 Welcome to the Dr. Gundry podcast. So lately I've been hearing from a lot of people asking me the same question. Dr. Gundry, should I go vegan? Well, as I discussed in the longevity paradox, there is scientific evidence that some vegans do live longer than their non-vegan counterparts. But does that mean that you need to go vegan to live a long, healthy life? Well, on today's episode of the Dr. Gundry podcast, I'm going to try and answer that question. So stick around, because I'm also going to discuss the dangers of a vegan diet, how you can get the benefits of veganism without giving up your favorite foods, and why some of my least healthy patients, when they first see me, are actually the vegan ones. So stick around, you don't want to miss this one. Okay, real briefly, what is a vegan diet? I can't tell you the number of people who meet me and describe themselves as... Well, let's just use an example. I'm a vegetarian. I only eat chicken and fish. Seriously, I hear this all the time. That's not a vegetarian. I'm a vegan. I only eat eggs and milk. No, that's not a vegan. That's a vegetarian who's a lacto-ovo-vegetarian. A pescatarian is someone who just eats fish as their source of animal protein. So a vegan forgoes all forms of animal protein, whether it's eggs, whether it's milk products, dairy, whether it's chicken and fish, meat in terms of beef. So that is a vegan. Okay, so why does cutting down on animal protein seem to have such big longevity benefits? Well, most of the research centers around something that I talk a lot about, but we're going to talk about it again. There is an energy-sensing molecule called mTOR, little m capital T, capital O, capital R, that's present as a sensor of how much energy is available for that organism. And originally, we thought that mTOR was only in mammals. It turns out that mTOR is in all living things, as far as we can tell, even little worms. And it senses not only the sugar available, but also protein available. And it's so sensitive that it's far more sensitive to certain amino acids. And most of those are the branched chain amino acids. Some people know them as BCAAs. And this is leucine, isoleucine. It's also sensitive to methionine, another amino acid that's very present in animal protein. And when it senses the building blocks of making cells, it tells the cell, hey, we got plenty of energy, let's make some more cells. If it doesn't sense the present of these proteins and sugars, it says, uh-oh, times are rough and we should hunker down. We should try to protect all of our essential workers and let everything else go by the wayside to try and stay alive until the next time food arrives. And quite frankly, your cells don't know from day to day when food's going to arrive, normally. And just as a plug for the energy paradox, believe it or not, one of our problems in our society is that we are overfed and undernourished at the cellular level. So stay tuned for that. Okay, so back to mTOR. So we know that people who have mTOR that's highly stimulated will make a hormone called insulin-like growth factor. There's a very important word there, growth factor. And the other important word is insulin-like. It behaves like insulin. And insulin is also a growth hormone. So as I tell my patients, as we get older, I can assure you that there is nothing in us that we want to grow. And most cancers are incredibly stimulated by insulin-like growth factor as well as insulin. In fact, we measure IGF-1, insulin-like growth factor in all of our patients every three to six months. And a high IGF-1 correlates, sadly, with the development of cancer. And a low IGF-1 correlates very well with longevity. In fact, if you look at my patients and other people's patients in their late 90s, early 100s, who are thriving, they run very low insulin-like growth factors, around 70 to 80. So you can have this test done. It can be measured. There's a little bit of lab variation I've noticed as we change labs in this day and age. But in general, a low IGF-1 is a good thing. So getting back to mTOR. In general, plant proteins are fairly limited in terms of branch chain amino acids in methionine compared to animal proteins. So one of the theories of how plant-based diets improve longevity is that you're not stimulating mTOR and you will have a low IGF-1. And in fact, I see this all the time with my patients. They'll do an experiment for me, and they will really cut back on animal proteins, and that includes cheeses, that includes eggs, that includes fish, that includes chicken, and their IGF-1s plummet. They'll drop 50 points depending on the time period compared to their last one. In fact, we just had one this week who had been running IGF-1s of 200, 170, had a scare because of a cancer, changed over to a vegetarian diet keto, my keto version. And the next time we measured their IGF-1, it was 70. Went from 200, 170 to 70. And that's how powerful the stimulating effect of animal protein is. Now, they also got rid of fruit in their diet. So two things stimulate mTOR, certain amino acids, more prevalent in animals, and sugars. And fruit sugar is one of the things that will stimulate mTOR. Okay, the other evidence comes from the blue zones. And I've written about this extensively in the longevity paradox. And the blue zones have wildly different diets. And just to recap, blue zones were defined by the journalist, Dan Buckner, as places with considerable longevity compared to other places in the world. And I happen to have lived in the blue zone, Loma Linda, California for much of my career. And I'm actually the only nutritionist who has ever lived and worked in a blue zone. And one of the unique factors of blue zones is not the commonality of their diets. They're wildly different. The Okinawans eat an 85% carbohydrate diet of sweet potatoes. The Sardinians use a liter of olive oil per week. So wildly different from high fat to low fat. But what all of these programs have is they have very limited animal protein in their diet. Do some of them have animal protein? Absolutely. But if you look at the Loma Linda data, and the Adventists of Loma Linda now have been studied for pretty much a 50 years study now. And one of my colleagues, Gary Frazier, has been studying these folks for as long as I've known him. And the vegans of the very long lived Adventists are the longest living of the Adventists. Now they're followed by the vegetarians who are the Lacto-Ovo vegetarians. They're followed by the cheaters, as they call them in the Adventist society, who eat fish or chicken. And so they've shown and published very good results that for every small uptick of animal protein, of any source in the Adventist diet, you see an increase in heart disease, you see an increase in cancer, and you see a decrease in longevity. Now that's, you know, dogged on it. That's really too bad. There's another factor that I think bears mentioning. It's controversial. We could have an hour-long debate with one of the Carnivore MDs about this, but it was a chemical called TMAO that was discovered by the Cleveland Clinic a few years ago. And this chemical is made by gut bacteria, a metabolizing animal protein, primarily choline and carnitine, into what's a chemical called TMA, which is then transported to the liver and it's then changed to TMAO. There's a great deal of literature primarily from the Cleveland Clinic that elevated TMAO levels correlate with severity of coronary artery disease, with severity of hypertension, with damage to blood vessels. And there's some pretty good papers showing a pretty strong correlation. Now, the Cleveland Clinic found that vegans do not in general have elevated levels of TMAO for two reasons. Number one, they lack a bacterial population that manufactures TMAO. And they even proved this by getting some vegans to actually eat animal protein. And they in fact did not generate TMAO. So there is a bacterial community, if you eat a vegan diet, that is protective from making TMAO. Now, to the Cleveland Clinic's credit, some of the researchers said, well now wait a minute, the Mediterranean diet has remarkably low coronary artery disease rate, and yet the Mediterranean diet has fish, it has eggs, it has cheeses, it has salamis, there's meat eating, what gives. So they found that there is a compound in some olive oils, balsamic vinegar, and in red wine that is called 331 dimethylbutanol, that paralyzes the bacteria that make TMAO from animal protein. It doesn't kill them, but it paralyzes the enzyme systems. And so they believe, and I think they're correct, that the reason the Mediterranean diet can have these animal products is that the olive oil, the balsamic vinegar and the red wine in that diet have changed the bacterial ability to make TMAO. And so if you wonder why I have a lot of olive oil and balsamic vinegar and red wine, I'm paralyzing my bacteria so that I don't make TMAO. Okay, so far so good. Now unfortunately, recently it was discovered that some deep water fish have TMAO already in their flesh. Now this threw a real monkey wrench into the Cleveland Clinic's claim that TMAO is bad for you because fish eaters in general have better health than red meat eaters. And if fish eating raises your TMAO, that would seem to be a very bad thing. So interestingly, to save face, the Cleveland Clinic, when they measure TMAO, they ask you to abstain from fish eating for four to eight hours before the test so you don't screw up the reading. And as I tell my patients, well, if TMAO is bad for you and you're eating fish, wouldn't you want to know what your TMAO level is? So long story short is the jury is still out. There's a recent paper that suggests that TMAO may actually dilate blood vessels. So stay tuned. And by the way, I have two lifelong vegan patients in their 70s who have ungodly high TMAOs. And the Cleveland Clinic can't figure it out. We've tested them multiple times and they are vegans with high TMAOs. So stay tuned. Are there other benefits to a plant-based diet? When we get, when you see the energy paradox, you're going to find out that we have a class of bugs. They're really good bugs. I call them gut buddies who absolutely positively love soluble fiber and fiber in most vegetables and in some fruits, that they convert into a host of incredibly important what are called short-chain fatty acids. The most famous one is butyrate. And as you're going to learn in the energy paradox, butyrate may be one of the most important compounds that you can possibly have and generate. And it's good for your brain. It's great for your mitochondria. It's incredibly protective to your cells. And it's what's called a signaling molecule. It actually tells all of your cells, all of your mitochondria, that things are going great down in the engine room, down in your gut, and that, you know, carry on and do great things. It's also a great energy-producing substrate that your mitochondria can use and your brain can use. So long story short, the more butyrate-generating bacteria that you have, and the more you give those bacteria fiber in plants, the better off you are. Also, there are some incredibly important compounds in the cruciferous vegetables and the allium family like garlic and onions and leeks that make hydrogen sulfide. Now everybody goes, wait a minute, hydrogen sulfide, that's a poisonous gas. Well, and by the way, hydrogen sulfide is the rotten egg smell. It turns out that hydrogen sulfide follows a hormetic curve, and if you've read any of my books, hormesis is best defined by Nietzsche's famous expression, that which doesn't kill me makes me stronger. So exposure to small amounts of what might otherwise be poisonous or toxic is actually beneficial to an organism. And we found that in these hormetic compounds, none is not good, some is great, and a lot is really bad. And it's finding this sweet spot, what I call the Goldilocks effect in the energy paradox, of these compounds that really make the difference. And it turns out that hydrogen sulfide is an incredibly important gaso-messenger. And boy, are you going to learn about gaso-messengers in the energy paradox. So lots of really, really good reasons to eat plants and plants that have soluble fiber, as many of you have heard. The chicory family is one of the best sources of soluble fiber you can get. I happen to have my artichoke socks on today if you're watching on video. Artichokes are a phenomenal source of soluble fiber. I've got my carrot tie on today, and raw carrots are actually another great source of fiber. Please don't cook them because the sugar comes out. Okay, next question. Okay, this is a great question. So if vegan diets are so beneficial, why isn't everyone a vegan, including most of our ancestors? So that's another really great question. Let me give you, I've talked about this personal example. My wife and I were raw vegans, raw vegans for nine months. I can tell you that I think both of us had the best health we ever had in our lives, but it was virtually impossible to sustain. And in fact, almost all raw vegan chefs, and I know a lot of them, eventually stop being raw vegan chefs. Multiple reasons. Number one, I travel a lot up until COVID-19, and getting off a plane, renting a car, going to a grocery store or a health food store, and buying bags and bags of lettuces and vegetables, and carrying them to my hotel room and praying there was a refrigerator as a pain in the neck. Finding a raw vegan restaurant is pretty hard to do. They do exist. So it's just very impractical. Number two, you have to eat a huge amount of plant material to maintain your weight. And this is something that gorillas know. Gorillas eat 16 pounds of leaves every day. And I challenge you to eat 16 pounds of leaves every day. You will be eating all day like a gorilla, and that's absolutely not practical. The other thing that vegans resort to is they unfortunately eat large amounts of highly processed foods that are plant-based but are pure sugar. And they unfortunately suffer the consequences. The other things that vegans rely on is a heavily grain-based diet and a heavily legume-based diet. Somewhere, someone got the idea that we can't get all the amino acids we need without adding legumes to our diet. We can meet all of our amino acid requirements without adding rice or wheat or legumes to our diet. There's plenty of other sources. There are nutrient efficiencies that we see in my vegan population that has been documented before. B12 is not readily available. We have to manufacture it from precursors by mostly our gut bacteria. And vegans do a horrible job of manufacturing vitamin B12. So in general, vegans have to supplement with a methylcobalamin to have an adequate B12. Choline. Choline is present in eggs. Most people think of eggs as a great source of choline. Choline is an incredibly important phospholipid that manufactures one of the most important communication chemicals in our brain called acetylcholine. And most of you know about acetylcholine esterase inhibitors, which are used in treatment for dementia, among other things. But choline is incredibly important for brain communication. And in general, vegans have very low levels and very low intake of choline. Recently it's been discovered that vegans have very low levels of creatine. Many people know creatine from the bodybuilding lore. Creatine increases muscle bulk. But creatine is also an incredibly important component of the brain. And there have been very good studies that show that vegans have very low levels of creatine in their brain. And creatine supplementation in vegans will restore those levels to normal. And I think it's one of the not well-known consequences in brain health in vegans. Now speaking of brain health, most vegans are under the mistaken impression that they can get their omega-3 fats from, for instance, flaxseed oil, which is an omega-3 fat. And they will manufacture the essential long-chain omega-3 fats from the short-chain omega-3 fat that's in flaxseed oil, which is alpha-linoleic acid. Unfortunately, we have a horrible, horrible system for combining short-chain omega-3 fats into long-chain omega-3 fats. And that efficiency is only about 5%. And when I first see my vegan patients and measure their EPA levels and their DHA levels, they're woefully inadequate. In fact, almost all vegans that I see who eat a ton of flaxseed, drink flaxseed oil, take flaxseed oil capsules do not have an adequate omega-3 index. Now I've talked about this in the longevity paradox. Our brain is about 70% fat. And half of the fat in our brain is DHA, that long-chain omega-3 fat. If you look at people, omega-3 index, which looks at two months of EPA and DHA in our blood, people, as they age, who have the lowest omega-3 index, and I'm talking to you vegans, have the smallest brains, the most shrunken brains, and the smallest areas of memory, the hippocampus. And people who have the highest omega-3 index have the largest brains and the largest areas of memory. So what do you do? Well, the good news is there is now algae-base DHA and even algae-base EPA available. So there's actually no excuse not to get adequate levels of DHA in you, even if you're a vegan. So my recommendation is to try and get 1,000 milligrams of DHA per day. And it's easy to do with capsules. You'll read the label. The milligram on the front doesn't tell you what the DHA is. You've got to look on the back. So get 1,000 milligrams. And stay tuned because I've been doing some exciting research about another long-chain omega-3 called DPA. And we'll be having an exciting announcement about DPA very shortly. Okay, now I mentioned in the introduction that some of my least healthy patients when they first come to see me are vegan. And a great number of my autoimmune patients with Hashimoto's disease, with Lupus, with MS, with rheumatoid arthritis are vegans. Now, hold on vegans who are listening to me, let me explain why. Most of these people who see me, I have a reliance on a lectin-heavy diet, which includes whole grains, which includes legumes, which includes cashews and peanuts and quinoa. And a great number of them are gluten-free because they're convinced that gluten is a problem, but they're not lectin-free. And in March, I published a paper at the American Heart Association looking at people who were already on a gluten-free diet with leaky gut who, when we put them on a lectin-free diet and removed these other troublesome lectin-containing foods from their diet, they not only sealed their gut, but their autoimmune disease regressed. And I can't tell you how mischievous some of these compounds are. Just this week, we found another person who was having cashew butter, cashew milk, had Hashimoto's, was gluten-free and low and behold in three months' time when we got rid of all the wonderful cashew products, low and behold the Hashimoto's resolved. Same thing with this craze with oat milk. I got news for you. There's lectins and oats that cross-react with gluten, and your body can't tell the difference. As I said before, 70% of people who are gluten intolerant or actually celiac react to corn as if it is gluten. And corn is in so many gluten-free foods, and I can't tell you how many of my vegan patients live on corn chips and popcorn and corn tortillas. Please, these are not health foods. And you can claim that your ancestors ate them, but almost all of us in America and in the world for a matter are not from the Americas where corn is from. And even Native Americans are not from America. You're Asian, so none of us were exposed to this. Okay, now if you're already a vegan, don't worry. There's plenty of ways to get healthy nutrients into your body without switching diets. Here's what I recommend. Try, try, try to get all the grains out of your diet. If you're going to use legumes, if you're going to eat beans, get a pressure cooker. My latest cookbook, the Plant Paradox Family Cookbook, is devoted to using a pressure cooker or an Instapot for making your meals. It's quick, easy, you can feed your family. Don't have enough time. Get yourself Eden brand beans. They are pressure cooked and they have a BPA-free can. Believe it or not, this week, once again, I had beans and mushrooms every night and I want to repeat that again. During the week, I generally eat a vegan diet, both my wife and I do. And about every other week, it'll be beans every night. Dr. Gundry is not against beans. I'm against beans that haven't been treated properly. Beans are some of the best fiber-containing foods. It's just that they're some of the best lectin-containing foods that you can eat untreated. Tempeh is a great choice. It's fermented soy, but I'll tell you, when I wrote the Plant Paradox, tempeh was pretty available without added grains. Now, for some obscure reason, almost every tempeh I find in all the stores, and I'm always searching every store I go into, have some added grain in them. So please be careful. If you can only find one with a grain, find the one with white rice. That's going to be the safest of a bunch of bad choices. You do not need these for protein, but if you're convinced you have to have some seed-based protein. There's plenty of protein in hemp powder. There's plenty of protein in hemp seeds. There's plenty of protein in nuts, and there's plenty of protein in mushrooms. So there's lots of options for protein. If you're a vegan, please, please, please get yourself some methylcobalamin, put it under your tongue sublingually, and please get algae-based DHA. Do your brain a favor? And I would highly recommend getting a creatine supplement. There are vegan sources of creatine. You won't break the rules by taking creatine. Okay, now I promise in the beginning there is a way to get all the benefits of a vegan diet without being a vegan. And I've written about this in the Plant Paradox, in the longevity paradox. I've done an entire podcast lecture on this. And if you really want more details, go to podcast episode number 104. All about the fasting-mimicking diet, the vegan fasting-mimicking diet. Now, this diet and this research was done by my colleague and friend, Dr. Walter Longo, from the USC Longevity Gerontology Center. And what he found, both in animals and now in human studies, that you can mimic the effect of calorie restriction. You can mimic the effect of a vegan diet. If five days in a row, once a month, you eat a low-calorie vegan diet of anywhere from 800 to 1,100 calories, five days in a row. And he's shown that this has dramatic effects on limiting mTOR, on limiting IGF-1, on stimulating stem cell growth, and actually potentiating your immune system to actually go after cancer cells. He's also recently shown that the fasting-mimicking diet will potentiate the effect of chemotherapy for cancer treatment. And this is actually very exciting news. It sets up cancer cells to be, in a way, more hurt by traditional chemotherapy and immunotherapy. So, long story short, five days a month. No, you can't say, okay, every Monday I'm going to eat a vegan diet and I'm going to do it every Monday and that'll be five days. That won't work. You've got to do it five days in a row. And the good news is, that's, you know, come on, that's Monday through Friday or Sunday through Thursday. Once a month. And it's actually a really easy, doable thing to do. And the good news is, the guidance is in the plant paradox, the guidance is in the longevity paradox. We've got the meal plan for you. They're easy to do. And what an easy way to be a pseudo-vegan and reap the benefits of veganism without the difficulty. Let's put it that way. So, that's our wrap on the vegan diet. There's a lot to like about it if you do it right. There's a lot that I see in my early patients wrong with it because the choices are unfortunately incorrect in most American vegans. I, as you know, travel the world. There are some very successful vegan diets in China, in Japan that I've studied. There's even some very successful vegan diets in Italy that I've studied. They eat totally differently than we do as American vegans and we ought to learn from that. Okay, it's time for the audience question. This week's question comes from Heather Campbell on DrGundry.com. I like this. I am so hungry in this phase one to three-day cleanse. Do we have to stick to exactly those portions or we can have some more? Well, actually, if you read the fine print, it says that here's some snack options for when you really get hungry. But as you're going to learn in the energy paradox, and as I tell all of my patients, particularly early on in these programs, I want you to embrace the hunger. We actually have been conditioned that if we are hungry, there is something horribly wrong. And I can tell you from the energy paradox that hunger is one of the most useful things that's actually been taken away from us because big food companies have brainwashed us into thinking that hunger, even a little stomach growling, is something to be avoided at all costs. And I assure you our ancestors were hungry. And we're hungry for a great deal of time. And it actually helped them survive. And you're going to find out you're going to get more energy by embracing the hunger than feeding yourself during those times. And you're going to be shocked for why that is. So if you just can't make it through, as I told you before, nuts are still one of the best ways to get through this period. Have a half an avocado. It'll work great for you. Make yourself a small salad. Have some crudities. There's lots of options, and they're actually in that part of the book. So embrace the hunger, and you'll get through the three days. Okay, now it's time for the Review of the Week. This week's Review of the Week comes from Heather Carlsberg on YouTube who writes, I am so beyond grateful and appreciative for you, Dr. Gundry, exclamation marks. The information you provide and share consistently and freely is phenomenal, life changing and health transforming. So appreciative for you, and I tell everyone I know and new people I connect with, all about your work, the plant paradox, and all your Dr. Gundry YouTube videos. Well, thank you very much, Heather. That's why we do this. That's why I take time out of my busy patient schedule to make time for you. Because as you know, I am Dr. Gundry, and I'm always looking out for you, Heather and everybody else. That's it for today. See you next week.