Q&A with Dr. Greger 2

I know you work hard to make the best lifestyle choices. You can improve your

health, Destiny and Longevity

and there's lots of information out there on how to do just that. So, where do you start? Well,

we start with the facts.

Welcome to the nutrition facts podcast. I'm your host dr. Michael Greger. My job is to bring you the latest peer-reviewed nutrition and health research and share it with you here. Today, we have a special edition of

Facts Q&A where I answer a wide variety of your questions on

YouTube. On a

cornucopia of topics including the

prevalence of bone, fractures and vegans and how to wean yourself. Off blood pressure medication. Enjoy,

I am here in an air B&B in Los Angeles temporarily. While I figure out kind of as well as a staging ground to figure out where I'm heading off to, to write my next book in 2021.

Do you know normally I'm

restricted to cities

with big airports because I travel

so much but now since no

one is traveling much anymore, I can live anywhere. So with a good internet connection. So if anyone has any good housing leads for a book Retreats you know I'm thinking Austin's. Yeah. Well who knows? But I can go anywhere so

let me know if there's a quiet place with good internet

you recommended. Maybe I'll write my next book in

Her hometown or Hamlet or city or

who knows by next month. Hopefully, my next month's live Q&A. I hope they'll be back in my treadmill and know

where I'm going to be in the near future.

All right, let's get to your questions, shall we? All right. Oh, see. At the beginning. There's so few other questions haven't aren't coming in at such a rapid rate. I can

actually pick and choose

some. There they go. I was

to pick and choose but now they're flooding in so much. I just have to do my roulette wheel and click on one and we'll see

what pops up in the feed.

Alright. Um, new track a semi familiar with gardein products and if you are, are they any good? Yes, o Guardian. Is, I manufacturer plant-based meets famous, I think for their plan based chicken products. And so I view these plant-based, recent did a whole webinar and I have

The videos coming up on it

is a great stepping stone foods. Not everyone can go kale, quinoa overnight but you know, for someone who, you know, wants

to eat healthier, but once the same texture and mouthfeel and

Familiar Taste that they've grown up with, that's where I see

the role things like the impossible burger and Beyond meeting all these things coming in. Helping people transition towards a healthier diet

though, I wouldn't want people to kind of to stop there to stall there and

Continue to improving healthier to improve the healthfulness of their diet by

eating as many whole unprocessed plant Foods as possible.

Next up, Danielle asked new articles, new articles published on bone fractures in vegans came from the Epic

Oxford study recently. I think one or

two days ago studies often criticized because they're looking at a cohort of British

vegans is the second, largest study of vegans in human history.

But in the UK, If you do surveys, that number one reason people eat plan.

Is for like, Animal

Welfare reasons rather than health,

whereas here in the US

where, for example, the largest study of being is taking place the advantage to study, people tend to, you know, start cutting down to meet etcetera because of, for personal

health reasons. So, over in the UK,

the vegans in this study are eating kind of junky diets because they're really not caring about their own health, or just kind of thinking about

Kind of animal suffering concerns

and so. But that criticism only goes so far because the study, I mean, it's not like the meat eaters aren't eating crap to and so it's comparing people eating crappy diet of processed foods with or without meat eggs and dairy and so you can see what does that do. Does that a meat eggs and dairy to crappy processed foods? How much does

that impinge on one's Health? One

just can't extrapolate the

These outcomes of that group of vegans to people who are eating more Whole Food, plant-based diets, who you know, people who are actually eating their

vegetables. And it's interesting, the advantage to studies, actually the reverse, its

everybody's eating healthy

and so it's like, what if you actually compare people actually eat their vegetables or eat their vegetables plus me texting there. And so then again you can

compare the vegans for meteors the same kind of

cohort and see

What does adding meat eggs and dairy to an overall healthier diet or an

overall kind of standard Western diet

in the case of Epic Oxford and so. But again, you can't necessarily extrapolate the disease outcomes. So, you know, the event is to study vegans. Have so much less cancer. But yeah. But they're also eating healthier. So, you know, you can't, you see vegan Donuts, all day and

think I'm be protected from cancer necessarily anyway,

so but epic Oxford.

Actually just well couple weeks ago. Finished video series on bone

health in vegans. This course before this new study came out

and, you know, epic Oxford had some

preliminary data on bone fracture years ago, and

found. Well, let's instead we get in before we get to the fracture data, if you look at the bone mineral density of

vegans versus meat eaters,

it's lower bone.

All density, but that difference disappears

when you troll for body mass index and the explain what that means.

So heavily your people have stronger bones. Why? Because they do weight-bearing exercise walking across the living room, right? It's use-it-or-lose-it. Your skeleton is constantly Remodeling. And if you in pay, if you go out jogging, you do some impactful, you know, you put some beer, some weight on it, your skeleton get stronger,

And so, you know, so being overweight is like having a 50 pound backpack on all day long. If you got a fifty or a hundred extra pounds on your back all day long, your skeleton would get really strong. And so that's why in general regardless, what you eat,

those who are obese can have higher bone, mineral density

also having all that excess fat

for women. Well, for men to increases estrogen levels and estrogen makes for

stronger bones out

Is why

women going through menopause start losing accelerate, the loss of their bone mass because they have less estrogen. But obese women have higher estrogen levels in the blood because there's an enzyme in fat tissues that that, that produces estrogen, which is

bad for breast cancer risk, but I'm kind of good for bone health. And finally, I mean if you just having extra padding, right? It's harder to break your hips. If you have a lot of padding between

Bone and the sidewalk you've accidentally fall. So there are number of reasons why people who are overweight obese, have less, you know,

hip fracture rates for example.

But and so, but it's so if you compare for the so, you know, vegans tend to be so Slender on average and so, but if you compare meat eaters and vegans with at the same weight, then indeed the

difference in bone mineral density disappear. So, the only reason they have low bone mineral density is because there's

So slender overall.

And so the reason why epic Oxford the vegans had higher fracture rates most actually wrist fractures and and you know part of that it's not necesarily awesome product bone but you people are more active tend to have more risk factors because they're out playing

tennis and stuff and you know, are active

individuals. And so, you know, vegans are both slender and so healthy. They're out there, they're active, maybe they're more

My to injure themselves and break a bone as opposed to like vertebral fractures or hip fractures, which tend to be less kind of injury related or activity related, physical activity, related more having to do with having excessively porous bone.

But epic Oxford. Actually control for physical activity levels and still found higher fracture rates among vegans, but that difference disappear when you control for calcium. So vegans, who are getting more than 525,

Milligrams of calcium a

day did not have higher rates of bone fracture and

so you know

this is a you know video I

did a long time ago saying we just have to make sure we get enough calcium. Where do you

get possibly source of calcium almonds and sesame seeds and tofu and calcium fortified plant-based milk

healthiest or so is dark green. Leafy vegetables. That's where the cows get their calcium from but you don't have to eat grass. Kale collards bok choy

any of the

Green leafies, with the exception of spinach, beet, greens, and

swiss chard, fantastic food, but a little

stingy with their calcium. But

so anyway, Eat Your Greens. Okay. But the new epic Oxford study, they still found excess fracture rates even after controlling, for

exercise and even after controlling for calcium. I mean, take

and even

To controlling for bone mineral density. So the question is Okay, now what's going on? So definitely have to go back and redo the video series because it

was done before,

but the videos aren't even up yet. So that's perfect. And I'm happy to

always go back when that's the whole point of science is, to is to update with new data.

And so, so there's a number hypothesis that that the

investigators reached out. So for example, protein intake

Igf-1 this cancer-promoting growth hormone, is it when you eat a lot of protein, you increase your igf-1

levels and so you can increase certain types of cancer,

but it is a growth hormone and can cause bone growth as well, but that's

unlikely to be the case.

Because plant-based protein associated with much stronger bones then animal. So plant-based protein like beans associated with much denser, bones, stronger, bones than animal-based.

Protein like me. So that doesn't seem to make sense. What about Vitamin K? Vitamin K

comes from dark green. Leafy vegetables. But that's vitamin K1. There's another type of vitamin K called vitamin K2. That's found mostly in animal products like meat and dairy could that be what's going on.

Well, with there's actually never been good evidence that there's any difference between the activities of K1 and K2. So K warns you to everything the K2 does but it doesn't matter why.

Cause we make all the game to we want. The only reason the cow has K2 is because the cow makes k 2 and we have because they're mammals. And guess what? We're mammals to. And we make a to have an enzyme discovered in 2010 that just creates K2,

no reason to take vitamin K2.

And so that's not the problem either. Um, probably more

likely vitamin D. So this

it was

in Great Britain, and during the end, we'd like to get our vitamin blood, vitamin D levels up to about, probably ideal a 75 animals per liter which

is like you know, 30 uh nanograms per milliliter depending on what kind of units. You use

and vegans, totally nail that in the summer. There's the sunshine vitamin. But during the winter months and we're creeping into that vegans, dip down in the UK.

There is such a high latitudes. The

sun's rays are at such an angle,

that vegans, dip down

like below 40. So that's like less than like 15 and grams per milliliter

and that's because there are the food. They're not eating food sources of vitamin D, like oily fish and there's just not a lot of sun around. So that's why it's important for those getting inadequate sun exposure. My look doesn't matter where you could live in Phoenix. If you never go outside, right, then then you know, yeast,

You need to get vitamin D from from somewhere and so the vegans are dipping low enough

during the summer months on vitamin D, that that may play a role.

Although the same time, you know, if you do randomized, control, trials, giving people vitamin D and increasing levels, you don't see a benefit in

fracture risk. So then that we're kind of argue against the vitamin D, hypothesis. However,

you give them calcium and vitamin D together, you can decrease fracture rates. So it may

actually be a combination of the fact that

Vegans on in Great Britain. Dip too low during the winter months and I may have inadequate, calcium intake. And that combination is what's causing these excess fractures.

Or you know, it could actually be D12, there's

recent system, systematic review, you know, they don't supplement organic foods in the UK by law with betrayal. That's like an added like artificial things and buy organic standard.

Doors over there, like the swing milk and, you know, you know, plant-based meat and things that we normally have B-12 here in the state doesn't have any B12. And so if you're not supplementing, you probably not getting it. And so,

the vitamin

B12, deficiency rates among vegans in London, is really off the charts. It's really, they need to better job over there. Getting people. I'm eating plant-based diets to take the B12.

But this latest systematic review on B12 and Bone

suggests is really kind of complicated.

The relationship between bone and b12. But

complicated is my middle name. That's what you pay me for. That's what you make donations to nutritionfacts.org the fire, 501,

c, 3

non-profit. I'm to do the Deep digging and figure out. So I'm going to do a deep dive and

just like it is with the stroke data and the come up with series videos and figure out what's going on with those that the new data

and then I'll get it out to you so we can all be healthy.

Okay. Next question, John asks, have been your program for six weeks. Getting off a blood pressure medication sholay. Fantastic lost 5 pounds, but now have plateaued on beta

blockers. In terms of, it's one of the blood pressure, kind of medications,

so I would encourage. So the first thing I think of is excess sodium intake, so you can eat plant-based but still

Get excess sodium

on because so many so many basically almost anything in a can or a box or bag. Processed foods has a lot of salt, add to it as a taste

enhancer. So I'd encourage you to you know hit the American Heart

association's. Recommended 1500 milligrams of socio sodium limit which which means basically really cutting out processed foods and I

Bet you more blood pressure will drop to reflect your new healthier diet. Have some videos coming up on, potassium salt, potassium chloride, and whether or not that it was a number of salt substitutes on the market, whether that's a good alternative and spoiler

alert. Yes, it is actually not just maybe

neutral harmless but actually helpful actually beneficial because so many of us don't get enough

potassium. So

But there's a very important caveat. You have to have

the kidneys to handle your kidneys. If you have healing kidneys kidney, dysfunction, kidney failure, you can these substitutes are too high in potassium, so, but a lots more details coming up in that video. I think I'm old. Seriously, this coming up, I've been buffering videos like crazy because I had kind of come up with a whole

years worth of it, is because I got to write the next book. And so, I've got

the just all sorts of fun.

Juicy stuff coming up for you. All right. Next up,

ah, and that is just replying to somebody Adele osweiler's. Yes, indeed you not ask. So you wait 30 minutes to an hour before or after eating meal to drink, matcha tea, bro? That's a great question. Although, I mean, I'll read the whole questions just in case. I don't know you're listening to this is some kind of podcast in the car or something, but for those who can't see the screen here, it says, should you?

30 minutes to an hour before and

after eating meal to drink matcha, green tea for optimal nutrient absorption. What we're concerned about is iron absorption, any kind of tea doesn't have to be green tea, black tea, any of the t's will do it. In fact, coffee does it to do T is worse.

And indeed, you should not drink tea with meals, a so 30 minutes to an hour before? Absolutely, probably even

longer afterwards. You can take hours for your stomach to empty and you really don't want tea in your stomach is the same time.

I'm as I am with fruits because it'll actually bind up the iron and will inhibit its absorption. So no tea with meals,

drink it before that you're

some drain and then wait a few hours afterwards to resume your tea habit. Same thing with coffee, but just not as bad. Absolute videos coming up on that too.

Okay, special issued with a certificate of analysis proves. There's no

pcbs, mercury in dioxins to save source of D DHA.

Many of these so-called

certificates are just bogus, they're not third-party independent, they just don't company certifies itself, which is kind

of slimy. There are certainly it. So, there's the problem with there's distillation

techniques where you can just fill out some of the heavy metals, but unfortunately, I many of the pesticides.

Some of the lighter industrial toxins just spill over. And so, even when you do actually look into distill fish oil, you still see pollutants. You unfortunate just can't get away from it and make and still make an affordable supplement. So, and the

question is like, why would you need fish oil? The first place there are polluting

free, completely polluting free sources. Algae-based

Tasty PA DHA or your own body. Can make some from the searching Omega-3s. You get in walnuts and flax seeds and hemp seeds and chia seeds, Etc. All right, thank you

Vladimir. For that question. Next up, Amy asked is night on something and needed if you eat iodized salt already? Um,

no you should you probably if you eat, I die. So, like typical people eats up,

um, You probably getting in a five nine

First of all, you should make sure it's iodized.

Yes, you look at the ingredient list, only about half the salt is I Dice and all the pretty much all the salt use commercially like, you know, in restaurants and processed foods is not iodized sea salt. Tells me, not ionized all those fancy. Silly salts like Himalayan sea salt stuff.

Not I die. And but, I don't think you should

eat any. I'd I sold, why? Because you shouldn't eat.

So if you do, it's a definitely do.

Ooh, ionized. He's very good iron, but

we shouldn't be eating. So, because sodium is digest. Number one. Dietary risk factor for death on the planet Earth. Worst thing about Humanity's diets, excess sodium. Not like I said, increase your risk of high blood pressure, heart disease, kidney disease on down the

list. Anyway, so where do you get your nighttime from the healthiest? Source is see much troubles like Nori

or you know those Nori sheets. You can get you.

Quantum is snacks. So to add, a, get all the iodine you need

or, you know, like,

was like a happen. Forget you have to look at the video. Things like 1/2 teaspoon of dull, saw rerum. A really mild seaweeds are people who don't like to see. We do taste or like a spoonful of will comedy, the make seaweed salad, with, or something like that.

There's be the healthiest sources

of iodine. And then there's

iodine in foods grow on the ground, but it depends. What kind

of soil either.

Animals are so you want to figure rival Source, particularly if you're pregnant, so critically important that all prenatal vitamins have iodine and they don't, which is ridiculous.

So so

make sure your prenatal has iodine, critically important for all pregnancies to get. Make sure you have enough iodine.

Well anyway, okay, Angelica history of blood clots and transitioning plant-based Foods. Well, if you,

I'm not sure what your question is. But if you are on a

Blood thinning medication called Coumadin, generic and Warfarin. Then you need to make sure you type your doctor tight race, two levels of that drug to vitamin K rich foods. Dark green leafy vegetables. Because so Vitamin K is important for blood clotting. So when you take a drug that blocks

vitamin K, the action of vitamin K. And so then your Bloods really

thin, but if all the sudden you eat a big spinach salad and your you have so much vitamin K that your drug dose,

Is too low. Then also you blood clot again. So, if you have a clotting

disorder that can be bad, in which case, it's not like you shouldn't eat those

greens. You just make sure you the same amount of greens every day and have your doctor titrate up to do. So, with optimally blocks, and then you get all the benefits of greens at the same time, Best of Both Worlds.

Maria says, is it right that when you eat animal products, you consume antibiotics and weakening your body. Someone said that when you

heat in a box, it doesn't work, no more. So it doesn't matter if you consume it that way.

I'm there are antibiotic residues found

in found in meat

of the primary problem

with the use of antibiotics. And then my culture is it's

just gross and antibiotic resistant bugs that can then. And so that's the biggest threat that you'll get some antibiotic-resistant infection. Either from me products or

from someone who eats meat or from you know, manure runoff or there's all sorts of really ways.

These antibiotic-resistant bacteria can infect

People, regardless of what they eat. So that's the primary problem but there are

antibiotic residues found in the antibiotics themselves. But what effect it has on the microbiome or on human health in general, it remains an open question. So but if there's any about that, I'll do videos about it.

Okay. Next up, NK

says, what B12 supplement brand. Do you

recommend? So I

I'm glad that NK specified,

cyan of golemon, because that's the best form because the most shelf stable form

and what's the brand. So I

recommend you in terms of supplements in general,

you can see if they have something called good manufacturing practices seal that at least need some kind of minimal standards

in terms of supplement manufacturer, but ideally it would be

Be UPC certified, which is,

which is a third party certifier that actually goes. And make sure that what's in the bottle is, actually what's on the label actually is actually widen the pill now doesn't mean it's good for you. I mean, I mean so just because that's on the subnet doesn't mean you

should take that something

but it just says that there's truth in advertising, right? That it says this must be 12 and that's how

much the pill has

and so that would be the best so I know

Shouldn't a couple different brands that do that, you just have to look at the actual bottle. I think one brains

called Nature's made. Another one's called Kirkland brand was like, Costco brand on my think is UB CE certified. You'll see the little circle, little seal on those products and then you just know that you're actually getting B12

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