EPISODE 17: HOW NOT TO DIE

Featuring: Dr. Michael Greger

 

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The Engine 2 Team is on-site at the 2019 Plant-Stock this week, so we’re bringing you a special edition of the podcast featuring a live presentation directly from the stage of 2018 Plant-Stock featuring the ever-popular, Dr. Michael Greger, and his take on “How Not to Die.”

Michael Greger, M.D. FACLM

Michael Greger, M.D. FACLM

Michael Greger, M.D. FACLM is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, among countless other symposia and institutions; testified before Congress; has appeared on shows such as The Colbert Report and The Dr. Oz Show; and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial. In 2017, he was honored with the ACLM Lifestyle Medicine Trailblazer Award.

Dr. Greger's most recent scientific publications in the American Journal of Preventive MedicineCritical Reviews in MicrobiologyFamily and Community Health, and the International Journal of Food Safety, Nutrition, and Public Health explore the public health implications of industrialized animal agriculture.

Dr. Greger is also licensed as a general practitioner specializing in clinical nutrition and is a founding member and Fellow of the American College of Lifestyle Medicine. He was featured on the Healthy Living Channel promoting his latest nutrition DVDs and honored to teach part of Dr. T. Colin Campbell's esteemed nutrition course at Cornell University. Dr. Greger's nutrition work can be found at NutritionFacts.org, which is a registered 501(c)3 nonprofit charity.

He is the author of Bird Flu: A Virus of Our Own Hatching and Carbophobia: The Scary Truth Behind America's Low Carb Craze. Both of his latest books, How Not to Die and the How Not to Die Cookbook, became instant New York Times Best Sellers. View the book trailer here. Dr. Greger is a graduate of the Cornell University School of Agriculture and the Tufts University School of Medicine.

Dr. Greger is proud to be a Council of Directors member of the global voice for lifestyle as medicine, the True Health Initiative (THI). This is a growing coalition of more than 360 world experts representing 35 countries. It is an unprecedented assembly that includes physicians, university Deans, former Surgeon Generals, Olympic athletes, chefs, environmental professionals and a diverse group of nutritionists. Together they offer clarity over confusion and support the foundational principles of healthy eating and healthy living.


Rip Esselstyn: Hey gang, this is Rip. This week I am on site in Black Mountain, North Carolina about 20 miles outside of Asheville, North Carolina. I am here for the ninth annual Camp Plant-Stock event. It's going to be a barn burner of a weekend. This location may possibly be one of the most gorgeous places in the northeast United States. It sits at about 3000 feet of elevation. It is so foresty. It's loaded with Rhododendron, ferns, and pine trees. There is a raging stream that bifurcates at the top of the property and slices through the campus. It is really nothing short of magical.

Rip Esselstyn: I want you to know that we will be returning to our regularly scheduled programming of the podcast very soon, but in the meantime I want to bring you this lecture from the 2018 Plant-Stock stage. This individual kills it. He will be returning in 2020 talking about his new book that everybody is going to want a copy of. Okay. With that, let me say, let's just take us straight to the stage of Plant-Stock 2018.

Rip Esselstyn: The next man up is a man ... He has turned into a supernova. I mean, this guy is on fire. If he was any hotter, he would self ignite. I'd have to take that fire extinguisher down there and put him out. He has been on a roll for a long time, but he has just like come into his own like nobody's business. This is a man that was one of the founders of the American College of Lifestyle Medicine in 2004. As you guys all know, he is Mr. Nutritionfacts.org that he started in 2011. How many of you subscribe to Nutrition Facts? All right. I mean, every day it's another blog, it's another video. I mean, this guy, does he ever sleep? Right? How Not To Die. I think How Not To Die is going to become the next China study, and the China study's sold over 2 million copies.

Rip Esselstyn: He's also got the How Not To Die cookbook. It is like crazy. I mean, New York Times bestselling author, physician, international speaker. This guy is in high demand and he was nice enough to come to Plant-Stock this year. When I asked him, I said, "Michael, what's your favorite movie?" And he said, "Rip, who's got time for movies? There's lives to be saved here." But he's going to drop a hint during his talk, because he does have a favorite movie, and see if you can pick it up. Michael, bring it up. Let's put it to the test.

Michael Greger: That looks great. Thank you all. Hello.

Michael Greger: Allow me to begin on a personal note. There's a picture of me taken around the time that my grandmother was diagnosed with end stage heart disease and sent home to die. She already had so many bypass surgeries she basically ran out of the plumbing at some point. Confined to a wheelchair, crushing chest pain, her life was over at age 65. Then she heard about this guy, Nathan Pritikin, one of our early lifestyle medicine pioneers. What happened next is actually detailed in Pritikin's biography.

Michael Greger: My grandma was one of the death's door people, Francis Greger. My grandmother arrived at one of Pritikin's early sessions in the wheelchair. Mrs. Greger had heart disease, angio claudication, her condition so bad she can no longer walk without great pain in her chest and legs. Within three weeks though she's not only out of her wheelchair, she was walking 10 miles a day. Here's a picture of my grandma at her grandson's wedding 15 years after doctors had abandoned her to die. She was given her medical death sense at age 65, but thanks to a healthy diet was able to enjoy another 31 years on this planet till age 96 to continue to enjoy her six grandkids including me. That's why I went into medicine.

Michael Greger: Years later Dr. Dean Ornish published his landmark lifestyle heart trial, proven with something called quantitative angiography, that indeed heart disease could be reversed. Arteries opened up without drugs, without surgery, just a plant based diet and lifestyle program. When this happened, I mean, I assumed this was going to be the game changer. I mean, my family had seen them with their own eyes, but here it was in black and white, published in some of the most prestigious medical journals in the world. Yet, nothing happened.

Michael Greger: So wait a second, effectively the cure to our number one killer could get lost down some rabbit hole and ignored what else might there be in the medical literature that can help my patients but just didn't have a corporate budget driving its promotion? Well, I made it my life's mission to find out. For those who are unfamiliar with my work, every year I read through every issue of every English language nutrition journal in the world so busy folks like you don't have to.

Audience: Don't have to.

Michael Greger: Very nice. I then compiled the most interesting as well as the most groundbreaking, most practical findings, and new videos and articles I upload every day to my nonprofit site, Nutritionfacts.org. Everything on the website is free. There are no ads, no corporate sponsorship, strictly non-commercial, not selling anything, just putting it up as a public service, as a labor of love, as a tribute to my grandmother. New videos and articles every day on the latest in evidence based nutrition. What a concept.

Michael Greger: Okay, so where did Pritikin get his evidence from? Well, network of missionary hospitals set up throughout sub-Saharan Africa uncovered what may be one of the most important advances in health according to the one of our most prestigious medical figures in the last century, Dr. Denis Burkitt, the fact that many of our major and commonest diseases were universally rare, like heart disease, in the African population of Uganda, for example, coronary artery disease is almost nonexistent.

Michael Greger: Well, wait a second. Our number one killer almost nonexistent? What were they eating? They were eating lots of vegetables and grains and green leafy vegetables taken by all, even at breakfast--kale--and their protein almost entirely from plant sources, and they had the cholesterol levels to prove it, very similar to what one sees in kind of modern day plant eaters.

Michael Greger: Wait a second. Maybe they were just dying early from something else? Never lived long enough to get heart disease. No. Here's heart attack rates in Uganda versus St. Louis. Now, 632 autopsies in Uganda, only one myocardial infarction. Now, 632 age and gender matched autopsies in Missouri, 136. More than a hundred times the rate of our leading killer. In fact, they were so blown away, they went back, did another 800 autopsies in Uganda still just that one small healed infarct, meaning it wasn't even that caused the death, at 1,412. Less than one in a thousand. Whereas, here Heart disease is an epidemic.

Michael Greger: Atherosclerosis, hardening of the arteries is a disease that begins in childhood. By aged 10 nearly all kids raising the standard American diet already have what are called fatty streaks building up inside their arteries, the first stage of the disease. These streaks then turn into plaques in our twenties, get worse in our thirties, then can start killing us off. And our heart cause a heart attack and our brain, the same disease process can cause a stroke. So if there's anyone here today older than age 10 then the question is not whether or not to eat healthy to prevent heart disease. It's whether or not you want to reverse the heart disease you likely already have, whether you know it or not.

Michael Greger: But is that even possible? You know, researchers took people with heart disease, put them on kind of plant based diet followed by populations that do not get epidemic heart disease. Their hope, say maybe we could slow the disease down or something, maybe even stop it. Instead, something miraculous happened. As soon as people stopped eating artery clogging diets their bodies are able to start dissolving some of that plaque away, opening up arteries without drugs, without surgery, suggesting their bodies wanted to be healthy all along, but were just never given the chance.

Michael Greger: This remarkable improvement in blood flow in the heart muscle itself was after just three weeks of plant based nutrition. Let me share with you what's been called the best kept secret in all of medicine. The best kept secret in medicine is that sometimes, given the right conditions, the body can actually heal itself. You know, if you whack your shin really hard and a coffee table, right? You got all red, hot, painful, swollen, inflamed, but will heal naturally if you just stand back, let your body work its magic, right? But what if you hit your shin in the same place day after day? In fact, three times a day, breakfast, lunch, and dinner? You'd never heal.

Michael Greger: You'd go to your doctor to be like, "My shin hurts." They'd be like, "No problem." Whip out their pad, write you a prescription for pain killers, right? You're still whacking your shin three times a day. Still really hurts like heck, but oh, feel so much better with those pain pills on board. Thank heavens for modern medicine. All right?

Michael Greger: It's like, I mean, our body wants to come back to health if we let it, but if we keep re-damaging ourselves three times a day, we may never heal. It's like smoking. One of the most amazing things I learned in all my medical training, was that within 15 years of stopping smoking our lung cancer risk approaches that of a lifelong non-smoker. Isn't that amazing? Our lungs can clear out all that tar and eventually it's almost as if we never started smoking at all, and every morning of our smoking life that healing process starts until, wham, first cigarette in the day. Re-injuring our lungs with every puff, just like we can re-injure our arteries with every bite when all we had to do all along, the miracle cure is to just stand back, get out of the way, stop re-damaging ourselves, and let our body's natural healing processes bring us back towards health. Right?

Michael Greger: The human body is a self healing machine. Sure, you can choose moderation. Hit yourself with a smaller hammer. But why beat yourself up at all? Right? Look, it's up to each of us to make our own decisions about what to eat and how to live, but we should make these choices consciously, educating ourselves about the predictable consequences of our actions.

Michael Greger: Look, this is nothing new. Look, American Heart Journal, 1977, cases like Mr. FW here, heart disease so bad couldn't even make it to the mailbox. Started eating healthier, few months later he was climbing mountains, no pain. All right. Now, there are these fancy new classes of anti angina drugs on the market now, cost thousands of dollars a year. But hey, at the highest dose, maybe able to extend exercise duration as long as 33 and a half seconds. Does not look like those following the drug route are going to be climbing mountains anytime soon. See, plant based diets aren't just safer and cheaper. They can work better because you're treating the underlying cause of the disease. Like, what more do we need to know?

Michael Greger: I mean, there's only one diet ever proven to reverse heart disease in the majority patients, right? So anytime someone tries to sell you on some new diet they heard about it, do me a favor, ask them a simple question. I want you to say, wait, has this diet been proven to reverse heart disease? You know, the number one reason me and all my loved ones will die? If the answer is no, why would you even consider it? I mean, if that's all a plant based diet could do, reverse the number one killer of men and women, shouldn't that be the default diet until proven otherwise? And the fact that it can also be so effective at preventing, arresting, or reversing other leading killers, like type two diabetes and high blood pressure, would seem to make the case for plant based eating simply overwhelming.

Michael Greger: Let me just touch on those two cases. We've known that you can reverse diabetes with a plant based diet since the 1930s, where a small group of diabetics were placed on a variety of plant based diet, and in a period of five years, a quarter of them were able to get off their insulin altogether. Say, yeah, yeah, yeah, but plant based diets tend to be relatively a low calorie diets, so maybe their diabetes just got better because they lost so much weight.

Michael Greger: I mean, to tease that out what we'd have to do is put people on a healthy diet, but force them to eat so much food that they don't lose any weight, right? Then we could see if there's some unique benefits to plant based eating beyond just all the easy weight loss. Well, we'd have to wait a few decades, but here it is. Subjects are weighed every day and they started to lose weight. They're made to eat more food, in fact, so much more food some of the participants have problems eating it all. They're like, "Oh, not another salad. Oh." But eventually adapted. So, no weight loss despite restricting meat, eggs, dairy and junk. Okay. So with zero weight loss, was there still any benefit to their diabetes? Well, insulin dose was cut 60% across the board. Half the diabetics ended off all their insulin altogether. Wow. How many years did that take? No, 16 days. 16 days later.

Michael Greger: So we're talking about diabetics who have had diabetes for as long as 20 years injecting 20 units of insulin a day, then 13 days later on none. Diabetes for 20 years, then off all insulin in less than two weeks. Diabetes for 20 years because no one had told them about a plant based diet. For decades they were just 13 days away at any time.

Michael Greger: Here's participant number 15. 32 units of insulin on the control diet, then 18 days later on none. Better blood sugars on 32 units less insulin. That's the power of plants. Now, remember this was with zero weight loss. His body just started working that much better. What about the side effects? Oh, how about cholesterol is dropping like a rock to under 150 as a nice little side benefit, again, only in a matter of weeks? So just like asking people to make modest changes in the diet will net you modest benefits in terms of cholesterol reduction. How moderate do you want your diabetes? Right?

Michael Greger: Everything in moderation is a truer statement than many people realize. Asking our diabetic patients to make, you know, moderate changes in diet can leave them with moderate blindness, moderate kidney failure, moderate amputee, maybe just a few toes or something. Moderation in all things is not necessarily a good thing.

Michael Greger: You know, there was this famous study published in a journal called Cell Metabolism, which purported to show the diets high meat, eggs, and dairy could be harmful to health as smoking, suggesting that people in middle age, we eat meat, eggs, or dairy, four times as likely to die from cancer or diabetes. Let's look at the actual study. You'll see that's simply not true. Those using lots of animal protein during middle-age didn't have 4 times the risk of dying from diabetes, they had 73 times the risk of dying from diabetes. No, those that chose moderation only in a moderate amount of animal protein. Oh, they just had 23 times the risk of death from diabetes. The academic institution where the study was done sent out a press release with a memorable opening line, "That chicken wing you're eating could be as deadly as a cigarette."

Michael Greger: Now look, quadrupling one's risk of cancer? I mean, that's comparable to what one might get smoking cigarettes. Right? So what was the response in the scientific community to this revelation, that diets high meat, eggs, dairy, can be harmful to health as smoking? Well, one nutrition scientist said it's potentially dangerous to tell people about this study. Why? Because a smoker might think, "Hey, bother quit smoking? My ham and cheese sandwich is just as bad for me." So let's not tell.

Michael Greger: That reminds me of this famous Philip Morris Cigarette ad. They tried to downplay the risk by saying, "Hey, you think secondhand smoke is bad, increasing risk of lung cancer 19%? Well, hey, drinking one or two glasses of milk every day, maybe three times as bad. 62% increased risk of lung cancer, or doubling your risk frequently cooking with oil, tripling your risk of heart disease by eating non-vegetarian, multiplying your risk six fold if you eat lots of meat and dairy," so, they conclude, "Let's keep some perspective here."

Michael Greger: The risk of second hand smoke may be well below that of other everyday activities, so breathe deep. That's like saying, yeah, don't worry about getting stabbed, because getting shot? So much worse. How about neither, right? Two risks don't make a right. Of course, you'll note Philip Morris stopped throwing dairy under the bus once they purchased Kraft foods, just saying.

Michael Greger: All right, let me skip down. High blood pressure here. 78 million Americans affected, that's about one in three American adults, and as we get older, our pressures get higher, higher such that by age 60 the majority of us have hypertension. Say, wait a second, if most of us get high blood pressure when we get older, maybe he's less a disease, more just a natural inevitable consequence of aging. No, we've known since the 1920s that high blood did not occur, 1000 people in rural Kenya had their blood pressures measured. A typical Kenyan diet, something like this, lots of corn and beans and vegetables, fruit, greens, there's the G word again. Our pressures go up as we age, such as by age 60 we're hypertensive, their pressures go down and the lower the better.

Michael Greger: We now have evidence, even people under 120/80 may benefit from blood pressure reduction. So the ideal blood pressure, the no benefit from reducing it further blood pressure, 110/70. What? It's even possible to get pressures down to 110/70? It's not just possible, it's normal living a healthy enough life. Three years of this rural Kenyan hospital, 1800 patients were admitted. How many cases of high blood pressure did they find? Zero. Wow. They must have lower rates of heart disease, right? They had no rates of heart disease. And as I was saying, no cases of Atherosclerosis, our number one killer, was found.

Michael Greger: Rural China, same thing. About 110/70 their entire life. 70 year olds with same blood pressure as 16 year olds, right? So, wait a second, African diet, Asian diet, vastly different diets. What they shared in common is that they were eating plant based day to day, with meat only eating on special occasions. And you say, wait a second, why do we think it's the plant based nature of their diet that was so protective? Because in the Western world, the only folks getting it down to that low on average were those eating strictly plant based diets, coming in at an average of about 110/65.

Michael Greger: Here's the largest study of plant based users to date, the Adventist 2 study looked at the 89,000 folks varying from non-vegetarians to so-called semi vegetarians or flexitarians who eat meat about once a week, but certainly not every day, compared to pesco vegetarians, those who eat no meat except fish, compared to those who eat no meat at all, compared to those who eat no meat, eggs, or dairy. This is an Adventist study, so even the non-vegetarians weren't eating a lot of meat, eating lots of fruits and vegetables, tended to exercise a lot, not smoke. This is a really healthy cohort of meat eaters, but still found this step wise drop in high blood pressure rates the more and more plant based people tend to eat. Same thing with diabetes. Same thing with obesity, right?

Michael Greger: So sure, you can throw the vast majority of risk out the window by eating plant based, but it's not all or nothing. It's not black or white. Any movement we can make along this spectrum towards eating healthier can accrue significant benefits. You can show this experimentally. You take vegetarians, you give them meat, pay them enough to eat it, and their blood pressures go up. Or you take people who already meat, cut meat out of their diet, their blood pressures go down within seven days, and it's after the vast majority had to stop their blood pressure medications or reduce their blood pressure medications. They had to, I mean, you can't treat the clog and be on multiple blood pressure medications. Your pressures will drop too low, right? It'd get dangerous, fall over, get dizzy, right? Might hurt yourself.

Michael Greger: So lower pressures on fewer drugs. That's the power of plants. So does the American Heart Association recommended a no meat diet? They recommended this low meat, so called DASH diet. So, wait a second, when this DASH diet was being created, I mean, were they just not aware of this landmark data by Harvard's Frank Sachs? No. They were aware. The chair of the design committee that came up with the DASH diet was Frank Sachs. See, the DASH Diet was created with a number one goal of capturing the blood pressure lowering benefits of a more plant based diet, yet contain enough animal products to make it palatable to the general population. They didn't think the public could handle the truth, right?

Michael Greger: Now, look, I recently talked at Harvard where Frank Sachs was still there, and you know, and I tried to be sympathetic and said, "Look, I understand," right? Look, just like drugs never work unless you actually take them, diets never work unless you actually eat them. So you know, they're thinking, "Look, how many people are going to go strictly plant based, right? If we soft pedal the message, we come up with some kind of compromise diet, well, then on a population scale we may do more good in the world." Okay. So I asked them, "Okay, tell that to the 1000 American families a day that lose a loved one to high blood pressure."

Michael Greger: Maybe it's time to start telling the American public the truth. And the truth is that most deaths are preventable and related to nutrition. According to the [Global Burden Disease 00:25:48] study, this is the largest study ever on disease risk factors in human history, funded by the Bill and Melinda Gates Foundation, the number one cause of death in these United States? It's our diet. Number one cause of disability in the United States? It's our diet. Now bumping cigarettes to number two. Tobacco now only kills about 500,000 Americans every year, whereas our diet kills hundreds of thousands more, right?

Michael Greger: So if most deaths are preventable, related to nutrition, if diet is the number one cause of death and disability, then obviously nutrition is the number one thing taught in medical school, right? Obviously it's the number one thing your doctors talked about at every single visit that ever, right? So we're saying, how can there be this disconnect between the science and the practice of medicine? Let's do a thought experiment. Imagine yourself a smoker back in the 1950s. You know, back in the 50s the average per capita cigarette consumption, 4,000 cigarettes a year. I mean, the average person walking around smoked half pack a day. On average. The media was telling you to smoke. Famous athletes agreed. Even Santa Claus wanted you to smoke.

Michael Greger: I mean, look, you want to keep fit and stay slender? Make sure to smoke. Oh, and eat lots of hot dogs to stay trim, and eat lots of sugar to stay slim and trim a lot better than that apple there. I mean, sheesh, right? Though, apples do connote goodness and freshness reads one internal tobacco industry memo, which brings up many possibilities for youth. They wanted to make apple flavored cigarettes for kids. Shameless. For digestion's sake, you smoke. I mean, no curative powers claimed by Philip Morris, but hey, better be safe than sorry and smoke, right?

Michael Greger: Blow in her face and she'll follow you anywhere. No woman ever says no. They're so round, so firm, so fully packed. I mean, after all John Wayne smoked them until he got lung cancer and died. You know, back then even the Paleo folks were smoking and so were the doctors. Now, this is not to say there wasn't controversy within the medical profession. Sure, you know, some doctors smoke camels, you know, but others preferred Lucky's. There was a little disagreement there. The leader of the US Senate agreed. Who wouldn't want to give their throat a vacation?

Michael Greger: Not a single case of throat irritation. How could there be when cigarettes are just as pure as the water you drink? Maybe in Flint, Michigan. But don't worry, if your throat does get a little irritated your doctor can always write you a prescription for cigarettes. This is in the Journal of the American Medical Association, right? So when the AMA is saying smoking is good for you, not just neutral, but actually good for you, where could you turn back then if you just wanted the facts? What's the new data advanced by science? Well, she was too tired for fun and then she smoked a camel. Babe Ruth spoke of proof positive science, that is, while he still could speak before he died from throat cancer.

Michael Greger: You know, if by some miracle back then there was some smokingfacts.org website that could deliver the science directly, bypassing commercially corruptible institutional filters, you wouldn't become aware of studies like this. This is an Adventist study out of California in 1958 showing that non-smokers had at least 90% less lung cancer than smokers, but this wasn't the first. When famed surgeon Michael DeBakey was asked why he studies back in the 30s linking lung cancer and smoking were simply ignored off the face of the earth, he had to remind people what it was like back then. We were a smoking society, right? It was in the movies, airplanes, right? Medical meetings were one heavy haze of smoke. Smoking was in a word, "normal." Right?

Michael Greger: All right, well let's go back to our thought experiment then. Right? So if you're a smoker in the 50s in the know, what do you do? I mean, have access to the science. You realize the best available balance of evidence suggests your smoking habit, not so good for you. So do you change or do you wait? I mean, if you wait until your doctor tells you between puffs to quit, you could have cancer by then. If you wait until the Surgeon General, the powers that be, say, "Stop smoking," you could be dead by then. It took more than 7,000 studies and the deaths of countless smokers before the first Surgeon General's report against smoking came out.

Michael Greger: You'd think maybe after the first 6,000 studies they could give people a little heads up or something. Powerful industry, right? Maybe we should have stopped smoking after the 700th study like this, as a smoker back in the 50s on one hand, you had all of society, the government, the medical profession itself, telling you to smoke. On the other hand, all you had was the science, right? If you're even aware of studies like this. Well, let's fast forward 55 years. You know, if there's a new Adventist study out of California warning Americans about something else, they may be putting in their mouths, and of course, it's not just one study, right? Put all the studies together and the mortality from all causes put together, many of our dreaded diseases, is significantly lower among those eating more plant based.

Michael Greger: So instead of someone going along with America's smoking habits in the 50s imagine you or someone you know going along with America's eating habits today. What do you do? I mean, with access to the science, realize the best available balance of evidence suggests your eating habits, not so good for you. So what do you do, right? Do you change or do you wait? If you wait until your doctor tells you between bites to change, it could be too late. In fact, even after the Surgeon General's report came out, the AMA went on record officially refusing to endorse it. Why? Could it have been because they were just handed a $10 million check from the tobacco industry? Maybe.

Michael Greger: Okay. So we can see why the AMA was sucking up the tobacco industry, but wait a second, why weren't more individual doctors speaking up? Well, there were a few ahead of their time speaking up against industries killing millions, but why not more? Maybe it's because the majority of physicians themselves smoke cigarettes. Just like the majority of physicians today continue to eat foods that are contributing to our epidemics of dietary disease. What was the AMA's rallying cry back then? Everything in moderation. Extensive scientific studies have proven smoking in moderation, oh, that's fine. Sound familiar?

Michael Greger: The food industry uses the same tobacco industry tactics, twisting the science, misinformation. The same scientists were hired, paid to downplay the risk of second hand smoke and toxic chemicals, are the same hard by the National Confectioners Association to downplay the risks of candy, and the same paid for by the meat industry to downplay the risks of meat, right? Whereas, animal products and processed foods are wiping out at least 14 million people every year. Those of us in this room involved in this evidence-based nutrition revolution, we're talking about 14 million lives in the balance.

Michael Greger: So maybe plant based eating should be considered kind of the nutritional equivalent of stopping smoking. How long do we have to wait, though, before the CDC says, "Don't wait for open heart surgery before starting to eat healthier as well." Until the system changes we need to take personal responsibility for our own health, for our family's health. We can't wait until society catches up to the science again because it's a matter of life and death.

Michael Greger: Dr. Ken Williams became president of the American College of Cardiology a few years ago. He was asked in an interview why he himself follows the recommends to all his patients, strictly plant based diet. "I don't mind dying," Dr. Williams replied, "I just don't want it to be my own fault." Thank you so much, everybody.

Rip Esselstyn: If there's one key element to my success in eating a plant strong diet for all these years, it's my breakfast. I start every single day with Rip's big bowl cereal. It's a concoction that I created to fuel my performance as a professional triathlete going back 32 years. It's commercially available at Whole Foods Market, or on Amazon, or you can make your own nixing a quarter cup of raw old fashioned oats, a quarter cup Ezekiel 4:9 nuggets, a quarter cup bite size shredded wheat, and a quarter cup Uncle Sam's toasted cereal. After adding Chia seeds and fruit, I then hose it down with oatmeal.

Rip Esselstyn: Lately, my big bowl has taken a turn for the better ever since the Nutramilk came into my life. It's a super efficient, high speed blender designed to make alternative milks in less than two minutes. I take great pride in making my own oat milk now, and I can't believe how it's freshened up my breakfast bowl. You can grab one too. Visit the thenutramilk.com and use the code Plant Strong for a $50 discount and free shipping.

Rip Esselstyn: I want to thank my co creator of the podcast, Scott Battishill of 10-Percent Media; Laurie Kortowich, producer extraordinaire, and director of Engine 2 events; Ami Mackey, Engine 2's Curator of Creative Content; Wade Clark with Bumble Media, our audio engineer; and Carrie Barrett for technical production.

Rip Esselstyn: I have to thank my parents, Anne and Essy, who have been such guiding lights and inspirations over the years, as well as the great pioneers of this movement who have been pushing this boulder up the mountain. As they say, we are standing on the shoulders of giants. Remember, if you're digging the show, please rate us at Apple podcasts, Spotify, Stitcher, Google Play, or wherever you get your podcasts. And with that, let me say, Peace, Engine 2, keep it plant strong.

Ami Mackey