 Hello, this is Dr. Michael Greger coming to you live from my treadmill. I'd answer any questions you might have for those of you unfamiliar with my work every year. I read the reviews of every language, language, nutrition journal in the world. So busy folks like you don't have to. I think probably the most interesting, most groundbreaking, most practical findings and the new videos and articles I upload every day to my non-profit site nutritionfacts.org. But then the website is free. There are no ads, no commercial sponsorships, no corporate sponsorships, strictly not commercial, not selling anything, just putting it up as a public service as a labor of love, as a tribute to my grandmother whose own life was saved with evidence-based nutrition. That's why I became a doctor and that's why I practice type of medicine, I practice the day lifestyle medicine. All right, let's get to your questions. They are already lined up. Julie has the first question. Julie Lats, what's my opinion on doing genomic testing for estrogen receptor positive cancers? Don't have cancer but want to know what steps, take the steps to learn about any hiccups in my genes that could cause it. So I assume you're talking about like bracket testing for breast cancer. So it's something I definitely talked to you, doctor, about a lot of it depends on your psychology. So for example, if you found out you were particularly high risk for breast cancer, what would you do? Well, you'd eat healthy exercise, lose weight, do all the things, cut down alcohol, consumption, all the things that would otherwise increase your risk of breast cancer. And if having that information would make you more likely to improve your lifestyle, then maybe it's worth it. If having information would make you just kind of throw up your hands in the air and be less healthy then maybe it's not such a good idea. But again, you know, genes load the trigger, environment pulls, no, genes load the gun, environment pulls the trigger. And so regardless of what your genetic risk, regardless what bad genes we've been dealt, we can reshuffle the deck with diets. Stephanie Sousa says, a mother has aquagenic parietis gets extremely itchy when water touches her skin. What can she do about it? It's not something that I've ever seen in relation to diet. If you wanna type in aquagenic parietis and the word diet into pubmed.gov, the database of National Library of Medicine, large medical library in the world, anything pops up and you don't have access to it, let me know. I will pull the articles myself, share them with you. And if there's something there that I think has kind of broader interest among people that's groundbreaking or practical or I'm interesting, I will do a video about it. Thanks for your question, I hope she feels better. Rowena Smart asks, starchy food makes me extremely tired immediately after eating them, what do I suggest? Well, if I start you food, you mean like what? Typically people eat a starchy food, which is refined carb junk, like cookies crackers, most bread. I mean, these are refined foods and we should try to minimize them. So in my traffic license in there, yellow light foods mean they should be minimized on a day-to-day basis. If however you're talking, starchy foods like legumes, bean split peas, chickpeas, and none of those are whole grains, particularly whole intact grains, then that should not be happening to you. So what do I suggest? I suggest you stop eating refined junk, if that is indeed what you're doing. TedB2012 asks, I've heard freezing fruit damages the fibers, does freezing affect digestion and our healthfulness and what is the relationship between the actual fibers and its fiber? So freezing, so frozen, so if you look in my freezer there, it's full of frozen berries, half frozen greens, frozen fruits and vegetables are great, convenient, cheap, pre-chopped, pre-cleaned way to get more fruits and vegetables and you die, sometimes it can be even healthier than fresh because the so-called frozen, I'm excuse me, the so-called fresh fruits and vegetables have been sitting on a ship from halfway around the world, New Zealand or something, losing nutrition every day, exposed to air, exposed to sunlight, exposed, and whereas frozen produce may be frozen on the day of picking, they should retain more nutrients. Of course, ideally fresh local, freshly picked is best, that's why we belong to, proudly belong to a community-supported agriculture project here in Maryland and so we get the best of all the worlds but look during winter months, what are you gonna eat? And frozen is a great option. In terms of the actual fibers, so those actual fibers in plants are fiber, are fiber fiber, but the soluble fiber, like in berries, for example, is what gels it up, you don't actually see fibers as per se but they're all good, eat them. Anton Zinavev asks, yes, in about dental root canal treatment and wants to know, ah, it sounds like maybe this is a question about enamel, mercury-containing dental enamel, I'm not sure. Please clarify the question, be happy to answer it. TedB212 is back saying, I have a very sensitive digestive tract and eating mostly, eating anything mostly, causes intestinal gas, is it possible, hopefully plant-based, that I will cause food to travel too quickly, that I will miss vital nutrients? I don't see the connection. I mean, if you have diarrhea, things are moving quickly, but gas isn't a sign that things are moving particularly quickly, if you have chronic diarrhea, yes indeed, you may not be absorbing as many nutrients as you like and put your risk for electrolyte abnormalities, you should definitely go see your doctor about it, but intestinal gas, normal, healthy, if you have excessive gas, then you may have, there's all sorts of reasons, like lactose intolerance, et cetera, then you can get that checked out. It's probably a microbiome issue if you recently went through certain types of antibiotics that can wipe out your good gut flora. Leanne asks, is it more helpful to use meso, salt replacement, than is to leave outside and salt and meso completely? Does using it in baking deteriorate any of the healthfulness? Great questions. No, well, so a meso is health-promoting food. Do you need to use it? No, so I mean, so there's three options, salt, meso or nothing, as long as you do, as long as you don't use the salt option, you're fine, so meso or nothing would be the best, and you can bake meso all you want, and that shouldn't affect its healthfulness. Other than, of course, destroying the good bacteria in it, so you're not going to get kind of the, any effects, the live bugs in meso would have, but we're not sure what those might be. Leanne further asks, can't find meso without rice as an ingredient. So maybe it's just kind of some rice starter, something that should be worried about or snacking meso, no, presumably if it's just a little rice, I wouldn't worry about it. Is chickpea meso a green light, or does only soy-based meso overcome the salt issue? Oh, good question. So is chickpea meso, does that have any soy in it, or is it all chickpeas? So, I mean, the reason we think that meso, despite its all content is not associated with stomach cancer, not associated with hypertension, is due to things we're cutting down our salt intake for, is because of the protective benefits of soy. Do we have the same protective benefits in chickpeas? I don't know. It hasn't been put to the test. So, yeah, so, good question, I don't know. Is lemon juice, is lemon juice still green light? So, well, not technically, right? So green light foods are whole plant foods. So any juice, lemon juice or otherwise, is a processed food because you're throwing away the fiber, but how much lemon juice are you eating? Probably just like a little spoonful, so it doesn't really matter. But because it's technically like green light, actually in the, how not did I cookbook? Do I have a cup, oh, I have a cup somewhere. How not did I cookbook coming out December 5th, which I'm excited about? Because I wanted all the ingredients to be green light, we actually don't use lemon juice. We actually, what I do is that we just throw a piece of lemon in the blender. So instead of like half of a lemon's worth of juice, you just peel a lemon and cut it in half and throw it in the blender and then you get the juice, plus all the other wonderful stuff in it. So, but you have to do that. No, you can just use lemon juice. I just, we wanted everything to be as healthy as possible. If you use whole stevia leaf straight from the plant, is that a green light sweetener? It depends how much you use. So it's, there's, it's harmless. And doses I described in my, I did a video about it. If you type in stevia to nutritionfacts.org, you'll see that there's a level at which you can exceed the amount of stevia compounds and may have negative health effects. But if you use it in, in doses in, in, in kind of doses like left in five stevia sweetened beverages a day, I think was the, the best metric then according to the WHO should be harmless. Have I come across any research on preventing or overseeing age-related hearing loss? Oh yeah. So what got me interested is that there are some populations that do not suffer from age-related hearing loss which suggests, oh wait a second, it may be a consequence of lifestyle, diet and lifestyle. So, so I'm, that is one of my research projects on my list to find out what is it about these populations? What are they eating? How are they living that may contribute to their preservation of hearing? That's a great question. All right, Ted B212 asks, are there any concerns about eating 100 grams of protein a day if the protein is all from healthy sources? Has there been research done on high levels of plant-based proteins? Well, there was the Eco-Ackens diet by the Jenkins Group of the, up at the University of Toronto. They ate a relatively high plant-based protein sources and did not see the kind of negative effects one sees with high animal protein intakes. For example, if you look at that famous somatabolism study that I feature in a bunch of videos, high levels of animal protein intake associated with during middle age, associated with 75% increased risk in premature death, four-fold increased risk of dying specifically from cancer. That was for predominantly animal protein, not plant-based proteins. So as long as you're eating whole food sources, so if you're just eating lots of beans, the only reason you're getting that much protein is because you're just eating lots of lentils, eat lots of lentils, that's fantastic. The important thing is not so much some macronutrient ratios, but the fact that you're getting your nutrients from whole food sources. Tammy C. asks, starting more potatoes and getting a pain in the hip. Could it be because of a night chain vegetable consumption? Well, about one in 20 people with joint pain feel better when they cut out night chains. So try it and see if it helps. You may be lucky. Intralympidus asks, has a vitamin D3 pills, 5,000 Nile Sheenins. Can I take two every five days? Two every five days. Or is your body only storing vitamins for a day? Can't split them up. Oh, yeah, your body stores it up. In fact, your body's so good at storing vitamin D you can, it lasts throughout the winter. I mean, your D levels drop lower than we'd like and so that's why I encourage people to supplement with vitamin D, but to absolutely. So you could take, you know, so I recommend like 2,000 Nile Sheens a day for most people. So you could take one of those every other day or every three days or however you want to do it. That's fine. Your body will kind of average it out because the fat side of a vitamin, it sticks in you. That's why you can actually get too much. But like you described, it's not too much. Master Coach, University asks, if the crust on my bread is brown, darker than the rest, that's kind of the definition of crust, then will that crust contain AGE? Should I cut the crust off like mom used to do? Not in G's, but acrylamide. So AGE's are formed from high fat, high protein foods. Bread, it really isn't a high fat food unless it's crusted with nuts and seeds or something. But if there's like sunflower seeds or something on the outside, they get brown. Absolutely, they can have AGE's in them, but acrylamide. So crispy carbs, I have acrylamide. I have a bunch of videos on acrylamide. And so that's one of the reasons why we should prefer lighter toasted bread compared to darker toasted bread until we know more about the acrylamide story. Intralympidus, why do I have a buffer on my videos? I don't know what that means. Why do I have a buffer on our videos? If anybody knows what that means, in fact, if you intralympidus can describe what that means, I'd be happy to answer. I'm not sure what that means about having a buffer on my videos. Master Coach University says, on any studies on the difference between raw cacao and roasted cocoa, is there any reason to have concern about theobromine in cocoa or cacao? I would, well, just check out all my cocoa videos. So I'm a big fan of cocoa powder, which is basically de-fatted, no sugar cacao. And so those are the two things, two potentially bad things about cocoa. Chocolate is the sugar and, well, and the dairy, if it's milk chocolate, but the sugar, fat, and dairy. And so cocoa powder has none of those. And so actually it has health-emoting activities which you can show in randomized controlled trials as I have videos about. Master Coach University asks again, because it's like an ad to keep saying their name. If I get my beans from an MBA can, is there any other problem with the fact it's canned? Yeah, canned beans can have high sodium content. Why? Because they add salt. So just make sure you get no salt added beans. Do I have thoughts on ashwagandha? I do not, because it's not something I've ever looked into. Any reason to rotate, rotate. Oh, rotate my nuts and seeds so as to not get exposed to the same protein every day. I was imagining you like turning your little nuts and seeds around, rotating them. No. Well, I mean, variety is good. So I encourage people to add lots of variety. But if you just stuck to walnuts and pumpkin seeds, then that'd be great. That'd be better than most people who aren't getting nuts and seeds in a daily diet. All right. MattJH33S, any more calories to gain lean muscle with exercise, okay? If I take 250 milligrams of algae, I'll go long chain omega-3 fatty acids and tips from ground flexes every day. My nuts, can I eat without adversely affecting my omega-6 to 3 ratio? You know, if you're taking preformed long chain omega-3 fatty acids, then that's why we want to keep a low omega-6 to omega-3 ratio so we better elongate the short chain alphalonic acid. I'm sorry if this is confusing for people that don't know, are unfamiliar with omega-3 kind of biology. But basically, if you're taking long chains, then the ratio is less important. So I wouldn't worry about the ratio and I would make sure, and I would eat all the nuts you want. Would Matt, oh Matt's back again, would add in calories like whole grains of lentils that contain more sodium than calories make the amount of sodium safe to consume. Ah, so if you dilute high sodium foods, can you kind of get away with eating the sodium and processed foods? So long as you're eating less than 1500 milligrams of sodium a day, then that's a great convenient way to mix pre-made food with made food. So in my bachelor days, there'd be some kind of prepackage to something where I'd pick up something in a restaurant or a takeout. And then I bring it home and add cans of beans and big things of steamed vegetables and greens. And then I'd have a whole bunch of meals. So I'd have the taste of whatever sauce, which is probably because there's a restaurant too high sodium, too high fat, too high any, too high, not high fat, high oil, things like that I wouldn't want. But because I just massively add lots of vegetables, it was actually pretty healthy. So that's a great strategy, but still want to keep people under 1500 milligrams of sodium a day. Ideally. Dave Miller asks, what about the freshness of spices? Many spices like turmeric, cinnamon, et cetera have been on store shelves for months. And at multi-year expiration dates, does age affect potency? I'm not sure it does. How do you know you can get fresh stuff? Well, I might want to try bulk spices. So if you have access to like a whole foods or one of these natural food stores, they often have bulk spices. It's just actually cheaper and you can see that. I mean, they're constantly replenishing them. And so presumably you're getting fresher stuff than some, you know, turmeric that's been sitting in a jar in the corner of some, you know, gas station convenience store that no one's touched forever. You can also often see just the kind of the vibrancy. Like if you look some chives or something, chives turn from bright green to brown very quickly in the bottle. So you see if it's your chives, for example, look all brown, they've obviously been there for a while. So just by kind of looking at it, you may be able to get a sense. All right, any problem? Leanne asks, any problem with eating raw squash seeds? Oh, no, great. Eat raw squash seeds. I mean, they might be a little slimy so you can dry them out. So like you could put them in like a toaster, like a toaster oven kind of thing at like 200 degrees. I mean, so that's low enough where you're not gonna be creating these glycotoxins, but it just kind of speeds up the making them kind of dry and crispy. And then roasting veggies is fine, right? Because it's only the high fat, high protein foods that create these glycotoxins. So roasting veggies is a great way to eat more veggies. Dave Miller asks, after discovering the eco-accounts diet, blah, blah, blah, what's my stance on eco-accounts? Is it safe, if people kept it to mostly whole food plant-based? If you're eating a whole food plant-based diet, I am not concerned about your ratio of macronutrients. You need a healthy, high fat whole food plant-based diet eating lots of nuts, seeds, nuts and seed butters, avocados or low fat or high carb, low carb, high protein, as long as you're eating your nutrients in the whole plant food form, I think that's probably the most important thing. Or the BPA is the BPA in canned beans enough to worry about. BPA canned beans are more expensive. If you're worried about the cost of beans, I mean, if a can of bean is too much, you can get dried beans, cook them yourself and get really cheap beans. But I encourage people to buy BPA canned, if you're gonna buy canned foods, try to get BPA-free cans or cook them yourself. There's these electric pressure cookers, which within minutes, you can have fresh beans from dried beans and it's amazing. And they actually taste better than beans in the cans, just because they're better texture. Can beans are kind of mushy, whereas if you make beans yourself, they have a really nice kind of firmness to them. And I know that, I mean, for some dishes, it doesn't matter if you're blending, you can make a bean dip or something, but it's actually kind of nice. So check it out. And of course it's way cheaper. Martin Van Wezzel asks, people worry veg diets are hard, and there are many rules, rules, where people think adding meat fixes everything. Can I talk through if a vegan diet is harder to get right? So I mean, eating, I mean, if you think about, yeah, there is certainly the sense that, if you ate a restrictive diet, like cutting out groups of foods, like not eating dairy, not eating meat, then you might, there's this deficiency mindset, that, oh my God, I might get deficient in something. And particularly among the dietetic professionals, because that's their whole, I mean the whole field of dietetics was formed, you know, surrounding these kinds of deficiency states, scurvy, plague rub, berry berry, you know, all these kind of now, thankfully rare, of course you work a rare nutrient deficiencies. Whereas now we are suffering from kind of nutrient excesses. So we're getting too much calories, too much sodium, too much cholesterol, too much saturated fat, too much sodium in our diet, too much refined sugar, too much refined grains, too much processed junk in general. And so now actually the problem with our diets is primarily not deficiencies. It's this kind of excess. And so it's actually easier to avoid those excesses if you're eating a healthier diet, a plant-based diet. And there are a few nutrients we actually aren't getting enough of, like fiber and potassium, where those found predominantly in whole plant foods. So just by eating a diet based around whole plant foods, you will get more of most nutrients. In fact, I have a video about that, you know? And so ironically, eating this restrictive diet, you're actually getting more nutrition, vastly more nutrition than kind of your traditional, oh, I don't have to worry about my nutrients because I don't know, eat breakfast cereal and go out to fast food or something. It doesn't make any sense. Having said that, of course, there's a critical nutrient deficiency in getting a strictly plant-based diet and that's vitamin B12 deficiency. You need to ensure regular reliable source of vitamin B12. But beyond that, you actually, it's easier to eat healthfully if you're eating lots of plant foods because that's where the nutrition is found. That's how the animals that people eat get the nutrition. They're eating whole plant foods. We can cut out the middle mood, by getting our nutrition straight from the ground where the animals that we eat get it from later on. Liz Taylor asks, what dietary recommendations would I have for hypoglycemia? Well, as always, treat the cause. Why are you hypoglycemic? You should go to your doctor and find out. Often people look up on the internet what hypoglycemia symptoms are and say, oh, I have hypoglycemia without actually testing their sugars and seeing that if their sugars are actually dipping low enough to be symptomatic. So you should get that all figured out and then find out what the cause is, treat the cause rather than trying to put a dietary band-aid on it. Leanne asks, does it matter for health digestion whether you sit or stand while eating? Good question. I don't know the answer to that. I don't think I've ever run across any studies. Yeah, so I don't think it's actually been looked into but if you find an article about it, that would be a fun video to do. So let me know and I'll do a video about it. For Shay at Tapas asks, what do I think about Moringa? Oh, I have, there's very, actually very little research done surprisingly on Moringa, but I have them all compiled in a Moringa folder. In fact, I can tell you exactly how many articles are, there it is, Moringa. There are only 46 papers that I can find in the English language, peer-reviewed, medical literature on Moringa. I'm going to read those all and do however many videos I can pull out of that and I will let you know. All right, Master Coach University asks, is it true that the adventure study didn't adjust result? Oh, that's not true. It didn't adjust the results for drinking, smoking out of the risk factors. That's not true at all. In fact, yeah, no, I mean, the whole point of the event, the original adventure study, when they compared them to Baptists and Mormons and things, it was to actually look at the effects of smokings and the contributions of smokings. The adventure studies have done, go through all the kind of main, confounding risk factors to pull out. What are the contributors of diet compared to other lifestyle factors in terms of chronic disease? In fact, they're famous for that. Botany Woman asks, when will, when will the fasting videos? Yeah, oh my God. So they actually may be pushed back even farther. So that's what I was working on last time, last week to spoke. The, doing, I was going to put together a dozens of videos on fasting, intermittent fasting, ketogenic diets, calorie restriction, and then new book deal. So the, doing this new book, How Not to Diet, talking about weight control. Manuscript is due March, 2019. And so I need to buffer out videos. I only have about 100 days to script out 115 videos. And so I have to give up working on massive topics like fasting and move to smaller, easier, scriptable topics like T-troll and aloe vera, which is what I've been working on the last two days because there's just very little in literature, whereas there's hundreds of fasting videos or something like a few dozen videos on aloe vera. And so, ah, very easy to script videos because I have to buffer out videos so I can spend a year writing my next major work. And speaking of lots of videos, I mean, there are 80,000 articles published on obesity every single year. So already by the time I start writing, I'm hopelessly behind. So it's a huge, intimidating research task, but I am looking forward to taking it on. But to do that, I'll have to push fasting back. So I know if writing goes amazing and I get this book done by the end of the year, by the end of 2019, no, 2018, months before the manuscript is due, then my priority will be both the fasting series as well as my how to read a research paper series, another series of videos, which I think will be really helpful for people putting the webinar as well. I feel terrible about those. I love doing the webinars. I do have one more webinar coming up. You have 11 days from today to sign up for my next webinar, my cannabis webinar. You go to NutritionFacts.org slash webinar to sign up. There will be a delay till the next one, just because I have to go back into the library into research hunker down mode. And our time is up. I'm actually a minute late for a, that's my interview calling. I've got to go. Sorry. Quick.