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

by Michael Greger

(Considered the gold standard of research, a randomized, double-blind, placebo-controlled study is a trial in which neither the participants nor the researchers know who is receiving an experimental treatment and who is receiving a placebo until the end of the study.)

What do your friendly flora eat? Fiber and a certain type of starch concentrated in beans. These substances are called prebiotics. Probiotics are the good bacteria themselves, whereas prebiotics are what your good bacteria eat. So the best way to keep your good bacteria happy and well fed is to eat lots of whole plant foods.

When you eat fresh produce, you can get both pre- and probiotics into your gut. Fruits and veggies are covered with millions of lactic acid bacteria, some of which are the same types used in probiotic supplements.

But there is already something that can boost your immune system for free and by so much that you can achieve a 25–50 percent reduction in sick days. And it has only good side effects.

Approximately 95 percent of all infections start in the mucosal (moist) surfaces, including the eyes, nostrils, and mouth.54 These surfaces are protected by antibodies called IgA (short for immunoglobulin, type A), which provide an immunological barrier by neutralizing and preventing viruses from penetrating into the body. The IgA in saliva, for instance, is considered the first line of defense against such respiratory-tract infections as pneumonia and influenza.55 Moderate exercise may be all it takes to boost IgA levels and significantly reduce the chance of coming down with flu-like symptoms.

chlorella extract supplements failed to boost overall immune function,63 there is evidence that whole algae may be effective. In a study out of Japan in 2012, researchers rounded up athletes ripe for infection during the middle of training camp. Among the control group, who received no supplements, IgA levels dropped significantly during intense exercise. But among those who were given chlorella, IgA levels remained steady.64 One note of caution: A disturbing case report from Omaha, Nebraska, was published recently, entitled “Chlorella-Induced Psychosis.”65 A forty-eight-year-old woman suffered a psychotic break two months after starting to take chlorella. Her physicians told her to stop it and put her on an antipsychotic drug.

nutritional yeast has a pleasant, cheese-like flavor. It tastes particularly good on popcorn.

while down-regulating the part that results in chronic inflammation (and all those annoying symptoms). Mushrooms may just do the trick. Just as algae can be thought of as single-celled plants, yeast can be thought of as single-celled mushrooms. Thousands of edible mushrooms grow naturally, with worldwide annual commercial production in the millions of tons.71 But check the nutrition label on a carton of mushrooms and you won’t see much beyond some B vitamins and minerals. Is that all mushrooms have? No. What you don’t see listed is the array of unique myconutrients that may boost our immune function.

sickened each year by Salmonella-tainted eggs.87 That’s an egg-borne epidemic each year in the United States. But eggs are “only” number ten on the worst pathogen-food combination list. Poultry and Salmonella Eating chickens, not their eggs, is actually the most common source of Salmonella poisoning.88 A nationwide outbreak of a particularly virulent strain of the bacteria was linked to our sixth-largest poultry producer, Foster Farms. It lasted from March 2013 until July 2014.89 Why

manufacturer’s brakes malfunction, it announces a recall due to safety concerns. Why hasn’t Salmonella-tainted chicken been recalled? The U.S. Department of Agriculture once tried to shut down a company found to be repeatedly violating Salmonella standards. The company sued and won. “Because normal cooking practices for meat and poultry destroy the Salmonella organism,” the judges in the case concluded, “the presence of Salmonella in meat products

Studies have shown that up to 80 percent of the time, placing fresh chicken on a cutting board for a few minutes can transfer disease-causing bacteria.95 Then, if you put cooked chicken back on the same cutting board, there’s about a 30 percent chance that the meat will become recontaminated.

practices.”97 In other words, it should be considered normal for chicken to be contaminated with Salmonella. Eat at your own risk. Why are American consumers placed at such high risk? Some European

In a meat industry trade publication, an Alabama poultry science professor explained why we don’t have such a “heavy-handed” policy: “The American consumer is not going to pay that much. It’s as simple as that.” If the industry had to pay to make it safer, the price would go up. “The fact,” he said, “is that it’s too expensive not to sell salmonella-positive chicken.”

good bacteria in their guts seemed able to muscle the bad guys out of the way. The problem, unfortunately, is that people tend to eat chicken more than once every ten days, so they may be constantly reintroducing these chicken

nearly two hundred samples from cities across the country and found that more than two-thirds

spores of the pathogen have been shown to be readily transmitted with a handshake even after using hand sanitizer.144 As one of the lead researchers who discovered another superbug in the U.S. meat supply, MRSA,145 has advised,146 people who handle raw

miracles. The director-general’s prescription to avoid this catastrophe included a global call to “restrict the use of antibiotics in food production to therapeutic purposes.” In other words, only use antibiotics in agriculture to treat sick animals. But that isn’t happening. In the United States, meat producers feed millions of pounds of antibiotics each year to farm animals just to promote growth or prevent disease in the often cramped, stressful, and unhygienic

My book certainly couldn’t have caused more injury to Dr. Atkins than his own diet. You see, he died the year before, overweight and—according to his autopsy report—suffering from a history of heart attack, congestive heart failure, and hypertension.

she was diagnosed with type 2 diabetes. Millan had struggled with obesity all her life and suffered through the highs and lows of years of yo-yo dieting. She had tried nearly every fad diet she could find but, not surprisingly, would quickly gain back whatever weight

Diabetes mellitus is characterized by chronically elevated levels of sugar in your blood. This is because either your pancreas gland isn’t making enough insulin (the hormone that keeps your blood sugar in check) or because your body becomes resistant to insulin’s effects. The insulin-deficiency disease is called type 1 diabetes, and the insulin-resistance disease is called type 2 diabetes.

Your digestive system breaks down the carbohydrates you eat into a simple sugar called glucose, which is the primary fuel powering all the cells in your body. To get from the bloodstream into your cells, glucose requires insulin. Think of insulin as the key that unlocks the doors to your cells to allow glucose to enter. Every time you eat a meal, insulin is released by your pancreas to help shuttle the glucose into your cells. Without insulin, your cells can’t accept glucose, and, as a result, the glucose builds up in your blood.

Type 1 diabetes is therefore treated with injections of insulin, a type of hormone-replacement therapy, to make up for the lack of production.

significantly overweight. The largest study ever to compare the obesity rates of those eating plant-based diets was published in North America. Meat eaters topped the charts with an average BMI of 28.8—close to being obese. Flexitarians (people who ate meat more on a weekly basis rather than daily) did better at a BMI of 27.3, but were still overweight. With a BMI of 26.3, pesco-vegetarians (people who avoid all meat except fish) did

Doctors can actually measure the level of freely floating fat in the bloodstream. Normally, it’s between about one hundred and five hundred micromoles per liter. But people who are obese have blood levels between roughly six hundred and eight hundred.

Not all fats affect our muscle cells in the same way. For example, palmitate, the kind of saturated fat found mostly in meat, dairy, and eggs, causes insulin resistance. On the other hand, oleate, the monounsaturated fat found mostly in nuts, olives, and avocados, may actually protect against the detrimental effects of the saturated fat.

Reducing belly fat may be the best way to prevent prediabetes from turning into full-blown diabetes. Though calorie cutting has been the cornerstone of most weight-loss strategies, evidence suggests that the majority of individuals who lose weight by portion control eventually regain it. Starving ourselves almost never works long term.

Saturated fats may also be toxic to the cells in the pancreas that produce insulin. At around age twenty, the body stops making new insulin-producing beta cells. After that, if they are lost, they may be lost for good.49 Autopsy studies have shown that by the time type 2 diabetes is diagnosed later in life, you may have already killed off half your beta cells.50

Fruits and vegetables, on average, contain about 80–90 percent water. Just as fiber can bulk up the volume of foods without adding calories, so can water. Experiments have shown that people tend to eat the same amount of food at a meal, regardless of calorie count—probably because stretch receptors in the stomach send signals to the brain after a certain volume of food has been ingested. When much of that volume is a zero-calorie component like fiber or water, that means you can eat more food but gain less weight.

a review of similar studies found that, in addition to weight loss, individuals consuming plant-based meals experienced improved blood sugar control as well as reduced risk of cardiovascular disease compared with people who followed diets that included more animal products.59 Such are the benefits of a plant-based diet. Diabetics are more likely to suffer from strokes and heart failure.60 In fact, diabetic patients without a history of coronary heart disease may have the same risk of heart attack as nondiabetic individuals with confirmed heart disease.61 In addition to improving insulin sensitivity better than conventional diabetic

diabetics were split into two groups. Half were put on the conventional diabetic diet as recommended by diabetes organizations; the other half were prescribed a plant-based diet consisting mostly of vegetables, grains, legumes, fruits, and nuts. At the end of six months, the plant-based group reported both a significantly better quality of life and significantly higher mood scores than those assigned to the conventional diet. Patients consuming the plant-based

of Asian diets. Rather than compare vegetarians to modern-day omnivores, these researchers compared vegetarians to those eating a traditional Asian diet, which customarily included very little fish and other meat. The women

lower odds of diabetes. Those who avoided meat altogether appeared to have significantly lower risk of both prediabetes and diabetes than those who ate plant-based diets with an occasional serving of meat, including fish. The researchers

worst, containing ten times more of a class of toxic chemicals called PCBs than wild-caught salmon.71 Industrial toxins like hexachlorobenzene and PCBs were largely banned decades ago. So how could they account for any of our increasing rates of diabetes? The answer to

individuals may be effectively carrying around a personal toxic waste dump on their hips. Without significant weight loss, people whose bodies contain salmon pollutants may take between fifty to seventy-five years to clear the chemicals from their bodies.73 Do those who avoid meat completely get enough nutrients? To find out, researchers looked at a day in the life of thirteen thousand people all across America. They compared the nutrient intake of those who ate meat to those who didn’t. The study found that, calorie for calorie, those eating vegetarian diets were getting higher intakes of nearly every nutrient: more fiber, more vitamin A, more vitamin C, more

nutrients that are so rich in plant-based diets are among the very ones that most Americans normally don’t get enough of—namely, vitamins A, C, E, not to mention fiber, calcium, magnesium, and potassium. At the same time, people who avoided meat also ingested fewer harmful substances, such as sodium, saturated fat, and cholesterol.74 In terms of weight management, those eating meat-free diets consumed an average of 364 fewer calories daily.75 That’s about what most people on traditional weight-loss programs strive to cut out, meaning a meatless

thousands of men and women who were followed for years. It’s the largest study ever to investigate eating meat and body weight, and it found that meat consumption was associated

are at elevated risk for such serious health problems as heart disease, premature death, blindness, kidney failure, and amputations, as well as fractures, depression, and dementia. And the higher people’s blood sugar levels, the more heart

major surgery may be obtained without you ever having to go under the knife and getting your internal organs rearranged.85 The bottom line: Blood sugar levels can normalize within a week of eating six hundred calories daily, because fat is pulled out of the muscles, liver, and pancreas, allowing them to function normally again.86 This reversal of diabetes can be accomplished either by voluntary calorie restriction

it is critically important to work with your doctor when radically improving your diet, because if they don’t reduce or eliminate your medications accordingly, your blood sugar levels or blood pressure may drop too low.)

further. How were the researchers able to achieve such a high degree of dietary compliance even in an uncontrolled setting? “Pain and ill health,” the researchers wrote, “are strong motivating factors.”108 In other words: Because plant-based diets work. Think about it. Patients walk in with one of the most painful, frustrating, and hard-to-treat conditions in all of medicine, and three-quarters of them were cured in a handful of days using a natural, nontoxic treatment—namely, a diet composed of whole plant foods. This should have been front-page news. How could nerve damage pain

healthier meals, blood flow may improve to the extent that neuropathy disappears.114 Within an average of two years of eating a plant-based diet composed mostly of rice and fruits, even diabetic vision loss can be reversed in as many as 30 percent of patients.115 So why didn’t I learn about any of this in medical school? There’s little money to be made from prescribing plants instead of pills. The neuropathy

there may be an even better tool than BMI that we can use to gauge the health risks of body fat. It’s called Waist-to-Height Ratio, or WHtR.120 Instead of a scale, grab a simple measuring tape. Stand up straight and take a deep breath, exhale, and let it all hang out. The circumference of your belly (halfway between the top of your hip bones and the bottom of your rib cage) should be half your height—ideally, less. If that measurement is more than half your height, it’s time to start eating healthier and exercising more regardless of your weight.

insurance reimbursement for the extra time spent, a lack of resources, a lack of time, and a lack of knowledge.125 We’re just not training doctors how to empower the people they serve. The current medical education system has yet to adapt to the great transformation of disease from acute to chronic. Medicine is no longer about just setting broken bones or curing strep throat. Such chronic diseases as diabetes are now the principal cause of death and

Foundation, the Global Burden of Disease Study involved nearly five hundred researchers from more than three hundred institutions in fifty countries and

The results allow us to answer such questions as “How many lives could we save if people around the world cut back on soda?” The best answer? 299,521.3 So soft drinks and their empty calories don’t just fail to promote health—they actually seem to promote death. But apparently soda isn’t nearly as deadly as bacon, bologna, ham, and hot dogs.

Processed meat is blamed for the deaths of more than eight hundred thousand people every year. Worldwide, that’s four times more people than who die from illicit drug use.

Eating more whole grains could potentially save 1.7 million lives a year. More vegetables? 1.8 million lives. How about nuts and seeds? 2.5 million lives. The researchers didn’t look at beans, but of the foods they considered, which does the world need most? Fruit. Worldwide, if humanity ate more fruit, we might save 4.9 million lives.

The number-one risk factor for death in the world they identified is high blood pressure.6 Also known as hypertension, high blood pressure lays waste to nine million people worldwide every year.7 It kills so many people because it contributes to deaths from a variety of causes, including aneurysms, heart attacks, heart failure, kidney failure, and stroke.

happen if, instead of consuming ten times more sodium than what your bodies were designed to handle, you just ate the natural amount found in whole foods? Is it possible your blood pressure would stay low your whole life? To test that theory, we’d have to find a population in modern times that doesn’t use salt, eat processed food, or go out to eat. To find a no-salt culture, scientists had to

adolescents.38 In other words, they start out with an average blood pressure of about 100/60 and stay that way for life. The researchers couldn’t find a single case of high blood pressure.