We talked to Dr. Greger about performance-boosting greens, the unexpected value of pizza and staying alive on a plant-based diet, without giving up living.
Dr. Michael Greger is a physician and New York Times bestselling author whose website NutritionFacts.org is a treasure trove of the latest nutrition research. He is a tireless advocate for a whole foods, plant-based diet. We count ourselves lucky to get a chance to pick his brain.
Can you tell me about your new book, How Not to Die and what inspired you to write it?
Dr. Greger: The Nutrition Facts website is really extensive, we’ve got over 1000 videos and hundreds of articles. The book is a way to organize decades of research and bring the most essential information about the impact of our diet on our health. In the first part of the book I go through the 15 leading causes of death in the United States (including heart disease, high blood pressure, kidney disease and diabetes) and talk about what you can do to prevent them through nutrition and lifestyle choices. In the second half of the book I talk about the best way to prevent each of these specific diseases with changes to our diet.
I’m really interested in switching to a plant-based diet, but there’s so much information out there. Where would you even begin?
Dr: Greger: In How Not To Die I talk about my Daily Dozen, which are foods that I eat every day and I recommend everyone to incorporate into their diet.
What kind of things are in your Daily Dozen?
Dr: Greger: Flaxseed, nuts, turmeric, beans. Then, once you’ve established a baseline with your diet you can address any lingering issues. If you’ve got high blood pressure or diabetes, then you add certain other things to your diet.
That’s so much easier than trying to eat every single thing that’s supposed to be good for you! Every day you’ll read about some new miracle ingredient that you absolutely must add to your diet. It’s impossible to keep up.
Dr. Greger: Exactly! It doesn’t have to be so extreme. You do whatever you can. For example, based on the research that’s out there, I recommend eating berries every day. Blackberries pack the greatest punch, nutritionally, but if you don’t like them or just can’t get them, that’s okay— eat a different berry. It’s all relative.
That’s such a relief to hear. What other advice would you give someone who is thinking about changing to a whole food, plant-based diet?
Dr. Greger: Avoid processed foods. The processed food industry has completely manipulated our palates with sugar and salt. Even the ripest peach in the world tastes sour after eating a bowl of Fruit Loops and that’s done on purpose. They want to get your palate so dulled down that only their products will satisfy. But just a few weeks after switching— it’s absolutely amazing— your taste buds will change. For example, people will cut down on salt and all of a sudden everything tastes like cardboard and they think, “I can’t live like this for the rest of my life!” But little do they know, in a few weeks food will start tasting so good. They’ve done studies where people who had cut down on salt for a bit went back to the soup they used to eat, and lo and behold, now tastes too salty and they actually don’t like it.
That’s amazing! It’s like a little beacon of hope to get people through the first transitional weeks. I think for a lot of people switching to a plant-based diet is also really emotional. The food your mom or your grandmother makes for you, there’s such a strong connection there. How can you give it up?
Dr. Greger: Food plays a really deeply ingrained cultural role, a social role. You know, people come to me and say “I’d love to eat healthy but I could never give up my grandma’s chicken soup.” And I say, “Well, don’t! You don’t have to and say hello to Bubbe for me! ” But how does that prevent you from eating fewer pepperoni pizzas? There’s a problem with this all or nothing thinking. It doesn’t matter what you eat on holidays. It doesn’t matter what you eat on your birthday. It’s the day to day stuff that adds up. You eat badly one day, you do a little better the next day.
Your body can recover from repeated insults. We shouldn’t prevent these kinds of mental blocks from moving us in the right direction. If you love pepperoni pizza, continue to eat pepperoni pizza but make it a special occasion. Really enjoy it! If you’re going to eat crap, you should get the best possible crap and really savor that. You can’t beat yourself up over this. There’s this black-and-white thinking, almost this religiosity when it comes to food. Labels like vegan or vegetarian, all of it can prevent people from making the first step and that’s really the worst part.
Yes! The terms vegan and plant-based are so similar, but the word vegan has been elevated, as you said, almost to a religious level where people can’t connect to it.
Dr. Greger: I think it’s helpful to remove some of the ideology. You can be on a plant-based diet and still wear leather shoes. What’s more, a label like “vegan” tells me what you don’t eat, but it doesn’t tell me what you are eating. Twenty years ago vegans had to eat healthy by default, but now there’s vegan junk food. Ben and Jerry’s just came out with four new vegan ice cream flavors. There are even vegan doughnuts. You can eat as crappy as you want and be vegan. But if you come to me and tell me you eat a whole food, plant-based diet, then I know you’re actually eating your vegetables. And it doesn’t matter to me if there’s some ingredient in there, whether it came from a plant or an animal, that’s unsavory. The question is, is the bulk of your diet healthy or not?
What about the importance of choosing organic foods? Is that something people should splurge on or is whatever you get at your supermarket fine?
Dr. Greger: I talk about this in the book. There is a study in Food Chemical Toxicology that suggests that if half of the American public ate a single extra serving of fruit and vegetables every day we would prevent 20,000 cancer deaths a year— not just cancer cases but cancer deaths. Because they were talking about conventional fruits and vegetables, they calculated that the pesticides burden would cause an extra 10 cancer deaths per year. So, all in all we would prevent 19,990 deaths from cancer every year if everyone ate just one extra piece of fruit from the supermarket. You get a sense of the tremendous scale of benefits from fruits and vegetables versus the tiny bump in risk from pesticides. You can ask, why accept any risk at all? Why not choose organic? Well if you can— great, but we should never let concern about pesticides prevent us from stuffing our faces with as many fruits and vegetables as possible.
A lot of Fit Nation readers are athletes, and serious ones at that. I know that there’s this myth around athletics and eating plants, that you need animal protein to stay competitive. Is there any truth in that?
Dr. Greger: Whether it’s endurance or strength sports, there are people at the top of their game eating strictly plant-based diets. Some of the best athletes in the world—like Ethiopian runners and Mr. Universe, of all people—are vegan. There’s a guy who got into the Guinness Book of World Records for carrying more weight than anyone ever and he’s on a strictly plant-based diet. You can take a step back and think about the strongest animals in the world— elephants, rhinos, gorillas—what are they eating? They’re eating plants all day.
A gazelle here and there.
Dr. Greger: I don’t know that the gorillas are eating too many gazelles.
In terms of actual performance the only good data we really have is on recovery time. Because of the anti-inflammatory effect of whole plant foods, athletes eating a plant-based diet don’t have that 24- to 48- hour muscle soreness that they would otherwise. There aren’t those micro muscle tears from overexerting themselves which enables them to train more frequently. The diet isn’t what’s making them compete better, but it is allowing them to train harder and it’s the training that gets you to compete better.
Is there anything that you recommend athletes eat for training purposes or the day of the race?
Dr. Greger: Nitrate-containing vegetables. You’ll hear a lot about beet juice, but you can just eat beetroot or even canned beets. I’ve got videos on my site that go into into the proper timing and dosing for things like beets, spinach and arugula. It’s just fascinating. Most important are the nitrates which allow for enhanced blood flow and improve efficiency of the use of oxygen so you actually get more energy per breath. Divers, for instance, can then hold their breath longer.
Dr. Greger: Sure, and in terms of time trials, there have been controlled double blind studies conducted with cyclists and marathon runners. Some got regular beet juice and others beet juice from which the nitrate had been removed but it still tasted and looked the same. Neither the athletes nor the researchers knew who was getting which until the code was broken at the end of the trial. And, indeed, there were these significant effects and, as you know, when it comes to athletics— a fraction of a second can really make a difference, right?
Exactly. Do you think that more physicians are now switching to nutrition-based, preventative medicine in lieu of the traditional approach?
Dr. Greger: Oh, it’s unbelievable! There’s a whole new field called Lifestyle Medicine. I leave tomorrow for 28 days on the road speaking mostly at hospitals. They’re really desperate for this kind of information and part of that comes from financial pressure. If corporations that self-insure their employees have a few cases of diabetes, it completely changes their bottom line because chronic diseases are so expensive. That adds to the momentum, but mostly doctors just want to help people feel better. Unfortunately, it’s frustrating to practice conventional healthcare these days because about 80% of what we see is chronic disease. With acute conditions like a broken bone or an infection we can fix you up, but there’s very little we can do for diabetes, hypertension and heart disease. We can slow down your diabetes with drugs, slow down your rate of blindness and liver failure but unless you treat the cause—and the cause is not medication deficiency—then you’ll never actually be able to reverse these diseases.
I went to a doctor a few years ago with a minor problem, and she told me to eat leafy, green vegetables
Dr. Greger: No way! I love your doctor!
Yes, I adore her! I remember thinking “What?! You’re a doctor! You’re supposed to give me pills and things I don’t understand that are much more complicated.
Dr. Greger: Ha ha! Right!
The idea that I was in charge of my own health was really powerful.
Dr. Greger: And that’s really the good news. That’s what really comes out of my work. We have endless power over our health and our longevity and the vast majority of premature death and disability is preventable with healthy lifestyle behaviors including a plant-based diet.
Thank you so much for all of your insights. I feel really inspired! And I admit, I like that you don’t make me feel bad about eating pepperoni pizza once in awhile.
Dr. Greger: Ha ha! Look, if having that pepperoni pizza once in a while enables you to eat healthy the rest of the time, then that’s actually good for you. So I say, whatever it takes.
Want to know more about the benefits of a plant-based diet? Read on: