 We have a lot of choices to make about our diet, add to that, doing the right thing when it comes to preventing or treating a chronic disease, fighting a virus, or losing weight, and suddenly our nutrition choices can seem almost overwhelming. Well, I'm here to help. Welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger. I'm back on my treadmill today and ready to answer a multitude of your questions, including whether or not it's a good idea to get full-body MRI or CAT scans and the benefits of protein restriction. Plus, I'll share with you a few dietary secrets. Okay, this is from Aiden. She says, What are your thoughts on full-body MRI scans to detect cancer at an early stage? Are the benefits outweigh the harm? And the answer is no, they would not. Now, you'd think it's really interesting. So this brings up the concept of overdiagnosis. You'd think, oh, my God, that's exactly what we want, right? Because then you can nip any budding tumors before they hurt you. The problem is most people have cancer, but most people die with their cancer rather than from their cancer. And so if the cancer is not going to affect you in any way in your lifetime, you don't want to know about it because then you just suffer, you have no benefits. I mean, the thing is when you find it, you have no idea if it's going to hurt you or not. So of course, you got to do something about it. And so whether it's surgery, chemo, radiation, whatever, you certainly have downsides from that. And if in actuality, you would have never been affected by this tumor in the first place. So all risk, no benefit. And so almost everyone dies with thyroid cancers, like it's over 90% on autopsies. People have thyroid cancers, but 90% of people don't know they have thyroid cancers. You don't want to know. Similarly, when you do, if you look at car accident victims, women in their 30s, a significant percentage, I forget, I think about a quarter of women in their 30s have breast cancers. But many, the hope is that it'll grow so slowly that they never even know it by the time they died from something else. And so because of overdiagnosis, you have to be very careful about cancer screening. And there are a few cancer screenings that are undeniably useful. You can actually have randomized control trials showing you actually affect all cause mortality, actually save people's lives. And that cervical cancer screening with public exams and colorectal cancer screening. And there's a whole bunch of reasons to do that. And then there's certainly pros and cons of other screening methods, but not as both much less certainty in terms of benefit for all cause mortality. And that includes PSA testing and mammograms and oral cancer screenings, et cetera. Anyway, great question and kind of counterintuitive answer. But in the end, we actually don't want to know, in many cases, and full body. And so it could start us down some therapeutic pathways that would actually do us more harm than good. And here we go. Next question. Donna Dana says, you said carrageenan extract isn't good, but it's whole Irish or CMOS good as a source of iodine. Okay. So our CMOS is where they get carrageenan from, packed with carrageenan. And we know that at least the carrageenan used in the food industry may cause intestinal inflammation. I'm just starting now that the next book, How Not The Age Is Done, and then just in fact checking and editing stages, I've started to script my next batch of videos for nutritionfacts.org. And I'm going to do an update on the carrageenan story. So we'll see where that leads us. But for that reason alone, I would assume that Irish CMOS, just because the carrageenan content, if carrageenan isn't good for you, then Irish CMOS probably isn't good for you either. And I don't know what the iodine content is. I would stick to ones that I do know, which is something like Dole. So Armae or Nori, stay away from kelp, because it's too much iodine, and stay away from Hadjiki, because it has too much arsenic. Next up, Kirsten or frozen greens like calcimich as nutritious and fresh. As fresh in fact, sometimes can be more nutritious, because they were actually frozen the day of picking, as opposed to wilting for a week on the shelf, and then in your crisper, losing nutrients, being exposed and losing nutrition every day. So frozen greens pre-chopped, pre-washed, basically last forever in the freezer, so you don't have to keep going getting greens every day. We're instacarting them, and so you look at my freezers, half frozen berries, half frozen greens, and so I'm a huge fan, and I say go for it. Okay, next up, Phyllis says, how to reduce swelling in the legs after heart surgery? And so as always, we need to treat the cause. It's basically three reasons that we have swelling, or so-called edema in the legs, and that's problems with our kidneys, problems with the liver and problems with our heart. If it's a heart surgery issue, then perhaps we're talking about heart failure, in that your heart just can't effectively pump blood throughout your body, so it kind of pool and stagnate in the legs. There are some things like compression stockings and elevation that can decrease the swelling, but really it's all about finding out the cause and treating the cause whenever possible. Okay, HG says, oh, what am I eating today? Oh, my purple sweet potato easing smoothie is fantastic. That's very sweet. I wish I could have a purple sweet potato. In fact, I just ordered a bunch yesterday, and the store didn't have any. So I moved, many of you know, to rural Virginia recently, and there is a long list of things I can't find anymore that I did when I actually lived in civilization. I'm in a big city. And so, for example, I can't get purple sweet potatoes, and I can't get lots and out of kale, my favorite kind of kale, on this whole long list of stuff. I can't get my favorite unsweetened. So I'm like, yeah. Anyway, it's beautiful out here, and there's lots of wildlife and trees, and there's certainly some perks, but I do miss my purple sweet potatoes. Anyway, what am I eating today? This morning, oh, this morning I had my crayon. I forget what I call it. My POM, Cran Chocolate Bowl thing. I actually have a, it's one of the few things I have a cooking video about. Dr. Gregor in the kitchen. It's the last one I did. So if you just search for pomegranate on Nutrition Factor, it'll pop up. It's a great video. And actually, because mostly the editing is just so good, so it really isn't me. It's just, we got great editors. It's funny and delicious. So yeah, because pomegranate season, don't miss out. There's only like two months where I can enjoy pomegranates and they're gone. Or at least certainly, I'm glad I can even find pomegranates around here. Oh, and then lunch, I had some leftover pasta, the whole way pasta with tomato sauce made from, you know, salt, stewed tomatoes, put in a blender, and then tons of veggies, and kale, and capers, and garlic and onions, obviously. What else am I putting in it? No pepper, lots of spices, about some vinegar. Anyway, delicious. Oh, so I made that like three days ago, but had a little leftover. Oh, and then supper time, probably after this, I'll be able to eat before my next interview. And I got another leftovers, which was leftover chili, actually with sweet potatoes, kidney beans, black beans, more canned tomatoes, lots of chili powder. Oh, and then umbral, on my, you know, purple barley, lentil, oak groats, ryeberry mixture, my prebiotic mix. Oh, and then with a bunch of kale, just regular curly kale, because you can't get the good stuff. Anyway, if anyone comes to visit, bring me some kale. All right. Next is from swag astronomer. Oh, other than what? Common, anything else for herpes? Great question. That's the only thing I've run across, although no, yeah, I'm thinking of HPV for green tea. Yeah, I haven't run across anything else. Although I have not done a search. So I will do a search in my lab, in my batch for my next video to see if there's anything else about herpetic infections. Great question. Thank you. Lisa, kale, can you, oh, the great, oh, the prebiotic mix. Okay, broil. Although, now I've added so many new stuff, it really doesn't spell broil anymore. But so the bee stands for barley. I get some wonderful purple barley. R stands for rye, so you can get rye berries. O stands for oats. So you use oak groats, the whole oak groats. And then L is for lentils. So I use these little beluga lentils. But also add sorghum now. I found a source of red sorghum, amazing. So it's like morals. And then I have millet. What kind of millet? It's a really funky kind of millet. So millet actually, as you know, isn't a real thing. There's no such thing as millet. Mill just means small grains. There's like dozens of millets. Well, we think of as millet. It's just pearl millet, one of many millets. They're all different planes with different effects. But this is finger, finger millet. So you finger millet and red sorghum. What else? There's something else I put in there. I think that's it. So it's like rolls, rolls, something. I need a better acronym. And so, yeah, you could swap out the rye and barley if you wanted a gluten-free version. Okay. Jay says, when's the last time I was sick? Last month with COVID. It's been years since I've been sick. And I haven't gotten COVID. And it's funny. I kept telling everyone, no problem, avoiding COVID, just avoid crowded indoor spaces for long periods of time. So I tell everyone that. And then what do I do? I go to a crowded indoor space for a long period of time. Get COVID. Ironically, it was at a plant-based nutrition conference. It's a national plant-based nutrition conference. Went there and got COVID. In fact, this is sad. I actually canceled. I was going to switch to virtual. I was recently going to be there in person. I was like, you know, I can just do it virtually. It's not as fun. I miss everybody. I want to see everyone. But, you know, it's not worth getting COVID over it. I hate being sick on the road. You know, switch to virtual. But then I'm like, oh, I want to see everybody. I've been stuck in my house for years. And so I was finding, okay. And so I was just so excited to tell the organizers, I'm coming! COVID be damned. Got COVID. Ah! Anyway. And actually suffered from, I don't know, kind of this rare side effect which continues to bug me. So anyway, I should take my own advice. Next up, Mike says, oh, oh, would I recommend taking, vegans taking vitamin K2 supplement? I just did a webinar on that. And the answer is no. Why? Because there's no data suggesting vitamin K2 does anything with vitamin K1, doesn't do. And vitamin K1, where's that found in found in dark green leafy vegetables? And so there's purported benefits, K2 for heart and bones. And bones and what was the other thing? Heart bones are third. Anyway, it doesn't work for any of them. In fact, there was a big scandal of fraudulent data fabrication. Anyway, even if we did find out there were some unique benefits to vitamin K2, our body makes K2, not only a microbiome from vitamin K1, but the cells in our body make K2 from K1, just like the animals that we eat. They're animals. We're animals. Mammals do it. We're mammals. So we make K2 from the K1 that we eat. But of course, we have to eat K1. How do we do that? Eat our greens. Kira says can diet, oh yeah, diet can cause pancreatitis. I have pancreatic insufficiency, but I don't drink or smoke. So yeah, so alcohol, alcohol binge can give you pancreatitis. But pancreatic insufficiency, you know, there's two functions, main functions of pancreas. There's the endocrine functions where we're like making insulin. And the extra functions actually spits out hormones to a duct into our digestive tract, helps with digestion. And that's what we typically think of with pancreatic insufficiency. So I don't think of that as being related necessarily drinking or smoking. So ideally treat the cause. And then there are some dietary tweaks. There's nothing you can do to kind of help with the symptoms of pancreatic insufficiency. But ideally, find out what's causing the first place, treat the cause, and reverse the condition. That's always the best way to go. Jonah says how to eat when you already had to mention how to pressure hospitals and care homes to give this food. Oh, good question. Well, you know, Dr. Dean Ornish right now after conquering killing number one heart disease and showing for the first time in a randomized control trial, you can actually reverse the progression of cancer. In this case, early stage prostate cancer with a plant-based diet says, all right, I'm just getting started. Let's see if we can reverse Alzheimer's disease with a whole little plant-based diet. And it's currently running that trial now. We don't have the results back yet. It's not done, but I'm excited to report when it does. And if we do find out, then indeed diets can help. Then it's all about getting good food to our loved ones. In terms of individual foods, there's lots associated with prevention. Trying to think of any, but the only thing comes to mind immediately in terms of slowing the progression would be controlling cardiovascular risk factors. So controlled cholesterol, high blood pressure. I can actually slow the progression of Alzheimer's dementia, which certainly has to do with our food. There will be certainly a lot more. The biggest chapter is the dementia chapter, preserving your mind in how not to age. Looking forward to that coming out. In fact, if I didn't have so many questions, I could look up that chapter right now and see if there's any particular foods that have been put to the test. Nothing jumps to mind. It's mostly in the prevention realm. Unfortunately. Okay. Please help. Says Rose. Do I know of anything about Ehlers-Danlos? Yes, that's like this hyper-flexibility syndrome. Just diagnosed of a food plant-based diet. Oh, stomach pain. I wonder if that's related. So you typically think of Ehlers-Danlos with problems with one's heart, problems with one's. You can run into joint problems. There's skin changes. I don't think of severe stomach pain. So I'm going to assume that that's separate. And so one shouldn't just kind of ignore it. It's like, oh, well, I got this syndrome. So that's why I got stomach pain. You really, your physician really, or your healthcare professional, really should look into why you have severe stomach pain. And it could be something serious and something easily fixable, something like an ulcer or something. And so you want to get that checked out. Sirius says, can caffeine really affect anxiety? That's a good question. Let's look really quick, shall we? Oh, I'm doing a whole series on anxiety. Although I don't think I cover caffeine. So yeah, in scripting my next, the USPSDF, the United States Preventive Services Task Force, recently suggested we should be screening kids for anxiety, which seems like a huge gift to the pharmaceutical industry, this thing I don't want to drug these kids. But then the question is, so what are the lifestyle approaches to anxiety? So I'm going to do a whole series. And so I'll include looking into something like caffeine. Let's look at an anxiety for those with panic disorder. It turns out, yeah. So caffeine in a dose is roughly equivalent to five cups of coffee induces panic attacks in a large proportion of panic disorder patients. Also increases anxiety in panic disorder patients, as well as among healthy adults at these doses. So it sounds like if you have panic disorder, should not be drinking five cups of coffee worth of caffeine. At least according to the latest systematic review on the subject, published in 2022. Okay, Dr. Greger, this is galactus. Yeah, you don't seem to advocate for a mostly fruit diet. Why? And so the video is one of my paleo diet videos, and it talks about how whether or not we're kind of my mostly frugivores, mostly folivores I think was the video. Whether mostly are we more like the leaf eating monkeys or the fruit eating monkeys, and we are more towards the fruit eating monkeys. But that's a different thing from saying, well, frugivores. Yes, fruit may, it's an important part of our ancestral diet. And so why don't I recommend for mostly fruit diet because there's an entire class of foods that are healthier than fruit, and they're called vegetables. What is a vegetable? Vegetables, any other type part of the plant that's not the fruit. So there's root vegetables, stem vegetables, like celery, rhubarb, leafy vegetables, flower vegetables, like cauliflower. And there's actually higher nutrient density in those than in fruits. And so if you ate a lot of fruits, you wouldn't maybe not get enough vegetables in your diet. There's really so much stomach room, only so many calories you can eat in a day. And so I want people to get all these other wonderful parts of the plant into your daily diet. All right, Stephanie. Stephanie is confused because sometimes I read you need to be 12 with methylcobalamin, sometimes it was cyanocobalamin. Which one should I be taking? Cyanocobalamin. I already have videos saying why cyanocobalamin is better. I have another video coming out because people continue to get this message from people that are selling you methylcobalamin because it's more expensive. But cyanocobalamin is more shelf stable. And so more likely to actually contain B12. And since B12 is kind of important, you want to make sure that you actually get it. So that's why I recommend cyanocobalamin. Okay, Maxine said, what's the worst thing I ate recently? Well, in five days, it's my birthday. That's my 50th birthday in five days. And so we actually just went on a nutrition fact staff retreat. And they're so sweet. They made me a cake, which was actually a big black bean brownie. So that was super healthy. But to make the 50, they did little marshmallows. Yes, I ate some marshmallows. That's the worst thing I ate recently. Okay, Seba, can I explain why sugar is bad for our health? I'm an athlete not worried about calories. So indeed, sugar causes cavities, dental cavities. And if you say, well, I don't care about cavities, okay. So it's empty calories. And you say, well, I don't care about calories. Well, so you don't worry about getting excess calories. But, you know, we only have a certain amount in the calorie bank every day. If you're an athlete, you have more than others. The concern is that you are, you know, if you eat 100 calories of sugar, for example, you are in effect, certainly over time, excluding 100 calories of something else, you could be eating. Though, I mean, 100 calories of sugar gets you effectively zero nutrition. Whereas 100 calories of broccoli, 100 calories of strawberries, 100 calories of almost anything else. Any other whole plant food, get you tons of nutrition. And you're just leaving that all on the table when you eat sugar. So, yeah, those are some reasons why we shouldn't waste calories on sugar. STLD says, any recommended food or un-recommended food for type one diabetes, it would be the same recommendation for type two diabetics as type one diabetics. What we're trying to do is improve insulin sensitivity. So that's the responsiveness of our liver and muscles to insulin, whether created by our pancreas, if we have type two diabetes, or whether it's, we inject it, which is type one diabetes and sometimes type two diabetes as well. And so we want every unit of insulin to do as much good as possible. So we don't have to, so we inject less insulin, which is good in terms of cancer risk and other and cost, God. So we are making our body as responsive as possible. And the way we do that is we decrease our saturated fat intake. I would also say trans fat, but there's not much trans fat in our foods plan anymore. So decreased saturated fat intake that interferes with insulin singling in our muscles and liver. And so it doesn't work as well. So you have to have more insulin, either injected or pumped out from a pancreas. You don't have type one to bring blood sugar down the same amount. So improving insulin sensitivity is the way to go. And it's the same dietary changes centered predominantly around increasing fiber intake and whole intact plant foods and decreasing saturated fat intake. Okay. Leon says protein, protein, protein restriction over calorie restriction for human longevity. Minimize BCAAs, branching amino acids, can we be too low as to a detriment on whole food plant-based protein below 10% of calories? Oh my God. This is juicy. And that's not just protein restriction in general, but we're targeting the silver containing amino acids like methionine, as well as the branching amino acids. But then you run into, well, what if protein gets too low? Do we worry about frailty? Do we worry about sarcopenia or muscle loss with aging? And so what should our target protein be? And what about all the metabolic benefits and longevity benefits you see from protein restriction, but how much is too much? And so basically the answer is we should shoot for 0.8 grams per healthy kilogram body weight from plant sources. It's kind of the bottom line. And that does the protein restriction for you in terms of BCAAs and methionine. Although I think over age 70, I was recommending going up to one gram per healthy gram body weight. Don't quote me, but there is a bump later in age. I forget the age cut off, but you're totally right in thinking about this balancing act. And so, but under age 65, 0.8 grams per plant protein sources, and then we stick with plant protein sources, but we bump it up a little later in life. We would love it if you could share with us your stories about reinventing your health through evidence-based nutrition. Go to nutritionfacts.org slash testimonials. We may be able to share it on social media to help inspire others. To see any graphs, charts, graphics, images, or studies mentioned here, please go to the Nutrition Facts podcast landing page. There you'll find all the detailed information you need, plus links to all the sources we cite for each of these topics. For a vital timely text on the pathogens that cause pandemics, you can order the e-book, audio book, or the hard copy of my latest book, How to Survive a Pandemic, or go to your local public library, for that matter. For more recipes, check out my new How Not to Diet Cookbook. It's beautifully designed with more than 100 recipes for delicious and nutritious meals. And of course, all the proceeds I received from all the sales of my book, Scoved to Charity. NutritionFacts.org is a non-profit science-based public service where you can sign up for free daily updates on the latest in nutrition research via bite-sized videos and articles. Everything on the website is free. There are no ads, no corporate sponsorships, no kickbacks. It's strictly non-commercial, not selling anything. I just put it up as a public service, as the labor of love as a tribute to my grandmother, whose own life was saved with evidence-based nutrition.