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.