How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease

by Michael Greger

So pairing your greens with a green-light source of fat may not only make them taste better but will maximize nutrient absorption.

It doesn’t take much. Just three grams of fat in an entire hot meal may be sufficient to boost absorption.25 That’s just a single walnut or a spoonful of avocado or shredded coconut. Snack on a few pistachios after a meal, and you’re all set. The greens and the source of fat just have to end up in your stomach at the same time.

Randomized, controlled trials involving both diabetic and nondiabetic individuals suggest that adding two teaspoons of vinegar to a meal may improve blood sugar control, effectively blunting the blood sugar spike after a meal by about 20 percent.

The Union of Concerned Scientists estimates that if the nation increased its consumption of fruits and veggies to meet the dietary guidelines, we might save the lives of more than one hundred thousand people a year.3 You should eat more fruits and vegetables as if your life depended on it, because maybe it does.

The same principle applies when you don’t diversify your fruit and vegetable consumption. By only eating apples, you also miss out on oranges’ nutrients. You don’t get the limonoids in citrus, like limonin, limonol, or tangeretin, though you may get more malic acid (from the Latin malum, meaning apple).

Ergothioneine appears to function as a potent intramitochondrial antioxidant, meaning it can get inside the mitochondria—the microscopic power plants within your cells. The DNA inside the mitochondria is especially vulnerable to free-radical damage, since many other antioxidants are unable to penetrate the mitochondrial membrane. This is one reason ergothioneine may be so important. Depriving human cells of this amino acid leads to accelerated DNA damage and cell death. Unfortunately, the human body cannot make ergothioneine; you can only get it through food.

What are the best dietary sources of ergothioneine? The highest levels by far have been reported in mushrooms.

Ergothioneine is heat stable, which means it’s not destroyed when mushrooms are cooked.29 This is good news, because it’s best not to eat mushrooms raw; there’s a toxin in edible mushrooms called agaritine to which you should minimize your exposure. Thankfully, the toxin is destroyed by cooking.

Sweet potatoes themselves can be considered a superfood.35 They are ranked as one of the healthiest foods on the planet36

When picking out varieties at the supermarket, remember that a sweet potato’s nutritional content is tied directly to the intensity of its color.

Sweet potatoes are healthier than plain potatoes, but if you’re going to choose the latter, seek out those with blue or purple flesh. The consumption of one boiled purple potato a day for six weeks was found to significantly decrease inflammation, something neither white nor yellow potatoes were able to accomplish.40 The same was found for oxidation, but much faster. Within hours of consumption, purple potatoes increased the antioxidant capacity of study subjects’ bloodstream, whereas white potato starch appeared to actually have a pro-oxidant effect.41 Blue potatoes may have ten times more antioxidant power than regular white ones.42 The most exciting purple potato study to date had people with hypertension eat six to eight microwaved small purple potatoes a day, and they were able to significantly bring down their blood pressure levels within a month.43

In the words of the researchers, “a diversified diet, containing several distinct classes of vegetables (and hence of phytochemicals) is essential for effective prevention of cancer.”

There is no evidence to suggest, however, that eating raw foods largely or exclusively is healthier than eating a combination of cooked and raw whole plant foods.

Deep-frying leads to the production of dangerous heterocyclic amines in meat (as detailed in chapter 11) and to acrylamide in deep-fried plant foods.

To make your own pesticide-reducing bath, add one part salt to nine parts water.

From a purely nutrients-per-dollar standpoint, it’s not clear that organic foods are any better.

People not only tend to overestimate the nutritional benefit of organic food, they also overestimate the risks of pesticides.

Dried fruits and nuts appear to be so satiating that people feel full and unintentionally offset the calories elsewhere throughout the day.

The Global Burden of Disease Study calculated that not eating enough nuts and seeds was the third-leading dietary risk factor for death and disability in the world, killing more people than processed meat consumption. Insufficient nut and seed intake is thought to lead to the deaths of millions of people every year, fifteen times more than all those who die from overdoses of heroin, crack cocaine, and all other illicit drugs combined.2

For example, in major study6 after study7 after study,8 people who eat nuts tend to live longer and suffer fewer deaths from cancer, heart disease, and respiratory disease.

To date, there have been about twenty clinical trials on nuts and weight, and not a single one showed the weight gain you might expect. All the studies showed less weight gain than predicted, no weight gain at all, or weight loss—even after study subjects added a handful or two of nuts to their daily diets.19 However, these studies lasted just a few weeks or months. Perhaps prolonged nut consumption leads to weight gain? That question has been examined six different ways in studies lasting up to eight years. One found no significant change, and the other five measures found significantly less weight gain and reduced risk of abdominal obesity in those who ate more nuts.20

The bottom line? Yes, nuts are high in calories, but through a combination of dietary compensation mechanisms, your body’s failure to absorb some of the fat, and increased fat-burning metabolism, nuts can be a lifeline without expanding your waistline.

In fact, by measuring blood flow in a man’s penis with ultrasound, doctors can predict the results of his cardiac stress test with an accuracy of 80 percent.34

In medical school, we were taught the forty-over-forty rule: 40 percent of men over age forty have erectile dysfunction. Men with erection difficulties in their forties have a fiftyfold increased risk of having a cardiac event (like sudden death).36 We used to think of erectile dysfunction in younger men (those under age forty) as “psychogenic”—meaning it’s all in their heads. But now we’re realizing that ED is more likely an early sign of vascular disease.

The reason even young men should care about their cholesterol levels is because they predict erectile dysfunction later in life,38 which in turn predicts heart attacks, strokes, and a shortened life span.39 As one medical journal put it, the take-home message is that “ED = Early Death.”40

Fenugreek appears to significantly improve muscle strength and weight-lifting power output, allowing men in training, for example, to leg press an extra eighty pounds compared to those ingesting a placebo.

There is a side effect of fenugreek seed consumption, however: It can make your armpits smell like maple syrup.

About twenty sprigs of cilantro daily for two months reduced inflammation levels in arthritis sufferers and cut uric-acid levels in half, suggesting that lots of cilantro may be useful for people suffering from gout.47

Ginger is now considered a nontoxic, broad-spectrum antiemetic (antivomiting agent) effective in countering nausea during motion sickness, pregnancy, chemotherapy, and radiation, and after surgery.71

Consuming ginger 20 min prior to travel can assist in anti nausea effects

The most antioxidant-packed common herb is peppermint.73

Radioactive iodine is sometimes given to people with overactive thyroid glands or thyroid cancer to destroy part of the gland or mop up any remaining tumor cells after surgery. For days after the isotope injection, patients are so radioactive that they are advised not to kiss anyone or to sleep close to anyone (including their pets), and to maximize the distance between themselves and children or pregnant women.74 The treatment can be very effective, but all that radiation exposure appears to increase the risk of developing new cancers later on.

Other petri-dish studies with oregano suggest anticancer and anti-inflammatory properties.

Marjoram is a closely related herb and also shows promise in laboratory studies. It appears to significantly inhibit the migration and invasion of breast cancer cells in vitro.79 None of these studies on oregano family herbs was done on people, though, so we have no idea how, if at all, these effects will translate to a clinical setting.

The most antioxidant-packed common spice is the clove.81

Researchers concluded: “This argues strongly for the need to include high antioxidant foods in each and every meal in order to prevent this redox [free-radical versus antioxidant] imbalance.”88

The researchers concluded that “the incorporation of spices into the daily diet may help normalize postprandial [after-meal] disturbances in glucose [sugar] and lipid [fat] homeostasis [control] while enhancing antioxidant defense.”

So what’s the upper limit of poppy seed consumption that’s probably safe? Based on median morphine levels,98 about one teaspoon for every ten pounds of body weight.

The toxic dose of nutmeg is two to three teaspoons.

There are two main types of cinnamon: Ceylon cinnamon and cassia cinnamon (also known as Chinese cinnamon).

Unless it’s specifically labeled Ceylon cinnamon, a quarter teaspoon of cinnamon even a few times a week may be too much for small children, and a daily teaspoon would exceed the tolerable upper safety limit for adults.111

So, in a nutshell, when it comes to lowering blood sugars, cinnamon may not be safe (cassia), or it may be safe, but apparently not effective in reducing blood sugar (Ceylon). I still encourage Ceylon cinnamon consumption, given that it is one of the cheapest common food sources of antioxidants, second only to purple cabbage.

Consistent with recommendations from leading cancer1 and heart disease2 authorities, I recommend at least three servings of whole grains a day.

whole grains appear to reduce the risk of heart disease,4 type 2 diabetes,5 obesity, and stroke.6

Or, as presented in less technical terms in the American Journal of Clinical Nutrition, “Whole-grain intake cools down inflammation.”18 Even excluding heart disease and cancer, habitual whole-grain intake is linked to a significantly lower risk of dying from inflammatory diseases.19

Gluten is a group of proteins found in certain grains, including wheat, barley, and rye.

The placebo effect takes place when you give patients something useless and they feel better; the nocebo effect occurs when you give someone something harmless and they feel worse.

I suggest using the Five-to-One Rule. When buying healthier, whole-grain products, look at the Nutrition Facts label on the package and see if the ratio of grams of carbohydrates to grams of dietary fiber is five or less (see figure 7).

There is so much more left over for your gut flora to eat when you eat your grains intact. Few people realize that the bulk of stool is not undigested food but pure bacteria—trillions and trillions of bacteria.56

But when grains are unnaturally processed into flour, almost all of the starch is digested in the small intestine, and you end up starving your microbial self. When that happens regularly, it can result in dysbiosis, an imbalance in which bad bacteria can take over and increase your susceptibility to inflammatory diseases or colon cancer.59 The moral of the story: Whole grains are great, but intact whole grains may be even better.

Based on the best evidence to date, authorities from Europe, the U.S. Institute of Medicine, and the World Health Organization recommend about eight to eleven cups of water a day for women and ten to fifteen cups a day for men.13 These recommendations include water from all sources, though, not solely beverages. You get about four cups from the food you eat and the water your body actually produces on its own,14 so these guidelines roughly translate into a daily recommendation for drinking four to seven cups of water for women and six to eleven cups for men (assuming only moderate physical activity at moderate ambient temperatures).15 You can also get water from all the other drinks you consume, including caffeinated beverages, with the exception of stronger alcoholic drinks like wines and spirits. Coffee,16 tea,17 and beer can leave you with more water than you started with, but wine actively dehydrates you.18 Note, though, in the cancer and heart disease studies mentioned earlier, the health benefits were almost exclusively associated with increased consumption of water, not other beverages.