Dr. Fuhrman interviews Dr. Gregor

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Dr. Fuhrman interviews Dr. Gregor

Postby didi » Sun Mar 11, 2012 7:26 pm

Jeff, I am interested in reading of any comments you might have on the study referred to in Dr. Fuhrman's interview of Dr. Gregor in which they both agree that the low fat, starch based diet is not science based, but rather ego based and based on the opinions of experts.

Here is Dr. Fuhrman's study, the only one he offered:

http://www.drfuhrman.com/library/high_n ... _loss.aspx

Bye the way, I was quite surprised that the mean value of the drop in cholesterol after two years on Fuhrman's program was only 15 points.

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Re: Dr. Fuhrman interviews Dr. Gregor

Postby JeffN » Mon Mar 12, 2012 9:59 am

I will comment on the above linked study but before I do, a few comments on the interview...

First, we have to be careful with any posted online interviews as what we see is often only snippets of what may have been really said. And without seeing the full discussion, it may be hard to put it all in context. Now, this is usually done for time and space considerations and does not mean anyone is deliberately trying to be misleading (though that is sometimes they case as we saw with the famous Gary Taubes article). I have even see this several times with my own interviews that have show up online in video or text.

Second, while this is only anecdotal, (though proven out in all of their studies), Dr Greger said himself in the interview...

"I wanted to put a bigger dent in our health care mess, especially after seeing my grandmother suffer so much from her multiple bypass surgeries and then being sent home to die, wheelchair bound with crushing chest pain. My grandmother then became one of Pritikin’s earliest adopters and I watched her actually reverse her heart disease and get well. She was able to live another 31 years after her terminal heart disease diagnosis to be 96, and enjoy her 6 grandchildren, including me. "

So, in spite of it being one of the stricter low fat, plant based diets around, Dr Gregers grandmother became well on it, reversed her heart disease and lived another 31 years to 96 after having had multiple bypasses, been wheelchair bound and sent home to die.

Not bad for a diet that is supposed to be "outdated", "ego-based" and based on "old theories" and not the "best science-based advice." :)

In regard to the science, here is the full list and description of all the evidence from Pritikin (1981-2008)

http://www.pritikin.com/your-health/pri ... ation.html

In addition, the Ornish "Reversal" program, remains a 10% low fat plant based diet and can be seen here

http://www.pmri.org/lifestyle_program.html#nutrition

Their long list of published peer reviewed research can be found here..

http://www.pmri.org/research.html#heart-study

Third, I work closely with Dr McDougall and Dr Esselstyn and ran the Pritikin Center for 10 years, and none of their diets are "white rice" or "white potato" based. In addition, McDougall and Pritikin include the use of nuts, Esselstyn includes flaxseed and Ornish includes fish oil.

In regard to the study linked above, while we have analyzed studies here many time before, we can walk through this one today (even though this study is not actually referenced in the interview), as this is a great opportunity for us to look at an actual study and how studies are done and learn from it. This is especially timely to do now since our very recent discussions here on "The Importance of Evidence."

And, as Dr Greger himself said in the interview, "it's always best to seek out the primary sources to review them rather than rely on expert opinion."

So, lets do that.

For anyone who wants to follow along, you can read the full study here...

http://www.nutritionalresearch.org/site ... ss-HND.pdf

Here are my comments...

1) The study uses what is called a convenience sample. However, a convenience sample does not adequately represent a population and therefore cannot scientifically be used to make generalizations about a population.

In regard to a convenience sample....

"A convenience sample is a sample where the patients are selected, in part or in whole, at the convenience of the researcher. The researcher makes no attempt, or only a limited attempt, to insure that this sample is an accurate representation of some larger group or population. The classic example of a convenience sample is standing at a shopping mall and selecting shoppers as they walk by to fill out a survey.

In contrast, a random sample is one where the researcher insures (usually through the use of random numbers applied to a list of the entire population) that each member of that population has an equal probability of being selected. Random samples are an important foundation of Statistics. Almost all of the mathematical theory upon which Statistics are based rely on assumptions which are consistent with a random sample. This theory is inconsistent with data collected from a convenience sample.

In general, the statistics community frowns on convenience samples. You will often have great difficulty in generalizing the results of a convenience sample to any population that has practical relevance."


2) Obesity is still the biggest health problem of Americans. Today, 68.8% are overweight with 35.7% of them considered obese. The average BMI (body mass index) of American adults is 28.7 - on the high end of the overweight range (25.0-29.9), and inching closer to the obesity mark (30.0).

As such, we should be concerned that in over 3 years, only 56 patients could be accumulated for a study on weight loss. This might indicate that the practice may not be seeing a large amount of patients in general, let alone for weight loss, which only further diminishes the "convenience sample" evidence we get from these subjects.

3) Of the 56 patients seen for weight, only 38 could be located and of the 38, only 33 returned after a one year follow up (which is a one year drop out rate of 41% of the total and a14% drop out of those who could be located ) and only 19 returned after 2 years (which is a 2 year drop out rate of 66% of the total and a 50% drop out rate of those who could be located). This would seem to indicate very poor follow-up and/or a lack of compliance. This is important to consider as it would be important to know why and what happened to the other subjects and why they did not return. Most importantly, it is difficult to draw any firm conclusion on any study when over 1/3 of the participants dropped out after one year and 2/3 of the participants dropped out after 2 years.

4) In the study, “overweight” was defined as men with body weight >170 lbs and females >130 lbs.” This indicates that only body weight was considered (and not height) when determining which subjects to include as being "overweight." However, according to the NIH and CDC, overweight and obese ranges for adults are determined by using BMI, which takes into account both weight and height. As such, using weight in and of itself, is never a determining factor for labeling someone overweight or obese. So, the credibility of a study on weight loss is really undermined when the accepted criteria for determining overweight is not used.

5) In addition, the study does not describe how the weight loss was determined and/or how it was measured (actual, self-reported, recall, etc). As such, we also don't know if there was any consistency (individually or collectively) in how any of the subjects were measured (ie same scale, same time of day, similar clothing, etc). Again, since the focus of the study is on weight loss, this is a vital piece of information that is missing.

6) The article says, “A HND diet as demonstrated with this group may be the most health-favorable and effective way to lose weight for appropriately motivated patients.”

"Health favorable" usually means, more than just weight, as we all know that just being thin, does not always equal being healthy. So, we have to look at the other parameters mentioned in the study (ie blood pressure, cholesterol, etc) and see what happened to them.

So, lets look at Table 1.

- In regard to weight loss, there is a decent drop from initial vista to 6 months (221 to 189). However, the weight basically stayed the same from 6 months to 18 months. Then another drop of 188 to 168 from 18 months to 2 years. So, without knowing more, and knowing that there was a big dropout between between year one and two, it looks like only those who stuck with it came back at 24 months and the others may have dropped out because they were not losing any more weight. In addition, while weight is important, it would be more important to know their BMI's.

- In regard to BP, while there was a initial drop in systolic from 158 to 141 at the first 6 months, it never dropped any further over the next 18 months. 141 is still high. Same with Diastolic, which, while it dropped from 93 to 85, it never went below 80, let alone 70, which is what is ideal. So, total overall change in blood pressure was 158/93 to 143/84. Based on parameters of the American Heart Association these are both in the category of High Blood Pressure Stage 1. This says that while pressure went down somewhat, there was no "clinically" significant change in blood pressure.

- In regard to cholesterol, there was a drop of 196 to 185 in the first 6 months, but no further change over the next 18 months. Same with LDL, it dropped from 122 to 108 but never went lower. And, we see it actually went up from 108 to 118 at 12 months and 18 months and then dropped again to 107 at 24 months. Under 100 is what is recommended for LDL and under 70, is considered ideal. Overall total change in cholesterol went from 196 down to 183 which is a drop of 13 points over 2 years, which is about a 6.6% change. This is a modest benefit at best. The overall drop in LDL was 12%, which is good but as we see, it could be better.

- Triglycerides fell from 154 to 129 in 6 months but both numbers are considered good as anything under 150 is considered ideal. However, the TG's were trending up as they were higher at 2 years than at 6 months.

- Lastly, notice all the (n)'s at each time interval is different meaning they were not able to get all measures on all people. For instance, at two years, they have the weight of 19 people but the BP of 14 and the TC, LDL and TG's of only 10. So, we have 19 final subjects but only the lipid numbers on about half. I would be important to know where are and what were these numbers for the other 9 subjects. Without knowing this, it only further diminishes the value of any of the stated results.

8 ) The beginning discussion and review of the literature was not very thorough. The one study that was referenced was a very small study with very few subjects and it only lasted 30 days and was done in 2001. However, many well done studies on weight loss that have shown much greater success in weight loss (over 100 lbs) and in adherence (from 2 to 7 to even 10 years) and much better lowering of risk factors (BP, Chol, etc) were left out of the discussion.

So, with all due respect to all of the authors of this study, it is not very well done at all and it proves little to anything about the effect of a HND on weight loss.

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Re: Dr. Fuhrman interviews Dr. Gregor

Postby Adam1984 » Mon Mar 12, 2012 11:16 am

This is the problem witn nutritional science. Someone
Takes a convenience sample and after 2 years only 2 years
Makes the conclusion that this may be the best way to eat and lose
Weight.
This is why the food recommendationa change all the time.
Researchers are convinced a certain way of eating is the only
Way and desperately looks for evidence to prove his point.
Any small, biased piece of evidence is taken as suggestion that
His hypothesis is right.

Jeff, I have read your work, DrM's work, dr.Ornich work and I
Don't get why some people would think of your ways of eating as
One that only cares about percentage of fat. It's frustrating because
People easily believe when it comes from other dieticians. For
2 years I thought starch is all junk that should be eaten rarely because
Of comments like this interview.

Imagine someone like me, yes I have a degree in statistics but when
Someone like fuhrman ir gregor says something we easily believe it.

After switching to a starch based diet, i am doing very well. No
More junk for me. I dont crave junk anymore!
people say they have to be motivated before
They do something. I say do it and the motivation
Will come.
-Dr.Oz
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Re: Dr. Fuhrman interviews Dr. Gregor

Postby JeffN » Mon Mar 12, 2012 11:23 am

Adam1984 wrote:Jeff, I have read your work, DrM's work, dr.Ornich work and I Don't get why some people would think of your ways of eating as One that only cares about percentage of fat.


You raise a very good point.

During my tenure with Pritikin, I had them remove the emphasis on "low fat" and even "very low fat" which they had often used previously.

The reason was, even though the diet was lower in fat, and especially saturated fat, this was only one aspect of the diet and really did nothing to describe the many other wonderful aspects of the overall diet and lifestyle that they recommended. (unrefined, unprocessed, high fiber, low cholesterol, low sugar, low salt, etc etc)

So, Just as we know that there are unhealthy vegan diet and healthy vegan diets, we know there are unhealthy low fat diets and healthy low fat diets and it is important to distinguish between the two (and any diets in comparison) by examining the overall qualities of the diet/lifestyle.

This is also the same message I teach in the label reading and the key point I made in the recent DVD, Nuts and Health. We must look at the overall picture and context and not any one isolated aspect of a diet or of a food.

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Re: Dr. Fuhrman interviews Dr. Gregor

Postby greentea » Mon Mar 12, 2012 5:25 pm

Wow Jeff, thanks for that lesson in looking at a study! I really learned a lot.
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Re: Dr. Fuhrman interviews Dr. Gregor

Postby noelalexis2000 » Tue Mar 13, 2012 5:31 am

Thanks Didi for posting question and thank you Jeff for such a thorough reply to the topic. :)
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Re: Dr. Fuhrman interviews Dr. Gregor

Postby didi » Tue Mar 13, 2012 5:34 am

this is the first time I ever heard of the term, convenience sample. Does that make Dr. Esselstyn's study one that used a convenience sample? The people who come to him are self selecting. One third of his original patients dropped out of the initial study but we do know what happened to them--they had more coronary events.

I seem to remember that pritikin allowed a few egg whites, a cup of skim milk and three ounces of lean meat a day but no more than a pound and a half a week.. He did recommend going without this meat a couple of times a week, however. I think he, himself,was more strict with his own diet than that recommended in his book.

I am surprised Fuhrman's patients did not lose more weight since it seems his diet is closer to the MWL plan of McDougall. I think the big difference could be not so much in the actual diet but the fact that Dr. Esselstyn gives so much personal support to his patients. I am also wondering if the poor results in cholesterol and blood pressure lowering are also due to the lack of frequent contact with the study subjects and thus an increased degree of non compliance. The McDougall website and all the support it provides from others on the diet and from the questions answered by the experts and the available access to the results of research has to go a long way to ensure compliance.

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Re: Dr. Fuhrman interviews Dr. Gregor

Postby JeffN » Tue Mar 13, 2012 8:47 am

Thanks.

You raise many good points, all of which only furhtur highlight the recent discussion thread on the "Importance of Evidence" and how to understand it.

didi wrote: this is the first time I ever heard of the term, convenience sample. Does that make Dr. Esselstyn's study one that used a convenience sample?


His sample had a self-selection bias and both a self-selected sample and a convenience sample are examples of an "unrepresentative sample" which means it does not accurately represent the total population.

Sometimes though, a narrowing of the sample is important and even necessary. In other words, if I was going to test the impact of a drug to lower cholesterol, I would need to test it only on people with high cholesterol. :) So, while they do not accurately represent the entire population, they do represent my "targeted" population. However, I would still need to randomize them as much as possible especially into who gets the drug and who doesn't.

In regard to the MS study, we are only targeting subjects with MS but within this group of subjects with MS, we are randomizing them into who gets the treatment diet and who gets the standard diet. As such, in the conclusion, it will state, "in patients with MS....".

So, all studies have strengths and weaknesses and it is important for both the authors of the study to point these out and for the readers of the study to understand them so we can all put each study into the proper context.

As an FYI, I think Dr Esselstyn happens to do a great job of that and I would encourage anyone who has not read his full studies to do so here.

http://www.heartattackproof.com/study01_background.htm

http://www.heartattackproof.com/reversal01.htm

I think he does a great job of putting his work into the proper perspective while recognizing its limitations. This was also something that I thought Pritikin always did well. The authors of their studies recognized and discussed their limitations while putting their results into the proper perspective.

didi wrote: The people who come to him are self selecting.


Correct so both have inherent limitations.

Many of the studies used in our WF,PB "world" have a pre-existing bias, whether it is a lack of randomization from using either convenience sample or a self-selected sample, or the lack of a control group or a small sample size, or other limitations. This does not make the data useless, but is important for us to know these issues and as such, to be fair in how we present the data.

Think about it, anyone who comes to see Dr Esselstyn, Dr McDougall, Dr Fuhrman, or the Pritikin center, voluntarily chose to do so, and was motivated to do so, which eliminated the issues of the sample being totally "random" and lowers the strength and application of the study. However, Dr Ornish's original study was both a randomized and controlled trial but was limited in the size of the two groups.

Fortunately today, the quality of the research has improved. Dr Barnard has done several RCT's and the current MS study by Dr McD is a RCT. I know Dr Fuhrman is working on a new study and I believe it will be a RCT also.

didi wrote: One third of his original patients dropped out of the initial study but we do know what happened to them--they had more coronary events.


Yes. The good news in this situation was that he kept them in the study and used them as the "control" group but again, not the ideal way of choosing a control group. Usually a control group is selected as part of the random sample where as here, the control group was self selected by those who choose not to follow the program.

didi wrote: I seem to remember that pritikin allowed a few egg whites, a cup of skim milk and three ounces of lean meat a day but no more than a pound and a half a week.. He did recommend going without this meat a couple of times a week, however.


The original Pritikin Diet allowed only 3.5 oz of fish a week. It also allowed for 3-4 egg whites per week and a cup of non fat dairy/day.

didi wrote: I am surprised Fuhrman's patients did not lose more weight since it seems his diet is closer to the MWL plan of McDougall.


Agreed. However, besides the sampling issues, we also have the issues of how overweight was defined and also how it was recorded. So the bottom line here is that we really don't know what happened.

didi wrote: I think the big difference could be not so much in the actual diet but the fact that Dr. Esselstyn gives so much personal support to his patients. I am also wondering if the poor results in cholesterol and blood pressure lowering are also due to the lack of frequent contact with the study subjects and thus an increased degree of non compliance. The McDougall website and all the support it provides from others on the diet and from the questions answered by the experts and the available access to the results of research has to go a long way to ensure compliance.


This is another good point. In order for us to be successful, most all of us will require support in many ways (education, reinforcement, social, family etc) and for most of us, the more support we have available to us, the better. Many studies over the years have pointed out that the more contact points we have with the patient (phone, email, visit, etc) and the more frequent, the better the patient does.

Dr Fuhrman has a fully functioning website that provides online support including his active involvement and that of other MD's in it. However, we do know what access was made available to the patients in the study during the course of the study, if any at all. We also don't know how regularly the patients were seen if at all between the recorded intervals, and if there was any other support provided (email, mail, phone, group, etc) all of which would be important to know.

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Re: Dr. Fuhrman interviews Dr. Gregor

Postby landog » Tue Mar 13, 2012 9:49 am

To demonstrate that a particular diet can halt or reverse heart disease, it is necessary that the participants in the study have heart disease. Dr. Esselestyn took patients with severe heart disease and demonstrated that diet alone can halt and, in many case, reverse heart disease.

I don't think the fact that his sample wasn't representative of the general population detracts from the significance of his results.

Thank God (and Dr. Essy) that he did, else I would still be eating hamburgers and statins and heading towards a heart attack!

Be well,
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Re: Dr. Fuhrman interviews Dr. Gregor

Postby JeffN » Tue Mar 13, 2012 10:10 am

landog wrote:To demonstrate that a particular diet can halt or reverse heart disease, it is necessary that the participants in the study have heart disease. Dr. Esselestyn took patients with severe heart disease and demonstrated that diet alone can halt and, in many case, reverse heart disease.

I don't think the fact that his sample wasn't representative of the general population detracts from the significance of his results.


Correct 100% as with the example I gave above with MS and with cholesterol drugs. Sometimes, you have to limit the selection process.

This is why not all bias's and limitations are bad but just need to be pointed out and discussed and applied appropriately.

And, I think he did an excellent job of doing so.

Even Dr Campbell has expressed these issues himself in one of the AJCN articles where he is discussing the results of the "China Study"....

"First, this study is ecological and includes 6,500 individuals residing in 130 villages. Thus according to widely held assumptions, any inferences concerning cause-and-effect relationships should be considered to be hypothetical only, with validation to be provided only by intervention or prospective analytic studies on individuals."

Campbell TC, Junshi C. Diet and chronic degenerative diseases: perspectives from China. Am J Clin Nutr 1994;59 (suppl):1153S-61S

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Re: Dr. Fuhrman interviews Dr. Gregor

Postby secdroid » Sat Mar 17, 2012 9:50 am

Thank you for the detailed analysis. Very helpful.
JeffN wrote:This is another good point. In order for us to be successful, most all of us will require support in many ways (education, reinforcement, social, family etc) and for most of us, the more support we have available to us, the better.
This certainly has been true for me. While I've read books from McDougall, Ornish, Esselstyn, Fuhrman, Hyman and others, as well as viewing Novick videos, I find the McDougall forum community to be invaluable. The Star McDougaller examples, tips, and answers from experienced McDougallers has been extremely helpful in convincing me that I could really do it. (Also Dr. Greger's videos, Engine 2, Happy Herbivore, FOK, and other sites.)

If all these people actually did it, maybe I owed it to myself to finally give it a serious try. So I did. I've lost 50 pounds, even doing it imperfectly. :D
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Re: Dr. Fuhrman interviews Dr. Gregor

Postby JeffN » Fri Jul 27, 2012 9:22 am

Dr Greger just uploaded his newest talk, "Uprooting the Leading Causes of Death" which you can see here...

http://www.youtube.com/watch?v=30gEiweaAVQ

It is an excellent 56 minute talk and one that everyone should see.

The talk was presented and recorded at the 2012 Vegetarian Summerfest and as he states, it focuses on "studies published just over the last year in peer-reviewed scientific medical journals." And, as many of us may know, his personal goal, as stated at his websites is "to present you with the results of the latest in nutrition and health research, presented in a way that is easy to understand."

In watching the excellent presentation, there were several points raised that I would like to clarify, especially in light of the above interview as this thread was started because of that interview and the following quote from it...

"Yes, I have learned it's always best to seek out the primary sources to review them rather than rely on expert opinion. Too often we hear outdated information that is ego-based and supporting old theories that have been proposed. These include extremely low fat vegan diets, without nuts and seeds, or centering one's diet around white potatoes or white rice. This is just not the best science-based advice."

So, again, lets take a closer look and at the primary sources...

During the segment on cancer, he raised the issue of "what if you put cancer on a vegan diet." He then begins to describe and discuss the research of the Pritikin Research Foundation on prostate cancer. (Yes, you know, that crazy outdated very low fat diet.) ;)

The first study was actually done by both the Pritikin and Ornish groups, and, as he describes, was 8x better than the SAD in fighting prostate cancer cells (9% vs 70%)

Now, let's be clear on what these "vegan" diets actually consisted of.

From the actual paper...

"Experimental group patients were prescribed an intensive lifestyle program that included a vegan diet supplemented with soy (1 daily serving of tofu plus 58 gm of a fortified soy protein powdered beverage), fish oil (3 gm daily), vitamin E (400 IU daily), selenium (200 mcg daily) and vitamin C (2 gm daily), moderate aerobic exercise (walking 30 minutes 6 days weekly), stress management techniques (gentle yoga based stretching, breathing, meditation, imagery and progressive relaxation for a total of 60 minutes daily) and participation in a 1-hour support group once weekly to enhance adherence to the intervention.10 The diet was predominantly fruits, vegetables, whole grains (complex carbohydrates), legumes and soy products, low in simple carbohydrates and with approximately 10% of calories from fat.11"

So, this was the very low fat, "near" vegan diet that was criticized above.

For the record, this was a diet that was a blend of the Pritikin & Ornish guidelines with no dairy (which both Ornish & Pritikin allow) or animal protein (which Pritikin allows), 10% fat & no nuts, seeds or oils (which is accordance with both Ornish & Pritikin) and a fish oil supplement (which is from the recommendations of Dr. Ornish).

But there is more...

He then moves on to breast cancer to show the power of a plant based diet in just 2 weeks in its ability to both slow down the growth rate of several types of breast cancer cells and also to actually kill breast cancer cells.

This study was done solely by the Pritikin group and used the usual Pritkin intervention diet which has been described many times in the literature.

From the actual study ...

"These results show that a very-low-fat, high-fiber diet combined with daily exercise results in major reductions in risk factors for BCa while subjects remained overweight/obese."

Here is more details of the intervention.

"The subjects of this study were postmenopausal women attending the Pritikin Longevity Center Residential Program where they were given a low-fat (10-15% Kcal.), high-fiber (>40 gm/d) diet along with one hour of daily supervised exercise, primarily treadmill walking. The diet consisted of natural whole grains, fruits and vegetables with limited amounts (<3.5 oz) of fish, fowl or lean meat and nonfat milk."

In the third Pritikin study, he looks at the effect of exercise and a plant based diet on cancer cells. In this study, they compared the control group (sedentary SAD) to those on the SAD for 14 years who exercised heavily and to those who were on the plant based diet with moderate exercise for 14 years. The Pritikin diet was 2x as powerful.

The same very low fat Pritikin diet, as described above, was used.

[As a side note, in Dr Greger's presentation, it is made to seem as if these participants went for a stroll each day. The truth is, at the center, everyone did 45 minutes of aerobics, 6x a week, in their target heart zone, which was based on a stress test. It is mentioned in the study as "treadmill walking." Well, many may have "walked" but it was very vigorous walking and not just a stroll. We monitored each subject and their heart rates. This was the same advice they were sent home with. And yes, as you can tell, most all these studies, except the latest one, happened during my tenure at Pritikin]

He then moves on to describe the mechanism by which this is happening and gets into the IGF-1 issue, using some of the same Pritikin studies and another Pritikin study showing that power of the program to lower IGF-1 in 12 days and how much lower it is in those following the Pritikin program for 14 years.

He then moves on to another study to show how vegans have the lowest IGF-1 levels. This is generally true, however, excess protein, even concentrated plant proteins can raise IGF-1 as has been discussed here many times. And, all of the above mentioned results on breast and prostate cancer, which he highlighted, including the lower IGF-1, were accomplished on the Pritikin Diet, which allowed for a small amount of animal protein.

The Pritikin Diet is a very low fat diet that is not vegan or vegetarian, and during the 12 day intervention in all the above studies, does not include any nuts and seeds and does include (though not based on) some white potatoes. While it allows some animal protein in the form of animal flesh (fish, chicken or wild game), egg whites and non-fat dairy, the total amount of animal products is carefully limited. Many consider it a very low fat, "near" vegetarian diet. Their research is not just new, but has been going on for over 30 years and is still current and valid. (see below)

In addition, in the discussion of diet and hypertension, Dr Greger asks the question, how long does it take to bring BP down eating a vegan diet. He then goes on to show Dr McDougall's study from 1995, which was able to lower BP 5-7% in just twelve days.

The McDougall Diet is a very low fat diet and during the 12 day intervention in the above study, it included little to no nuts and seeds and does include (though not based on) some white potatoes. I know, I was an intern there at the time. :)

As Dr Greger clearly shows, even as of this moment today, both of these programs are some of the most powerful science-based evidence we have for the power of a plant based diet.

I agree.

Thanks Dr Greger!

In Health
Jeff

PS as mentioned above, here is the full list and description of all the evidence from Pritikin (1981-2008)

http://www.pritikinresearchfoundation.org/research.html

And these are from 2008 forward

Benign prostatic hyperplasia: does lifestyle play a role? Barnard RJ, Aronson WJ. Phys Sportsmed. 2009 Dec;37(4):141-6. Review.

Growth inhibitory effect of low fat diet on prostate cancer cells: results of a prospective, randomized dietary intervention trial in men with prostate cancer. Aronson WJ, Barnard RJ, Freedland SJ, Henning S, Elashoff D, Jardack PM, Cohen P, Heber D, Kobayashi N. J Urol. 2010 Jan;183(1):345-50. Epub .

Analyzing serum-stimulated prostate cancer cell lines after low-fat, high-fiber diet and exercise intervention. Soliman S, Aronson WJ, Barnard RJ. Evid Based Complement Alternat Med. 2011;2011:529053. Epub 2011 Mar 15.

Phase II prospective randomized trial of a low-fat diet with fish oil supplementation in men undergoing radical prostatectomy. Aronson WJ, Kobayashi N, Barnard RJ, Henning S, Huang M, Jardack PM, Liu B, Gray A, Wan J, Konijeti R, Freedland SJ, Castor B, Heber D, Elashoff D, Said J, Cohen P, Galet C. Cancer Prev Res (Phila). 2011 Dec;4(12):2062-71. Epub 2011 Oct 25.

A Short-term Diet and Exercise Intervention Ameliorates Inflammation and Markers of Metabolic Health in Overweight/Obese Children. Izadpanah A, Barnard RJ, Almeda AJ, Baldwin GC, Bridges SA, Shellman ER, Burant CF, Roberts CK. Am J Physiol Endocrinol Metab. 2012 Jun 19. [Epub ahead of print]

Effect of a Low-Fat Diet Combined with IGF-1 Receptor Blockade on 22Rv1 Prostate Cancer Xenografts. Konijeti R, Koyama S, Gray A, Barnard RJ, Said JW, Castor B, Elashoff D, Wan J, Beltran PJ, Calzone FJ, Cohen P, Galet C, Aronson WJ. Mol Cancer Ther. 2012 Jul;11(7):1539-46. Epub 2012 May 4.
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Re: Dr. Fuhrman interviews Dr. Gregor

Postby jamietwo » Fri Jul 27, 2012 2:34 pm

Jeff, how do you know - in any diet-based study - that the people charged with eating a certain diet are faithfully following that diet?
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Re: Dr. Fuhrman interviews Dr. Gregor

Postby JeffN » Fri Jul 27, 2012 2:40 pm

jamietwo wrote:Jeff, how do you know - in any diet-based study - that the people charged with eating a certain diet are faithfully following that diet?


That is a great question.

At the Pritikin center and other live in residential programs, like the McDougall program, we lock them up and control their food. :)

While anyone can cheat, even in a residential setting, anyone who is included in a study has signed papers agreeing to be in the study so they know the importance of trying to be adherent.

In observational studies, you don't and that is part of the problem with them.

In Health
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Re: Dr. Fuhrman interviews Dr. Gregor

Postby jamietwo » Sun Jul 29, 2012 2:45 pm

Thanks for your reply! It sounds like the live-in programs are the way to go. Too bad they can't do long-term studies that way!
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