
Killer number 10 is suicide.
We've known that those eating healthier have healthier mood states.
In fact, only about half the depression, anxiety, stress scoring,
compared to those that eat meat.
Researchers suspect that it's the arachidonic acid,
this inflammatory long-chain omega-6 fatty acid found predominantly
in chicken and eggs; that's where it's mostly found in the American diet.
But you can't tell if it's cause and effect until you put it to the test.
So they took people eating the standard American diet,
removed meat, removed fish, removed poultry and eggs from their diets.
Significant improvement in mood scores within just two weeks,
thanks, perhaps, to this removal of arachidonic acid from their body,
which they thought was adversely impacting mental health
via a cascade of neuroinflammation, brain inflammation,
but we could bring down that inflammation in their brain within just two weeks
by removing, you know, cutting out eggs, chicken, and other meat.
Now am I just cherry picking though?
What about all the other studies, randomized controlled trials
showing that other diets have improved mood?
There aren't any.
A recent review concluded that only that plant-based intervention
fits the bill in terms of working.
It's hard to cherry pick when there's only one cherry.
Works in a workplace setting too:
significant increase in physical functioning, general health, vitality, mental health,
and not surprisingly translating into improved worker productivity.
The biggest such study, across 15 corporate sites at Geico, found that plant-based diets—
significant reported improvements in depression, anxiety, stress,
improvements in emotional well-being, etc., etc.
So lifestyle interventions like exercise can help mental
as well as physical health,
and among the most effective of these is this plant-based diet.
Killer number 11, blood infections.
Sure, foodborne bacteria can kind of burrow through the intestine into the blood stream
and in women can creep up into their bladder.
We've known for decades that it's bacteria creeping up from the rectum
that actually caused bladder infections, but only recently did we figure out
where this rectal reservoir of UTI-causing bacteria was coming from,
and we now know it's chicken.
We have DNA fingerprinting proof of a direct link between farm animals,
meat, and bladder infections, solid evidence that urinary tract infections
can be what's called a zoonosis, an animal to human disease.
Say, wait a second.
Can't I just use a meat thermometer; cook the meat through?
No, because of cross-contamination.
We've known for decades that if you give someone a frozen chicken to prepare
and cook in their own kitchens as they normally would,
and a multitude of antibiotic resistant bacteria jump
from the chicken into the gut of the volunteer, before they even eat it!
So you could incinerate that thing to ash.
You don't even have to eat any of it.
You're infected before it even makes it into the oven.
Just handling it is the problem.
Within days, the drug resistant chicken bacteria had multiplied
to the point of becoming a major part of the gut flora.
The chicken bacteria was like taking over their intestines.
Now what about if you follow the safe handling guidelines as well.
No one actually does this, but the official USDA recommendation is
you should disinfect all common kitchen surfaces with a bleach solution.
Then they spray the bleach on all the—
OK, what if you did this,
and then came in later and swabbed common kitchen surfaces?
And when you do that, researchers find pathogenic fecal bacteria:
salmonella, campylobacter—serious human pathogens—still left behind in the kitchen.
The reason that most people have more bacteria from feces
in their kitchen sink than on their toilet seat
is because most people rinse chickens in the sink, not the toilet.
So unless our kitchen is like some biohazard lab, the only way
we're going to guarantee we're not leaving infection around the kitchen
is to not bring it into our homes in the first place.
But the good news is it's not like you eat chicken once and you're colonized for life.
In this study, the chicken bacteria only seemed to last about 10 days
before your good bacteria can kind muscle it out of the way.
The problem is that many families eat chicken more than once every ten days,
so may be constantly re-introducing these chicken bugs into their systems.
Say, wait a second.
You can't sell unsafe cars; you can't sell unsafe toys.
How is it legal to sell unsafe meat?
Well, they do it by blaming the consumer.
As one USDA poultry microbiologist said, "Look, raw meats are not idiot-proof.
They can be mishandled, and when they are, it's like handling a hand grenade.
You pull the pin, somebody's going to get hurt."
While some may question the wisdom
of selling hand grenades in supermarkets and we get sick, it's our fault.
The USDA poultry expert suggests that
"it's the consumers responsibility, but we just refuse to accept it."
It's like a car company saying, yeah, we installed faulty brakes,
but it's your fault for not putting your kid in a seat belt.
The head of the CDC's food poisoning division famously responded
to this kind of blame-the-victim attitude coming from the meat industry.
She asked, "Is it reasonable that if a consumer undercooks a hamburger,
their three-year-old dies?" Is that reasonable?
Not to worry though: the meat industry is on it.
They just got the FDA approval for a bacteria-eating virus
they can spray onto the meat.
Now the industry is concerned about the consumer acceptance
of these so called bacteriophages may present
somewhat of a challenge to the food industry,
so of course they're not going to label it or anything.
But if they think that's going to be a challenge,
check out their other bright idea.
"The Effect of Extracted Housefly Pupae on Pork Preservation."
This is a science-y way of saying they want to smear a maggot mixture onto the meat.
Now wait, it's a low cost and simple method.
Think about it.
Look, maggots thrive off of rotting meat.
However, there have been no reports of—
Sorry, it's a new clicker for me. We'll see if we can get through it.
However there are no reports of maggots having serious diseases, right?
Have you ever seen a maggot sneeze?
I don't think so.
They must be filled with kind of anti-bacteria, something right?
So let's take some maggots, grow them 3 days old, wash them off, towel them,
a little Vitamix action there, and voila!
Safer meats.
We did kidney failure.
What about liver failure?
We've known for decades that a plant-based diet
could be used to treat liver failure,
significantly reducing the toxins that would otherwise build up
eating meat without a fully functional liver to detoxify your blood.
Well, I have to admit, though, that some people,
there are some people eating plant-based diets with worsening liver function.
They're called alcoholics, living off barley and corn and grapes.
Strictly plant-based, but not doing so good.
It's not clear what—
High blood pressure is next, affecting nearly 78 million Americans;
that's nearly one in three of us.
And as we age, our pressures get higher and higher,
such that by age 60, it strikes more than half.
So wait a second.
If it affects more than half of us, then maybe it's less of a disease
and more just kind of an inevitable consequence of aging.
No. We've known since the 1920's that high blood pressure need not occur.
Researchers measured the blood pressures of a thousand people in rural Kenya
who ate a diet centered around what?
Whole plant foods.
Starchy vegetables, grains, vegetables, fruit, and dark green leafies.
Our pressures go up as we age; their pressures actually go down.
And the lower the better.
The whole 140 over 90 cut-off is arbitrary.
Even people that start out with blood pressure under 120 over 80—
you went to your doctor, had 120 over 80, you would get a gold star.
But even 120 over 80, people appear to benefit from blood pressure reduction.
So the ideal blood pressure,
the no-benefit-from-reducing-it-further blood pressure is actually 110 over 70.
Say, wait a second.
Is it even possible to get blood pressures down to 110 over 70?
It's not just possible, it's normal, for those eating healthy enough diets.
Over two years at a rural Kenyan hospital, 1,800 patients were admitted.
How many cases of high blood pressure did they find?
Zero. Wow!
So they must have had low rates of heart disease, right?
No, they had no rates of heart disease.
Not a single case of arteriosclerosis (our number 1 killer) was found.
Rural China too, about 110 over 70 their entire lives.
70-year-olds: same average blood pressure as 16 year olds.
Now, of course, Africa, China: vastly different diets,
but they share this common theme that they are plant-based day-to-day
with meat only eaten on special occasions.
Now why do we think it's the plant-based nature of their diets that was so protective?
Because in the Western world, the only group getting blood pressures
down that low, according to the American Heart Association,
are those eating strictly plant-based diets,
coming in at an average of 110 over 65.
Based on the largest study of those eating plant-based diets to date—
this is a study of 89,000 Californians—
there appears to be this step-wise drop in blood pressure rates
the more and more plant-based one's diet gets,
as one goes from meat eater to kind of flexitarian,
to just fish, to just eggs and dairy, to all the way plant-based.
Same thing with obesity and diabetes:
the more and more healthy we eat, the better.
So of course, yes, we can eliminate the vast majority of our risk,
but what's important about this slide as well is that it's not all or nothing.
It's not black and white.
Any steps we can make on the spectrum towards eating healthier
can accrue significant health benefits,
which just get better and better the more you actually do it.
Blood pressure-wise, you can show this experimentally.
You take vegetarians; you give them meat
and pay them enough to eat it, and their blood pressures go up.
Or you remove meat from their diet
and their blood pressures go down after 7 days
in this mysterious McDougall program cohort, whatever that is.
And this is after the vast majority had already stopped or reduced
their blood pressure medications completely.
They had to reduce their blood pressure medications,
because you're treating the cause of the disease.
And so if you don't have high blood pressure anymore
and you're on blood pressure medications, you can drop your pressures too low,
fall over and crack your head open. You have to reduce---
So we've got lower pressures on fewer drugs.
That's the power of plants.
So does the American Heart Association recommend a no-meat diet?
No, they recommend a low-meat diet, the so-called DASH diet.
Why not vegetarian?
When the DASH diet was being created, were they just not aware
of this landmark research done by Harvard's Frank Sacks?
No, they were aware of the landmark research.
The Chair of the Design Committee that came up with the DASH diet
was Frank Sacks.
See, the DASH diet was explicitly designed with the number one goal
of capturing the blood pressure lowering benefits of a vegetarian diet,
yet contain enough animal products to make it palatable to the general public.
They didn't think the public could handle the truth.
Now in their defense, you can see what they were thinking.
Just like drugs never work unless you actually take them,
diets never work unless you actually eat them.
So they're like, OK, well, no one's going to go on a strict vegetarian diet, right?
So if we soft-peddled the truth on the population scale,
maybe we'll actually, you know, help more people.
Alright, tell that to the thousand families a day
that lose a family member to high blood pressure.
Maybe it's time to start telling the American public the truth.
Killer number 14 is Parkinson's disease.
Does a plant-based diet reduce the risk of Parkinson's disease?
Well, most studies to date suggest this link
between dairy products and Parkinson's, but why?
Well, there's evidence that milk is contaminated with neurotoxic chemicals.
High levels of pesticide residues have been found both in the milk supply,
and in the brains of people that die from Parkinson's disease.
These are compounds like tetrahydro-isoquinoline,
which is actually what they use to induce Parkinson's in primates in a laboratory,
found mostly in cheese actually.
And so there's been calls that we should have toxin screenings of the milk supply.
Yeah, good luck with that.
Of course, you could just not drink it, but then what would happen to your bones?
That is a marketing ploy.
If you look at the actual science, milk does not appear
to protect against hip fracture risk, whether drinking in your adult years,
or whether you're drinking in your teen years.
If anything, milk consumption was associated with an increase in fracture risk.
Maybe this is why hip fracture risks are highest
in populations where they drink the most milk.
So Swedish researchers decided to put it to the test.
A 100,000 men and women, followed for up to 20 years,
and milk drinking women had the higher rates of death: more heart disease,
significantly more cancer for each daily glass of milk.
Three glasses a day was associated with nearly twice the risk of premature death.
And they had significantly more bone and hip fractures, too.
More milk, more fractures.
Milk-drinking men also had higher rates of death, but for some reason
you never see milk ads like this. I'm not clear why.
And finally, aspiration pneumonia, which is caused by swallowing difficulties
due to a stroke or Alzheimer's or Parkinson's,
things we've already talked about.
OK, so, where does this leave us?
These are the top fifteen reasons that Americans die,
and a plant-based diet can prevent nearly all of them,
can help treat more than half of them, and even prevent and even reverse
the course of disease in some of them,
including in some cases our top three killers.
Now look, there are drugs that in some circumstances can help, too.
There's the cholesterol-lowering statin drugs.
There's usually a whole bunch of different classes of
blood pressure lowering medications one has to be on.
There's blood sugar pills and insulin injections.
But think about the diet.
This same diet, though, does it all.
It's not like there's a liver-healthy diet, and then there's a heart-healthy diet,
and a different brain-healthy diet.
No, a liver-healthy diet is a kidney- healthy diet, is a body-healthy diet.
One diet to rule them all.
And what about drug side effects?
I'm not talking a little rash here or something.
Prescription drugs kill more than a 100,000 Americans every year.
You say, wait a second,
100,000 American deaths every year from adverse drug reactions?
Well, wait a second.
That means that the sixth leading cause of death in the United States
is actually doctors!
The sixth leading cause of death is me!
Thankfully, I can be prevented with a plant-based diet.
Seriously, though, compared to 15,000 American vegetarians, meat eaters:
about twice the odds of being on aspirin, sleeping pills, tranquilizers, antacids,
pain-killers, blood pressure medications, laxatives (of course), as well as insulin.
So plant-based diets are great for people that don't like taking drugs;
for people that don't like paying for drugs,
and for people that don't like risking drug side effects.
Want to solve the healthcare crisis?
I've got a suggestion.
There is only one diet that's ever been proven to reverse heart disease
in the majority of patients, a plant-based diet.
So anytime, anyone tries to sell you on some new diet they heard about,
do me a favor. Ask them a simple question.
"Wait a second.
Has this new diet been proven to reverse heart disease?
You know, the most likely reason me and all my loved ones will die?"
If the answer is no, then why would you even consider it?
If that's all a plant-based diet could do, reverse our number 1 killer,
shouldn't that kind of be the default diet until proven otherwise?
And the fact that it can also be effective in preventing, treating, and reversing
other leading killers like type 2 diabetes and hypertension,
would seem to make the case overwhelming.
Most deaths in the United States are preventable and related to nutrition.
According to the most rigorous analysis of risk factors ever published,
the number 1 cause of death in the United States,
and the number one cause of disability is our diet,
which has since bumped tobacco smoking to killer number 2.
Cigarettes only kills about a half million Americans every year,
whereas our diet kills hundreds of thousands more.
So, let me end with a thought experiment.
Imagine yourself a smoker in the 1950s.
The average per capita cigarette consumption was 4,000 cigarettes a year.
That means the average American smoked a half a pack a day.
The media was telling you to smoke; famous athletes agreed.
Even Santa Claus wants you to smoke.
I mean, look, you want to keep fit and stay slim,
stay slender, and keep yourself trim by eating lots of hot dogs.
So you smoke, eat your hot dogs.
And to stay slim and trim, you eat a lot of sugar, too.
A lot better than that apple there.
Can you see that? I mean, sheesh...
Although apples do "connote goodness and freshness,"
according to one internal tobacco industry memo,
which they see many possibilities for youth-oriented cigarettes.
They wanted to make apple-flavored cigarettes for kids.
Shameless!
"For digestion's sake, you smoke."
I mean no curative power is claimed by Philip Morris,
but look, an ounce of prevention is worth a pound of cure,
so better safe than sorry and smoke.
"Blow in her face and she'll follow you anywhere."
"No woman ever says no."
They're "so round, so firm, so fully packed!"
After all, John Wayne smoked them until he got lung cancer and died.
You know, back then, even the Paleo folks were smoking, and so were the doctors.
This is not to say there wasn't controversy within the medical profession.
Yes, some doctors smoked Camels, but other physicians preferred Luckies,
so there was a little conflict there.
The leader of the U.S. Senate agreed.
I mean, who wouldn't want to give their throat a vacation?
How could there be a single case of throat irritation when
"cigarettes are just as pure as the water you drink?"
Perhaps in Flint, Michigan.
And if you do get irritated, no problem.
Your doctor can always write you a prescription for cigarettes.
This is an ad in the Journal of the American Medical Association.
So when mainstream medicine is saying that smoking, on balance, is good for you,
when the American Medical Association is saying that,
where could you turn back then if you just wanted the facts?
What's the new data advanced by science?
She was "too tired for fun, and then she smoked a Camel."
Babe Ruth spoke of proof positive medical science,
that is when he still could speak, before he died of throat cancer.
Now, if by some miracle, there was a SmokingFacts.org website back then
that could deliver the science directly,
bypassing commercially corruptible institutional filters,
you would have become aware of studies like this.
This is an Adventist study in California published in 1958.
Showed that nonsmokers, have at least 90% lower lung cancer risk than smokers.
But this wasn't the first.
When famed surgeon Michael DeBakey was asked why his studies
published back in the 30s linking smoking and lung cancer
were simply ignored,
he had to remind people what it was like back then.
We were a smoking society.
It was in the movies; it was everywhere.
Medical meetings were one heavy haze of smoke.
Smoking was, in a word, normal.
So back to our thought experiment.
If you're a smoker in the 50s in the know, what do you do?
Do you change or do you wait?
If you wait until your doctor tells you, between puffs, to quit,
you could have cancer by then.
If you wait until the powers that be officially recognize it,
like the Surgeon General did in the subsequent decade,
you could be dead by then.
It took 25 years for the Surgeon General's report to come out.
It took more than 7,000 studies, and the death of countless smokers,
before the first Surgeon General's report against smoking came out.
You'd think maybe after the first 6,000 studies, they could have given
a little heads up here or something?
No.
A powerful industry.
So one wonders how many people are currently suffering needlessly
from dietary diseases?
Maybe we should have stopped smoking after the 700th study like this came out.
So as a smoker in the 50's, on one hand you had all of society, the government,
the medical profession itself telling you to smoke.
And on the other hand, all you had was the science,
if you were even aware of studies like this.
Now let's fast forward 55 years.
There's a new Adventist study in California, warning Americans about the risks
of something else they may be putting in their mouths.
And it's not just one study.
According to the latest review, the sum total of evidence suggests mortality
from all causes put together, many of our dreaded diseases—
stroke, cancer, diabetes, etc.—
is significantly lower among those eating plant-based.
So instead of someone going along with America's smoking habits in the 50s,
imagine you or someone you know
going along with America's eating habits today.
What do you do?
With access to the science,
you realize that the best available balance of evidence
suggests that your eating habits are not so good for you.
So do you change or do you wait?
If you wait until your doctor tells you, between bites, to eat healthier,
it could be too late.
In fact, even after the Surgeon General's report was released,
the medical community still dragged their feet.
The AMA actually went on record refusing to endorse
the Surgeon General's report.
Why? Maybe it’s because they
just got a $10 million check from the tobacco industry.
Maybe not, maybe it's coincidence.
OK, so we know why the AMA
may have been sucking up to the tobacco industry,
but why weren't, you know, just individual doctors speaking out?
Well, there were a few gallant souls ahead of their time as there are now,
writing in as there are today, standing up
against institutions killing millions, but why not more?
Well, maybe it's because
the majority of physicians themselves smoked cigarettes,
just like the majority of physicians today continue to eat foods
that are contributing to our epidemic of dietary diseases.
What was the AMA's rallying cry back then?
Everything in moderation.
"Scientific studies have proved that smoking in moderation—"
Oh, that's fine. Sound familiar?
Today, the food industry uses the same tobacco industry tactics,
supplying misinformation, twisting the science.
The same scientists-for-hire paid to downplay
the risks of second hand smoke and toxic chemicals
are the same paid by the National Confectioners Association
to downplay the risks of candy,
and the same paid by the meat industry to downplay the risks of meat.
Consumption of animal products and processed foods
cause at least 14 million deaths around the world each year.
14 million people dead.
Plant-based diets can now be considered
kind of the nutritional equivalent of quitting smoking.
How many more people have to die, though, before the CDC says,
ah, don't wait for open-heart surgery to start eating healthy as well?
Until the system changes, we need to take personal responsibility
for our own health, for our family's health.
We can't wait until society catches up to the science
because it's a matter of life and death.
Last year, Dr. Kim Williams
was made President of the American College of Cardiology.
He was asked why he follows his own advice that he gives to patients
to eat a plant-based diet.
"I don't mind dying," Dr. Williams replied.
"I just don't want it to be my own fault."
Thank you very much.
[Comments and Q&A session follows after the applause.]
Thank you so much.
If you want to share the talk that I gave, it's actually on a combination—
it's kind of the best of my last four annual DVD
talks on The Leading Causes of Death, The Leading Causes of Disability,
The Most Common Diseases, The Most Dreaded Diseases.
We have all those DVDs here, as well as, I think, my latest DVD.
I'm up to Volume 30 or something by now.
All proceeds from the sale of all my books, DVDs,
and speaking engagements all goes to charity.
And I'm so excited, for the first time here
at McDougall to actually have my book here,
"How Not to Die."
Remember back in September I was like, "In three months my new book is out,"
and now finally I'm so excited to be here.
Of course, all my work is available free at NutritionFacts.org, yes!
Michael, you're the master.
Thank you, Dr. Greger.
It was a wonderful presentation.
I have a question for you since you are the master of reading studies,
disseminating them to the general public.
Are you aware—I know that you cited the research regarding the impact on cancer
with a plant-based diet, Dr. Dean Ornish's study on prostate cancer out of UCSF.
Are you aware of any other clinical human trials that are happening now
that we can expect to see some results that actually show the impact
of a plant-based diet on the treatment of cancer, as opposed to preventing cancer?
Professor Campbell, wouldn't that be an amazing study to do?
Yes!
All right.
The only studies we have—
so there are some studies on individual foods, but in terms of a plant-based diet, no.
We just have Ornish's study until we have future studies coming out, hopefully soon.
But currently we have, for example, you know,
I have videos about the effect of strawberries, for example,
on the progression of esophageal cancer, where they just took people
with these pre-cancerous lesions in their esophagus and gave them basically—
basically I think two pints of strawberries a day for a month.
That's a lot of strawberries, but it was just strawberries.
And found that in the majority of patients—
I think 80% of the patients, the lesions got better,
and I think half the patients they disappeared completely, like they went away.
And then they did biopsies and saw all the gene changes that took place, you know,
onco genes go down, the tumor suppressor genes go up.
And there's been similar studies on black raspberries painted onto oral cancer lesions,
and given black raspberry suppositories for rectal cancer lesions.
Yeah, don't try it at home, folks.
And then studies on flax seeds, and studies on, you know, soy for breast cancer patients,
and things like that, where there's been individual foods.
But when you say, wait a second: what if your entire diet was filled with plant foods?
And all we have to point to, I mean in terms of clinical studies,
is Dr. Dean Ornish's landmark work, beyond all the kind of ex-vivo work
like we saw with the breast cancer patients where, yes, we're using what happens
in your body after eating healthy for two weeks in terms of what happens
to your blood stream's ability to suppress cancer growth.
But that's different from taking people with cancer,
changing their diets, and actually seeing what happens.
You say, well, wait a second.
Why hasn't anyone done that study?
Big broccoli doesn't quite have the same kind of research budget, I'm afraid,
that big pharma does.
But wouldn't you—I mean, I certainly would donate to have that kind of study done.
Wouldn't you be like, "I want to see that study done."
And so if, for example, Dr. Campbell put together such a research proposal
and got some research institutions involved, and said let's take cancer patients,
let's put them on a plant-based diet and see what happens,
and put out like a Kickstarter kind of program—
I told him, we'll raise money for him in a flash.
I'll promote it on the site.
We'll get it out there, and I think it's going to be doable.
So hopefully next year we'll get back with some better news, right?
Mike, forgive me for this interjection on this topic,
but something very profound happened February 13, 2015,
and that's [when] the American Cancer Society came out and recommended
that people with cancer follow a diet in this direction because it improves survival.
And there are multiple studies that have been done that show that people
with breast cancer, prostate cancer, colon cancer, even melanoma,
when they eat a healthier diet, they live longer.
So the American Cancer Society has come out and supported
the treatment of cancer with diet.
If you have cancer, you're to follow this kind of diet, and up to date,
which is often referred to, in February, then they sent me the same conclusion.
Part of the fundamental treatment of all cancer patients
should be a plant-food based diet.
So there's a lot of information to find out there about that.
So there certainly have been studies showing that, for example,
women who eat more saturated fat after breast cancer diagnosis
live significantly shorter and have greater recurrence.
And so, absolutely, so more plant food consumption.
But in terms of actually randomizing people to plant-based diets, unfortunately
there's not enough of those studies, but hopefully that will change.
I was wondering if there's any correlation between a good diet or a bad diet
and joint replacements, because everyone seems to be getting them.
Yeah, well, there is - I mean probably the number one reason,
so when you're talking about knee replacements,
why are people’s knees wearing out is because they're carrying 200 pounds,
not in their back but in their waist.
I mean that's kind of the primary cause where we get this osteoarthritis in our knees.
Our knees grind down and they have to get replaced.
And so, does diet have anything to do with obesity?
If you think there's some possible mechanism there, then absolutely—
kind of our most common replacement surgeries.
But it's not like you can be like, "Oh, I've got to get my knees replaced next week.
OK, well, let's do some dietary reversal."
No, it's got to start decades before
so you can prevent that kind of response in one's joints.
Thank you so much for this talk.
I'm a nutrition educator and my question is are there any studies done
where the people make more drastic changes if they're told the truth
about eating a plant-based diet versus when they are told, you know,
make some changes, eat more plant foods while you're still eating animal foods?
Like what group of people make more changes in their long-term diets?
Like as an educator, should I teach the PCRM programs
or should I work for public health and teach some classes but where I don't go fully out
and say, "Get on a plant-based diet because it can cure you of diabetes"?
There's actually a study; there's a rich psychology of literature
on behavioral change, and it turns out the more you ask for, the more you get.
So I think doctors are like, "Well, I'm going to scare people off if I tell them the truth,
so I'll be like: eat an apple once in a while."
But it turns out, no, I mean it's kind of the old adage, you know,
you shoot for the stars and end up on the moon or something like that.
I think it's the other way around,
but it doesn't make sense astronomically, so I have to flip it.
Now it doesn't mean your patient is ever going to follow it, but you say,
look, we don't tell our patients: cut down to a pack a day.
We tell them to quit.
I mean is smoking half a pack a day better than two packs a day?
Probably.
But no, it's not good for you.
Ideally we should only put healthy things in our mouths,
and that's what we should tell our patients.
And so when we tell patients "this is the ideal"—
So like in my book, it's funny, out of all the kind of radical ideas in my book
I get all this push back about my exercise recommendation.
You know, I just review the science on what's best—
So I recommend 90 minutes of exercise a day, like walking.
And people are like, "90 minutes a day?"
I'm just like, "Well, look. The science shows—"
"So wait a second.
Then why does the government only recommend 22 minutes a day?"
Because they're trying to make it palatable; they're trying to make it doable.
They don't want to scare people off, instead of telling people the truth.
But if you look at the science, it's very clear:
30 minutes are better than 22 minutes;
60 minutes is better than 45 minutes, and then 90 better than 60.
And then there's no studies where anyone's ever exercised more than 90 minutes,
so we don't even have studies past that.
So the best available balance of evidence is just 90 minutes is better.
OK, so that's what—look, it doesn't mean you have to do it every day,
but you should just know that that's kind of the—
And then anything we can do towards that is—
And the same thing with diet.
We should tell people this is the ideal diet.
"This is the diet that's actually going to reverse disease.
And then, look, then it's up to you.
You're an adult. You want to smoke cigarettes?
It's your body; it's your choice,
but you should know the predictable consequences of your actions."
As physicians, that's our role: informed consent.
I'm going to go shoot for the stars.
All right!
You know, Michael, without a doubt everyone in the audience would agree with me,
we could just sit here and listen to you all afternoon.
But the time has come, and Michael, if you'll go outside
because I know you're going to have a big crowd, and we'll be back in six minutes.
Thank you.